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HomeMy WebLinkAboutMiscellaneous - 21 Lavender CirclePEACHTREE REE FARM s� LOT ## 23 26 LAVENDER CIRCLE RECEIVED AUG 11 2004 BUILDING DEPT. 0 l.av,eti� 0,li2CIle �6s e Gaea� �4+ Building Permit Check List Lot 9 Date %/d9f �v C:�41L1 l Building Permit Application completely tilled out a Signed by Constriction Super b Signed by Peachtree Represenative c Square footage of house on permit aForan U signed off a DPW (check for sewer tie in) b Fire Department c Planning Deparhnent d ConservE tion (check for wetland bond, where applicable) 3 GroNaith Management Foran el) ® 4✓tert.ified Plot Plan 0 as built foundation plan required for construction permit "e�5 Copy of Construction Supervisor's License 6 Workman's Comp Affidavit .VO 7 2 Copies of Building plans include a copy of the sprinkler plans PIS' y o e c n rac ) 9 Copy, of the Mascheck (energy audit) lU Copy of the Form J u 11 Check for Permit a Foundation Permit b Building Permit 0 0 AFFIDAVIT I, SCOTT L. MASSE, attorney for KENNETH W. REA do hereby depose and state: 1. 1 represent Kenneth W. Rea, owner of a certain parcel of land located on Rea Street, North Andover, MA and more specifically described in a plan of land recorded with the Essex North Registry of Deeds as instrument/plan number 14502. 2. 1 am duly authorized by Kenneth W. Rea to act on his behalf regarding furtherance of the above stated instrument/p1an. 3. Authorization is hereby given that Gerry -Lynn Darcy, and/or Peach 'Gree Development LLC be allowed to act as the agent for Kenneth W. Rea regarding any and all matters relative to a certain Building permit(s) issued by the Town of North Andover for any lots affiliated with the above stated plan. Signed under the pains and penalties of perjury this day of J e 20t)3• S TT L. MA SE 7-A nTL0_7011-0J0 --L:AIl.1nQ9u ATn:vn cn QT unr 0 The Commonwealth of Massaclr,.(setts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit cjtC Please Print Name: 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 Failure to secure coverage as and/or one years' imprisonrnei understand that a copy of this providing workers' compensation for my employees working on this job. l .Vl �.0�, I X� ��ll�► ll� �r� `� ��NZi�s� r PiwPc�--NocM�°�y�PSJ i He4e-) - __ _. _ _-__.. _.... _....... ., o„ - L� LIM J11jPLJ5juon or cnmmai penances at,a fine up to $1,500.OD G_dual.,penalties.in..thefnrmrfa_STOP WORK_ORDERafid_afine of.�$1D0 40J.aAay against -me.. I may be forwarded to the Office of Investigations of the DIA for coverage verification. and penalties of perjury that the information provided above is true and correct. '.hone # �_ J�_� SC do not write in this area to be completed by city or town official' City or Town Permit/Licensing ❑Check if immediate respoBuilding Deptnse is required Licensing Board p Selectman's Office Contact person: Phone #: n Health Department F1 Other 06/16/2003 14:59 1978317 WILLOWS0 NOTICE OF ASSIGNMENT EMPLOYER: PEACHTREE DEVELOPMENT LLC COMBO I.D. 231 SUTTON ST SUITE 2E -F 000139954 NORTH ANDOVER, MA 01845 The Waiver of Our Right to Recover from Others Endorsement is available on Pool policies. Contact your agent for details. AGENT WILLOWS 7N$ AGCY INC OR 522 CHICKERING RD PRODUCER: N ANDOVER, MA 01845 AGENCY FEIN. 223 8 5 66 64 COVERAGE GROUP 0139954 PAGE 02 STATUS OF EMPLOYER Limited Liability Cote Coverage under this assignment applies to Massachusetts Operations only. For coverage outside of Massachusetts, contact the appropriate Pool or Plan for that state. INSURANCE COMPANY: TRAVELERS INDEMNITY CO MS JACKIE DENNIS P 0 BOX 3556 ORLANDO, FL 32802 (800) 443-4404 CLASSIFICATION OF OPERATION mM� CLASS ESTIMATED RACE iSTZMATED CODE TOTAL ANNUAL PREMIUM -------------------------------------- ----- REMUNERATION -------------- -------------------- RPENTRY-DETACHED PRIVATE RESIDENCES 5645 $0 10.62 $0 .2PENTRY-DWELLINGS-3 STORIES OR LESS 5651 $0 10.62 $0 EMPLOYERS LIABILITY 100/100/500 9845 LOSS CONSTANT 0032 $50 STANDARD PREMIUM $50 EXPENSE CONSTANT 0900 $122 TERRORISM CHARGE 9740 $0 RISK MINIMUM PREMIUM 0990 $500 ESTIMATED ANNUAL PREMIUM $500 DTA ASSESS, 4.5% OF STANDARD PREM. $17 EST. ANNUAL PREM. PLUS ASSESSMENT $517 INSTALLMENT BASIS: Annual REQUIRED DEPOSIT PREMIUM $517 COMMENTS Coverage effective 12:01 AM on 05/23/03 DATE OF NOTICE: 05/24/03 PREPARED BY: Joanne Shea EXT 530 * SERVICING CARRIER ASSIGNMENT * * LETTERID: 419982 COPY: AGENCY The Workers' Compensation Rating and Inspection Bureau of Massachusetts 101 Arch Street • Boston, MA 02110 (617)439-9030 • FAX (617)439-6055 - www.wcribma.org CcC lee f'R�ntiS 4 t 3 GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT,, TOWN OF NORTH ANDOVERBUILDING DEPARTMENT �le.i.._ . . . . . . _ I FROM REScheck Compliance Certificate Massachusetts Energy Code REScheckSoRware Version 3.5 Release ld Data filename: K:1Laudani\PcachtrcclHouscD\housed.rck PROJECT TITLE: House "D" CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUC ION'IYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 01/21/04 DATE OF PLANS: 4-10-03 PROTECT DESCRTPTiON: Peachtree Farm DESIGNER/CONTRACTOR- Peachtree Development LLc. COMPLIANCE: Passes Maximum UA — 549 Your Home UA _ 548 0.2% Better Than Code (UA) Ceiling 1: Flat Ceiling or Scissor Truss Ceiling 2: Cathedral Ceiling (no attic) Skylight 1: Wood Framc:Double Pane with Low -E Wall 1: Wood Frame, 16" o.c_ Window 1: Wood Frame:Double Pane with Low -L Door 1: Solid Door 2: Glass Floor 1: All -Wood Joistf niss:Over Unconditioned Space Funiace 1: Forced Hot Air, 80 AFUE (WED)JAN 21 2004 0 /ST. 6.18/No.6802897118 P 4 Gross Area or Cavity Perimeter R -Value Permit Number Checked By/Date Glazing Cont. or Door R -Value U -factor LFA 1468 30.0 0.0 51 521 30.0 0.0 18 6 0.420 t 2998 11.0 0.0 229 323 0.320 103 42 0.180 8 62 0.340 21 2457 19.0 0.0 115 COMPLIANCE. STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submittcd with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in REScheckVersion 3.5 Release td (formerly MECchecl and to comply with the mandatory requirements listed in the REScheckInspection Checklist. