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HomeMy WebLinkAboutMiscellaneous - 21 CIDERPRESS WAY 4/30/2018 (2)i 00 L- .01 Date....... a.g............... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...........r�......... ............. has permission to perform ..... N&i4-J ..../................................. wiring in the building of ...... T!-!..�,lQ� r.....�° ��!.. ........ l �i l�E/� ��P S l t/ Y........ , North Andover, Mass. Fee . �'�...... LIc. No M e �7/ 6 O ECTRICAL INSPECTOR / Check # r / � /0 E' R -Commonwealth of MassachusettsFOccupaNncy Official Use Only Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS nd Fee Checkedleave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (W1 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of. NORTH ANDOVER To the Inspctor of Wires: By this application the undersigned gives notice of his Location (Street &Number) or her intention to perform the electrical work described below. Z` Cc� tf ,L +p k.�S G / Owner or Tenant Owner's Address M-� ✓ LLC Telephone No.�- Is this permit in conjunction with a building permit? yes No i ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. 10 766 3- Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service JLD_ Amps LqVoIts Overhead ❑ Und rd g Eg"' No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: S =Receptacle ssed Luminaires p inaire Outlets pinaires bptacle Outlets (Opches 3 0es No. of Waste Disposers l No. of Dishwashers 1 No. of Dryers No. of Water KW Heaters No. Hydromassage Bathtubs OTHER: Completion of the followir No. ofEllusp. (Paddle) Fans No. ofubs Swimool Above ❑ In- ❑ rnd. rnd. No, ofrnersNo. ofrners l No. of Air Cond. ( Total 3 Tons !!�Tpoutaa'nls: Number Tons KW .................... . Space/Area Heating KW Heating Appliances KW No. of No. of Signs Ballasts No. of Motors Total HP table may be waived by the Inspect No. of Total Transformers KVA Generators KVA FIRE ALARMS No. of Zones No. of Detection and Initiatinigr Devices No. of Alerting Devices No. of Self -Contained Detection/AlertingDevices Local ❑ Municipal Connection ❑Other Security Systems:* No. of Devices or Equivalent Data Wiring: ` No. of Devices or Equivalent Telecommunications Wiring: NO. of Devices �> Attach additional detail if desired, or as required by the Inspector of Wirgs. Estimated Value of Elal Work: _ (�. ppn. (When required by municipal policy.) Work to Start:At-LRA' Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCEEGE: 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 c�ov,e�r is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE IndBONlJ,❑ OTHER ❑ (Specify:) I certify, under thepains and penalties ofperjury, that the information on this application is true and complete. FIRM NAME: LIC. NO.: Licensee: ,�.�� r Signature (If applicable, enter "exempt" in the license number line.) LIC. NO.: Address: 4t�to� d� �-j� [ / .�t�c� "10-J tet/ Bus. Tel. No.:fti!�-�Niil *PerM.G. c 147, s. 57 61, s currty work requires Department of Public Safety "S" License: Alt. Lil.e. No.No.� OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 3`g ELECTRICAL PERMIT NO." INSPECTION REPORT: ELECTRICAL INSPECTOR - D OUG SMALL I. ROUGH INSPECTION: Passed — Failed— [ ] Re -inspection requirecT ($50.00) - [ ] Inspectors' comments: (Inspectors' Signature - no initials) ^Date LI -FINAL INSP TION; Passed — Failed — Inspectors' comments: t (Inspectors' Signature - no 3. UNDERGROUND INSPECTION: Passed — [ ] Failed — [ ] Inspectors' comments: J,-Lubknu.urs- signature -no u F SPECTION —SERVICE: E CALLED NATIONAL GRID: d — [ ] Failed —tors' comments: (Inspectors' Signature - no fuh ra TIITGbT.