HomeMy WebLinkAboutMiscellaneous - 29 JOHNNY CAKE STREET 4/30/2018 (2)0
z
0
m
Cl)
-4
;u
m
m
--4
Location
No C, Date (/, /0 eZ2
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $ (-9
HU
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # /�—`
Building Inspector
Date ...... 7 -�/ '!.�
.......................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
or This certifies that ..... I "" , r
............ ; ............................................................................
has permission to perform ............ . .. . . ...............
wiring in the building of ... ......... ..........
...... . . ........... . North Andover, Mass.
............. .........................
Fee-:��.� .... . ....... Lic. No.� ..... ...... . ..................
"ELEcrRICAL INSPWMR
Check #
1� "S
I
A
4
Clmmottwea& ol Vaijacliujelb official Usc Only
Penrut No.
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev- 11/991 (1cave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accoidancc With (be MaSSOCIMSCHS Elcci(icll CDde (MEC), 527 CNIR 12.00
(PL EASE PRINT IN INK OR TYPE. -ILL INI.*ORAL ITION) Date: ? —,:Z>—,�o
City or'Yown of: & 4xwlb O&Z— To the Inspector of IT'ires.-
By this application the undersigned L,,Ivcs notice oflifs or hcr intention to perform the c1cctrical work described below.
Location (Strect & Number)
Owner or Teriant L
Owner's Address 2
Is (his perinit in conjunction with a building permil?
Purpose of Building
Existing Service Anips
r,
New Service
Anips
Volts
Volts
-0
Telephone No.
Yes'P,—No 0 (Check Appropriate
Utility AuNiorization No.
Overhead El Undgri-10
Over-headEl Unclord 0
Number of Feeders and AnipacitN
Location and Nature of Proposed Electrical Work: 4JI12<5—
No. (if Meters
No. of Meters
Cotunle.lion ofthe follinvinf, iriblp--, I ... ... -r IV;,—,
No. of Recessed Fixtures 14
No. of Ceil.-Susp. (Paddle) Fans
No. of Total
Transformers KVA
No. of Lighting Outlets
No. of Ilot Tubs
Generators KVA
No. of Lighting Fixtures 2—
Above 11 In- El
Slyin,111in.0 Pool arnd. grnd.
0.0 inergency igliting
Batteg Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
INo. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
Initiating, Devices
No. of Ranges
Total
No. of Air Cond. Tons
No. of Alerting Devices
Heat Pullip
T "S KW
Number 1 o
No. of Self -Contained
No. of Waste Disposers
To als:
I ]
Detection/Alertin g Devices
No. of Dishwashers
Space/Area Heating KW
Local [] Mu"I"p?l 0 other
Connection
No. of Drvers
Heating Appliances K NN"
Security Systems:
No. of Devices or Equivalent
No. ot"Water KW
No.—of No. of
DAa Wiring:
Heaters
Si -vis Ballasts
— No. of Dei,ices or Equivalent
No. Hi-droinassaae Bathtubs
No. of illo(ors Total HP
Teleconimunicitions NViring:
i b
No. of Devices or Equ valent
OTHER:
Attach additional delait ij desired, or as required b , v the hispec[or of Wires.
INSURAANCE COVERAGE: Unless walved by the o�\ ner, no permit for the performance of electrical work May issue UnICSS
the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The
undersigned certifies that such cove�rp<e is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURkNCE Vr BOND [] OTHER [] (Specify:)
Z— (Expiration Date)
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: lns�cctions to be requested in accordance wit I Rule 10, and upon completion.
I cel-lifj,, 111111e). the mins andpenalties ofpe1jiti)-, that the inforniatioll oil is a licatiol s true and Complete.
