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HomeMy WebLinkAboutMiscellaneous - 239 WEBSTER WOODS 4/30/2018FPI ql ON --Locationg,3 Y W -e to No. 17q z Date TOWN OR NORTH ANDOVER A "Certificate of Occupancy $ ^°> '" • �7s',.•°' E<� Building/Frame Permit Fee $ s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 0,45 6365 U Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT !FAI& RENOVATF, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUELDING PERMIT NUMBER: DATE ISSUED:6R y 10 SIGNATURE: Building Commissioner/I or of Buildings Date SECTION I- SITE INFORMATION I 1.1 Property Address: U qg-,eP' sews bye_ 1.2 Assessors Map and Parcel Number: Map Number ParcelNui6ber 1.3 Zoning Information: Zoning District proposw use 1.4 Property Dimensions. Lot Area (sf) Frontage (it) 1.6 BUILDING SETBACKS (ft) Front Yard Side Yard Rear Yard ReqWred Provide RcqWred Provided ReqWred Provided + 1.7 Wow Supply AGI -C-40. 54) I.S. Flood Zone Infoundios: Public 0 Private 0 zow Outside Flood Zane 0 1.8 Sewmp D*md System: Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY owNERSIEPIAUTHORMD AGENT NO 2.1 Owner of Record Name Address for Service Signature Telephone 0 2.2 Owner of Record: I Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable X License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable A Company Name Registration Number Address Expiration Date Signature Telephone SECTION 4 - WORKERS COMPENSATION (KG.L C 152 f 2! Workers Compensation Insurance affidavit must be completed and submitted in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......0 No ....... 0 SECTION S _Description of Proposed Work (check an anotkabk i New Construction ❑ 1 Existing Building ❑ . 1 Repair(s) 0 with this application. Failure to provide is affidavit will result Alterations(s) 0 1 Addition ❑ Accessory Bldg. 0 I Demolition ❑ 1 Other 0 Specify Brief Description of Proposed Work: I SECTION 6 - ESTIMATED CONSTRUC'TTON MRTS I Item Estimated Cost (Dollar) to be Completed bpermitapplicant OMCIAL USE ONLY I. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction QD 3 Plumbing Building Permit fee t1> x (b) -� 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number ONA-Ai P11 Ii VML•/•w11V111 1V DZ %_VMLrL J[Z" WnZfV OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby autho ' •1 i< r to act on My , in ,ma re alive to work authorized by this building permit application. Si lure of Owner� ✓ SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION Date I, ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name 6 -T_ds_ Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS Or 2 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHMINEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 4 r w /� Q Ri u)ZO U Cd v Cw v U w a ►� a a w a w V w w°' j w r w a c0 z v� v 0 cn ui am c c V A gV v Cw r ♦: O C •ac� o : Y m �° ~ 3 IL ods r Ea O V �mx N Om v o me_r IL�o E (COLO O o o 3 � r r •� v =m ♦ = c N N N C o � N m CDcm CLS m z mor m :41�:: :otoCD o d Q 0C = m :CD QQC N o P g dt W C Z UJ W=V m 43 cm a m��� O g GO N a�N= O =aaZcon 5 I �ll .V I Ccm E m m 0 CD = O� �3 O got M o a via c ev C.3 0 ca C ZCL � V N� O C C ca h 0 W U) Y/ 19 W W 19 W N 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 SECTIO APPLICANTILA,tE LOCATION: Assessors Map Number ZLLJ SUBDIVISION STREET ADMINISTRATOR OFFICIAL USE ONL DATE APPROVED DATE REJECTED 9 TOWN PLANNER DATE APPROVED DATE REJECTED PHONE 93: - OTT- UJA PARCEL_,2� LOT (S) __ q ST. NUMBER 03 I FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED -------------- PUBLIC WORKS - SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE RevWW 07 jm 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:P�V pp (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector A I TOWN OF NORTH ANDOVER BUILDING DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER MA 01845 978-688-9545 978-688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print `r DATE JOB LOCATION ';)31 U EQ r G/` Number Street Address Map/Lot HOMEOWNER f—A Home Phone PRESENT MAILING ADDRESS d U �^"IE -Q ba Work Phone City/Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section 108.3.5.1.) DEFINITION OF HOMEOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is or is intended to be, one or two family dwelling, attached or detached structures attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedw r u' em d that he/she will comply with said procedures and requirements. HOMEWOWNER S SIGNATURE APROVAL OF BUILDING OFFICIAL -. � �' 1 - . < � 9l .:moi �6 7 .d ((- cER nFIEta PL 0 T PLAN ter' r a� S.E. CUMM/NGS S ASSOC/A TES i3 _o P.O. BOX 1337 PLA/STOW, N.M. 03885 TELEPHONE (608) -082-5065 FAX (803)-382-5216 S _ 06'4242" E �BS�R SCALE I" = 60' l HEREBY CERTIFY TO TOWN OF NORTH ANDOWER, MA BUILDING DEPARTMENT THA T THE EXISTING FOONDA TION DRA WN ON THIS PLAN /S L OCA TED AS SHOWN AND THAT/ T DOES COMPLY TO THE MINIMUM BUILDING SETBACKS TO PROPERTr LINES S 55 00" E M-5{ EDGE OF FLAGGED WETLANDS N 06:38'50' W DA TE.