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CERTIFICATE OF USE & OCCUPANCY
Town of North Andover
Building Permit Number 0/ cl Date I&
THIS CERTIFIES THAT
THE BUILDING LOCATED ON
MAY BE OCCUPIED AS 3�v
F4m,l
IN ACCORDANCE
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND
SUCH OTHER REGULATIONS AS MAY APPLY.
of, T, CERTIFICATE ISSUED TO 91,41W41t �Ptdye- --Ve(�Ikkc
V
ADDRESS 173-3��'ovhikr, S� Sode /6-o? A.A.
CHUS Building Inspector
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APPLICATIONFOR CERTIFICATE OF OCCUPANCY/INSPECTION
Zt
ADDRESS/LOCATION OF PROPERTY:- ZO
DATE REQUESTED FILED/READY FOR INSPECTION 2
CLOSING DATE ON PROPERTY: 12- 1 �'- �Y
FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED
ALL WORKAND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME
FRAME. A RE -INSPECTION FEE, OF TWENTY DOLLARS $20.00) WILL BE
CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES.
SIGNED
ROUTING
CONSERVATION
PLANNING
DPW - WATER METER
NOTE
Z(*q av',i_ I a - 10— 11 -4,a-z aA-d-9--t 11
R-1 dovvcct-�I&k_�
DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED
PRIOR TO SUBMITTAL OF7HE OCCUPANCY/INSPECTION REQUEST
DPW
Sig
File: OC form revised 6/8198
N2
Date...
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ..................
............... ..............................................................
has permission to perform ..... ...................................................
_J
wiring in the building of ..... ...... -.2. 1 ........... ..........................................
at ... .. . ...... ... . . ................... . North Andover, Mass.
el -�-v 111�0
Fee../X ........... Lic. No././. ....... .....................
ELEcmicAL INS;�
08 &41� i 1: 30 450.00 PAID
WHITE: Applicant A Y: Building Dept. PINK: Treasurer
permit N(71 7
-------------
Ocamancy Fee Cltteckea_
A RE PREVENTION REGULAT10NS 527 GMR 12:00 L—
ICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All W&k to be perfaimed in ac=dance with the Massachtisetts 8e=cw Cocie s27 cmR 12 -co
(Please Print in ink or type all informa-honk
oate, - - -�— "2-6 — � �
To the Inspemr of Wires:
Twwn & North Andover
The undemigned amikun f(r a Pwnit to Pcrft" ft 610=31 work dimcribeil bem.
Locafion (Street & Nu mti�\ 2— 2-4 S—
j
Owner's Address 7 3.--� 7
't, �jTz:rk
is this permit in conjunction with a bui1ding perinit Yes P( No 0
Purpose of auddina—, C
Eds� Service Air" 0-,t,
,ead r1
W& L Volts Ove-rhead
(Chea ApproMs* Box)
Authormadon No. 9,1)52-17
Undgrrid NCL Of MR&t
U d NcL of Vatin
Number of Feeder5 arid Ampw-.ty___,,_
Locattion and Native of Proposed EMctncal
No. XjAghtfingOutfets
No- of Hot ftise
Total
No. of Transformer-- KVA
Above C
in El
Nq. of Ughting Fixtures
Swimming FL ---.1 gm�- 0 gmd 0
Generawg WA
No. of E.---g---y Ugftng
NO. Of Receptacles Outlets
No. of Oil Burners
Units
me; of SwItch Oultleft
No of Gas Sumers
FIRE ALAR14 No. of Zo no
NO, Of Detection a--
Total
No.o[Ranges,
No of Air Cond
Tons
Initialing Devices
Heat Total TOW
Na Of Diposal
No. Pumps
Torls
MAY'
No. W, Sourimflo, Dew"
No;/ of S Ae! Contained
NO. of Dishwashers
Soac&Area Healing
KW
Detection/Sounding Devices
Ca Municipal C1 Other
NO. of Pryors
L=W Connection
No. of
No. of
LOW Voltage
No. a f Water Heafars KW
Sips
Ullases
Wifing- - -
Hvdro
41 Massage Tudr,
NO. at momrs
TOMIHP
ER:
Mi UKANUL UOVERAGE. Pliftfidt M the requireme,n6ts of IVIassachusetts Qenerat Laws
I have-ax-unew Liabilitv, Insurance Policy includi"mipleted Operations Coverage or its subsWntial equi NO
Utr%Oid Mod of some to the QX(5�YES - NO' -Ny-o-u-n-av-ed*C$MYES'Pfease-i6dcateth,e- tAw of coverage by checking the appropriate box
TH
ER = Oease Specify)
(Expimdon Date)
Estimated Value of WOW— ,
Work to start -7
Inspection Oats Resquestod Rough W CU C6JJ Final
&44ed, under the Penalties of perjury:
FIRM NME A LIC. NO.