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 78OCMR 1310 and 14.4. FROM(WED)JAN 21 2004 � /ST. 6: 18/No.6802897118 P 5 ••,, 0 RtiiIder/DesZg»er nate C7/' I. Q Q FORM 3 LOT RELEASE The undersigned, being a majority of the Planning Board of the Town of North Andover, Essex County, Massachusetts, hereby certify that.- a. hat: a. the requirements for the construction of ways and municipal services called for by the Performance Bond or Surety and dated and/or by the Covenant dated May 20, 2003 and recorded in the Districts Deeds, Book 7827, Page 143; or registered in Land Registry District as Document No. and noted on Certificate of Title No_ in Registration Book , Page ; has been completed/partially completed, to the satisfaction of the Planning Board to adequately serve the enumerated lots shown on Plan entitled "Definitive Subdivision and Special Permit Plan Peachtree Farm in North Andover Massachusetts" PIan dated October 24,'2002, last revised May 16 2003 recorded by the Essex North District Registry of Deeds, Plan No. 14502 or registered in said Land Registry District, Plan Book , and said lots are hereby released from the, restrictions as to sale and building specified thereon_ Lots designated on said Plan as -follows: (Lot Number (s) and street (s)) Lots 1 — 9 and 20.— 28 inclusive Peachtree Lane and Lavender Circle b. (To be attested by a Registered Land Surveyor) C°'. C.P. I hereby certify that lot number (s) Lots 1 — 9 and 20 — 28 inclusive, on Peachtree Lane and Lavender Circle do conform to layout as shown on Definitive Plan entitled "Definitive Subdivision and Special Permit Plan Peachtree Fann in North Andover, Massachusetts". (K0259882.1 ) Registered Land Surveyor c. The Town of North Andover, a municipal corporation situated in the County of Essex, Commonwealth of Massachusetts, acting by its duly organized Planning Board, holder of a Performance Bond or Surety dated 20 and/or Covenant dated May 20, 2003 from Big Kahuna Properties, LLC of the City/Town of North Andover, Essex County, Massachusetts recorded with the Essex North District Registry of Deeds, Book 7827, Page 143, or registered in Land Registry District as Document No. and noted Certificate of Title. No. in Registration Book Page acknowledges satisfaction of the terms thereof and hereby releases its right, title and interest in the lots designated on said plan as follows: Lots 1 — 9 and 20 — 28 inclusive EXECUTED as a sealed instrument this Majority of the Planning Board of the Town of North Andover COMMONWEALTH OF MASSACHUSETTS ESSEX, ss. November 1, 2003 Then personally appeared bwf mr^ ry". , -Cme-rt the above-named members of the Planning Board of the Town of North Andover, Massachusetts, and acknowledged the foregoing instrument to be the free act and deed of said Planning board, before me, Notary Public u V 1 My Ctor�imission Expires 2 of 2 ;K0259882.11 ,F Date.//—/"), ................................ TOWN OF NORTH ANDOVER PERMIT FOR WIRING -%i-:� de, This certifies that ......... ) ..... ..... . ........................................... has permission to ....... ( --� . ............................................................. wiring in the building of,�-.-,� ....... �� ......................... atz ...... Qv.............North Andover, Mass. Lic. NA ..... ....................... ELECTMCAL INSPECTOR Check # 5419 rA 7BE C0llM0NWEAL7H0FAWS4CHUSE77S Office Use only DEPAXrMENT0FPUM1CS4FW Permit No. BOARDOFFIREPREVEVHONRF.iGUl &ONSR7CMR12.VO ` G3 Occupancy & Fees Checked APPLICATIONFOR PERMIT TOP ORMELE=CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MAS ACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Vl fires: The undersigned applies for a permit to perform the electricak work Oescribed below. Location (Street & Number) a� MW L iq W Owner or Tenant I Owner's Address 0 31 S-+ r--1 54� gi 1hJ O0 v,<— -f Is this permit in conjunction with a building permit: Yes ® No (Check Appropriate Box) I& 0o S' Purpose of Building Cj N 6-`4P_ lt, Utility Authorization No. Existing Service AmpsVolts Overhead Undergrounr No. of Meters New Service Amps Q /a yo Volts Overhead Underground 0 No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work %y i00 -e— P7'CR6LIC No. of Lighting Outlets No. of Hot Tubs No. of Transformeg Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA round 1:1round No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners 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 Local Municipal Other No. of Dryers Heating Devices KW 1:3 Connections No. of Water Heaters KW No. of No. of igns Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER• kW1a=C0WG4r. RuR=tDttrmWr<emattsdNbmdusetC=2alLaws IbaNeaamuttlmbkyhm ==Pblicymckxh gComplete Covaageorits rialewwalat YES a NO I NesubmWdvalidpmdcfsamatodrOffioe YES j-1a1� ffyouhawdrdodYES,pknwin&*drtypeofoDvwWby INSURANCE [KIx. ,x BOND r7 MIER (Plea9eSPecc�Y) �Olo Eq*afion�"'"D& Esdm&dVahrofE1acftJcalWbik $ WbiktoStwt hrspecbmD,*RNue�sldd .�,Roou'gh �, Final FWMNAME ��� '/fii'Yl1� (JLJq (,l(�l:/ lyyU7C �V�- LimmNo. Liamme X 1, 6V14-f,1Y P" IAMIi46 0 Signatim Li�t>SeNo Busi mTelNo. ),Y yo 3 01/- 97 �C 1 Alt. Tel No. J,?