+nmr�,.r NAME: inspection required ($50.00) - Date. 77%2 j Date Date -A JL1v1v - V JL"_v n: Passed — [ ] Failed — [ 7 Re -inspection required ($50.00) inspectors' comments: (Inspectors' Signature - no initials) Date DOOR TAGS ARE TO BE FILLED OUT AND LEFT ON SITE IF THE AREA TO BE INSPECTED IS NOT ACCESSIBLE AND A RE-WSPECTION OF $50.00 IS TO BE CHARGED. M The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, AM 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: Phone #: Are you an employer? Check the appropriate box: L ❑ I am a employer with 4. El am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached shget. I ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] 3. ❑ I am a homeowner doing all work officers have exercised their right of exemption per MGL myself. [No workers' comp. C. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12. ❑ Roof repairs 13.❑ Other —.,y aNY„UanL uia� cnecics oox s i must atso Intl out the section below showing their workers' compensation policy information. fi Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company N Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 6. Other Contact Person: 4. Electrical Inspector 5. Plumbing Inspector Phone #: <D Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy; please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1.877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia 6 bo, Date. �........ TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ... /. `v ... /� �r/�'? .... �F ........ . has permission for gas installation . • 9 in the buildings of ... r......' c`'F' ff`'t?...f{J /.. vs £ at ? . i .... : �P!`. ;�/ °SS ............... North Andover, Mass), ROM /. M . Q . Lic. No. / S• S 7 .. .......................... . GAS INSPECTOR Check # 60 CIYTI loco MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town: � �1��1 MA. Date: Permit# Building Location:(,14h �yr�j Owners Name: /'/��,�ti,. lilS� LPGt�+rtreir�� Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential New: Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑ CIYTI loco INSURANCE COVERAGE: I have a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy E� 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 ❑ Signature of Owner or Owner's Agent Owner [:] Agent By checking this box ❑, I hereby certify that all of the details and Information I have submitted (or entered) reaardina this aooliratinn ara trip and dccurd[e cD me Desi or my nnowieage ana tnat 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 of the General Laws. Type of License: By ❑ Plu er Title ❑ as Fitter Signat re of Licensed Plumber/Gas Fitter Master Cit crown ❑Journeyman License Number: APPROVED OFFICE USE ONLY ❑ LP Installer W < N Q U O = I- Z H OFLU J Z N O 06 w OLu Z O 1X Lu w m O Q m w W U W W it Z O Q = fn OLu WLu UJ = LL > Lu LuF 1 -- 1 -- Om Z m >- W Vx o � LL J (�7 w z O z O Oa z O W w F>>> F> Z~ O SUB BSMT. BASEMENT 1 FLOOR ° 2 FLOOR 3 FLOOR 4 THFLOOR 5 FLOOR C --FLOOR iTIF FLOOR _6TIF FLOOR Check One Only Certificate # Installing Company Name: 11,71 •� Address:k Ov City/Town: / ElCorporation State: ❑ Partnership i Business Tel: `0 v/36/ i/ � Fax: El Firm/Company Name of Licensed Plumber/Gas Fitter: INSURANCE COVERAGE: I have a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy E� 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 ❑ Signature of Owner or Owner's Agent Owner [:] Agent By checking this box ❑, I hereby certify that all of the details and Information I have submitted (or entered) reaardina this aooliratinn ara trip and dccurd[e cD me Desi or my nnowieage ana tnat 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 of the General Laws. Type of License: By ❑ Plu er Title ❑ as Fitter Signat re of Licensed Plumber/Gas Fitter Master Cit crown ❑Journeyman License Number: APPROVED OFFICE USE ONLY ❑ LP Installer Date .. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ....���.,ev..�.t.' ` l.... !.. ........... has permission to perform ...../. ...`.t,9.0-. f................ plumbing in the buildings of .... ` l T- f{„ . �/t-.14r?e S fr!c at :'.�....0 i A&,\ PK'(,S..S..............11.. , North Andover Mass. F e ..JUq . 40.. Lic. No. ,/. /. `? .