- MARCH 28, 2000 MINIMUM SETBACKS. FRONT -- 30 FEET SIDE - 30 FEET REAR - 30 FEET 754--OPP14 Town of North Andover F NanrH y Building Department 410 tt4eo ,6 e` z . 27 Charles Street 0 North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 o (O[RI[ wNR TED 9SSACHUS�� APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS o2 3 9 toe 6s74 -Pr wocW_s Ln LOT NUMBER % y SUBDIVISION e--_�w,0 6e %/ GreSf DATE REQUEST FILED / de2 (© l®p DATE READY FOR INSPECTION /j03 e�Q FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUC D NOT MEET ALL APPLICABLE CODES. SIGNATURE "OFFICIAL USE ONLY ROUTING CONSERVATION DATE PLANNING , DATE Zn 17_/1 k U r— D.P. W. —WATER METER Oe -T,TL,) DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATUREVDAV AUTHORIZATION Mesiti Dev Group Fax:978-5578160 Jul 17 2000 1354 P.01 R• TOWN OF NORTH ANDOVER DIVISION OF PUBLIC WORKS 384 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 Mr. Kenneth. Grandstaff, President Mesiti Development Group 231 Sutton St. Suite 2 F North Andover, Ma. 01845 July 14, 2000 Re: Conditional Operation of the Campbell Forest Sewer Pumping Station. Dear Mr. GrandstaT The Division of Public Works has inspected the sewer collection system and sewer pumping station, and appurtances on Campbell Road related to the construction of the Campbell Forest and Lyons Way subdivisions. We hereby grant conditional approval for use of the system and pumping station subject to the fbHowing: I . Completion of items 1 through 15 as listed on the July 10, 2000 letter to Mr Dennis Bedrosian from Maurice Harpin of Mesiti Development Group, a copy of which is attached. The work will be completed within 45 days of acknowledgement of the receipt of this letter. 2. Satisfactory completion of an as -built plan for the Campbell Road sewerage system- 3. ystem3. Submittal for our review and approval a copy of the preventive maintenance contract for the pumping station. 4. A performance guarantee shall be provided in the amount of $25,000.00 to insure the proper maintenance and operation of the pumping station. 5. The Division of Public Works will be allowed access to the Pumping Station and will be allowed to reconstruct, repair, replace, add to, service, inspect and operate the pumping station and related equipment. and facilities in the event - __.._....--.--_---..._..__ ............ _ . _ that Mesiti Development or its agents fain to adequately perform maintenance of the pumping station. mesiti Dev broup Fax:9(8-55x8160 Jul 17 2000 13:54 P.02 6. Mesiti development shall reimburse the Town upon demand for the reasonable costs of emergency repairs to the Pumping Station. 7. Mesiti Development Group and its successors or assigns shall indemnify, defend, and save harmless the Town of North Andover and its Division of Public Works and their respective employees, officials and agents against all suits, claims, judgments or liability of every name and nature arising at any tires out of or in consequence of the acts of the "Town" or its agents, employees and officials in the performance of the access purposes covered by this grant of conditional use or the failure of the developer and its successors or assigns to comply with the terms and conditions of this grant. Very TO ours, J. William Hmurc' E. Director of Public Works M' . The undersigned acknowledge the receipt of and agrees to the terms and conditions of the above grant of nditional use. Mesiti e3 up �! K th Gr ds dent Date: Date.- N2 4464 TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING This certifies that ..�.� . C .... �, *• has permission to perform ... A-� plumbing in the buildings of ....1-1.4.e..0 c.. < ................ at.d �.lt:rt/T,c L41r,a�/...LL- .r . /, North Andover, Mass. Fee.3.3Lic. No.. ........:. . 