Licensee IfXf-iS Signatum AJ,41--t4� m -NO. 117 1,4
Bu& Tel No.
Address Alt Tel. No.—
OWKER'S, INSURANCEVANM: I am aware that the Ucens" does not have the insurance coverage or ft substantial -equivalent -as -required by Namchusetts
General Laws. And that my signature an this permit application waives this roqulrqrqorit� Owner A
__g4fif (Please Check one)
N2 1734
q1t -
Date ......
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
This certifies that . .......
has permission to perform ...... ... ............
wiring in the building,of
at .......
A .. I ......... . North Andover, Mass.
Fee'��..O ...... Lic. NoA Y .......
/-----_ELECTRiCAL INSPECTOR
06/23/99 14:03 50.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
14 rMAP
'S
PARCEL7W
;; o 7 2 t, , �s- ve,"mS9775
4 P-6& s4w
N REGULATIONS 527 CMR 12;00
affice use &�
Permid NM_Ljj,'�
O=upaxy & Fee Checked
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
AJI wak to be performed in accordance with the Massachusetts Ele� Code 527 CIVIR 12:00
(PjqW Print in ink or type all Information.)
Tom a Nodh Andover
The undersigned applies for a permit to pabm the electric -00 wa-k d-e--scnbed below
Location (Street & Number_ Z014 2 , --& <I� t1A
Ownear a
Owner's
Date 5
To the Inspector of Wirew.
is am permit In conjunction with a building permit yes
G "11 �:::::: ...... ......
=,7#
N�g Sem= A,0 _,As= ___y9ft
-Nufte-r of Feeders and
Location and Nature d F
No C3 (Check Ammpriate Box)
Overhead 0
Overhe�
Authaization No. . 10 3 -S � I/
Undgmd C3 No. of Meters
Undgrnd 0 No. of Meters
OTHER:
INSURANCE COVERAGF- Pursuant to Me requirenten6ts of Massachusetts Genersi Laws
I have a current Lability Insurance fticy including Cornpleted Opmiiam C�� ent Y�F-S= 10
to the office � _ _ e gr its substantial equi go lay checking the appropriate box
ld�ld r=Qf same YES = NO = if you have checked YES please indicate
a
pr'4.0—n, .10
N OTHER (Please Specify)
(Expiration Date)
(-;��rradvd V�aiue of Elecbie4LVWorkS %. -
Work to Rough I. Final
Signed une: inspection Daft Rmumft- -d
r tyriPsnatties of 09jury: 5;-/" C"� (�o UC. NO.-
Rm NAAtE Lae, 7 ? -- - - - cla -4-
NO-------- —
Sus. Tel No.
-7 Aft Tel. No.
