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Miscellaneous - 236 GRAY STREET 4/30/2018 (2)
BUILDING FILE f' Date . TOWN OF NORTH ANDOVER F PERMIT FOR GAS INSTALLATION This certifies that has permission for gas installation . in the buildings of. . e t . S at . . . ;. 3 6. • V^!• • • 5 T : . . . . . , North Andover, Mass. Lic. No. .J.Q?.?. . . . . ;6� . . . . GASINSPE TO Check# COYY/S/vSy y� 8806 `- MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY .p��1`th(,1c1i_>,0t/ MA DATE �I"�'� II PERMIT# JOBSITE ADDRESS OWNER'S NAME 16 OWNER ADDRESS -G� - _ TE 7 ^ B 33-OS 1`J �FAX TYPE OR OCCUPANC TYPE COMMERCIALS EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: __. RENOVATION:0 REPLACEMENT: PLANS SUBMITTED: YESF--] NO D APPLIANCES Z FLOORS-- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE .-.- . DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR _ �_ FURNACE I 1 --_J �-1 - -- �� - - —� } ._.--- - ...... GENERATOR --:1 I _ _�I _- -1 GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNITz. _ , . J - . I OVEN -�, — POOL HEATER ROOM/SPACE HEATER = - . T I = - --:. - n - - - _ . I _ . ROOF TOP UNIT TEST v n r u UNIT HEATER _ C�- -- UNVENTED ROOM HEATER WATER HEATER OTHER —__ I INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent ich meets the requirements of MGL.Ch.142 YES J..._ NO 0 1 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY 0 BOND --_I 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 0 AGENT 0 SIGNATURE OF OWNER OR AGENT 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 co 'a ce with all P inent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME '-' �0r GolSLICENSE# Da -( SIGNATURE --� MP 01 MGF�� JP � JGF j LPGI CORPORATION[�J# =PARTNERSHIP 0#=LLC 1#=._ -._._______II COMPANY NAME: I-1 _#. A�xSADDRESS oZ CITY C-eSTATE ZIP T E LF V-360Y- �0 -(aYD{P _ FAX CELLEMAIL ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES ,Lf?A L9 Vz AK j The Commonwealth of Massachusetts Department of IndustrialAccWnls Office of Invesdgations 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: City/Sta�Zip: (� w rr.A t_e A4 A D( Phone M ;7 L�, ` (o f 3" 2�� Are u an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. �• F1 Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a 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 12.❑Roof repairs insurance ]ired.re q ut employees.[No workers' 13.�ther 9aao� comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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 thepolicy and job site information. Insurance Company Name:. 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 requiredunder 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 herebycertify under the pains and enalties o er•u that the information rovided above is true and correct. .1Y P P .fP I rY .� P Simature: Date: Phone#: 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 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - Contact Person: Phone#: 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 ofpublic 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 oflndustrial.Accidents Office of Investigations 600 Washington Street Boston,M.A,02111 Tel#617-727-4900 ext 406 or 1-877,7MASSAFB Revised 5-26-05 Fax#617727-7749 wwwxnass.gov/dia Date �+ TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING SACMUS ! This certifies that . . . . . . . . . . . . . . . . . . . . . 3 has permission to perform . . . . . . . U. -s. . . . . . . . . . . . . . . . } plumbing in the buildings of .7.s-.�mar. �.� . . . . . . . . . . . . . . . at . . . . . . . .r. North Andover, Mass. Fee.�" .Lic. No.. . . . . . . . . . . . Z � PLUMBING INSPECTOR 3 Check # 661 ? MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Building Location C�� f 23Co3/S� Owners Name �- Permit# Amount Type of Occupancy �P5 . r 7 New Renovation [3Replacement Plans Submitted Yes No ❑ FIXTURES i pS�� i` B4SE R �d,1 FI�lli 41H R" SII3 FIaR 6M FL" 7M FMM SIH FIDQt (Print or type) � L '( Check ne: Certificate Installing Company Name c—Am- > o/<<, J v�<<���,. � f t'1 orp. C��®' "� Address "en'n7 !'war Partner. Business Telephone Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the type -insurance coverage by checking the appropriate box: Liability insurance policy [3 Other type of indemnity 11 Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issue - r this application will be in compliance with all pertinent provisions of the Mas c etts State PI n o e and C f the General Laws. By: SignaEllre 01 Mcensea Type of Plumbi ense Title oocz City/Town License NumDer Master Journeyman ❑ APPROVED COFFMCE USE ONLY aoS8 Date..... ......................... 4,6 - TOWN OF NORTH ANDOVER PERMIT FOR WIRING US This certifies that ...7.......4 ...................................................... has permission to perform ......JY. ... ............................................... wiring in the ................. at..C..'u'l....... ............................. .North Andover,Mass. Fee.