6/UMBING INSPECTOR Check #16 77 l WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building 4v New M Renovation 0 _ 4/ � �J� r Date s Name Permit # /J Amount 3 3 inancv Replacement 1 TYTTTRT+.0 Plans Submitted Yes 11 No 0 (Print or type) Gerry Keefe Plumbing & Heatin Check❑Corp. Certificate Installing Company Name � IR - - -` Tewksbu MA 0187 � Partner. Address LV -U- 013 Business Telephone Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate ttm type of insurance coverage by checking the appropriate box Liability insurance policy Other type of indemnity 11Bond 11 Insurance Waiver. L 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 Issued for this application will be in compliance with all pertinent provisions of the Massachusetts Statol!onbing C ,qde,odoRter 143pf the General Laws. Title City/Town APPROVED (OFFICE USE ONLY Type of Plumbing License icense Mumoer - Master Journeyman ❑ • --.-m- MMM ............MM.. • `0 9 1 ..-.M..M..5MM.-.......--M 1 t@' mnmmm mmumm.mm..-..---.-. ............... 000000MM M11-11291 mom .00000000000M 1 •' ....-....--. (Print or type) Gerry Keefe Plumbing & Heatin Check❑Corp. Certificate Installing Company Name � IR - - -` Tewksbu MA 0187 � Partner. Address LV -U- 013 Business Telephone Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate ttm type of insurance coverage by checking the appropriate box Liability insurance policy Other type of indemnity 11Bond 11 Insurance Waiver. L 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 Issued for this application will be in compliance with all pertinent provisions of the Massachusetts Statol!onbing C ,qde,odoRter 143pf the General Laws. Title City/Town APPROVED (OFFICE USE ONLY Type of Plumbing License icense Mumoer - Master Journeyman ❑ 2460 Date............/' ....... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies. ......... that .. ............................................................ has permission to perform ) ....................................................... wiring in the building of ... ......................... ............................... 4 4�2 Z ...... at..c ......... .. ..................... ;&rith Andover, Mass. 2t Feel. ..... Lic. No . ............. .......... .... ... ....... LEc'rR`1CAL*1NSP-ECTDR ................. Check # c55�POI WHITE: Applicant CANARY: Building Dept. PINK: Treasurer -� T1EC0AD10AWF4L7H0FA SSAC'ftU = Office Use only DEPARTMENTOFPIIBLICS9= Permit No. G� BOARD OFFIREPREVF.IV170NRBgM4TIOI KS E7CMR 12.00 Occupancy & Fees Checked APPLICATION FOR PERMIT TO PERFORM ELEC.TIRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELE CAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATIO / _ Ga C5 Date Town of North Andover / �71 To the Inspector of Wires: The undersigned applies for a permit to pjrform the electrical work described below. Location (Street Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes r. No (Check Appropriate Box) Purpose of Building 6 o �:_. t), Utility Authorization No. 06+ 3 Existing Service Amps Volts OverheadM Underground No. of Meters New Service 4On - Amps I IJ % Volts Overhead [::] Underground �� No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work ln.l 77 0 F N M7.3 No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground 1:1and 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..ofDryers Heating Devices KW Connections of Water Heaters KW No. of No. of �No. Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER • - InRrdneC PtMattothero#MM%ris setsP=23I Laws Ihaream=tLiabrldyh wrxePtdicyirdxbV,, plere ' Cv�orits�taaieg4Adat YES[If NO Ihmest� mhr dvalici f sanewthe0� YES NO r7 If}wha%edmdWYES,pleaseirdmiethet cfe maFbyd=kirgthe .10 INSURANCE BOND p OTI-&R a (Ple=Spadfy) Nl"*J I rMA► ' MA IG 060 V EAmaiedVaivedUeeciral Wade $ r WOkt)Sta`7-77-00 t `� IspalmDaReWmwd Raft W Lt�1 �' FEW W1 Lc C/Ity SVCFIRM tnder3e l cfpt3jtsy — LIN 9 ALL �-7Zt� 7UC . LiosseNa 1� k 7 ? FIRM NAME ,r"��� - OWNM'SMJRANCEWAIVKlanawaedmttheljoawaotthecstranem►eage"sihWrW egm%d rtasm*aredbyM%m ttsMCaterJLam a>Iddvtmysgimealftpwi*Epplirationwai%M tsm*E iat (Please check one) Owner a Agent Telephone No. —PERMIT FEE $ Location -10- / j # -237 W -e I S7Y'R A) - No. OoZ57 Date �aRTM TOWN OF NORTH ANDOVER ; Certificate Occupancy $ + ; of ��,�s ",•°''�� sACMUSf Building/Frame Permit Fee $ Foundation Permit Fee $ �r Other Permit Fee $ TOTAL $ Check # C�6S 'I 36U1 ' Building Inspector Y v '/_ F O O CLI z n V) V) 0 w r. � w I�✓ it % L _ � co v v I V. • I w n V. V Y I o l° Y v '/_ F O O CLI z n V) V) 0 w � � w I�✓ it % L _ � co v v I V. • I w V. V. V Y w o l° Y v '/_ F O O CLI z n V) V) 0 w ~ I�✓ it % L _ I V. • I w V. V. V Y .7 .7 .