- CY6 F OWNQ SINSURANCEWANFR,IamawarethattheLicanedoesmthavethe insurancecoverWorilssubstantialegtrivalalasmgnedby GalealIaws andthatmysignaturecnthispmrdapplicationwaivesthismgz matt (Please check one) Owner M Agent l� signature ot Owner or gen -f. Telephone No. PERMIT FEE $ BUILDING FILE Town of North Andover Building Department, 5z 27 Charles Street North Andover, Massachusetts 01845 ,t (978) 688-9545 Fax(978)688-9542 � coc is waw.. 4 APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION LOT NUMBER 03 SUBDIVISION �C, - � ` � � C DATE REQUEST FILED DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRA-ME..A RE-LNSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS W_IL.L BE CHARGED IF SIGNATURE ROUTING D-P.W. —WATER METERr I� L+ �� DATE 11 /C) �L D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. Ka '& 0 +_ ��t SIGNATURE / DP AUTHORIZATION TRE COMWONWFUTHOFAMAICHUSEM Office Use only D l OFPUXJ'CSAF= Permit No. BOARDOFFREPREVEM ONREGUMNONS527CMR12:(X1 Occupancy &Fees Checked APPLICA71ONFOR PERMIT TO PERFORMELECTRIC,AL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date // U 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 /,J -ZZ /` Owner or Tenant ��r�ch h% -e L /1 No. of Gas Burners Owner's Address Q31 S-tAt,-� 54-N Is this permit in conjunction with a building permit: Yes ® No ID Purpose of Building J j N C,. L2 \ Tons Existing Service _. Amps��Volts Overhead New Service ub — Amps Q 3"Volts Overhead C Number of Feeders and Ampacity Pumps Location and Nature of Proposed Electrical Work (Yte No. of Lighting Outlets No. of Hot Tubs Space Area Heating KW, No. of Lighting Fixtures Swimming Pool Above Below round round No. of Receptacle Outlets No. of Oil Burners No. of Switch Outlets (Check Appropriate Box) Utility Authorization No. _ Undergroun No. of Meters Underground No. of Meters of Generators No. of Emergency Lighting OTHER• KVA Units No. of ZonesED Other -! h UrMWCoveraga Rrsuarttothe teclarmieWofM%sadumcmetalLam IhaNeaamtljabkykmancepobcylwkxkgConAAmoLembomCDNeaEporzgftnWegxvalfft YES NO IhaNesubtr>wdvalidptoofofsamebtheOffice YES I"' ffyouhavedrdedYES, plea9eit>dcatetheVpeofeomageby drckiqgdrINSURANCE BOND OTHER (Please Sp-iY) Amp �O WodctoS4rt htspectiortDateRegt>eWd Ro* Esti n*d Vahle of)~7" cal Wolk $ SigtedmderTie ofpetjuty Final FIRMNAME BVI C)C-F� �< / C%L LiMwNo. _ /� 46- 0— n l A f ✓l n ��ti Signattre LiX!WNo l C �" Bush ess TeL l b. Add= AIL ,tyg *HVSINSURANCEWANER,lamatawdutheLit�sedoesmthawtheirmra moowi porils&ks�ffMegmQhtast gxmdby�G=alLam andthatnysigttaamonthispemritffbcabmwagsthisIegm,Cwt (Please check one) Owner 1:1 Agent 0 Telephone No. PERMIT FEE signature or Owner or Agent No. of Gas Burners FIRE ALARMS 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 No. of Dryers Heating Devices KW Local Municipal Connections El No. of Water Heaters KW No. of No. of -signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER• KVA Units No. of ZonesED Other -! h UrMWCoveraga Rrsuarttothe teclarmieWofM%sadumcmetalLam IhaNeaamtljabkykmancepobcylwkxkgConAAmoLembomCDNeaEporzgftnWegxvalfft YES NO IhaNesubtr>wdvalidptoofofsamebtheOffice YES I"' ffyouhavedrdedYES, plea9eit>dcatetheVpeofeomageby drckiqgdrINSURANCE BOND OTHER (Please Sp-iY) Amp �O WodctoS4rt htspectiortDateRegt>eWd Ro* Esti n*d Vahle of)~7" cal Wolk $ SigtedmderTie ofpetjuty Final FIRMNAME BVI C)C-F� �< / C%L LiMwNo. _ /� 46- 0— n l A f ✓l n ��ti Signattre LiX!WNo l C �" Bush ess TeL l b. Add= AIL ,tyg *HVSINSURANCEWANER,lamatawdutheLit�sedoesmthawtheirmra moowi porils&ks�ffMegmQhtast gxmdby�G=alLam andthatnysigttaamonthispemritffbcabmwagsthisIegm,Cwt (Please check one) Owner 1:1 Agent 0 Telephone No. PERMIT FEE signature or Owner or Agent oK P(Vk5- �-- Location No.Date ��6f TOWN OF NORTH ANDOVER F A Certificate of Occupancy $Is 'SS�cMusEBuilding/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL, $ :. Check # �r�NvtieS Sv41s. ►�k 17018 BuildingInsspetfor T M X ic z O C1'( TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ,:. ! Y•"t P5 agip Sk'.w 7 .k..�.• j—�rly �♦y fr �5 k. S 9` •S`Dn" T .i BUILDING PERMIT NUMBER: L4S- I DATE ISSUED: I , I(.— o T % / —� SIGNATURE: `I Building Commissioner/12934ctor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: * ( 1.2 Assessors Map and Parcel Number: QQkr b " 1 Ny-,i v -f- Subdi w s} -on * special R rm �t rc�zP Plraa„ OSlicorM cry uJrenCQ Qq -+f Map Number Parcel Number �nrbuer. D ( Uorl'h m r� I AW C1�6s , --1h Sin, ryun+ #) ySoa, 1.3 Zoning Information: 1.4 Property Dimensions: Johdelros( � Zoning District Proposed Use I Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R red Provided Required Provided Q ' Q s0` �p - r a0` a^a 101 c�' LIS - 1.7 Water Apply M.G.L.C.40. S1 54) 1.5. Flood Zone Information: Ts Sewerage Disposal System: Public Private 0 Zone Outside Flood Zot 01 Municipal On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record 1 QnmeAn 1 #fir)&&Yrxpfi DlByS Name (Print) Address for Service: Signature Telephone 2.2 Owner of Record: Name Priitt Address for Service: Signature Telephone SECTION 3 - CONSTII, TION SERVICES 3.1 Licensed Construction Asor: Not Applicable ❑ Licensed C s ructio Supervisor: S 0 0 Lo . box go "v1, ,"n�(f � f Mh Dl S License Number Address _ ( �) _ 1; 0M Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor a Not Applicable ❑ Company Name Registration Number j Address Expiration Date Signature Telephone T M X ic z O C1'( SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 & 25e(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 bpilding permit. Signed affidavit Attached Yes .... ..A No ....... ❑ SECTION 5 Description of P o osed Work check all a Ucable New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. 