1, 1 RJN I N A N I E: a] 12 6Z15C-W,64-L- LIC. NO.: /W/512ej
Signature LIC. NO.:
Licensee: 4-466,*z
(If applicable, enter -exempi " in the license nuinber fine-) Bus. Tel. No.:
Address: Al�t- Tel. No.:
OWNER'S INSURANCE WAIVER: I am aware th3t the Licenset does not have the liability insurance coveiage normally
reqUired by By my signatuic below, I licieby \klji%e (his requirc-mcnt. I am the (check onc) 11 owncr [I owiici's a,-,ent
Owner/Agent
sion"Iture' felephone No. I'ILR W T F- E, E: S
PLEASE FILL OUT BACK SIDE
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
-7-
77 777 -77q,
""'Tr spetw for-, 77
BUELDING PERMIT NUMBER: see DATE ISSUED: 13
SIGNATURE:
BuUng Commissioner/Inspdtor of Auildings Date
SECTION I- SITE INFORMATION
1.1 Property Address:
1.2 Assessors Map and Parcel Number:
Map Number Parcel Number
f
1.3 Zoning Inforrnkton:
Zoning Distr �ct Proposed Use
1.4 Property Dimensions:
Lot Area (sf) Frontage (ft)
1.6 BUILDING SETBACKS (ft)
Front Yard Side Yard
Rear Yard
RecjWred Provide R�red Provickd
Reqwred Provided
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Infotmation:
Public 0 Private 0 Zone Outside Flood Zone 0
1.8 SewcMe Disposal System:
Municipal D On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSHW/AUTHORIZED AGENT
2.1 Owner of Record
Name (Print) Address for Service
Signature Telephone
t
2.YOwner of Record:
Name Print Address for Service:
Signature Telephone
ASECTION 3 - CONSTRUCTION SERVICES
,'3.1 Licensed Construction Supervisor:
772�qG_,%& =(�74_ 97�-jN f
Licehsed Construction Supervisor:—
� N
�Z 1_'t
Signatu Telephone
Not Applicable 0
License Number
Expirdio ate
3.2 Registered Home Improvement Contractor
Not Applicable 0
Company Name
70e
LIZ
Registration Number
Address
Expiration Dafe
SigtZrie Telephone
M
M
M
X
z
0
0
z
M
90
0
X`�
I SECTION 4 - WORKERS COMPENSATION (rYLG.L C 152 § 25c(6) I
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 ....... 0 No ....... 0
SECTION 5 Description o Proposed Work (check applicable)
New Construction 0
Existing Building 0
Repair(s) 0
Alterations(s) 11 1
Addition 0
Accessory Bldg. 0
Demolition 0
Other 0 Specify
Brief Description of Proposed Work:
4Ad 0 3 C?0-XZZ"
SECTION 6 - ESTIM[ATED CONSTRUCTION COSTS
Item
Estimated Cost (Dollar) to be
Completed by permit applicant
OFFICIAL USE ONLY
I Building
(a) Building Permit Fee
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
3 Plurnbing
Building Permit fee (a) x (b)
4 Mechanical (HVAC)
5 Fire Protection
6 Total (1+2+3+4+5)
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner/Authorized Agent of subject property
Hereby authorize to act on
My behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
1, as Owner/Authorized Agent of subject
property
Herebv declare that the statements and information on the foregoing application are true and accurate, to the best of mv knowledge
and belief
Print Name
Signature of Owne ent Date
I........... ..........
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS I ST 2 ND 3 RD
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHD�NEY
IS BUIIDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
-:�> "' (; G t 41)
KeL2(AOP LWO?41- 1 —0' 1 P A -
FORM U - LOT RELEASE'FORM
r
,3 ��- V -
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits fro
Boards and Departments having jurisdiction have'been obtained. This does not relieve
the applicant and/or landowner from compliance with any . applicable or requirements.
*****************************APPLICANT FILLS OUT THIS SECTION******
APPLICANT-]L� M__C6 0 S�Vu c" -Sqe -
PHONE 6 t� 3
LOCATION: Assessor's Map Number PARCEL -_I r) _8
SUBDIVISION LOT (S)
STREET—Z71—nk yv �J V -,e
%. ST. NUMBER C1
CONSERVATION
Comm
TOWN PLANNER
COMMENTS
FOOD INSPECTOR -HEALTH
IC(I'NSPE OR-HEA`LTH
COMMENTS
ell
USE
AGENTS:
TOR DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED—
DATE APPROVED
DATE REJECTED -
DATE APPROVED
DATE REJECTED
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
N
RECEIVED BY . BUILDING INSPECTOR DATE
Revised 9197 im
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 Perrnit
Number . is -that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by IVIGL
c 11, S 150 A..