�W. ...... Lic.Nd/.p ..... .... ELECTRICAL INSPE OR� Check # �'�'pveucsY Permit No. " 1 BQARDOFFIREPi�cvENrMRracill,4T�0 -waa,a.w _ev Occupancy&Fees Checked APPUCATTONFOR PERMITTO PERFORMELEcnuC,A.L WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACMJSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 4' —Z Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street dt.Number) a & C,> 5+ Owner or Tenant �-�' Owner's Address & ►'t Is this permit in conjunction with a tuilding permit: Yes No ED (Check Appropriate Bos) 1 Ol�l I a3 Purpose of Building •J) &1&,) 0 W t„t n:.g Utility Authorization No. Existing Service Amps Volts olts Overhead a Underground a No.of Meters New Service 2-0 0 Amps j�olts Overhead =] Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hat Tubs No.of Transformers Tota KVA No.of Lighting Fixtures Swimming Pool Above BrounAl Bei (kerreratora KVA 171 No.of Receptacle Ou" No.of Oil Burnera No.of Ernersency Lighting Battery Units Noe of switch Outlets U No.of du Burners No.of Range No.of Air Cad. / FIRE ALARMS No.of Toms i Tau G No.of Disposals No.of Haat Total Tota No.of Detection and Pumps Tons KW laidating Devices No.of Dishwasher Space Area Heating Kw Na of Sounding Devices Na of Sem Canuined DetxdaJ3oanding Devkea No.of Dryer ( Heating Devices Kw Local r-1 Municipal O " ConnectionsNo.of water Heaton KW No.of No.of Signal akasis L L No.Hydro Manage Tabs 1 No.of Motor Total HP S rre OITIER- v TP b► C, bJ==C0YW#tF,l�entbtllert�ier�de�Ga,®llaws a Iha eaaslmtlmtr*hst =FckirJud V or�s>l�rrider}ivalmt YES NO llnves hnftdv&ptoafaf=W1DdZOffi=YES ryouhmed,eaWYMpkmni aledztypeafW%mrby d EY BLRANM BC11m n ama WOWDStat —�� lilspeciirnDateRet}resod Rath E�n�dVaileefl1m"WadrS .a 5gndurld°r Piz�afpajiay►. Fuld FMMNAME1 LimwNa .VI I4!(9 G r;tee i c �cy� soman Iaoe,M � BuskzzTdNa -X7 -ICI&F Addm _B<-- )i N7 C l-V' J IQ 15 1, 11 Q Y 0:5--f 114 001 L24 ALTUNm WS-Sas aW?�WSIlV,AJRANIEWANFR;1anawaedN1dieLiaenie nth diens==wva*arise rid egivalffltagwgAedD m r.-I,"Lam ardd-airVsgiatnecrift--IS'LappicmLUVMV%sfig rat (Please check one) Owner [n Agent Telephone No. pERMff FEES �/ DI�1R711�V!'URPUB�'SAFSIY Pt;rtnie Na �`$ aOccupancy st Fen Chedod r—� APPLICATIONFOR PERMITTO PERFORMELECTRICAL WORK AM wolM TO BE MFORNIM IN MXORDANM WM THs MASSACH &M BL6MEAL,CODB,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date V -1 S Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. E Location(Street d<Number) Owner or Tenant Owner's Address (s - d is this permit in conjunction with a uilding permit Yesrl No E3 (Check Appropriate Box) �=ta a3 Purpose of Building W ck V13 Utility Authorization No. Existing Service Ampa..L..V olts Overhead Underground No.of Metes New S200 spa I /2 Nolts Overhead UwWg ound No.of Metes Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Na of L3a11drta Outlets Na of Hot TWO Na ot7tsostorrnws Total KVA Na of Uabdug Fixtures Swbnmina Pool' Above Below Osmatots KVA Na of Receptacle outlets No.d OH Burners No.of Broeraeaq L1Otina Battery Units Na of switeb Outlets No.of Oas Homers No.of Ranaes Na of Air Cond Tam l7 FIRE ALARMS Na of Zones Ton No,of Disposals Na of Had Total Totd Na of Delectim sad rams Tons Kw faidating Devices No.of Dishwashers Space Ams Heaft Kw Na of Souodlq Devices Na of self Combted DewW Devices Na of Dryers Hestina Devicss KW Load Q o CMMK*= C3 No.of Watts Heaters Kw Na Of Na of Sim dissis C No.Hydro Mwsae Two Na of Motor Totd HP L0 05 rYr7~r . Itt9t�1C7rQXWP Pala WeDd a afMaWd C3tomlLiRu IhaueatiaertI�nlriyhaamaei�fiy (�ar�iet�ra�iars trema Ytxliiwient YES NO irs zhTiWdvddpWc(n=tofleOfflZ Y$4 1�—�Jf ityour uec�edsdYBS�pt'arna�lebetypedeot�bjr nw* Y1 j c� WclklD,ad 2,dk*14') Rot* EstiQis�dVAzd mftWb&S 5Vmdtnder Pres ft43fp10W Air ERtMNAME �'' 1^' Lic=Na o l ,me l r�► Rc A Y LiomreNo �' ( r �1^1 eusioesTblNa - 1 � !21 2 -S o - OWMCSIIVSCIRAIN<SWAM ;lama #ntfieLimbe hmtcisumoewwwporbaboAdW4ultagmpWtopMmd>tsdbCnjWLHN arddtrtmp+siBierreonfiapmrii<�picabrvi�i�tite4ie�t (Please check one) Owner Agent Telephone No. Pte 'FES s 5L2v © �� .- �-- 3� , oma-- /�r,,� Location No. Date �oRT� TOWN OF NORTH ANDOVER 3 Certificate of Occupancy $ s i T ` ,qc us Building/Frame Permit Fee $ r Foundation Permit Fee $ 3 Other Permit Fee $ TOTAL $ Y'Lf 9 a Check # l 'I 18415 -0' Building Inspector NORTH Town of Andover 0 No. over, Mass., —#2 3 0 LA '0 . CHICHEWIP RATED Is WARD OF HEALTH Food/Kitchen PERMIT T Di. Septic System THIS CERTIFIES THAT......4*W)AII!��...... ..........aT I' BUILDING INSPECTOR ... .. ........................................... Foundation has permission to erect........................................ buildings on..X kf 4W 4".Y......a*.......... Rough to be occupied as1A"MSR. A.0^j.' stall 04081,#r 3 /0. X4P4#&4W#& Chimney ... ..... ....................." ........................ ........................................ provided that the person accepting this permit shall in every respect conform to the terms o the application on file in Final is office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings In the Town of North Andover. /40 7 P/ PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough .......................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Ocmpy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Date. .IVAI A,2:... .. . . Of`HORTM ,41 (/ 34. � 6 TOWN OF NORTH ANDOVER FO P 41 PERMIT FOR GAS INSTALLATION SS,f HUSEt _. This certifies that . . . .. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . .C u. .