^i T V - Y L Y v '/_ F O O CLI z n V) V) 0 w % L Z • t^. V. V. 'J. Y .7 .7 .^i ~Lr. L tr./ cw � Y v '/_ F O O CLI z n V) V) 0 w FORM U - VERIFICATION FORM 'JAIN 1 0 210100 INSTRUCTIONS: This form is used to verify that all n cessa g�..; rY, . .9 approvals/permits from Boards and Departments havigq@grisdi;otorllG�r have been obtained., This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: ��/e// �resf LLC ��t es�fi t7ey �r� Phone 87-s apo LOCATION: Assessor'. s Map Number /0 (0 3 Parcel l % Subdivision CRM Lots) Street lve6s�el escorts La„e a r�C//,%. St. Number 7_3 ************************Official Use Only************************ MISS r- Z& `IL RECOMMENDATIONS OF TOWN AGENTS: Date Approved Conservation Administrator Date Rejected p Comments Date Approved 111,01mo r Date Rejected Comments Food Inspector -Health Septic Inspector -Health Comments U 4 Date Approved Date Rejected Date Approved Q Date Rejected C� e' r-. W .Ar- tPublic Works - sewer/aerconn�eecc ions � W'A_ a driveway permit Fire Department (3N ' I2 A rp r fea.y�a� D� Wn4 Received by Building inspector Date Growth Management Eylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Cepartrent in their determination of exemptions under section 8.7.6 of the Town of.North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested 'below. Name of Applicant on cuilding Permit (below) Address of Property for Per it (helow) /-Le o39 Ayoeids 47. Map and Parcel :068T77Purpose of Application (check below) Phone Number of Applicant f Single Family Two Family 7--5-760 1 the undersigned applicant for the above property attest that the attached building permit for which this form is =mpleted does comply with the EXEMPTION section 8.7.6 of the North Andover Growth - Management Bylaw. I also understand providing this form does not absolve me cr any party to this permit from the requirements of obtaining other permits required prior to the issuance cf the 5�uiicing Permit. Further I understand that my interpretation of the E<EMP T IGN status is subjec: to review by the Building Department and is only officially accepted when the Building Permit ig issued. Based an section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and asscc'ated attactiments, camclies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement, restoration, or rec nstructicn of a dwelling in existence as of the effective date of this by-law, provided that no additional residential unit is created. J" The lot(s) werelwas created prior to May 6, 1996 are exempt from the provisions of this Secwcn 3.7 of the Zoning Bylaw. This application is for dwelling units for low and/or moderate income families or individuals, where all of the conditions of 8.7.6.oare met and/or represents Dwelling units for senior residents, where cccupanc/ of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this Secdon "senior" shall mean persons over the age of 55. This application is a part of a development project which voluntarily agreed to a minimum 40% permanent reductfcn in density, (buildable lots), below the density, (buildable lots), permitted under zoning and feasible given the environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently designated as open soaca and/or farmland. The land to be preserved shall be protected from deve!ccment by an Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism approved by the Planning Board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel an the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the Parcel. This application represents a lot which is ready far building permits.(i.e. all other permits from all other boards and commissions have been received and the project is in comptiance with those permits), and the Develocment Schedule does not accommodate issuing a building permit in that Year, one building permit will be issued per Year per Development until such time as the Development schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination' that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate informal he checking off of an .above item which does not comply, whether done to my knowledge or no is ground for refusal by the Building Oepartment to issue a Building Permit. v, 1 ignat4reotw orrazed Agent wno signed the Attached Building Permit Oate This form must be attached to the Building Permit upon application for such permit FROM : MCKENZIE ENGINEERING GROUP,INC PHONE NO. : 6176412662 Dec. 22 1999 11:07RM P2 Q: l The .Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print I Name: Location: City Phone # ❑ 1 am a homeowner performing all work myself. F7 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. r,,,n,.,��„ ��mo��..�, � /,zo/` �,�es� �L C //�tes� f: � �U• Cr��'P Address 07 31 sa 14)�- 0,_7 Sf- 5' f e o�2 F City: /n � `><'� /vim/�dyQi' / Q, ©/ ws Phone #7 0 7o- 6 $ 7 - 5`30 0 Insurance Co Ur)� led 19.9 eI Ic Palicv # /V ui V al %73 V V ,'-00 Company name: Address City: Phone # Insurance Co. Pollcv # 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 penalties in the form of a STOP WORK ORDER and a fine cf ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coveraae verification. 1 do hereby certify under the pain and pena ' s of perjury that the information provided above is true and correct. Signature Date IL11 a Print name ���� 6-7--/ // Phone # �76;-5-7-S-76 0 Official use only do not write in this area to be completed by city or town official' City or Town Permit/I icensino ❑ Building Dept ❑Check if immediate response is required ❑ Licensing Board ❑ Selectman's Office Contact person: Phone ❑ Health Department 171 Other �5.� ✓JLC U/0�!)1/JYGQ III/18CY.G�L Q! ���Jd2ClLCL4P.Cf } DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number: Expires: Birthdate: CS` 069234< 0510912000 0510911954 ` Restricted TM, 00 ALAN G RUSSELL v 400 MAIN ST` GROVELANO, MA 01834 N2 0747 1 Date .... [Z.-.�.6..-Y ? W TOWN OF NORTH ANDOVER RECEIPT This certifies that ...... �e,✓ .... 6. r�. e ........... 47(- bo:� .............................. has paid .................... "y for .... 11.1et�r .. of(.3..4.0000 */...... ii LL U)��T ........................... Received by .......................... ..... ........ W ... i .... Department ....................... ?,I �; , �J, �,Ls ......................................................... WHITE: Applicant CANARY: Department PINK: Treasurer Date.74�c... 0741 ... TOWN OF NORTH ANDOVER RECEIPT This certifies that .......... ........ pi:av- ............................ has paid .................. 70 Co j.. . .............. I .............................................. 1c: for ..... WJC�/�gwer.. /per,,, 4)00d,� it e, Received by .............. f(ft .... - . ......................................... -LJ,04� Department............................. t .... C .......................................................... WHITE: Applicant CANARY: Department PINK: Treasurer 11464 APPLICATION FOR SEWER SERVICE CONNECTION North Andover, Mass. 4�; 19 Application by the undersigned is hereby made to connect with the town sewer main in subject to the rules and regulations of the Division of Public Wor//kss..,,�� The premises are known as No. or subdivision lot no. f` / Owner Address Contractor Address Applicant's Signature PERMIT TO CONNECT WITH S The Division of Public Works hereby grants permission to to make a connection with the sewer main at 1A. subject to the rules and regulations of the Division of Public Works.. Inspected by Date 44 . Street Division of Public Works By See back for rules and regulations NO 926 Li •, ZDW,9312 5y1A1,1APPLICATION!'FOR WATER >SERVICEXONIV15CTION'-� :1 1 , e nwor qdT to rnif;noiloudhl2ib 6,11 '10 !:q. SIS H:)idw •anijirr, )w ?Jiv !4grm;1 Zii1C11� 71i+ti:�1 #Q noip{Jit}i i ��rp tirr4s �.t1 'yy ti'iJ aUi3nY i !I'it. i�ort Andover, fv'{ass.j' . 9 PP Y g y i =ar-r,"+n i@i n it „• - t,.x}. ` i3 ?r1 `ia'ini �t'r�L�J�-t7 Application b the undersigned is hereby made to �or{nec�with`�he town water mam m` subject to the rules vand regulations of the Division of.Public Works. Qsdi 10 9v' r,)n `'31a'n , yd noiiY; ?.ni 1u ritt:� �' iist)��ri `)d d? c3){' ,)e lelwv The premises are known as No. (�� e. 45?f 'd0� L , Cc GI c� , Street / 'gri"dul Isq oz):A ; TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 Telephone (508) 685-0950 Fax (508) 688-9573 O� yctt`cu n�QryO0 L F T A DRIVEWAY PERMIT Date: LOCATION: 2� ��� ���n� L BUILDER: phone: OWNER: ` , phone: 7— -5 �300 The North Andover Superintendent of Highway Utilities & Operations MUST be notified of the grade and set -back from street established in any driveway entry onto any street or way maintained by the TOWN. Call the Highway Superintendent's Office, before finish grading and surfacing for approval of such entry. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT Remarks: Approval: Timothv J. Willett Staff Engineer TOWN OF NORTH ANDOVER DIVISION OF PUBLIC WORKS 384 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 J. William Hmurciak, Director Telephone (978) 685-0950 Fax (978) 688-95173 Additional conditions for lots 14 and 26, Campbell Forest December 13, 1999 This Division agrees to sign the Form U, and issue water and sewer permits, for lots 14 and 26 in the Campbell Forest Subdivision subject to the following conditions. We agree to sign the Form U for these lots so that the construction of these two model homes can begin at this time. The conditions are as follows. 1. No sewer service shall be installed into either residence until all off site sewer facilities are declared "active" by this Division. These off site sewer facilities include sewer lines and a pump station on Campbell Road, as well as sewer lines and two pump stations on Turnpike Street. At this time, the construction of these items has not been completed. 2. No water service shall be installed into either residence until all off site sewer facilities are approved by this office. Any vic granted. Mesiti conditions will void both water and sewer connection permits. No refunds will be // 1g,I � L SSS Printed Name v ivision of is Works Printed Nayde CC: Bill Hmurciak Jim Rand Mike McGuire Heidi Griffin Date Date JAN -11-00 TUE 05:26 FM CAMPBELL FOREST FAX:1 978 557 5473 PAGE 5 Vgmt J TAT BIlUME The undersigned, being a aaj ori.tk er the Planning Board o:e the Town Of North Andover, Massachusetts, hereby certify that: a. The requirements for tha construction of ways and municipal servicas called for the Performance Bond or Surety and dated 19 . and/or by the Covenant dated 19 .�as d recorded in District Deeds, Book .....$$.;• Page or registered in Land Reg stry cistricr as., Document No. and noted an Certif icata of Tule ac. L -V Registratior Boak , Paye has been compieted/ParG_ally com.=leCed, to the satisfaction of the Planning bcard to adequately 4 Se Zhe erfu�:arat:ed lots shOWn art Plan entitled If CafM 1 e t ��,���i�E;�� Sabd��is►o,y PJv�, section (s) �,,,_,__,, heets �r , Play. dated Q=ftbgf .Ii 23 � recorded by the Essex No��+�i fiSrcf• iRegistry orQeeds, plan 3aok ��, or regZstered iz said Land Registry District, Plan HooK ?1a�1, 81- and said lots• are hereby releasad rron the restriction As to sale and buil-ding specified thereon. Lots designated on sa_d .P? an as fnIlOws: (Lot NU"Qr (S) and st:aet(s)� • a. (To be attested by a R=gistered Land $urJeva_) I he_ebt certify, that lot number (g) 14 A.M,r, ZCo on o4•.a+�+>e �tLw AY -A t ,o - street (s) 3a conPar:s to: layettt aS Sho�+r on Definitive Plar. entitled " C•�•+r�P 'U� '04. t" Section __ sheeteal t---1 " Rayistsred Lard surveycr ALBERT T \� TAL)DEL Jj No. 36889 N vH4t LRrin °� Z of z R,,,JJ :TaSffu1we0f * 3 c, AVAamo jAN-11-00 ITE 05:27 FM CAMPBELL FOREST FAX:1.478 557 5473 PAGE 6 C. The Town. of North Andover, a municipal corporation situated in the Cotaaty of Essex, ComWonaealth of HASBachusetts, acting by its duly organized planning Board, holder of a Performance ?and or Surety dated is and/or Covenant dated , Zg from Of the City/Totm of County, Massachusetts recorded kith the District Deeds, took , Page or :eaistarea itsIAnd Registry district as Document No. and noted ors Certificate of Title No'. in Registration Bock, Page��_, acknowledges satis:action of the terms thereof and hereby releases its right, title and interest in the IorE designated on said plan, as follows: ==C=ED as a Sealed instrument this ciav of ,,x/11 -9 Ha j orlty of 'tae Planning -Board of the Town of North Andover Col4.`WEWULTH or 21A&SACStt6P"_'T9 I��.l; A), � 19 Then personally appeared_�.t,Dll�'L�P��,2((,1(: o — mesabers of the PZanni:.s °� one a.. the above scar&- Of the Town of North Andover, M2ssacntt9®tts and acknowledged the fcreyo4 ng-nstrument to be tha free act and deed of said Planning Board, befo_e me. jL Jyr A Q Notary Public/ my/commissioA Expires 2 of 2 JAN -11-00 TUE 05:26 PM CAMPBELL FOREST FAX:1 978 557 5473 MAScheck COMPLIANCE REPORT Massachusetts Energy Code I Permit # I MAScheck Software version 2.01 I i I _ I I Checked by/Date I 1 CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: other (Non-Clectric Resistance) DATE: 1-11-2000 DATE OF PLANS: December 1999 TITLE: Lot 14 "The Harvard" PROJECT INFORMATION: Campbell. Forest Subdivision North Andover, Ma. COMPANY INFORMATION: Campbell Forest, LLC. / Mesiti Dev. Corp. 231 Sutton Strret Suite 2F North Andover, Ma. 01645 COMPLIANCE: PASSES Required UA = 511 Your Rome _ 447 HVAC EQUIPMENT: Furnace, 92-0 AFUE COMPLIANCE STAIEMENT: 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 requirements of the Massachusetts Energy Code. 