0 Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: n ' RA ho 1 l nce- a P-nooLh-on Q CmL ' I (05 laQ00 on n�fiof I� SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant t}FFICIAAI <USE (ONLY 1. Building FbundniiGn 14 -a(91l3o10 (a) Building Permit Fee Multi Tier 2 Electricalpp 8) 000 (b) Estimated Total Cost of Construction�- 3 Plumbing Building Permit fee (a) X (b) / 4 Mechanical HVAC 5 Fire Protection 560 6 Total 1+2+3+4+5 D a Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 11. � cl b c6A a ll as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION i 1,U/111,14VAas 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 `..,y knowledge and belief Pri t a e SOna't&e'Ofbca;erkient- Date NO. OF STORIES 'a SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS i x @ I "G 2 XI0 11'"O.C. 3 aX10 Ccu SPAN I q, q C• 5 I Co) ,,• C. DIMENSIONS OF SILLS a – 2.x(,o P , DIMENSIONS OF POSTS V,11, nqrol La DIMENSIONS OF GIRDERS y )q!4)cl!4 LVL, HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING Q It X 1W MATERIAL OF CHIMNEY IS BUIIDING ON SOLID OR FILLED LAND d Lan IS BUTLDING CONNECTED TO NATURAL GAS LINE 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 RQChbt_Z , I. U -1 op -9 of , LL C PHON Gids , 7-&- S90 Nnl* IysOL� as mcor cleda4- LOCATION: Assessor's Map Number kat, oce Fez &stry04JS PARCEL SUBDIVISION UC F11'an \I LOT (S) STREET 1,ender NrC U. ST. NUMBER "**OFFICIAL USE ONLY*********'"'************************ AGENTS: DATE APPROVED // /Z Z(Zz DATE REJECTED f COMMENTS TOWN NN FR' `/ " DATE APPROVED �� DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS %/PUBLIC WORKS - SEWER/WATER COI DRIVEWAY PERMIT. FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9N971m -1;5 ­-Od F License: CONSTRUCTION SUPERVISOR t' Number: CS 083065 Birthdate: 01/13/1973 Expires: 01/13/2007 Tr. no: 83065 Restricted: 00 GERRYLYNN DARCY i PO BOX 907 N ANDOVER, MA 01845 ' Administrator AFFIDAVIT I, SCOTT L. MASSE, attorney for KENNETH W. REA do hereby depose and state: 1. I represent Kenneth W. Rea, owner of a certain parcel of land located on Rea Street, North Andover, MA and more specifically described in a plan of land recorded with the Essex North Registry of Deeds as instrument/plan number 14502. 2. 1 am duly authorized by Kenneth W. Rea to act on his behalf regarding furtherance of the above stated instrument/plan. 3. Authorization is hereby given that Gerry -Lynn Darcy, and/or Peach Tree Development LLC be allowed to act as the agent for Kenneth W. Flea regarding any and all matters relative to a certain Building permit(s) issued by the Town of North Andover for any lots affiliated with the above stated plan. Signed under the pains and penalties of perjury this day of J e 2003. S 7"f L. MA SE 06/16/2003 14:59 19783276517 WILLOWS PAGE 02 NOTICE OF ASSIGNMENT EMPLOYER: PEACHTREE DEVELOPMENT LLC 231 SUTTON ST SUITE 2E -F NORTH ANDOVER, M.A. 01845 The Waiver of Our Right to Recover from Others Endorsement is available on Pool policies. Contact your agent for details. AGENT WILLOWS INS AGCY INC OR 522 CHICKERING RD PRODUCER: N ANDOVER, MA 01845 AGENCY FEIN: 223s56664 COMBO I.D. STATUS OF EMPLOYER 000139954 Limited Liability Com COVERAGE GROUP 0139954 Coverage under this assignment applies to Massachusetts operations only, For Coverage outside of Massachusetts, contact the appropriate Pool or Plan for that state. INSURANCE COMPANY: TRAVELERS INDEMNITY CO MS JACKIE DENNIS P 0 BOX 3556 ORLANDO, FL 32802 (800) 443-4404 CLASSIFICATION OF OPERATION __--� CLASS ESTIMATED RAVE �+ ESTIMATED CODE TOTAL ANNUAL PREMIUM -------------------------------------- ----- REMUNERATION -------------- -------------------- RPENTRY-DETACHED PRIVATE RESIDENCES 5645 $0 10.62 $0 APENTRY-DWELLINGS-3 STORIES OR LESS 5651 $0 10.62 $0 EMPLOYERS LIABILITY 100/100/500 9845 LOSS CONSTANT 0032 $50 STANDARD PREMIUM $50 EXPENSE CONSTANT 0900 $122 TERRORISM CHARGE 9740 $0 RISK MINIMUM PREMIUM 0990 $500 ESTIMATED ANNUAL PREMIUM $500 DTA ASSESS, 4.5% OF STANDARD PREM. $17 EST. ANNUAL PREM. PLUS ASSESSMENT $517 INSTALLMENT BASIS: Annual REQUIRED DEPOSIT PREMIUM $ 517 COMMENTS Coverage effective 12:01 AM on 05/23/03 DATE OF NOTICE: 05 /24/03 PREPARED BY: Joanne Shea EXT 530 * * SERVICING CARRIER ASSIGNMENT * * LE'rrER ID: 419982 COPY: AGENCY The Workers' Compensation Rating and Inspection Bureau of Massachusetts 101 Arch Street • Boston, MA 02110 (617)439-9030 • FAX (617)439-6055 • www.wcribma.org FORM d LOT RELEASE The undersigned, being a majority of the P1amling Board of the Town of North Andover, Essex County, Massachusetts, hereby certify that: a. the requirements for the construction of ways and municipal services called for by the Perfornlance Bond or Surety and dated and/or by the Covenant dated May 20, 2003 and recorded in the Districts Deeds, Book 7827, Page 143; or registered in Land Registry District as Document No. and noted on Certificate of Title No. in Registration Book ,Page ; has been completed/partially completed, to the satisfaction of the Planning Board to adequately serve the enumerated lots shown on Plan entitled 'Definitive Subdivision and Special Permit Plan Peachtree Farm in North Andover Massachusetts" Plan dated October 24, 2002, last revised May 16 2003 recorded by the Essex North District Registry of Deeds, Plan No. 14502 or registered in said Land Registry District, Plan Book , and said lots are hereby released from the. restrictions as to sale and building specified thereon. Lots designated on said Plan as follows: (Lot Number (s) and street (s)) Lots 1 — 9 and 20.