��``���-.. . . . . . . . . . . in the buildings of . . r.{s !� !: .�.�. . . . . . . . . . . . . . . . . . . . . . . . . . at r .�. .C � . CZ. . �.`. . . ! . . . ., North Andover, Mass. Fee.,:'. : . . . . . Lic. No/.Z fc. . . . . :: ,--� . . . . . . . %`GAS INSPECTO r Check# 1 MASSACHUSErIS UNIFORM APPUCATON FOR PERNffr TO DO GAS FTFrING (Type or print) Date NORTH ANDOVER,MASSACHUSETTS Building Locations — 4MCr 36 Permit# 1 Y V Amount$ 7 J Owner's Name O New Renovation ❑ Replacement ® Plans Submitted ❑ I w o �, N z c a z Z o H w � a � E~ a GCw7 F z C O U O ai .z� ppqq O P A C�7 a U a w H p SUB -BASEM ENT 1 B A S E M ENT i 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR STH . FLOOR "v (Print or tyke) Chec one: Certific jnstalling Company Name��C�i s�o,/y4� c1 S c� ``��r' FrCorp• / �G Address 's- ❑ Partner. (13 us,nessTee one �• 2C� C, S ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked yes,please nidi to the type coverage by checking the appropriate box. ❑ Liability insurance policy Other type of indemnity Bond 1:1 Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Ch ter 14 a eneral Laws. Signature of Licelumber Or Gas Fitter By: Q Plumber � Title City/Town ❑ Gas Fitter License Numner sten APPROVED(OFFICE USE ONLY) rneyman NMTM •� LTi CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 703 (,5-23-2005) Date: 12-13-2005 4 THIS CERTIFIES THAT THE BUILDING LOCATED ON 236 Qmy Street MAY BE OCCUPIED AS Single Family Residence 9 room, 2 2/1 bath, 3 Stall garage under IN ACCORDANCE WITH THE PROYISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHE1,REGULATIONS AS MAY APPLY. Certificate Issued to Litchheld co 26.RU Ave -B&Iijaeton MA 01803 Building spector C NORTH own of s 4 over No. 703 MW s4vep Aw lo` -= o dower, Mass., 3 'a o = A. A- COCHICHE W ICK lf�qo 7�ADRATED APS` `S BOARD OF HEALTH PERMIT - T Food/Kitchen Septic System THIS CERTIFIES THAT...... /I�iti ASC • BUILDING INSPECTOR 1`................................. ..... ............................ . . 10 ............... Foundation has permission to erect............... ........ buildings on..x �L . .. a*• ........ Rough..Iq to be occupied as.q..��.!'�'��. . .�A�lt.3..Sf ad v44#&r.... s N ct.jik...Rv a10��!bt'�► c y provided that the person accepting this permit shall in every respect conform to the terms o the application on file in Final rr this office, and to the provisions of the Codes and By-Laws relatin to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. /Q 7 ,D � PLUMBING liiSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough �:a r✓ -r3r '� :'�- /�l� rt''6i.t ........................ Service BUILDING INSPECTOR Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove RR a No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner street No. Smoke Det. SEE REVERSE SIDE l ilf7 t p Town of North Andover «toile ! Building Department "�a�,. " 400 Osgood Street North Andover MA 01845 978-688-9545 Fax 978-688-9542 APPLICATION FCS_R,C IST FI(;ATE OF 0CC PA 4 /INSPECT C)t� ADDRESS/LOCATION OF PROPERTY : DATE REQUESTED FILED/READY FOR INSPECTION._ _ 1Z 14aS 4: .....«.... CLOSING DATE ON PROPERTY:_ FIVE 1§1 P1 ,YA NOTICEPRIOR,TO,CLOSING D ,_TE 18 REQUIR_ED ALL WORK AND SIGN-OF S MUST BE CO!�PLETED WITHIN THUS TIME F F� E. A RE-INSPECTION FEE OF TWENTY DOLLARD $20,00) WILL BE CHARGED IF 1E STRUG E DOES NOT MEET ALL APPLICABLE CODES. f Signature 1 U - QEFICIAL USE QN rrrrrrrrrrrrrrrrrrrrrMrrrwMrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrri ■ rrrrrrrrr ROUT!�LG D.P.W. -WATER METER DATE 1 I I /c) D.P.W, MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED IOR TO THE INSPECTION REQUEST DATE. IGNATURE/D W AUTHORIZATION APPLICATION CEATIFICATO OF OCCUPANCY reWited 11.16,2004 Date. MORTh d 3=��� �o L TOWN OF NORTH ANDOVER FO 9 • PERMIT FOR GAS INSTALLATION �,SS^CHUSE�t This certifies that . . . . . . . . . . . . has permission for gas installation_. *.> ri-•p-��!t'!^-- �:..- - ! in the buildings of Y. . •.�. . . . . .lam . . . . . . . . . . . . . . . . . at -3 � . . -� . . . -.�. ., North Andover, Mass. Fee-��-d'. . Lic. NZ/)'A� � ... . . . . . . . . Ej R Check# L7` C3 5316 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) Anal Mass. Date Q� City, Town Permit # Building n Owner 's zo— AT: Location, (p Grow + Name SW Type of Occupancy: & ,&ncL New Renovation ® Replacement ❑ Plans Submitted Yes ❑ No y N W (� ) N N V z x N J N OC N O f/9 W m Z VD W W W O U k- � z ® W ►- a � Z H W e W ® z W O a O W H O O W d _ N O > W 1 W y�j N J Z Q Y a W W W W F Y q z a W d Q Z &�• �W O O > It yr U J H W Q W >" W O 2 Q W Q O O W W O W = s o c7 z w M 3 o a� 00 W > a °a F_ o SUB—BSMT. BASEMENT ISTFLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6THFLOOR t 7TH FLOOR 8TH FLOOR ,, (Print or Type) Check One: Certificate Installing Company NameH( 19 Corp. 