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 74.4. Builder/Designer_ U PAGE 1 Area or Cavity Cont. Glazing/Door Perimeter R -Value R -Value U -Value UA ------"_"---------------------------------------------------------------------- CEILINGS 2090 30.0 0.0 74 WALLS: Wood Frame, 16" O.C. 1915 19.0 0.0 115 GLAZING: Windows or Doors 442 0.350 155 DOORS 56 0.490 27 FLOORS: Over Unconditioned Space 1590 19.0 0.0 76 HVAC EQUIPMENT: Furnace, 92-0 AFUE COMPLIANCE STAIEMENT: 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 requirements of the Massachusetts Energy Code. 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 74.4. Builder/Designer_ U PAGE 1 JAiv-11-H AL 15:26 PM CAMHELL FOREST FAX:1 978 5�7 5473 PAGE 2 MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MA$check Software Version 2.01 Lot 14 "The Harvard" DATE: 1-11-2000 Bldg.I Dept .l Use I I CEILINGS: ( ) 1 1. R-30 I Comments/Location I WALLS: [ ] 1 1. Wood Frame, 16" O.C., R-19 IComments/Location I _ I WINDOWS AND GLASS DOOR$! ( ] 1 1. U -value: 0.35 1 For windows without labeled U -values, describe features: I # Panes_ „ Frame Type _ Thermal Break? (J Yes [ ] No I Comments /Location I DOORS: [ ) I 1. U -value: 0.49 1 Comments/location I - I FLOORS: ( ) l 1. Over Unconditioned Space, R-19 I Comments/Location I HVAC EQUIPMENT: ( ) 1 1. Furnace, 92.0 AFUE or higher I Make and Model Number _ I I AIR LEAKAGE: [ ) I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the buildina envelope, recessed lighting fixtures I shall meet one of the following requirements: 1 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM F. 283, with no 1 more than 2.0 cfm (0.994 L/s) air movement from the the 1 conditioned space to the ceiling cavity. The lighting fixture i shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: ( J I Required on the warm -in -winter side of all non -vented framed I ceilings, walls, and floors, I I MATERIALS IDENTIFICATION: I ) I Materials and equipment must be identified so that Compliance can JAIV it -UQ luh U5:ib FM CAMFEELL FOHESI FAX:1.978 557 5473 PAGE 3 I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R -values, glazing U -values, and heating I equipment efficiency must be clearly marked on the building plans I or specifications. I I DUCT INSULATION: ( ] I Ducts shall be insulated per Table J4.4.7.1. I I DUCT CONSTRUCTION: ( 1 I All accessible joints, seams, and connections of Supply and return I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. I I TEMPERATURE CONTROLS: ( ] I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: [ ] l Rated output capacity of the beating/cooling system is I not greater than 1251 of the design load as specified I in Sections 780CMR 1310 and J4.4. 1 ( ] I SWIMMING POOLS: I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20fi of the heating energy is from I non-depletable sources. pool pumps require a time clock. I ( ) I HVAC PIPING INSULATION: I HVAC piping conveying fluids above 120 F or chilled fluids l below 55 F must be insulated to the following levels (in.): I I PIPE SI2F.$ (in.) I HEATING SYSTEMS: TEMP (f) ?.." RUNOUTS 0-1" 1.25-2" 2.5-4" 1 Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 1 Low temperature 120-200 0.5 1.0 1.0 1.5 I Steam condensate any 1.0 1.0 1.5 2.0 1 COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 1 ( ] I CIRCULATING HOT WATER SYSTEMS: I Insulate circulating hot water pipes to the following levels (in.): I 1 PIPE SIZES (in.) I NON -CIRCULATING I CIRCULATING MAINS 6 RUNOUTS I HEATED WATER TEMP (F): RUNOUTS 0-1" 1 0-1.25" 1.5-2.0" 2.0+" 1 170-180 0.5 1 1.0 1.5 2.0 1 140-160 0.5 1 0.5 1.0 1.5 JAN -11-K) M X15:16 PM CAMPBELL FOREST FAX:1.978 55,7 5473 PAGE 4 1 100-130 0.5 1 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only)------------------------- . 0j Z. In O ti` _1 t v r�a O mZ �° o `o` .� j ° m -n N 3-=t rn cu m� M n AX /•n i (D O �D n 0 �, N 7 ((p ° p > tD C Q � h .� (DD 1 / x --4 > = .0 0 -9 a) < a 0Ey O..m a > CD- m n9 CL ooto n JogL -n c 0 o mE ��;` °c E o = * * To 0. L13 aj'd S 0 k m N (D d D o�et aj ajn. 0o:�� ni Ir '� O '.E c� a. Z I o "x �' 1 _. Z m c O , •,, CD C� "n s `'w ® A.. r 5:• :W t W �"% C O 71 doCDvoo� >* ov � �D —� O O .o z Z � o �. C o Cf) m m Cl) 0 m O CA O COO) kil C) CD O CD CA CD CA O CD 0 G CD 0 Ell M5 — O c ?� O d - N O Q ti 2 d a C m to � CC/,) �COD CD 0 m y C') CL n T Z m ? y' _1 O� �go .d.►m C T n maid m .