— 28 inclusive Peachtree Lane and Lavender Circle b. (To be attested by a Registered Land Surveyor) M 4Q CP I hereby certify that lot number (s) Lots 1 — 9 and 20 — 28 inclusive, on Peachtree Lane and Lavender Circle do conform to layout as shown on Definitive Plan entitled "Definitive Subdivision and Special Permit Plan Peachtree Fann in North Andover, Massachusetts". (K0259892.1) Registered Land Surveyor C. The Town of North Andover, a municipal corporation situated in 'the County of Essex, Commonwealth of Massachusetts, acting by its duly organized Planning Board, holder of a Performance Bond or Surety dated 20 , and/or Covenant dated May 20, 2003 from Bi-- Kahuna Properties, LLC of the City/Town of North Andover, Essex County, Massachusetts recorded with the Essex North District Registry of Deeds, Book 7827, Page 143, or registered in Land Registry District as Document No. and noted Certificate of Title No. in Registration Book Page acknowledges satisfaction of the terms thereof and hereby releases its right, title and interest in the lots designated on said plan as follows: Lots 1 – 9 and 20 – 28 inclusive EXECUTED as a sealed instrument this Z5 day of Nov Majority of the Planning Board of the Town of E 1T-rc oI North Andover 1=— COMMONWEALTH OF MASSACHUSETTS ESSEX, ss. November -A, 2003 Then personally appeared rylz- , -one-,of-the above-named members of the Planning Board of the Town of North Andover, Massachusetts, and acknowledged the foregoing instrument to be the free act and deed of said Planning board, before me, Notary'Public V i My CorlImission Expires 2 of 2 'K0259882.11 LLI s- • - . Ld 'LU 0 _jV.CL . " ■. •. • • ..�Lum• - • ' CLr ♦� - .' .LLI • - z1 l�j�s • • 1 - j��� � `jam ' . • ��� �9 s LU, v�o 0 anon • ...,>> i 4 .. �x""Qww��w" Q -\ • 0�0 s yj� y ,� DOD , u � luLO r\ LL • ago !'. :fit%LU LO CD � -{ -mss i C�u�c �� 4��••1"�_��r�i\//. i�. �/� i�•cwll• a 20 Lo. Fic -_ _ - cc• og ' 4//' • C, CA Cul in L X Li uj CL AFFIDAVIT I, SCOTT L. MASSE, attorney for KENNETH W. REA do hereby depose and state: 1. 1 represent Kenneth W. Rea, owner of a certain parcel of land located on Rea Street, North Andover, MA and more specifically described in a plan of land recorded with the Essex North Registry of Deeds as instrument/plan number 14502. 2. 1 am duly authorized by Kenneth W. Rea to act on his behalf regarding furtherance of the above statod instrument/plan. 3. Authorization is hereby given that Gerry -Lynn Darcy, and/or Peach Tree Development LLC be allowed to act as the agent for Kenneth W. Rea regarding any and all matters relative to a certain Building permit(s) issued by the Town of North Andover for any lots affiliated with the above stated plan. Signed under the pains and penalties of perjury this 14 day of J e 2003. SCOTT L. MA SE Z'd 01b13-2£9-BL6 410:£0 60 91 unr 06/16/2003 14:59 19783276517 WILLOWS PAGE 02 NOTICE OF ASSIGNMENT EMPLOYER: PEACHTREE DEVELOPMENT LLC 231 SUTTON ST SUITE 2E -F NORTH ANDOVER, MA 01845 The Waiver of Our Right to Recover from Others Endorsement is available on Pool policies. Contact your agent for details. COMBO I.D. STATUS OF EMPLOYER 000139954 Limited Liability Com COVERAGE GROUP 0139954 Coverage under this assignment applies to Massachusetts operations only. For Coverage outside of Massachusetts, contact the appropriate Pool or Plan for that state. AGENT WILLOWS INS AGCY INC INSURANCE COMPANY: OR 522 CHICKERING RD TRAVELERS INDEMNITY CO PRODUCER: N ,ANDOVER, MA 01845 MS JACKIE DENNIS P 0 BOX 3556 ORLANDO, FL 32802 (800) 443-4404 AGENCY FEIN: 2 23 8 5 6 6 64 CLASSIFICATION OFOPERATIONCLASS ESTIMATED RATE �- ]STxMATED CODE TOTAL ANNUAL PREMIUM REMUNERATION -------------------------------------- --------------------------------------- RPENTRY-DETACHED PRIVATE RESIDENCES 5645 $0 10.62 $0 APENTRY-DWELLINGS-3 STORIES OR LESS 5651 $0 10.62 $0 EMPLOYERS LIABILITY 100/100/500 9845 LOSS CONSTANT 0032 $50 STANDARD PREMIUM $50 EXPENSE CONSTANT 0900 $122 TERRORISM CHARGE 9740 $0 RISK MINIMUM PREMIUM 0990 $500 ESTIMATED ANNUAL PREMIUM $500 DTA ASSESS, 4.5% OF STANDARD PREM. $17 EST. ANNUAL PREM. PLUS ASSESSMENT $517 INSTALLMENT BASIS: Annual REQUIRED DEPOSIT PREMIUM $ 517 COMMENTS Coverage effective 12:01 AM on 05/23/03 DATE OF NOTICE: 05 /24/03 PREPARED BY: Joanne Shea EXT 530 * * SERVICING CARRIER ASSIGNMENT * * LETTERID: 419982 COPY: AGENCY The Workers' Compensation Rating and Inspection Bureau of Massachusetts 101 Arch Street • Boston, MA 02110 (617)439-9030. FAX (617)439-6055 - www.wcribma.org 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 L PHONE S 3-�osZi'a see p 4arn t 45oa Gs rrcorded LOCATION: Assessor's Map Number A; to Arun i�a��exc!s PARCEL SUBDIVISION 01G1b4,9_ m LOT (S)____ STREET_!L'i� iffGLe ST. NUMBER N OFFICIAL USE ONLY ***►*** COMMENTS AGENTS: Mu ,,WAUMINISTRATOR DATE APPROVED DATE REJECTED TOWN PLANNER FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMMENTS PUBLIC WORKS - SEWER/WATER DRIV FIRE DEPARTMENT RECEIVED BY BUILDING INSPE Revised 9197 im DATE APPROVED DATE REJECTED. DATE APPROVED DATE REJECTED DATE APPROVED. DATE REJECTED �_7/mil < Z M O ° @ o � a � . Z r5° a! L _ :rH y O -n N m m n a, >> > o c 3 �a 3 P � m y' o R to =0)y O m It R o IS �R8 O D W 0"R_ C cr �.m (a no k vl C o ;0 C 13 H �" a wo In (D c � CL c Ln O Oc c �« 3 A m O N C CL cr Ln 01) el b U3 aj m Q1 m 0 o 8! EL % 0Mmo m a(nD ® uC y Fm a ,-� +-1• v , ® CD a % ''d ® C co` O CD m '—' n ' y ora Z CD tz r d N � � y z. C U) m m C m com VI m CO) C � CD �az y CD O 0. O d _• y �0 CD ®o CDCL cr o CD Er It CD O CD od w C CD y� av y I � v CD COO O 10 Z CD � o CD 0 CCD Q^P 1501 la I Mimi Q z cnC z no 5.m � ti ao 0 H- 0 MCm z 7° • �� ca _I o .=tea ' .de m H T Zr =r.L CL o W �o an d o y H o m m 8 > > N m •p O C) co p O . �► O ozy.A C =r N s :� OL CO Oao t •� o :• ? 0 � O m N : CD c�-o : :A il o m , Cri ti O O N :T N d ; Q cccl d � o s ES ON O m '•�• ' n =r O '� • 3 CO) co C2: J ^; C dam: aCD o: c o :f o �r o 9V H CE MCOD yCA x O x ��. W ro 0 �o oc x o �e, C y/ ,��• p C C°Dp cnO f7 a n rDr r�+ 4 0 c Location U t No. s�CS'% Date �,:l t'_ NpRT" TOWN OF NORTH ANDOVER I O'i•.e .