Address mamachusem
CUMER'S INSURANCE WAfVrER: I am aware That the Ucensij-does not have the insurance coverage or its substantial equivalerrt aS required
General Laws. And that my signature on th(g permit applicadon waives this requirement. Owner Agent (Please Check on*)
M- W! MiT FEE S �
Total
.No. of W.ghtom Outi-l"s
NO. Of Hot fuse
No. of Transforrners KVA
Above 0
In 12
No. of UqMN Fixtures
Swimming Pod Ed 0
gmd C1
Generators KVA
No. of Emergency Lighting
No. of Recap tacies Outlets
NO. Of oil Burners
Battery Units
No. Of Swfth outlets
No of Gas Surners
FIREALARAa No.ofZone
No. of Detection and
Total
of Ranges
No of Air Cond
Tons
Initiating Dew . ices
Heat Total Total
4jJ12. Of 0100"
NO, Pumps
Tom
KW
No. of Sounding Devices
Noj of Seif Contained
DetectioniSounding DeWft
a Vanicipal a Other
No. of Dishwashers
Soace(Area Hearing KW
No. of Dryers
Heating Dew=
KW
Local Connection
No. of
No. of
Low Voltage
No. of Water Kgoters KW
Signs
Ballas"
VT1
No. Massage Tuds
No. of Mot=
Total HP
OTHER:
INSURANCE COVERAGF- Pursuant to Me requirenten6ts of Massachusetts Genersi Laws
I have a current Lability Insurance fticy including Cornpleted Opmiiam C�� ent Y�F-S= 10
to the office � _ _ e gr its substantial equi go lay checking the appropriate box
ld�ld r=Qf same YES = NO = if you have checked YES please indicate
a
pr'4.0—n, .10
N OTHER (Please Specify)
(Expiration Date)
(-;��rradvd V�aiue of Elecbie4LVWorkS %. -
Work to Rough I. Final
Signed une: inspection Daft Rmumft- -d
r tyriPsnatties of 09jury: 5;-/" C"� (�o UC. NO.-
Rm NAAtE Lae, 7 ? -- - - - cla -4-
NO-------- —
Sus. Tel No.
-7 Aft Tel. No.
Address mamachusem
CUMER'S INSURANCE WAfVrER: I am aware That the Ucensij-does not have the insurance coverage or its substantial equivalerrt aS required
General Laws. And that my signature on th(g permit applicadon waives this requirement. Owner Agent (Please Check on*)
M- W! MiT FEE S �
0
-------- -- -
Date ............. �7
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
. ......... �n�-.
This certifies that
has permission to perform ... .......................
plumbing in thlebuildings of 2
.......... I .......
.......... North Ap.49ver, Mass.
Fee//, 5�. Lic. NO.. .
PLUMBING INSP6
2�
08/04/99 11:35 450.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MAP
PARCEL
or print)
Building
TTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
o M M xov? ),T- Owners Name k
�ate ? — 3 o 57�
Permit 9 -4�Vav
6W
Amount 10�(Sb-
Type of Occupancy
New 0— Renovation Replacement M Plans Submitted Yes No
FIXTURES
(Print or type) Check one:
Installing . Company Name '�Q j / CA (F
_:::� � 1� 0 Corp.
IM , - [] Partner
Address
)V/', L" e 12 tt
Business Telephone '7 ? '-� - 1� ) / j Lj Finn/Co.
13 L) 5
Name of Licensed Plumber: I-),") vo L �;
Insurance Coverage: Indicate the type of insi 7rance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity r-1 Bond
Certificate
Insurance Waiver: 1, 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 pd-i)istal lations performed under Permit Issuegor this application will be in
compliance with all pertinent provisions of the tate PlpniVng Code and ChapterV2 of the General Laws.
By: Signature 01 Licensea riumDer
Type of Plumbing License
Title 1 14 S-' '�'-
City/Town nSe Nurnoer Master Journeyman Mi -
APPROVED (OFFICE USE ONLY
I
tV,
(Print or type) Check one:
Installing . Company Name '�Q j / CA (F
_:::� � 1� 0 Corp.
IM , - [] Partner
Address
)V/', L" e 12 tt
Business Telephone '7 ? '-� - 1� ) / j Lj Finn/Co.