� . .... y PLUMBING INSPECTOR Check MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING r Town: �e�l Yl► �,I/aPit- MA. Date • 3 /( Permit# ing Location: p% ( (' i�„ p Cc Owners Name: X, yA/rtar �L of OccupancPy: Commercial [] Educational ❑ Industrial ❑ Institutional ❑ Residential ff T' -SUB BSMT. BASEMENT 1' FLOOR 2ND FLOOR 3RD FLOOR 4r" FLOOR Sr" FLOOR 6r" FLOOR 7r" FLOOR 8r" FLOOR New: Ll Alteration: ❑ Renovation: FIXTURES Installing Company Name: W A I,, Address.J-0 City/Town: / Al" State:/91 Business Tel: 6 U3 ` K3 I Fax: Name of Licensed Plumber: Plans Submitted: Yes ❑ No DEDICATED SYSTEMS En D C3 M H z w > LU H aD: Qz C O p w U Q Q m m O 2 ~Q m w N Q 2 In o W H n0. rn o Z O 0 O O LL= Y Z IIQ C Q 3 ~ In Y _Z to Z 2 U Y in Q '~„ z > g H LLA 0 F- > 3 Z Q U.O O W J Q N o w p 'n Y Z w a Ln y 'w' Y Q Z z O U Q (D C7 Z u2i 3 F W O U = Fw- 3 Z O. n z H 3 W X w 0 Installing Company Name: W A I,, Address.J-0 City/Town: / Al" State:/91 Business Tel: 6 U3 ` K3 I Fax: Name of Licensed Plumber: Plans Submitted: Yes ❑ No DEDICATED SYSTEMS En D C3 M K IQJ 06 o Z N O Ln w En L W a � F 3 W H Check One Only Certificate # ❑ Corporation ❑ Partnership ❑ Firm/Company INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes No ❑ If you have checked Yes, please Indic a .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 Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. BY Title Type of License: O —1�1,11A ❑,Plumber Signature of Licensed Plumber Master _ Journeyman License Number: Permit NO: 6602, 2? of TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received 7 _� // Date Issued: IMPORTANT: Applicant must complete all items on this Daae U Print MAP NO: toil( PARCEL: T_ ZONING DISTRICT:_ Historic District Machine Shop Village TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential )i New Building ❑ One family ❑ Addition idTwo or more famil ❑ Industrial ❑ Alteration No. of units: J�s� ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands Q Watershed District kfl Water/Sewer ON OF WORK TO BE Please Type or Print Clearly) OWNER: Nan Address:/)S- CONTRACTOR Name: Al Phone: 92Fw Address: 11C C41 Supervisor's Construction License: 6Cf Exp. Date: Home Improvement License: Exp. Date: 11A Az ARCHITECT/ENG INEER6'Sj1/,Vm &41-6J3 Phone: -7p-g3q- 6/z Address FEE SCHEDULE: BOLDING PERMIT: N 7 Reg. No. 6610 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: 4,Z 5'_ (S6e h6ln 1 FEE: $�WJ ..-y (See r►dei) Check No.: Z-0816 Receipt No.: NOTE: Persons contracting with unregistered tractors do not have access to the guaranty fun -------- - Signature of Agent/Owne Sinature of contractor -- g - _ Plans Submit d Plan Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ (Seg. ��l 0� n i s C;, mress) TYPE OF SEWERAGE DISPOSAL Public Sewer K Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS COMMENTS Zoning Board of Appeals: Var Planning Board Decisio DATE REJECTED DATE APPROVED ❑ ❑ etition No: Zoning Decision/receipt submitted yes Comments Conservation Decision: Comm Wafer & Sewer ConneCtion/Signature & Date Driveway Permit DPW Town Engineer: Signature: FIRE DEPARTMENT - Temp Dumpster on site yes, Located at 124 Main Street Fire Department signature/date COMMENTS Located 384 Osgood Street no Dimension Number of Stories: v Total square feet of floor area, based on Exterior dimensions.L6 Y Total land area, sq. ft.: 3Q I A (- ELECTRICAL: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine W10%.7r-r-_..A 11 ATA /Co%r r1nnorfmant IICP_1 IVV I to a"U w— — - —' zo S l -1 s-� bq Sl zo Q S9 X) zs- ri S� Notified for pickup - Date Doc:.Building Permit Revised 2008mi Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H. I. C. And/Or C. S. L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products (VOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products I0TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit i all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording lust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi Location `'�� ��, 13 No. ' Date Check # TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Building Inspector CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 662-2011 Date: May 27, 2011 THIS CERTIFIES THAT THE BUILDING LOCATED ON 21 CideMress Way, North Andover, MA 01845 Meetinghouse Commons MAY BE OCCUPIED AS 1 of 4 units. Town House/Condo IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Fee: 100.00 previously paid Receipt: 24030 Meetinghouse Commons, LLC 115 Carter Field Road North Andover, MA 01845 Building Inspector T ~,. Z V �_ `��!. »� C-) o,� %$ $ 9 c @ 2 in E£ CA O #« c8, 2 » CA 0CQ0- 00 n0 £ � ~ ID 0 gE o ° g 9 v § 9 O � ■ �� � � Z Z.. k ;3� � 0 < . 2 C '\ : a0 coCOo G)� a % � BeP > , 2 =0 Co � > °` k 00 CLQ -4 -2 © n �2 CA) k� C) 2 * * \ m Go � APPLICATION FOR CERTIFICATE OF OCCUPANCYIINSPECTION Building Permit # (n6Z-- Z,bl 1 ADDRESS&OCATION OF PROPERTY: Z 1 C & r t�SS T' Map O q C Parcel 3) Lot Number 21 % ( . SUBDIVISION M,ea U DATE REQUESTED FILED/READY FOR INSPECTION !�ZyA -' II CLOSING DATE ON PROPERTY:_ SIZ-7/1 1 ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS'TIME FRAME. A RE- INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE CHARG�D IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. Permit Issued to': I —Ac6 " Camwmi LSC Address C/ . ROUTING CONSERVATION�•� v��ir PLANNING N /A 0 CH•4c) 8 DPW -WATER METERI% ,I- `O i► SEWER/WATER CONNECTION 0 NOTE DPW MUST INDICATE THAT THE MATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCYIINSPECTION REQUEST 1. Signature Fife: Application for OC form revised Jan 2007 • z. W WO A vial 1 � a i�- :,� � _1A s � 1 �. a� N �. P4 4) 6 z °j� till A cav p w v) G p a w W W p aG v� , is. O 0 G rx w z° rA vi cn CO. =cam o m A o d mv m 4 o a-� o z � Y . O O W m c / C�` V �3 = C �- c m o .a zip N O O O = o U C : a.c� m j�CD N-I%[�' CO CCD O. CA N mom~ m ca r ,r CLC- W Is Z � O G3 m 0 � ca C, Q GO d m� O� Q _ .0 ` N co a4- m goil 6 O O cm i C -,CO CD 0 32 ._ CA O .FE m m CD 0 CD LLft O� CD 0 ZooL Cc O a CL via C C,* c V �O 'p co CD m C Z O _ C. V C c cc CL 0 YI W W 19 W co CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 662-2011 Date: May 27, 2011 THIS CERTIFIES THAT THE BUILDING LOCATED ON 21 Ciderpress Way, North Andover, MA 01845 Meetinghouse Commons MAY BE OCCUPIED AS 1 of 4 units. Town House/Condo IN ACCORDANCE WITH THE PROVISIONS Ou THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Fee; 100,00 previously paid Receipt: 24030 Meetinghouse Commons, LLC 115 Carter Field Road North Andover, MA 01845 Building Inspector T 0 z v ` 1 5 z O U CD F. N :mom V .Oy O Z *113 O H a Ll ozw _ w Z :s a. w ~ U a X46 ! .^ GC r•1 �7"p •ca e_D �••• C r.+ �dt O H C FE .O IS caj ca 10 CD V Ow. COD d ` V apa u c ca ro�� a:2 m e w �, p w z Q \ V 0 w cn to Z - -r-( � qj) x.-� bo :3 Co �\ xw w" w w om< - H cq cn cn v ` 1 5 z O U CD F. N :mom V .Oy O Z O H a CO C ` mz 3 _ CD :s a. o WC O R r=... 'p D LL •ca e_D �••• C r.+ �dt O H C FE .O IS caj ca 10 CD V O Cie C COD d O. O:0 2 ev c ca .� a:2 m v ` 1 5 z O U CD F. E O O v Z a. O Q y C CD cm W N� o •— Q 'O O h Q Q 0 CD •T i� Q C* a ev o .. om< h C a, C CC � w_ �O. •v O .0 t3 C Z CD 0 CL C.3 O o C C � h t D M 1� LLI 9 ®e�� Y/ LLI U) W LLI 19 LUW U) • APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION Building Permit # w- toil ADDRESS/LOCATION OF PROPERTY: 21 Ct(&k r eSS III) a�/ r DqC Parcel SUBDIVISION Lot Number 21 U DATE REQUESTED FILED/READY FOR INSPECTION CLOSING DATE ON PROPERTY:_ s/t'7/11 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 CHARGgD IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. i Permit Issued to: V Address I 1 SIGNED CONSERVATION PLANNING DPW - WATER METER f - R UTIN `'IfsJ�r ti /A = cHkos " --)Of f , SEWER/WATER CONNECTION 0 NOTE G DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST DPW Signature