�,'b0 i • • i ; , Certificate of Occupancy $ �ssACHU`+t��'' Building/Frame Permit Fee $ 3 91 i Foundation Permit Fee $ Other Permit Fee $ TOTAL $ —, 9 0, * Check # l� 17126 /—Building Inspector U d b V ,�11°� � LCAT 25 `� 14268 S.F. �• 0.33 Ac. L OL Ln N � o DRAINAGE & UTILITY 15.03' 1 EA SEM EN T 1 l N � N 'T' 27 4T ?9 Ac. 43. 1 0 CA NJ 5�.�_,•�I,.._ 19.52'+ 23 3HEN M. S29653'44"W 127.38' LOT 26 12763 S.F. U-VIi Ac. CDV I UF' t UUNUH I IuIV V ELEVA110N=2-, 21.1' N29953'44"E 109,47' PEACHTREE LANE aQ$U!{VTC IS INTENDED ror% ZONING S ONLY_ IT WAS PREPARED FROM EXISTING PLANS AND RECORDS WITH THE STRUCTURES SHOWN LOCATED BY AN INSTRUMENT SURVEY. THIS PLAN SHOULD NOT BE USED FOR PROPERTY LINE DETERMINATION. 29 4' 0 m v 0 O O O D m z v m 10 u.r �a m0 r D=90'00'00" M R:;-- 30.00' L=X17.12' WE HEREBY CERTIFY THAT WE HAVE EXAMINED THE PREMISES AND THAT THE BUILDING IS LOCATED AS SHOWN, THE 3Tf:UCTURE SHOWN CONFORMS TO THE ZONING LAWS RELATIVE TO REQUIRED SETBACKS OF THE MUNICIPALITY WHEN CONSTRUCTED. ALSO. ACCORDING TO THE F.E.M.A./H.U.D. FLOOD INSURANCE RATE MAP, COMMUNITY PANEL NO. 250098 0006 C DATED 6/2/1993 , THE STRUCTURE IS NOT LOCATED IN AN ESTABLISHED 100 YR.FLOOD HAZARD ZONE. CERTIFIED FOUNDATION PLAN LOT 26 PEACHTREE FARMS MARCHIONDA & ASSOC.,L.P. NORTH ANDOVER, MA ENCINEERINC AND PLANNING CONSULTANTS PREPARED FOR PEACHTREE DEVELOPMENT, L.L.C. 62 ON AVE. SUITE I STONEHAAM, MA. 02180 P.O. BOX 3039 (781) 438-6121 ANDOVER, MA 01810 SCALE: 1"=30' DATE: 2/11/04 TO 996 82V T8L s�l�IJVJJVOVlL1iV11lJOVW we z5: Te, Date ...... ...... I Check # 5' 63 2TH ANDOVER )R WIRING ...................... ................ , North -'Andover, Mass. . ....................................... ELECTRICAL INSPECTOR Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REG APPLICATION APPLICATION FOR PERMIT TO All work to be performed in accordanc&,ith the N (PLEASE PRINT IN INK C City or Town of: By this application the unders. Location (Street & N her) Owner or Tenant 1a /, Owner's Address Is this permit in conjunction with a building permit? Purpose of Building Existing Service Amps / Volts New Service Amps / Volts Official Use Only Permit No. eo Occupancy and Fee Checked qS [Rev. 11/99] leave blank ERFORM ELECTRICAL WORK achusetts Electrical Code (MEC), 527 MR 12.00 Date:_ To the Inspecto ofWires,: ition to perform the electrical work described below. Telephone Yes.. ❑ No [ (Check Appropriate Box) _ Utility Authorization No. Overhead ❑ Undgrd ❑ No. of Meters _ Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security system Cmmnlptinn nfthe fnllnwino, tahla mnv ha wnivod by tho 1—n—mr nfWi.-oc No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures AboveIn- Swimming Pool rnd. ❑ rnd. ❑ o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: I Number I Tons KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers SpacI. e/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances g pp Kms' Security Systems: No. of Devices or Equi alent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring:No. of Devices or Equivalent OTHER: - Attach aaamonat aetau If aestrea, or as requirea by the Inspector Of wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: - (When required by municipal policy.) Work to Start: AVOI Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the ains nd penalties of perjury, that the information on this application is true and complete. FIRM NAME:Socupity LIC. NO.: 1 U.1C Licensee: John S. Bassett Signature LIC. NO.: 1533C (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 603 594 5928 Address: Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the LiCghsee 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) C] owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ ,AP Location:���.� No. Date 7 "� Check # 7684 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ydUd sBuilding InspectE �j V O z ft uml OMA C N O c c�_°a C.3 ac :•vo c Ea o c m.o 3 ICL Ac } � c r" Ac ID • v co r (� &A E ` Cal; � C V• o rA '•3 y r _c O y C m .O cm O �`Ey tv mo c IrC-1 ID O Cf Cn.Q c o� � m �c�i•v,0 � cxsZ o co 0 O C Q y do Q _ • m y- p fV ~ •O+ y mw~ m Z w 0 SIB ++ N d t O C Z ,.. oe �E v 10y o_ w �C L3 � g o- h aNE � O t $ m .a z 0 w w a I� ., O It co O O O v Z CL O y � C I Cm Cos 0 h O O 'E CO m CD C3 CD CL cm � O.a }- 3 O O c O Cc o a ca CD cZC. 3� 0 � c4J _ C cc _ (Y�• h ca LLI U) U) W W C9 W U) w a ch a ca � w � c� ;9 U � w a � A. o a4 C w a a W o rx c w a o rx c w" w � cA � cn ° cn uml OMA C N O c c�_°a C.3 ac :•vo c Ea o c m.o 3 ICL Ac } � c r" Ac ID • v co r (� &A E ` Cal; � C V• o rA '•3 y r _c O y C m .O cm O �`Ey tv mo c IrC-1 ID O Cf Cn.Q c o� � m �c�i•v,0 � cxsZ o co 0 O C Q y do Q _ • m y- p fV ~ •O+ y mw~ m Z w 0 SIB ++ N d t O C Z ,.. oe �E v 10y o_ w �C L3 � g o- h aNE � O t $ m .a z 0 w w a I� ., O It co O O O v Z CL O y � C I Cm Cos 0 h O O 'E CO m CD C3 CD CL cm � O.a }- 3 O O c O Cc o a ca CD cZC. 3� 0 � c4J _ C cc _ (Y�• h ca LLI U) U) W W C9 W U) P To: Robert Nicetta Building Commissioner Town of North Andover 27 Charles St North Andover, MA 01845 From: John Crawford Peachtree Development, llc 231 Sutton St North Andover, MA 01845 Subject: Construction Supervisor Change Dear Mr. Nicetta, This letter is to inform you that Michael Mammola will be our on site construction supervisor for all lots at the Peachtree farm subdivision. He has assumed the duties from Mark Venti, as supervisor, on all houses under construction including all active permits, which he is the supervisor of record. This includes 16, 41, 65, 71, 81, 105, and 124, Peachtree Lane, 