13 L) 5
Name of Licensed Plumber: I-),") vo L �;
Insurance Coverage: Indicate the type of insi 7rance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity r-1 Bond
Certificate
Insurance Waiver: 1, 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 pd-i)istal lations performed under Permit Issuegor this application will be in
compliance with all pertinent provisions of the tate PlpniVng Code and ChapterV2 of the General Laws.
By: Signature 01 Licensea riumDer
Type of Plumbing License
Title 1 14 S-' '�'-
City/Town nSe Nurnoer Master Journeyman Mi -
APPROVED (OFFICE USE ONLY
I
Location
2 Q
No. 0 Date
j011Tpj
0.1 TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
C US
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $ 36)el� C2
Ad' g Ins tor
119 72' &
il- -
1254%,/04/99 11:28 21000. 00 PA19 Div. P'U'bf(c Works
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NP 869.
APPLICATION FOR WATER SERVICE CONNECTION
I
9�North Andover, Mass. _19 -
Application by the undersigned is hereby made'to connect with the town water m . ain bo M
subject to the rules and regulations of the Division of Public Works. in Street,
The premises are known as No.
Street
or subdivision lot no.
tj.q e
Owner 5e>
Address
Contractor
Address
Applica
q
44, /- e,
9 2, C70
PERMIT TO CONNECT WITH WATER MAIN
I/
1p, , �
The Board of Public Works hereby grants permission to. 0)rJ (LI C/�
to make a connection with the water main at 43 L/ k9i k1i e -
subject to the rules and regulations of the Division of Public Works.
Inspected by
Street
o a r)d? Public Works
By
Date
See back for rules and regulations
RULES AND REGULATIONS GOVERNING THE -INSTALLATION OF WATER SERVICES
1. No persons shall tap or in any way tamper with water mains which are part of the distribution system of the Town
of North Andover without a valid permit from the Division of Public Works.
2. All water services shall be installed a minimum of five feet below the finish grade.
3. No water services shall be backfilled without inspection by a representative of the D P.W.—Telephone 687-7964.
4. service connections shall be I" type k copper tubing.
5. All fittings shall be brass flange type Mueller or -equal
H 15202 Corporations
H 15212 Curb stops
H 15402 Three part unions
H 8185 stop and waste valves
6. Curb boxes shall be installed at the property line and shall be of the Erie Type with 41/2 foot, rod and brass plug
type cover.
GEORGE PERNA
DIRECTOR
Date:
LOCATION:
BUILDER:
TOWN OF NORTH ANDOVER, MASSACHUSETTS
DIVISION OF PUIYLIC WORKS
384 OSGOOD STREET, 01845
,f C,
DRIVEWAY PERMIT
phone:
Telephone (508) 685-0950
Fax (508) 688-9573
OWNER: (Ctof P�4e ppz phone: 6C)3 -3�S-2,,44
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:
Growth Management Bylaw Exemption Statement
Town of North -Andover Building Department
This form shall be used to assist ihe Building Department in their determination of ex . emotions 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 Building Permit (below) Address of Property for Permit (below)
Z Z
Map and Pa el :S Purpose of Application (check below)
PhpXe umber of oplicant - L/ Single Family Two Family
I the undersigned applicant for the above property attest that the attached building permit for which this
form is completed does comply with the EXEMP-17ION section 8.7.6 of the North Andover Growth
Management Bylaw. I also understand providing this form does not absolve me or any party to this permit
from the requirements of obtaining other permits required prior to the issuance of the Building Permit.
Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building
Oepartment and is only officially accepted when the Building Permit is issued. '
Based on 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 associated attachments, complies with one or more of the
following sections as indicated by acheck mark.
This is an application for a building permit for the enlargement. restoration, or reconstruction of a dwelling in
existence as of the effective date of this by-;aw, provided that no additional residential unit is created.
The lat(s) were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning
Bylaw.