The debris will be disposed of in:
(Location of Facility)
Si ure of Permit Applica�nt
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through.the Office of the Building Inspector
Name
The Commonwealth of Massachusetts
Department of Industfial Accidents
Glffic� of Investigations
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
Please Print
am a sole proprietor and have no one working in any capacity
F-1 I am an employer providing wurkers' compensation for my employees vvorldng on this job.
Comr)anv name:
Address
Ck. Phone fk
Insurance. Go.
PollcV
Company name:
Address
Phone
Insurance Co. Poliev
Failure to secure coverage as required under Secdon 25A or MGL 152 can lead to the unposkon Of "WN -W penalties omf.a fim up to $1,500.00
andfor one years'imprisonmiNA-as-well-as ctW-pmakmjn-theJmn-d-aZTQPY4DW-ORDER-md-alkl.---aA$IjDD-OD)_ajdWagamstnw I
understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
rw�--Tir=;�gz
Sigrrdture.
Print nami
Official use only . . do not write in this area lo be completed by city or town officiar
City or Town icensinq
El Buildil7g Dept
OCheck flmmed)ate response As required .0 Llicensirig Board
E] Selectman's Ofte
Contact person: Phone A Health Department
Other
U)
m
m
m
m
m
:10
cn
m
C/)
0
m
CO)
CD
C2 z
E; 0
CL r,
CL
C)
CD
CL
cr
CD 0
CD
CD
cop)
-0.
kal
CD
=r
CD
CD
P.
CA
CD
GO
CD
CD
ccl
C;p Ca cr W
0 ds CD = CO)
CD 0 co C')
C2
CL C) m
CD .* c
z =r -C
a) C,*
0
CL
CL. -O m
=r cono
CD CD 0
C
CD
0 0
0 -0 0
C) z IN
0 o
0 CD
=r ='a
CO)
MC50* 90
CL,,
C
co =r E:
CD a co)
c
cD
CL
0 1=0
cn
C -CD
CD :#V
cn CaQ CD
3
P"
E; 0 =5
0
.0
=r
CD
CD
V, CD
T-. cn
cn
CaD
r
in
CD:4..
a=
C3
12
(n
0
C/)
Z,
0
to
OTI
M
z
tz
P�
0
tri
�Z
0
0
'71
0
V.
R.
0
En
a.
C/)
l<
W
al
0
a.
P�
;;.
()
x
to
0
>
0
I
1
91
omi
0
404
777777
VIC :��
y,i
. .010 '�
got
,"W
WAN
IF'
-IiIZ, 'tv
- n_'s
. . . . . . . . . . .
0 "1 1�
log IVW
u' �Z 5� iW71
"K, N 011�4411kklv
$6 5'1�f
i� rQ_1- QQ a Am,
AQ
"A.
Oil 50,
how WN Q
grg
iPi"'
RV W.",
4��" Was I _0111",
XF
A -nil
n -$jh, A v"
lot Tv;K-W "I May MCI
v'fii Wi
-I maw
x USAMAW
S;
�xj4 J;�-�";
Q:v nil
v Qyj
4 W—W
u W MARK
tint, " Oil,
JIM
1 a 5 1, V
Matz,
MAK TIN t
I -J
K 001117
............... . . . . . .
�11'11
OW44,
-5W
w"A'v". ":A ", �,�,..�.C�,A,�'A
1,7
CMA
4,�V �ilc,.!'�
n,�4
. . . . . . . . . . ..... P
.......... 1''A
""Ino AS
SAM. wmw�
T
mom,
Al U
'N44, 0
KWW Owl= '13
W sm
zw V" &MM
�,�004 A IAN 00,
it"
*"� 1 1; Q9
-i 1%11010w, Mj .-U--
........ . . . . . . . . . . . . . . .