12, 20, 26, and 32 Lavender Circle. Enclosed is a copy of his construction supervisor's license. Thank you for your help in this matter, John Crawford Peachtree Development, llc CC: Brian Darcy Mike Mammola Thomas Laudani Peachtree Development, LLC P.O. Box 907 • North Andover, MA 01845 • 978.327.6540 Fax/ 978.327.6544 • www.Peachtreefarm.net T BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 088997 Birthdat Q9&ffl/1969 Sid— Rgs:,0:g/.09/2007 Tr. no: 88997 12e'stEi�tec� 00 ` M104AEL V 7 SENECA ST G METHUEN, MA 01 S'4 Commissioner i I CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 457(1-16-04) Date: August 26, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON Lot #26 - 6 Lavender Circle MAY BE OCCUPIED AS Single FMil Dwelling w/2car garagie attached IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Peachtree Development, LLC PO Box 907 North Andover MA 01845 _ Building Inspector �jawerN s I CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 457(1-16-04) Date: August 26, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON Lot #26 - 6 Lavender Circle MAY BE OCCUPIED AS Single FMil Dwelling w/2car garagie attached IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Peachtree Development, LLC PO Box 907 North Andover MA 01845 _ Building Inspector z h R: 11 Q ui d. �50 �•m c CIS GG j� rn v or. q� co 'O ►.� U a .. o W z ar. cn ..0 c° C4 U g �n�.11 - E W "c r� C/) U) ui d. z 0 w w a 1 u 0 z Q u C/) r 2 O O E O O v Z O C. O y p C J ,c 0.— G3 y m m CD ZOzip% 0 p o cc o a C O C Z 0 O p. C.3 CO2 C to cc Q �C C cc J y ci 0 LLI U) W W 19 W U) �50 �•m c CIS ..I<c C O y C O ` W "c . am ca m c m EOC .� �m Ij mo $ a c E o.. 1: •Zwt a.. o r cw E CD i"• m m y .( • A. C y C y a ea SO O ^U l+ mo 'ai cm 0_..� y m omc •: o,o= C '12 o a r" y 4A: m um Z O ts C f`OA m C •QC = m N .�.e d_•' 03 vi m o �••' m ti LU •y = m 0 F— w•E C C o .0 � •y 2 o C3 m` om�� N� CL m •% o g Z 0 B� O O CL m z 0 w w a 1 u 0 z Q u C/) r 2 O O E O O v Z O C. O y p C J ,c 0.— G3 y m m CD ZOzip% 0 p o cc o a C O C Z 0 O p. C.3 CO2 C to cc Q �C C cc J y ci 0 LLI U) W W 19 W U) Date ......... !��& TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........ � .4. ..I ' r. P............ 4G - teas permission to perform ........ � ....i. ......,T r%��..� ............... wiring in the building of ............ �.�'` Q Lt!ld.................... of P at ......... ........... Vit....//.-��"..�G.........................../North do ,Mass. Fee .(..?.,... �.... Lic. No!''. Sv G7......... �� ELECTRICAL INSPECTOR Check # _�� 5260 J, TBE COMMOATWEALTHOFA ASSACHUSETTS Office Use only DEPARTNIE'NT'0FPUX1CS4FE7Y Permit No. ��() B0ARDOFFIREPREVEMONREGUL4HONS527CVB?12.M APPUCATTONFOR PERMIT TO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE D (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Town of North Andover The undersigned applies for a permit to perform the electrical'workad Location (Street & Number) Owner or Tenant Owner's Address Occupancy & Fees Checked r . FORMELE=CAL WORK JSSTS ELECTRICAL CODE, 527 CMR 12:00 J Date (�y To the Inspector of Wires: below. �i�i"M Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) (J�Purpose of Building � e.� l_ L b , Utility Authorization No.� � Existing Service Amps / Volts Overhead M Underground No. of Meters New Service 0610 Amps/,)6 Overhead r7 Underground �-� No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of LightinVFixtures Swimming Pool Above Below Generators KVA round round. No. of ReceF �cle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners No: of Ranges No. of Air Cond. Total FIRE ALARMS No. of Zones Tons No. of Disposals No. of Heat Total Total No. of Detection and Pumps Tons KW Initiating Devices No. of Dishwashers Space Area Heating KW NQ.. of Sounding Devices N6.:- %Self Contained • Detertion/Sounding Devices No. of Dryers Heating Devices KW Local Municipal Other Connections No. of *Nater Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP a •u: rl i. i.i r'•1 i •n • u:r•.•r r..l •'. • r 1.• n•ri 1. :. i .:.1 • • Flo, : • 1. l�• rl FstimatodVahJecfE ctriccaalic Wo>$ Final _ LiceJ>S % 33r 7e— LicffwNo 3J C3 ra Business Tei NO. S• ?FS y� 3 9✓e 3� �clrfixc l �C1�►`�C:1 �� ' r-=N'�— �'yl� A]tTel. No. )VVI, 2'S INSURANCEWAIVEP,IamawarethattheLicensedoesnothavetheinstuanceooverageoritsstbstantialecpvalentas1equffedbyMassactiusetisCoalLam -id that my sigma ureon this peunit applicat on waives this regirmyn t ?lease check one) Owner Agent ® �( Telephone No. PERIVITT FEE $ p( Igna ure oT Mwner or Agent The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation insurance Affidavit Name Please Print Name: 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 my employees working on this job. Company name: Address City: Phone #: Insurance Co. Policv # Company name: Address City: Phone #: Insurance Co. Policv # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to $1,500.00 and/or one years' imprisonment -as _well.as_civil..penal iesin.fheformnfa..STOP WORK_ORDER..and..a.fine_of_($1D0.DD)_aday against..me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. l do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone.# Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing E] Building Dept ❑Check if immediate response is required p Licensing Board ❑ Selectman's Office Contact person:_ Phone #: ❑ Health Department ❑ Other Location) �-t -2A, - 2t'., L o J4 t ,,-NC—YL No. ! -c.. Date !