— This application is for dwelling units for low andlor moderate income families or individuals. where all of the
Conditions of 8.7.8.r, are met and/or represents Owelling units for senior residents, where occupancy of the units is
restricted to senior persons through a properly executed and recorded deed restriction running with the land. For
purposes of this Section "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
reduction in density, (buildable lots), below the density, (buildable lots), permitted under zoning and feasible given the
environmental conditions of the trac.1, with the surplus land equal to at least ten buildable acres and permanently
designated as open space and/or farmland. The land to be preserved shall be protected from develooment 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 Oevelcper 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 Cevelopment Scheduling provisions far the purpose of can tructing one single family dwelling unit an the
parc–al.
'S e– e- /� ///,X e, X e
—This application represents a lot which is ready for building permits,(i.e. all other permits from all other boards and
commissions have been received and the project is in compliance with those permits), and the Development Schedule
does not ac=mmodate 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.
's
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 MiSle2ding and or
,inaccurate information, or the checking off of an abovt4.itern which does not comply, whether done to my
knowledge or not, is grounds for refusal by the Building Department to issue a Building Permit.
9
Signature ot-owner or Authcnzed Agent Who signed the Attacried Building Perm—it Daie
This form must be attached to the Building Permit upon application for such permit.
Town of Noft Andover Planning -Bosm
This form repruents the scheduts for allowing the following kft to be mmidered as OUQUO for
bWldWg pwmR* under the Tom of NoMh Andover Growth Management by-law Section 8.7 of
the Zoning by -low. Purmpt to 6. T .5 ft Devetopmerd Schedule mud be I'lled In the RsgWy of
DOOM ard be referenced an the dead of saM of Me Ift below and be filed with the Planning
fterd pew to Vw Imance of any btAft pennit or pamt for con0mcdorn.
Name and Address of Applicant for Lob:
Nomme-Of D"Wepme"r.
f^flo Y'i C
t ry, (Y. �5 UC* Z -
and PaVOI-OF 00111111" Lac
-kW �s I�UmAlft FIXV77 I
ova of Appikedon for jAsl Division:
Uft Covered by 60 Schedule:
jok, kc�ckl- �.-t
The Pjam" Board by their signature below, or a somdurs of a duly wAmftW repromisM.,
do WOW WWW for the above.m. d0velopmIt ft 1101101WIM Dft*OPnO ftt*&ft fOr
U* pApm of season 8.7 of the Growth manq~ &I -Law. The appkeK their - Ig -
mr-mm-1 AOM 20
I wo or subsequwd propq omm dW mft,v to Me fdkmft ooh
plowtv OVOW at IN "-womm1mve No to 06'en an each dead for 9M of VW
Ift Such dead mhom 1W ft dead of esO kg Od at a w**mm ieftsm Me
book ard page In ~ We DevolopmM Schedule Is ftd and CMW the I : 1p Ot
is su%W to a DovsbpmN S*Vd* pwaLOW fb ft Tkrm of N&M Andom ft%Lmal
WrOW—W—WPOW
ftdim ON* &MUM Wid ftp
WW AW OW a lot to 040b mr a &Aft par" to =*d fp*dW *Moon of ft
bm" 0, pw,,Wb per yew pw*mt 1p,mcdbo 97Ad of 1W Zxft *44w. '
The Planning Board � wm " whesule to WO) for the sho, s devokpneird as falliews:
3 nature of Planning Owd rnwrber or Autotted RWMAtSdvf
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,.,: ..:
FPLM FAX NO. 13704-702690
BLA:P,
Ma,�j. 14 1999 01:04PM P2
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HAkhock CO#LLMCE REPORT
Masrachusetts Energy Code i�
MOxhack, Software Version 2.01
CITTs North Andover
STATEs Massachusetts
HDD.- 6322
M.NSTRUCTION TYPZ-. I or 2 FamiLy, Detached
FMATZNG SYSTEM TYPEz Cther (14on-ElectrIc Resiatance)
I)A.TF,t 5-14-1995
C"LLRiCT.t PASSES
Required VA - S85
Your Rome - 622
Area or Cavity (:onc,
Perimeter A-Vaiue A--VaILO. -'Id 1 �J%�'
---------------------------
I;A
CULINGS 2232 30.0
'AIALLSi Wood Fran, 1611 O.C. 2720 19.0 11. Q
GLAPINGI Windows or Doors 0 1 3211�
GLAZINGt Windows or Doors
3LAZING, Windows or Doors 42$ 0.11,10
DOORS 21
FLOORSi Ovor Vnconditionod Space 2040 19.0 f.) , (j
'17
VVAC IQt;:ZMNTs Furnace, 92.0 Am
...............