'y Address Q I -I.IP I rI �-�- ❑ Partnership ❑ Firm/Company Business Telephone �" T 1' Dame of Licensed Plumber or Gasfitter I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. I Signature of Owner/Agent I have a current liability insurance policy to include completed operations coverage. ❑ By - TYPE LICENSE: Title ❑ Plumber Signature of Licensed City/Town Gasfitter Plumber or Gasfitter APPROVED (OFFICE USE ONLY) ❑ Master 4�_s ❑ Journeyman License Number BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. APPLICATION FOR PERMIT TO DO GASFITTING NAME& TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED DATE GASINSPECTOR The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 < www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le, gibly Naive(Business/Organization/Individual)' O 1 L /NG' LAddress: City/State/Zip: t��l4 L3 c� rJ / � �1_ ,Z12 Phone#: Q.ZL- S3�' Are you an employer? Check the-appropriate box: „Type of project(required): 1. I am a employer with ,}55 4. ❑ I am a genepl contractor and I 6. ❑New construction employees(full and/or part-time).* have hued the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet I ?• ❑ Remodeling 'Riese sub-contractors have 8. ❑ Demolition ship and have no employees . workers'compinsurance. working for mein capacity. 9. Building addition o workers' comp.insurance 5. El we are a corporation and its officers have exercised their 10.❑ Electrical_repairs or additions required.] I1. Plumbm r airs or additions homeowner do' all work right of exemption per MGL ❑ g repairs 3. El I am a >� c. 152,§ ( ),anwe have no 12. myself. [No workers comp. 14d h ❑ Roof repairs t employees. [No workers' nce required.] 13. Other insura eq ] - ❑ comp.insurance required.] *Any applicant that checks box 01 must also fill out the section below showing their workers'compensation policy inforrnation t Homeowners who sabmit 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 attacbed an additional sheet showing the name of the sub-contractors and their workers'cmp.policy information I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Instance Company Name:uiNotFsIR�-T,�rL iS'tJ,eP��cs Com���s >�`�� Co.,o ' -- �l T �u o fv �aoo Polig#or Self-ins.Lie. #: _1i(1C , d 4! Expiration Date: D! d City/StateMip: Job Site Address: - - . showin h oli number and iration date). 1 'on a e t o a co of the workers com 'enation policy dec arab p g ( g p cy exp ) Attach copy P 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 1he 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 penahies of perjury that the information provided above is true and correct. Si®ature• �� Date•. Phone#• K 7k' 581-,29S-1 Offxial use only. Do not write in this area,to be completed by city or town official City or Town: Permimeense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CitylTown Clerk .4.Electrical Inspector 5.Plumbing Inspector 6.Other Location ��� �3 r`J y Sf No. /G3 Date S'oZ r!-OS- TOWN OF NORTH ANDOVER O • os Certificate of Occupancy $ ,sJACHU Building/Frame Permit Fee $ „ Foundation Permit Fee $ o Other Permit Fee $ TOTAL Check # 0725 25 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIX RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING so Tl* offim. BUILDING PERMIT NUMBER. DATE ISSUED: X 17P,3 5--,.2 3 70 SIGNATURE: Z�llw Building Colnmissioneffl or dBuildings Date z SECTION i-SITE INFORMATION O t.I Property Address: 1.2 Assessors Map and Parcel Number: Lot #8 (236) Gray Street 107 -D Lot #5 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: W R2 Single Family House 133,400 51 Zoning N;_&c_toposed Use Lot Area Fronts 8 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard ReqWred Provide Regaired. Provided Required Provided v 1.3. Flood Zone Information: 1.8 Sewerage Disposal System: 1.7 Water ly M.G.L.C.40. 34) Zone Outside Flood Zone IX Municipal ❑ On Site Disposal � System Public Private ❑ '�` U SECTION 2-PROPERTY OWNERSHPAUTHORIZED AGENT " —a O M 2.1 Owner of Record Litchfield Inc. 26 Ray Ave. Burlington, MA 01803 "I p1 Name(P ` Address for Service: ]�► �-- fj Signature ool4r Telephone 2.2 Owner of Record: � A Name Print Address for Service: 4 � Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Joe Currier ^^ Licensed Construction upervisor: 26 Ray rAv/ie/. Burlington, MA 01803 License Number -n Address f; , r F �.�- ----- 617-839-2362 Expiration Date Signature r. Telephone 3 f1 Registered Home Improvement Contractor Not Applicable ❑ (bmpany Name M Registration Number �aass r Address OWNS, z Expiration Date G) Signature ._ Telephone v SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes....... No.......0 SECTION 5 Description of Proposed Work check an a bk New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: New Construction - Single Family Home, 4 Bedroom, 2 1/2 bath, colonial - C ' pool S, C2 Ila 434 tks Sia wto r- SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building $40,000 (a) Building Permit Fee Multiplier 2 Electrical $10,000 (b) Estimated Total Cost of L/n Construction 3 Mechanical PlumbingBuilding Permit fee(a)x (b) 1 �� 4 Mechanical HVAC $12,000-- - 5 Fire Protection / 6 Total 1+2+3+4+5 $74,000 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT L Gary J. Litchfield as Owner/Authorized Agent of subject property Hereby au Joe C ri r to act n My behalf, m r o a � d by this building permit application. Sid nature of Date SECTION 7b O ER/AUTHORIZED AGENT DECLARATION r\ I, d Q �0 2(Zc 2n as Owner/Authorized Agent of subject property 4 Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief r-y"zt � Print Name f�' - �-- U Signature of O er/.4 ent Date NO. OF STORIES