File: Application for OC forrn revised Jan 2007 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER ER Building Permit Number 662-2011 Date: May 27, 2011 THIS CERTIFIES THAT THE BUILDING LOCATED ON 21 Ciderpress Way, North Andover, MA 01845 Meetinghouse Commons MAY BE OCCUPIED AS 1 of 4 units, Town House/Condo IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Fee; 100.00 previously paid Receipt: 24030 Meetinghouse Commons, LLC 115 Carter Field Road North Andover, MA 01845 Building Inspector 16 GENERAL BUILDING NOTES/CHECKLIST- NOT LIMITED TO ITEMS BELOW POST ALL LOT NUMBERS, ADDRESS, AND PERMIT (COPY OK)..or no inspections INSPECTIONS: (Minimum) Excavation, Footing, Foundation, Frame, Insulation, Final. FOOTINGS: Continuous Full 2x4 Keyway Continuous strip footings for interior columns FOUNDATION: Rebar as required Anchor bolts or straps Damproofing Foundation drain - pipe/stone/fabric filter/cover and outlet connection. FRAME: Fireblock - over girts/plates between floor joist Penetrations for plumbing, heat, elec, etc. Walls at stair stringers. Windbrace corners and center bearing partitions. Size ridge to provide full bearing at rafter cuts. Hip and Valley rafters - watch bearing at walls. Ridge & Hip - Provide proper connections. Cathedral roof rafters provide proper connections and use "Hurricane Clips" tie to plate. Stair stringers - watch cuts and heal support. Joist hangers - fully nailed w/ hanger nails. Sill plates 2-2X6 (1 PT) w/sill seal. Girls - solid brick or steel plate bearing at foundations % " air space at sides in foundation pockets. Lateral bracing at ends. Certified calculations. required for Beams/LVL's Trusses. Solid bearing support for Headers/Beams etc. Check headroom clearances - stairways, under beams Attic Access. (min. 22x30 w/3' headroom above). Crawl space access. (min. 18x24). Bath exhaust fans to have metal duct to exterior (not in soffit). Firecode S/R wood frame of "0" clearance fireplaces & stoves Window Schedule or Every Habitable Room Must Have: Natural light equal to 8% of floor area. of required glazing shall be openable. 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UW = o az o 99) W O O = O= U U O z$ v N d Z 3y 9,03 x N O N Z 00p4 Vw 0: C,4 W oam�Wa� (ro W I(A 3> mmQ fs, Q Moo ,�� < 0 UU Q 0-< a W N -6 U O p Mgt $ O Z Z YY► 8 n a= W W F a t m 'V5z ��.1 S WC I I \ I i I I E -1 "', v', RES --:zec r Sof ware Version 4.3.1 Compliance Certificate Project Title: Meeting House Commons Energy Code: Location: Construction Type: Building Orientation: Glazing Area Percentage: Heating Degree Days: Climate Zone: Construction Site: Building 3 North Andover, MA 20091ECC North Andover, Massachusetts Multifamily Bldg. orientation unspecified 13% 6322 5 Owner/Agent: Tara Leigh Development, LLC 115 Carter Feld Road North Andover, MA 978-6876-2635 Compliance: 1.9% Better Than Code Maximum UA: 784 Your UA: 769 The % Better or worse Than code index reflects how dose to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum -code home. Designer/Contractor: O'Sullivan Architects, Inc: 580 Main Street Suite 204 Reading, MA 01867 781-439-6166 . •--. ...... ••------ I. —rwnurouneuopace 3169 30.0 0.0 124 Ceiling 1: Flat Ceiling or Scissor Truss 3769 30.0 0.0 132 Front Walls: Wood Frame, 16" o.c. 1392 19.0 0.0 67 Orientation: Unspecified Window 3: Vinyl Frame:Double Pane with Low -E 155 0.330 51 SHGC: 0.30 Orientation: Unspecified Window 4: Vinyl Frame:Double Pane with Low -E 42 SHGC: 0.27 0.280 12 Orientation: Unspecified Door 1: Solid 80 0.160 13 Orientation: Unspecified Sides: Wood Frame, 16" o.c. 2052 19.0 0.0 116 Orientation: Unspecified V'7indlow 5: Vinyi Frame:Double Pane with Low -E 125 0.330 41 SHGC: 0.30 Orientation: Unspecified Rear Walls: Wood Frame, 16" o.c. 1780 19.0 0.0 80 Orientation: Unspecified Window 1: Vinyl Frame:Double Pane with Low -E 345 0.330 114 SHGC: 0.30 Orientation: Unspecified Window 2: Vinyl Frame:Double Pane with Low -E 21 SHGC: 0.27 0.280 6 Orientation: Unspecified Door 3: Solid 80 0.160 13 Orientation: Unspecified Compliance Statement The proposed building design described here is consistent withthe building pl s, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet a 2009 IECC requirements in REScheck Version 4.3.1 and to comply with the mandato;rkem listed in th RESche Ins ection Checklist. Project Title: Meeting House Commons Report date: 07/28/10 Data filename: K:1ZahoruikolMeetinghouse Commons - No AndovedMeeting House TownhouseMCD'stBuilding 31Building_3.rck Page 1 of 2 -0laps Sub ' d Plans Waived Certified Plot Plan' Stamped Plans TYPE OF SEWERAGE DISPOSAL �ublicSeweTanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private (septic tank, etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE A PROVED PLANNING & DEVELOPMENT 4 D COMMENTS N , 7,9 A k QnS CONSERVATION -- Reviewed MMENTS ,TH Reviewed fll COMMENTS Orirz�yw wa.�2��be�.sef Zoning Board of Appeals: Variance, Petition No: Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments 7—Zlb -10 Water & Sewer DPW Town -Engineer: COMMENTS ..44 The Commonwertlth ofHassachusetts Department orrndust iul _4ccidents Offwe of.trnvesa afions 600 Washin.-Wn Street Boston, Mf4 02111 Workers' Compensa%on �ns>tu-ance Affidavit:Bnilde� MgS nt Information rs/Contrac%rs/Eiectricxans/plambers Name (Business ogmnization/Individuai): Address: City/StatrMp: .. C -- Phone#:-.(,8'�3.� Are you an employer? Check the appropriate boy 1_ ❑ I am a employer with 4. ❑ I am a general cow and I employees (fall and/or part time).* 2. ® I am a sole have hired the sub_0on=ctM proprietor or partner- Ship and have no employees listed on the attached sheet I These sub_ contractors have working for me in any capacity, [No ' comp. ice works' comp, insurance. 5. ❑ We are a corporation and its requfirz] 3- ❑ I offices have exercised their am a homeowaea doing all work mySMIf [No workers' comp• right of oxemptiou per MGL c. 152, § 1(4), and we have insurance required.] t no employees_ [NO Wim, C-orP- Type of project (required): 6. XNea' construction 7. ❑ Remodeimg . 8- ❑ Demolition 9. ❑ Budding addition 10.11 Electrical repairs or additions .1 Ln Plumbing repairs or additions 12.❑ Roof repairs ] 13.0 Other `-``say o+Iir$cot chbms bnx #I mtut tlao Ell ort the serlio= e^t%--= p'a&=, coot,= ...! Hometown= s.... Hometown== exs who submit Otis off davit mdiatiag $ey zn: dcangalt F+ark and 'C-onttactors 8mt chem Sus box must �� dM�� atumde mutt mdi=b aMwhed an addrhozod dwwmg he z me -of fbe — - rObmtt_s new g.sach— --- was and tLea worloQs, comp- policy �{ormatiaa para an emPkYa iha isprovidUT workers, co=pM&qg0n warurance info =adox for mY employes Below is I6e policy and job sue Insane Company Police # or Self -ins. Lie. # Expiration Date: Job Site Address: Attach a Copp of the workers' cum City/Siatetzip. pensaiion policy declaration page (ShOWilkg the Policy number and Faihf to s== coverage as requuOd under Section 25A of MGL c. 152 can lead to the imposition expiration date fine up to S1,500.00 and/or one-year imprisonmen, as well as civ$ °mon of � P�� of a Of up tb S250-00 a day against the violator. Be penalties in the fm$ of a STOP WORK ORDER and a fine Inv that aPy of 13tis s may be forwarded to the Office of estigations of 9re DIA "for insurance cation I do her Pis andP#ff&0 ofPa7 Y 69"t the in1mmadon provided is rice and coned -46 J??': Olid use only. Do not write in this area to be completed by cuy or town Oficial City or Town: Pernit/i.icease # - Iscuing Authority (circle one): - 1. Board of Health 2. Building, Department 3. City/Town Clerk 4. Electrical 6. Other Inspector 5. PIumb' ueb Inspector Contact- Person: Phone #t as , NIaJ%sachusctts - Iiepartmettt of Pubiic Safctj Board of Building Regulations and Standards Construction Supervisor License Expiration: 45=2 t`a�nmi �ivner Tr#: 21090