------------ W --------------------------------------
CWLIMCE STATEWTI The proposed building doeign doanribod h4rr.
COASIfittrit With the building plans, ayacifications, orid C11.11or
submitted wIth the permit application. The proposed L*';4.1..)dinq t1aw
dasLgntd ta meet thLe requirements of the Massachusetts Tnerqy code,
7h* hWimq load for this building, and t'he cooling 'r ft F. t t�,
j- prjL-cApr�
hiss been determined using the applicable Standard �'e:Y,61-tionz f.�Ulkd
in the Code. The HVAC oquipmt.nt selected to heat Or
ahall be no qreater than 126% of the design load do zp*�:;;fied 1 r,
Sections 700CM 1310 and J4.4.
Builder/ Dasigiier
01 '0 4
MHY-14-1� !,�:!>4 U.I. - NHbHUH Hoa5a t7a-'v R " F. 02/04
MAsc400k INSPECTION CHECKLIST
k%smehumottt znarcl� Coda
KASeheck Soltware Version 2.01
MM 5-14-1999
Sldq'1
Dapt.1 "
Use
R-30
Co=onts Locat
I WhLLS:
1 1. Wood Framb, 16" O.C., R-19
I Coment a /Location
i
WINDOWS AND GLASS tOORS-
I. U-v&Lue: 0.32
1 For windows without. labeled U-value�;' descz.*�bll-' fvl�at"M'S:
# Panes Fran Type_ Ther=1 �iro!Aj' Yes
Comperits/Location
1 2. U-Valug: 0.33
i For WiAdows without labeled U-vzluas, deact,�IJ-10, Z . t7iatUrflz.
i Pants rramt Typo rhermal
3. 0-valUe: 0.47
ror windows without labeled Tj-val,uev, dazcx,:).�e Cv4�,.jn:,s�
4 Panes TraMe Type Thermal BreaK? Y�.:
Co=&nWLocation
I DOM:
1 1, U-valuei 0.32
1 commnts/Locaticn
I
I FLOORS.
t I. Ovor UnconditLoned Space, R-19
I BVAC EQUIPMENTi
Furnace, 92.0 AM or higher
I Make and Model Num),)ex
I AIR LEWAGE,
I Joints, ponatr4tions, Rnd all other Such opPr`6i%g,; 1n trie Inilldirig
OnvilOPQ that are Sources of air leakage must [,,:t Inhan
I Installed in the building envelope, recessed
I shall meet one of the following reqvirements.
f 1. Ty;o IC rated, &Mufadturad with no pa not ",twonn
I irzide of the recessed fixture and ceilinq cavj�'-j aL.-,zj
I jaskQtad to prevent air loakage imto tho
1 2. Type IC rated, in accordance with Stazduz-��' 1: 253,
more than 2.0 cfm (0-944 7,/v) air move=rit. L�Lrt_
I. JM tne the
conditionod apace to the coiling cavity. t'c- lightinq L"lly.turt;
shall have been toetad at 75 pA or 1,57
difference and Shall he labeled.
a
a
MriII'-14-1999 13:55
NASHUn
Aol )0/.- "'Y' P. 03/04
'VAPOR RUAR11R,
Required on the warm-lh-winter aide Of all
catlings, wills, and ftoorzi.
I MPLTERIALS IDENTIMATION:
I Materials and equipment must be identified sc, CeXnPliance ';:111
I be determined. Manufe.c�vror manuals for ali
and cooliliq eqLlipment anci service water- �Qdtinu
provided. Insulation A-vdjueq, glazing hea"Ing
I equ.LpLoAnt efficiency must be clearly marked on blij.1ding �)ILLI.-.;
or opecIfiedtiong.