Z SIZE atF/ BASEMENT OR-664t3 SIZE OF FLOOR TIMBERS 'Z 'F c co ] Z f o 2' `F 12J 3 SPAN ( ' DIl,IENSIONS OF SILLS P - SIP DD ENSIONS OF POSTS 441 Y 1 DIMENSIONS OF G.MDERS Y'r Z HEIGHT OF FOUNDATION i'— THICKNESS Cc SIZE OF FOOTING (C) X z o MATERIAL OF CHIMNEY N ro- 1S BUILDING ON SOLID OR FILLED LAND 5. !r IS BUILDING CONNECTED TO NATURAL GAS LINE -(LJ r • FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION APPLICANT r � I� �. r"�� • PHONE ��/ �G•G�,�� LOCATION: Assessors Map NumberjA:E Number : E PARCEL/6 SUBDIVISION LOT($) STREET ST. NUMBER OFFICIAL USE ON-r** MM 10"IAMFTOWN S: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS T IQ PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD IN7?ECTOR-HEALTH DATE APPROVED DATE REJECTED SE01C INSPECTOR-HEALTH DATE APPROVED 2 DATE REJECTED COMMENTS �/ i c�-�-r7 /^ a ,z PUBLIC WORKS-SEWER/WATER CONNECTIONS 57- DRIVEWAY -DRIVEWAY PERMIT ': FIRE DEPARTMENT fD 64t or* �( eT(-cI!r�'e,� (-r-- � s �71,0 RECEIVED BY BUILDING INSPECTOR DATE RevIoW 9107 Jm 05/17/2(05 TUE 16:40 FAX 17812709406 Litchfield Company. ��4 NO. ANDOVER TRAILER 2001/001 " .1 ✓/ce"(9vonmzo�au�.a.�o��i4(.a.Qdac�uc6e��6 BOARD OF B.UJL ANG-REGUI:ATIONS s, Wcense: CONSTF UC'f10N Sit tRMSOR NumpeC Vis:.. 066839 B►riti K'l.�a (968 pieif"I t)�AS� jS5 Tr.no: 6738.0 Re," JOSEPH P MAIN � I I I GRAM) M FID BukuNGTi;N, MA 01$03. Atlmii►isfr�fot i is S $nand ut Ruilding Itrgulalians and Standards HOmE iY7 VEMENT CONTRACTOR ! 93C2 i vidual j'. JOSEPH P CUR'). JOSEPH CURB; 4! ; i CRAWFORD R I BURLILNGTON.r:4-,r,g' administrator n y Y Ta vu of North Andover planning Board Thi form represents the schedule for allowing the following lots to be considered as eligible for WE ding permits under the Town of North Andover Management by-law Section 8.7 of the zoning by aver. Pursuant to 8.7 this Development Schedule must be filed in the Registry of Deeds and be refs cenced on the deed of each of the lots below and be filed with the Planning Board prior to the isst ance of any building permit or permit for constriction, Naa ze and Address of Applicant for lots: Name of Development: Lk:hfieId Co., Inc Garay &Boston Streets 26:tay Ave.,Burlington,MA North Andover, MA. Ma) and Parcel of Ori inal: 107D, Lots 6& 10 Dat-.of Application for Lots Division: March 25 2003 Lot i Covered by this Schedule 1,2,3,4,5,6 7,8,91011,12,14,15 15 total) The Planning Board by their signature below, or a signature of a duly authorizes representative, do her,:by establish for the above named development for the following Development Schedule for the pur.3ose of Section 8.7 of the Growth management By--Law. The applicant,their assignees, suc lessors and or subsequent property owners shall confirm to the following schedule that limits the elig ibilxty of the following lots for building permits. This form must be filed in the Registry of Dec ds by the property owner or representative and be referred an each deed for each of the foll)wing lots. Such deed references for the deed of each lot shall at minimum reference the book and a in which this development Schedule is filed and contain the language;This lot is subject to P� P .� a D welopment Schedule pursuant to the Town ofNotth Andover Zoning By-Law; "This lot is sub ect to a Development Schedule pursuant to the Town ofNorth Andover Zoning By-Law all ow.vers,representatives,and future purchasers should avail themselves of said restriction by rev ew' the.a roved Develo meni Schedule as filed in Book and Pa e � pP p g Th( fact that a lot is eligible for a building pennit is subject to the limitation of the number of bui:ding permits per year pursuant to section 8.7.2d of the Zoning By Law." Tht Planning Board hereby schedule the lot(s) for the above development as follows: Num_borr of lots Building Office'Use Building Office Use Yea r EligibleEligible Date Lot Eligibility otes Completely Utilized Fisc al 04 6 Fisc al OS 6 Fisc at 06 2 10/15/2004 FRI 10:17 [JOB N0. 74411 [omni y a .-,VjV".v Ory y,•�t?:-^North DIaWd • - + - - '{ ••i.j�s ',fir:+'� r �• &gnature o g Board me r or Authorized Representative Date: 9 1��YA� S gna a of rty O r o d Re r entative Dater �G COMMONWEALTH OF MASSACHUSETTS ' ss �.J� _._,207 I hen personally appeared �toe as�the Applicant or his/its authorized agent and a:lrlaawledged the foregoing stns her free act and deed and the free act and deed o f the Applicant,before me. atis \X��IIIIIIIIII, Yrission Expires• , d o• M' Fj�r ay. M. COMMONWEALTH OF MASSACHUSETTS �� •-CeNQ G ss t �� _, 20 ell;o/1Ri1p11��1` 'hen personally appeared s U�� � the Planning Board Chair or his/its E uthorized agent and acknowledged the foregoing instrument to be his or her free act and deed and t ie free act and deed of the Applicant, before me. Notary Public My Commission Expires: MARY LEARY4PPOLITO Notary Publk Commonwealth OF Mossachusaits My Commission Expires June 7,2W7 10/15/2004 FRT In-17 r Tnn rrn M A i+ I n. i rOCT-29-2004 04:40PM FROM-MICHAEL T. STELLA SR,P.C. +9766635396 T-390 P.90i/003 F-919 T oith Andover Office Of the Flamminc, Depaxtment in f_-'orau-r¢-u-nf17 Development and Services Division 27 aarles Street or Andover, I�Izssaclau.seil#s 01•$45 h=.: v�Li�vvw.