� ©-- Check # 17555 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ C7.5 C..) Cr Building Inspector 0 0 M .0 pow "1 Q M r r sumz 0 TOWN OF NORTH ANDOVER WELDING DEPARTMENT APPLICATION TO CONSTRUCT' RSP I;ENOYAT OR. DEMOUM A ONE OR TWO FAMMY VWEia M dt. •. BUILDING PERMif NUMBER 111mg 'Oft DATE ISSUED: 7011 SIGNATURE: • • Commissioner of BW Date SECTION I. SITE INFORMATION 1.1 Property Add[sss: 1.2 AsaMM Map and Pa vd Namba: L.fc,, A0, Dcrvaf`d`e 1�cac�Wvl> cks ale c a Ag CLQ 4— I.awar-ce Re,, +9� I DePAS A �0e S ' Map Numbs Paroel Number AIRA , ,MA 0 cm � SNSF2uNn en, I y`v a� 13 7.atinghdbrmatian: Irb 4e,�-IA PtapetyDimeaaia R-'� S. le �a,,.ti �� �es__��etice� i`7,SS�s•r. /03. LIS- i Zam, District Use isi Arra ft MUM d 1.6 WHDING SETBACKS ft Front Yard Side Yard Rear Yard P'ravide Provided Provided E?e 50 as' ail o - 0-S- -J5-' Q- Jo , L7VYasar sap yMQ1.(.'t4. 34) 13. Flood zomhfosmabow Zan OaWU Flood Zone 1.E- Sarmwg D4oWSysu= Maoi l 'p Oa Sk*Dbp wl Syrrarn 0 P.eblio &irate 0 SECT ION 2 - PROPERTY OWNRRSHENADTHORMED AGENT 2.1 Owner of Rand Name (Print) Address Sar service: ' She �m �� av14 Signature 'ire 22 Owner of R000rd: Now Print Address for Service: Si re Tat hone SECTION 3 - CONSTRUCTION SERVICES Cu r: 3.1 Licaeacd Coastrrietim Sup -h Not Applicable 0 pwnt J. 1 CS / Liceased Coasmwtion Supervisor b 1 iaaseNtrmer �lM� �� Ic S+ t �y bC)ZAJ MI -T Address 6,76) / b `/B c/ 3745Ya EV n Dale Si Telephone .2 Registered provoment Contractor Not Applicnbk 0 Com Nam try Registration Number Address Expiation Date Signature Telephone M .0 pow "1 Q M r r sumz 0 Werkws Compensafm Imsumm affidavit must be eoaoeted and submitted with this aponawn. Fanuoe to pmvkto this affidavit win result LD the donial of the issttanoc of the bw __ _. Sped affidavit Aftacbed Yes ...... 0 'No ....... 0 SIMON S Descri •t Pro .. ' Work drCdcalf New Cwsiiuetion Existing Building 0 Repair(s) ❑ Alcetations(s) 0 Addition ❑ Accessory Bks. ❑ Demolition D Other 0 Specify Brief Description of Proposed Woric !r �7 1/r/1 11 ,T1y1 I .ONl71K-u�.N Sly' IC ,K�M.i 1 'Ni�� . SECTION b - $STD"TED CONSTRUCTION COSTS .- Item Estimated Cost (Dollar) to be Cgodod ty PMmit Mucant I. Building b5 (a) Building Permit Fee ' 'er Mul 2 Electrical Q (b) EstimAed Total Cost of $ v �� 1 COO Conan oa 3 Plumbing. Building Permit fee(,'b) �� o ooO 5 FuePotec" AC 57b 6 Total 1+2+3+4+5 3 00 a 4OW, 176 1 Chock Number SECTION 7a OWNER AUMOMATIiON TO 1313 COWLET" Wlaitiv OWN133t5 AGENT OR CONTRACTOR APPLIES F oR suiwi NG IPxRI►!IT L \A_) C2,gW � , a s6svnerlAuthorized Agent of subject property Hereby to act on My behalf, in relative to zirzed by this building permit application./ � s- t� Dater SECTION 7b OWNNEWAUTHORMD AGENT DECI.ARA71ON ,as-Oww/Authorized Agent of subject P VpMtY Hereby declare that the statements and information on the foregoing application are true and ac=*e, to the best of my knowledge and belief Si c of Owner/ ant Date Kb. '()F'STOMS a Y& ' 9 s -t^ BASEMENT OR SLAB SIZE OF FLOOR TI1viBERS l i I'/ " 4 -st 2 J '%g'' T, st 3 (5),10 971st SPAN. Vat e /71" L ti MENSIONS OF-SILLS a x 6 ? i DIMENSIONS OF POSTS Vo,-se' (See P/a-,- A-- S,'ze a-d /oea46,, DMNSIONS OF GIRDERS Vaeie5Ci-VL lea,+,s Sec ,., lu a, S,-2e ad /oec-Av-� HEIGHT OF fOUNDATION ? - 9 „ TMCKNESS /0 SIZE OF FOOTING /U " x o>v MATERIAL OF CHRANEY me&/ IS BUIIDDING ON SOLID OR FILLED LAND So /1 V IS BUILDING CONNECTED TO NATURAL GAS LINE Yes ' 0 PeackM:J*� Q �A **** NOTE **** Application is for a foundation permit only at this time. Application is missing sprinkler plans and certified foundation plan. Sprinkler plan and Certified foundation plan will be provided for review prior to issuance of a building permit. Peachtree Development, LLC P.O. Box 907 • North Andover, MA 01845. 978.327.6540 Fax/ 978.327.6544 • www.Peachtreefarm.net lAl WO z CL 5 0 a CD GO ca CJ E = CD CL. Mr - cc A cc =CD o a C/)'� E m o N oo. H y cn O SO s a3 .e-; O CL C N (n •r.■ •Cc 0i rc C C O 3 w U y :C H py � CLcm3 I.: c m CO O La $ o C',CL W •— o or v CD3 NZ 0 M 0 cc c o � I • 0 d C _ o 0 o S C H .Sm C40c = o LU •vii az Lu vJ O N■n m� �90 ~ = ena�ti� O �- zv Sam 3� O 0 L O C:' CL. cm< � C O 'O O Z CL w H C 4 .J v C O U) 19 W uj 19 ulW U) � � ,v O xcn W W a O v, a o w o w cqi w w U w" p°G d c7S w a°' w Aa cn cn z CL 5 0 a CD GO ca CJ E = CD CL. Mr - cc A cc =CD o a C/)'� E m o N oo. H y cn O SO s a3 .e-; O CL C N (n •r.■ •Cc 0i rc C C O 3 w U y :C H py � CLcm3 I.: c m CO O La $ o C',CL W •— o or v CD3 NZ 0 M 0 cc c o � I • 0 d C _ o 0 o S C H .Sm C40c = o LU •vii az Lu vJ O N■n m� �90 ~ = ena�ti� O �- zv Sam 3� O 0 L O C:' CL. cm< � C O 'O O Z CL w H C 4 .J v C O U) 19 W uj 19 ulW U) Z z H g CA O u O U 0 ami �c c L- m Q1 -.,e O NA c .3 o tm tn2 u aj Q' o c a� E� o a, CL o i c ga 4 w m O m� Gl u 0! c • t3� Ic My II�w vI W. W W 19 W U) (A LLJ V a W H N Z z H g CA O u O U 0 ami �c c L- m Q1 -.,e O NA c .3 o tm tn2 u aj Q' o c a� E� o a, CL o i c ga 4 w m O m� Gl u 0! c • t3� Ic My II�w vI W. W W 19 W U) PEACH TREE DEVELOPMENT, LLC 1706 8/16/2004 Town of North Andover Date Type Reference 08/16/2004 Bill C Cash Danvers Lot 23 Bldg. Permit Original Amt. Balance Due Discount 305.00 305.00 Check Amount Payment 305.00 305.00 305.00 FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits frorr, Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from ..compliance with any applicable. or requirements .----FF `APPLICANT FILLS OUT THIS SECTION******-* APPLICANT_ E ar.:htree- '1� I lop menf LLL PHONE 9�S &M - (ofLJO Sce p lar ti: i950a QS reUJrJed LOCATION: Assessors Map Numberai fit¢ )i> renc15Tt� PARCEL__ SUBDIVISION_PC"i111 e3� �rarm \ll LOT (S)_ STREET ST_ NUMBER ***.OFFICIAL USE TIO ATION AGENTS: DATE APPROVED ' Q DATE REJECTED COMMENTS Z Z—/ ` '} -DATE APPROVED DATE RIJECTED. T FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED. DATE -REJECTED COMMENTS PUBLIC WORKS - SEWERAIVATER CONNECTIONS Gyres DRIV W Y P RMIT FIRE DEPARTMENT Com - RECEIVED BY BUILDING INSPE Revised 9197 jm 6' -ZS