I DUCT INSULATION;
I Ducts shall be insulatod per Table 04.4.7.i.
i
MXT CONSTRUCTION1
All accessible jointu, seam, and coDnertlaft.'; �i E vuppLy and re L�A L a
d-Lietwork located outeida oonditioned i;psce, ztud 1,ays or
I joist cavities/apace$ usod to transport air, bi Fcalod
I using rootic And fiBrous backing tape inatalls�l lovord-;ny LCI dm-,
i manufacturetr's installiatJon imstruetitftS. 1,-1rjrt Trl.ay be,
I omitted where (japs are 11568 than 1ja inrh. Duvi. i-:, 11o,
I permitted. The FrVAC system rAutt provide a ivaan,r, for balancing
air and water symtems.�
TIMMRATURE CCVTROLS:
Thermootato *to r:cjuired for each separato IIV;;,,.' A mzui",al
i or automatic mean to Partially restrict or 5hu'.� r�ff �aetiaa
j aad�or ocoling input to each zone cr fLqor dshu.11, be P:.'�'Vidcjd.
i
I EVAC EQUIP14ENT SItING:
I Rated output capacity of Lhe heating /cool ixg
I not greater then 126t of the desigr load as
I in Saotiiona 78OW 1310 and 34.4.
I SwrA4MG POOLSS
All heated swi=inq pools must bave an on/off owiLI,:h ujid
roquire a cover unless over 20s of the hkaatLncz i.. ircms
I M0n-d§PlAtRbl4 SOUrCOS. Pool pumps rqqui ra a irn. lor V.
I
I HVAC 212ING INSULUIM
I KVAC piping conveying fluids above 120 E or fluid.s
I bolow 55 F must ba insulstod to tho following (ir'.)
I H&ATING SYSTEM
TEMP (F)
I Low pressure4tomp.
201-2SO
1 Low remporature
120-200
1 Steam coadeneate,
day
i COOLING SYSTEMSi
I ChIlled water or
40-55
1 rofrigor=t
LVIOW 40
1 CIRCULATING HOT TAMTEA SYSTEMS;
PIPE ;,',T7F;S fin.'i
2w RUNCUTS '2.5-2" 2, �,-4
1.0 L, 1 1 S
1.0
0.5 1.0
1.0 :1 1.
J/ J�j -- . I
MAY -14-1999 13:55 NAGHLJA ;� P. 0,4,'04
1 Injulato circulating hot wator pipes to tho, i,;
PIPE SIZES �illi)
NX -CIRCULATING 1 CIRCUTATTNO !�7L,',NS i RUNOUTI;
HUTED MER TDT (F) RUNOUTS 0-11
0 . 5
0.6
---- NOTES TO FIELD (BuildLng Dapartmont Tise Only) --------------------------
0
TOTPL P.04
FORM U - LOT RELEASE FORM
A
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 QKV, X C - PHONE 2
LOCATION: Assessor's Map Number 'OCV-- PARCEL
SUBDIVISION LOT (S)
STREET ST. NUMBER
USEONLY**************
RECOMMENDATIONS OF TOWN AGENTS:
COI�_SLRVAtION ADMINIVRATOK DATE APPROVED -5-1 J,�, 1 -7,
DATE REJECTED
TOWATCANNER"' DATEA�PPROVED
DATE REJECTED
COMMENTS
FOOD INSPECTOR -HEALTH DATE APPROVED
DATE REJECTED
-HEALTH DATE APPROVED ZZ
,9TTC IN61FECTOR
DATE REJECTED
COMMENTS Z?7
PUBLIC WORKS - SEWERIWATER CONNECTIONS
DRJVEWAY YRMIT x
FIRE DEPARTMENTAO&
RECEIVED BY BUILDING INSPECTOR DAT,
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