-townofizortli ind.over.com Pla g D rector: ,�, � ; F (978) 688-9555 . wood 9@-,'Owno-rriolrthanclovei.com t. y�. Jusa.Woods F (97,S) 688-9542 r, r tvsp-nty{24)days ! �' c3a.tc ofd cislon,filed...,......•,. NOTICE OF]DECISION � date -- SENT USPS VIA CERTIFIED MAIL �1td RE1'URN,RECEE"REQUESTED ' � _��, l Lai... .. ^�- =;. --',�-- f ;1�? Stella Realty Trust DI–Lots 8 and 9 Gray Street Special Permit Approval–Frontage Exceptions o The public hearings on the above referenced applications were closed by the Norrb Andover Planning SoArd on P'sbruatrr 18, 200a.Present were Planning Board Vice Chair•Alberro Angles,Clerk#tichard Nardella, Mennbers Felipe Schwarz and George White,Associate Member James Phinney,Plann�ng Director J. Justin Woods,^.rid Planning,assistant Debbie Wilson. Attorney George Stella and Joseph Setwatka,P.P.,appeared on behalf of The.petitioner. Nardella made, and White seconded, a motion to grant the Frontage Exception Opecial Permits to-,allow accts to ropcand Lots 8 And 9 on Gray Street thmt do not meet the frontage #nd width rcgatir�iinent�' reejeni. e,0 by Section 7.1.2 and 7.2 of the North Andover Zoning Bylaw. This Special Pertrit was re6dested"' by the Mary Stella Fealty Trust 111, 162 Gray Street, North Andover, MA 018.43. The original ap�lic"ation;ccl�' excluding Tevi sed documentation, as cited herein, was (tiled with the Planning Boar on November 1Q,=i002, with subsequent submitrais on file. The applicant submitted a complete application' which was noticed�a>nd 0 reviewed irk accordance with 7.22 and 10.3 of the Town of North Andover Zoning;ylaw zind NIOL Chapter �� 40A, Section 3. The motion to approve was subject to the FINDINGS OF #'.ACTS and SPFCI:A L CONDITIONS set forth in Appendix A to this decisban. �'�;-; ,- The Pla.nniag Roar€l voted on the motion by a vote of 5 in favor to 0 against. AJpeciai permit issued by a ii. gr � special p,,n granting authority requires a vote of at least four members of a five-member board. See MGL Cha)R ev; 40A, SeM?lon 9 and Section 10.3(5) of the Town of North Andover Zoning Bylaw. Accordingly, the Appiication:i for the Site Plan Special Permit is approved with conditions. The appi.Ac>.�4 is uereby notified that should the applicant disagree with this deei0on,the applicant has � the Ttht,under MOUL,Chapter 40A,Section 17,to appeal to this decision withini�venty clays after the w date this dec-ASion has been filed with the Town Clerk. II i Res t'Hly Submitted: I �� 1 `� f' Woods,Planning Director for the Nomb Andover Planning Boar, : Voted: John Simons,Chairman 5 -N—Absr_N/A Alberto Augles,Vice Chairman Y N A•bst N_ /A Richard Nardella, Clerk Y-N-Aust-N/A George White Y-N-Abst-N/A Felipe Schwarz Y-N-Abst-N/A James Phinney,Associate Member Y-' -Abst-1`J/A Q?Ii 3?l.)I''r�I'PF:5.i.5 C+8,4-4.-!i l�lltf,ANCT GSR-y)S•E� CON3I?.ItVIJTON bSS•Oi3q IIE,ILTH 6ftg 95-16 Pj.;1VN 1Cr GRF 9 35 IA/79/9A+ld VDT 7R. eo r { ry I 1 l OCT-29-2004 04:40PM FROM-MICHAEL T. STELLA SR,P.C. +9786835396 T-390 P-002/003 P-019 LZ•f S and Ut 9 Gray Street Special Permit Approval Stella Realty Trust III Frontage Exceptions Febroary 71, 2003 Page 2 of 3 The Pbumin'Bw;,rd makes the following findings as required by the North Andover Zoning Bylaw Seotioxts 7.2.2 & 10.3: FINDINGS t�n.r FACT. . 1. Section 7-11.3 of*4 North Andover Zonutg Bylaw defines how the lot area is calculated. If the total lot area of lots S and 9 are calculated as described therein,the lot areas do not meet this requirement. However,ticc Planning Board finds that if a waiver is granted from this sections,the lot areas erceed by Three terms the:minimum area required for that Zoning District(43,560 square feet)as Lot S ccntzins:3.010 acres and Lot 9 contains 3.001 acres. Accordingly, a waiver from Section 7.1,3 is gr'an`ted and the Board finds that the criteria in Section 7.2.2(a)is satisfied. 2- ihlata have a minimum continuous street frontage of not less than fifty(5 0)feet and a width of not 1css Than fifty (50 )feet at any point between the street and the existing home. Lot S contains 52.01' of frontage on Gray Street; Lot 9 contains 50.00 feet of frontage on Gray Street. 3. 7-here is o fl rorat-age exception lot with contiguous frontage with another frontage exception lot, Cather filan each ofthe proposed lots. 4. Tlnc lots ate,located so as not to block the possible future extension of a dead end street. The creation. of 'Amt.will not block the future extension of a dead end street. 5- `111e creation of'the lots will not adversely affeot the neighborhood. The development of single family homrs on lots ht excess of 3 acres is in keeping with the current zoning and respects t�se rural c1a,r-acter of nhe existing neighborhood. C- The Wanting ofLWs special permit will not be detrimental to the town as the alternative to the creation Of Leis lot is a multa lot subdivision that would exceed the number of lots generated by an approval not rc*Wr' wPIR11.%rccludil?g frontage exception lots, 7. 'roe.pm.,_tc e.and intent of the regulations contained in the Zoning Bylaw are met with the Special Pc t application. UP016reg,° =,irs ,the shove findings,the Planning Board approves this Special Permit with the following SpPCh�Conditions; I This er-,,a n must be filed with the North Essex Registry of Deeds. Included as a part of this °tc.i2�0�R a-re the following plans and decisions: Planes titled:Topographic PIan of Land Mary A Stella Realty Trust III Prt- aced by: Pembroke land Survey Company. P'=40' Scale.