-. CD O m y 14. CO) O m m 7CD > > CA -0 3 ro o c fD, d a 2 o � CC/,) �COD Z7 °� S. 0 T Cr7 C~ R C "� Z to ?x N n 0• S o rL 7 07 drt COO �^ o A. r) ai z 0 W 11 i9 CERTIFICATE OF USE &OCCUPANCY Building Permit Number6 Date cdVoet�2 al_ A e o THIS CERTIFIES THAT THE BUILDING LOCATED ON lot 14-235 WEt-IST�M \o Joob �•P oc- q P2.00n0N 12yz r3 At", 2"SMLL AivAec7�> MAY BE OCCUPIED AS s i NO -Lt Fg %,4 Y Rt -s ►-D d7i d c IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. 'EPSPt1XU2' 4A- Mn'LCrui CERTIFICATE ISSUED TO C PrvK9PaLLF�,2C-s ii , ,L,(C lmcsr-fr - y- 23l SaTra ., STTZ T' Su't {w 2 F:, -- ADDRESS A-+DvyC Building Inspector C �© o Arl '141.B7 °' 0 �CA C � �.CD . C-) Z co) CL Cl) CIO cn CL y mmac®. 0 m21, ft CPQ mCc) CD C L ® .ot PO• L. rr^) n VJ m w CD O i Er CD O 0 O m _ CD y� CL � CCS CD C CA 0 C t D CDco A C O CO ?-S o O d CL 0° —• CO) r d O oc® E y y 0 yna� m m 0 Z ?-ro- _ a H a y CT7 � .a•► �O•► m T m a" O m y a p y CD o i cg a a CCA) � -c : O n a ►-3 �Qm: G W c a• a '� 0 0 °Q CL 0° cc � O y mCD 0 CD m � 0 c _ a H a 0 0 °Q 0° 000 w '� w 1 ro C- � 0 S� CT7 q y0 n y JU c n a ►-3 G z 0 Q`-ocation 107`/% Wfl,/S% t'fZ No. ��'� v Date TOWN OF NORTH ANDOVER } Certificate of Occupancy $ Building/Frame /Frame Permit Fee $ s�CHusE 9 Foundation Permit Fee $ Other Permit Fee $ . TOTAL $ 13 4/ �CHeck# 1374.2 Building Inspector 0 CER1`mmo x Q T PLAN S.F. CUMM/NGS & ASSOC/A TEs i3 _o -0T� P.O. BOX 1337 PLAIMW, N.H. 03865 4"L s TELEPHONE (603)-382-5065 FAX f603i-382-52f6 S 06'4242 4 F SCALE l " = 60' / HEREBY CERTIFY TO TOWN OF NORTH ANDOVER, MA BUILDING DEPARTMENT THA T THE EX/STING FO(INDA TION DRAWN ON THIS PLAN IS LOCA TED AS SHOWN AND THAT/ T DOES COMPLY TO THE MINIMUM SU/LD/NG SETBACKS TO PROPERTY LINES. S 05'5500" E M-56 EDGE OF FLAGGED WETLANDS N 0638'50" W DATE. MARCH 28, 2000 MINIMUM SETBACKS.• FRONT - 30 FEET SIDE -- 30 FEET REAR - 3D FEET 7,U -n pu N2 1 98 9 Date .... &-/'o �� ....................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that1a_11-&-"-e-' --Z(26--'�� .......................... 11 .................................................................. -,4 has permission to perform ....... ........................................................ wiring in the building..................... ................................... at .... / .......................................... ...... Korth Andover, Mass. Fee AO .. 5 . ...... Lic. No. E -L' E, c**T* R'i*c' A -L-1* N*'S* P*'E* C- ** T* 0R" J4 WHITE: Applicant CANARY: Building Dept. PINK: Treasurer TR L't MIONW LTHQF1 UMCHUS�r�"' u. Office Use only DEPARTjWEVTOFPUBUC&4 E7Y Permit No. / BOAROOFFNEPRLYFV77ONREGUL4770AS5270M12.011 Occupancy_ &c Fees Checked APPLICATIONFORPF.RMIT TOPERFORMELECTM(CAL 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 (/ Town of North Andover To the Inspector of wires: The undersigned applies for a permit to perform the electrical work described below. PARCEL Location (Street & Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building'%e- M p <e i Vle js Utility Authorization No. Existing Service Amps / Volts Overhead r7 Underground r7 —No. of Meters New Service /b- Amps /0")0 1.)V U Volts Overhead [= 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 Lighting Fixtures Swimming Pool Above- Below Generators KVA ground uround No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Bumcrs 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 Municipala Other No. of Dryers Heating Devices KW Conncctions No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER - .0 .. • :.,. • :m • i• :...:u:.ti r.��.6 - :• m::• , i• • •r • • i •lis A `I. • �. •r.•.:• rr New 11 • • •r :.... • • :•v • i Va ml -L. eAll Wotk'toStart �02 % ILS s;�t.u>c��e)ofpajtay. �U� F�Q / EN M, j� Lioa�see �Ulill/Ls //o ��L�'t% sib Est�dVahrdBeciaFincalW6k $ al X207 J LicamNo $ 77T72 97?o> z Licerl9eNo ,/ BiSRmTeLNo. K43 P7 -&/R3 Arlhr�e /" o QX a, %� S,i"LC 2 IV�'/ d Jd � P&Td.ilia OW,Q SINSURANCEWAIVER;IamawacedwheLimmdoes not haw trmamceammweritsstb;la�legzajc�asrcgmedbyNbmadn Ckna-alLaws arxi thatmy signattae az this pmnit app}intirn waius this tecgtuar�art. (Please check one) OwnerAgent ® Telephone No. PERMIT FEE $ Signature o wner or Agzent sm� 1 \ , 6! iNO • `, fn AmA. \i zo S113S� z = �j C a J IX F �i SO I o Fn a F p pfd N F 3 x_ y I \ w rA x C) rm !�4\ A 140\�N %. I cn ' BLDG SETBACK • `U LDG �ETBJCK i - \.��1 \ C =N Ss 1+\O `� S O� a I�� I ��oN �\ 0 1i 'iN � ' 63 CO C � �a-5cD _ b oc/)`O ozn + J/ a x ? y a a / ti0 LA CD to w. X l