- 'tan Date.9/12/02, last revised February 5,2003. b) Prism to the endorsement of these plans by the Planning Board,the Topograpinle plan of Land Mary A Stella Realty Trust III, as depicted on the revised version dated February 7, 2003,must be revised to include the dates of revisions. c the Town l'larttAr must.approvo any other changes made to these plans. Any changes rnci substantial by the Town Planner will require a public hearing and a modification hy the Planning Board. a6ARD oF,,kpP,ALS 4z`?,&95Sn BUIL N0 688.9545 CONSERVATION 688.9530 HEALTH 688.9540 PLANNING 688-¢535 bYMM dt,Mwrrri rnV1Vlmj-MHCL I. 51ULA NN,P.C. +9788835396 T-390 P.003/003 f-819 fi Lot 8 and'dot c) Ciray Street Special Perr ait.EAppr• v al Stella Re:al�y Trust Ill February 21,2003 Pugs'3 of 3 2. Prier to any site disturbance: x,11 appropriate erosion control devices must be in place and reviewed by the Town Planner. b) (_._.T be decision of the Pl,uiuvng Board trust be recorded at the North Essex Registry of Deeds and a certified copy of the recorded decision must be submitted to the Planning Office. C) Thee clear ng.PMM be kept.to,,,a,Tib*urn; The area to be cleared shall not exceed the Fee clearing area depicted on the revised plans. 3. The carni;actor shall contact Dig 5A��.a�legit? hours prior to commencing any excavation. 4. Gas,telephone, cable, and electric utilities shill be installed as specified by the respective utility companies. 5. !No Qpen burning shall„be done except as is permitted during the burning season tinder the Fire Iepa}tinea€regulations.' 6. iso �.IfCbftrou nci fuel storage Aill',be installed except as may be allowed by Town Regulations- 7. 'lis,'pY6Vi5iota f Phis conclitiaaal approval shall apply to and be binding upon the applicant, its e.*nployees and all successors quid assigns in interest or control. 8. This"permit shall be deemed to have lapsed aflta ,a two-(2)year period from the date on which tho Mpecia,l:permit was granted unless substantial use or construction has commenced. 9. The rur+ofr"for the rooftops of all new buildings shall be completely infiltrated. c,. Cot,' erv�tticn Administraior DaTwoo of Public Works Fk .l h Administrator I�azi.�,ca�n��-=Spector police Chief Fire Cdef Abutter$ Ass or DMY File .� P�r1RLd c) '. Pl ? u-E - .��=e�,lt.rnj�fcr fiSY3 95•i5 CONSERVATION"Zf-9530 ITE.M1d..TH O.1-054D rl..MM4G G3S-9535 in/2Aignne VDT ,o. A. r North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Faci i ) ; 1gnature of Permit Applicant / Date NOTE: Demolition permit from the Town of North Andover must be obtained for this probeg ct throu h the Office of the Building Inspector a se �. The Commonwealth of Massachusetts Department of Industrial Accidents Ofte of tnveaddadbns Boston, Mass. 02111 workers'C rro n ew Instlrarlce Affld" Narr>. Pleats Print Name: Locadon: City Phone ! I an a homeawm performing d work myself. F-1 I an a sole pfo xkAor and have no one working in any capadty 0 Ian an employer providng workerd'compensation for my employees working on this job. CbMG=marts: Litchfield Company, Inc Addn 26 Ray Ave City: Burlington, MA 01803 Phone# (781) 270-6859 IrletJy8/10l CQ. Savers Property Insurance/Renaissance POjLV! W(onw i OA Camtoanv nArte: MOM Com. Phone! Ir1etJCilOe Co. Poftar! FaSn to secure coverage•romirsd under Section 25A or MOL 152 can bid to the hvwvw of akrinal psnd0ee d'a rdw up to sl's w andlaranoyds'bnprbortneatas.wd.asA@40osdhsJntnhmndABTOP]AIMDRDERmdAlbd.(,MWA%Ad*spdratma I undaraterd that■copy d this statsnnrk maybe to the Ofrbs d Imwdgs&m d the DU for coverage rerNfcatlon. I do hereby Ihs dM kWO,r WO provided a6oh Is t we and co, signature // plft 5/6/05 Print nate Kristi Ptt W# (781)270-6859 OfBdd use only do nut write In this be completed by city or town afCldal' CBy or Town Permits +• ❑ BuA*v Dept' ❑chock I Immedteft Ampanae 4 requ#W OLkerkift Board ❑ seliecftw's Ofte Confect person: Phone t. ❑ He&"Deparbnent 13 Other r Professional Land Surveyors Er Civil Engineers ESSEX SURVEY SERVICE 1958 - 1986 OSBORN PALMER 1911 1970 BRADFORD & WEED 1885 - 1972 PLOT PLAN OF LAND LOCATED IN 6&1 11(6�,Ii iASS. r� L70 w -L, N La / Z % 4 Sv2C I hereby certify to the#o27A-,Af1,gjkZ-71 � � �2- LOT :93 f PLOT FRONTAGE: /6L�F1 Building Inspector that the pro- posed construction shown conforms to the dimensional zoni FRONT YARD: 30f SIDE YARD: AVG i REAR YARD: X e/1/I- XAZWI/ SCALE:, �'��' •,, y r CHRISTOPHER G<n �j�y,�fid'//�/ MELLO %�9iYY °DATE: OW37 No.31317 � n ,� ", REFERENCE. < KYz PG oplierR': Mello 1I1S:r3T 'z': ► 104 LOWtLL'STREET- PEABODY, MASS01960 +{ tin 5: u:x(978)W;,8 21 Permit Number REScheck Compliance Certificate Checked By/Date Massachusetts Energy Code RES checkSoftware Version 3.6 Release 1 Data filename:C:\Program Files\Check\REScheck\Litchfield Companies.rck PROJECT TITLE:The Rosewood CITY:North Andover STATE:Massachusetts HDD:6322 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE:Other(Non-Electric Resistance) WINDOW/WALL RATIO:0.20 DATE: 10/26/04 DATE OF PLANS:October 26,2004 PROJECT DESCRIPTION: Litchfield Companies COMPLIANCE:Passes Maximum UA=562 Your Home UA=545 3.0%Better Than Code(UA) Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1:Flat Ceiling or Scissor Truss 1169 30.0 0.0 41 Ceiling 2:Cathedral Ceiling(no attic) 748 30.0 0.0 25 Wall l:Wood Frame, 16"o.c. 2848 13.0 0.0 184 Window 1:Wood Frame:Double Pane with Low-E 565 0.350 198 Door 1: Solid 38 0.370 14 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 1764 19.0 0.0 83 Furnace 1:Forced Hot Air,90 AFUE COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications,and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in RES checkVersion 3.6 Release 1 (formerly MECchecl and to comply with the mandatory requirements listed in the RES checkInspection 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 780CMR 1310 and J4.4. Builder/Designer Date REScheck Inspection Checklist Massachusetts Energy Code RES checkSoftware Version 3.6 Release 1 DATE: 10/26/04 PROJECT TITLE:The Rosewood Bldg. Dept. Use Ceilings: [ ] 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: [ ] 2. Ceiling 2:Cathedral Ceiling(no attic),R-30.0 cavity insulation Comments: Above-Grade Walls: [ ] 1. Wall 1:Wood Frame, 16"o.c.,R-13.0 cavity insulation Comments: Windows: ] 1. Window 1:Wood Frame:Double Pane with Low-E,U-factor:0.350 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break?[ ]Yes[ )No Comments: Doors: [ ] 1. Door 1:Solid,U-factor:0.370 Comments: Floors: [ ] I. Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-19.0 cavity insulation Comments: Heating and Cooling Equipment: [ ] 1. Furnace 1:Forced Hot Air,90 AFUE or higher Make and Model Number Air Leakage: [ ] Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: I. Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfm(0.944 L/s)air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. i Vapor Retarder: [ ] I Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. I Materials Identification: [ ] I Materials and equipment must be identified so that compliance can be determined. [ ] I Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. [ J I Insulation R-values,glazing U-factors,and heating equipment efficiency must be clearly marked on the building plans or specifications. I Duct Insulation: [ ] I Ducts shall be insulated per Table J4.4.7.1. Duct Construction: [ ] I All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces used to transport air,shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] I The HVAC system must provide a means for balancing air and water systems. I Temperature Controls: [ ] I Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. I Heating and Cooling Equipment Sizing: [ ] I Rated output capacity of the heating/cooling system is not greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. I Circulating Hot Water Systems: [ ] I Insulate circulating hot water pipes to the levels in Table 1. i Swimming Pools: [ ] I All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. Heating and Cooling Piping Insulation: [ ] I HVAC piping conveying fluids above 120 T or chilled fluids below 55 T must be insulated to the levels in Table 2. Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pine Sizes Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temnerature(Fl P12 to 1" Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Typs Range 2"Runouts 1"and Less 1.25"to 2" 2.5,to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD (Building Department Use Only) ®RT'9y Town o � �� �.: ,� Andover 0. 03 .. No. IL �, = o ndover, Mass. T 0 t- LAKE �yCOCMICMEWICK O® 0,t? RATED "'? C7 SSAC HUSH IT FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT ....... 7 ..'o........ ... ! . _..... ._ ............ r has permission to excavate and pour foundation at ../!.0 #a 3 �j CUP14 Y S� ... .................................. ....CUP14Y...... ......... 9 for the purpose of....,1.. 001''1 O� A ►I �1��, � ........!r�...'.. /IV ! �. .. ...... ..... . ! ................................ The person accepting this permit must return to the office of the Building Inspector a certified plot plan show of building thereon before Foundation will be inspected. VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. BLDG. PERMIT FEE :. y.g a 6- LESS FDA,EEE +d P - i g� 4&* ... ............ .. ..... . ......................................... DUE FRAME PERMIT y� '7 0 BUILDING INSPECTOR NORTiy 'g TO" of t 4Andover No. 70, -_ o �` dover, Mass. 's o > COC HICHEMCK V ADRATED Cl S BOARD OF HEALTH PERMIT T D I Food/Kitchen Septic System THIS CERTIFIES THAT BUILDING INSPECTOR ....... . ................................... ......................................................................................... Foundation has permission to erect.............../..................... buildings on'l ! �.444....�.r'4.y......A� .:........ Rough to be occupied as. R ee w1,�.Q AT'�1� 3 st �� &4P d1'#r 31 N ��. �e 11�0�'�b�'s Chimney ............................ ......... .. ......................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 'D`, b/J PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Roughf s ......A..a...... ................................ Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.