............
. . . . . . . . . . . . . . .
Location -
N o. Date /I/
I 14ORT#f TOWN OF NORTH ANDOVER
0 �,,to ,,�
0
Certificate of Occupancy $
Building/Frame Permit Fee $
Mu
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
,63 7
Building Inspector,'-/
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
A a for Wkid
BUILDING PERMIT NUMBER: DATE ISSUED:
SIGNATURE:
Building Commissioner/Inspector of Buildings Date
SECTION I- SITE INFORMATION
1. 1 Property Address:
L5, 7
Cg � 7:�t\V-\ e a
Map and Parcel Number:
Map Number Parcel Number
1.3 Zoning Information:
Zoning Di�-Uiic—t Proposed Use
1.4 Property Dimensions:
Lot Area (so Frontage (ft)
1.6 BUILDING SETBACKS (ft)
Front Yard Side Yard
Rear Yard
Required Provide Required Provided
Required Provided
1-
1.5. Flood Zone informa
1.7 Water Supply M.G.L.C.40 54) tion:
Public 0 Private 0 Zone Outside Flood Zone 0
1.8 Sewerage Disposal System:
Municipal 0 On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSIBPIAUTHORIZED AGENT
2.1 Owner of Record
6-19 r3 0-
Namc�-(Print) Address for Service
PC�,)O\J 0 GL IJAG6-1
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Licensed Construction Supervisor:
40RI-OL-5-
Address
U & A)
Signature Telephone
,V41111 0 &4� - ? q(?- 7 q �--
Not Applicable 0
2-
License Number
�- � 3 /
Expiration Date
3.2 Regitt�4cd Home Improvement Contractor
�qa- uel-6&7�
Not Applicable 0
3 '2
Compan� Name
Registration Number
Address
9111n,�
0
Expiration Date
Sign4e' e
U
OU
M
M
1 0
P It
.4
0
z
M
90
0
mn
M
rM
-L.,4
SECTION 4 - WORKERS COMPENSATION (KG.L C 152 § 25c(6) I
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 ....... 0 No ....... 0
SECTION 5 Description o Proposed Work (check applicable)
New Construction [I Existing Building 0 Repair(s) 11 Alterations(s) 0 dition 0
Accessory Bldg. 0 Demolition 0 Other 11 Snecifv
Brief Description of Proposed Work:
R—
SECTION 6 - ESTIMATED CONSTRUCTION COSTS I
Item
Estimated Cost (Dollar) to be
OFFICIAL.VSE ONLY
permit applicant
1. Building
(a) Building Permit Fee
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
-3 Plumbing
Building Permit fee (a) x (b)
Mechanical (HVAC)
-4
5 Fire Protection
-6 Total (1+2+3+4+5)
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BURDING PERMIT
I, , as Owner/Authorized Agent of subject property
Hereby authorize to act on
My behalf. in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
1, 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
Signature of Owner ent Date
-NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TMERS 2 ND 3M
SPAN
DMENSIONS OF SILLS
DMENSIONS OF POSTS
DMIENSIONS OF GrRDERS
HEIGHT OF FOUNDATION THICKNESS
-SIZE OF FOOTING X
-MATERIAL OF CHRvMY
-IS BUILDING ON SOLID OR FILLED LAND
L_ IS BUILDING CONNECTED TO NATURAL GAS LINE
�4
r
V,
E."
R5
1�
E
Z
CA
co)
cc
'a
cm
cm
ccl
CD
CD
Cf)
z
0
C/)
P-4
Cf)
z
0
u
C/)
Cf)
EMS
M -1-
u
0
E
0
CD
E
CD
L-
CL
C.)
cc
ca
CO2
CL
0
ts
co
CL
C40)
c
CD CM
CL
cc
CD
z ts
co
CL
COD
i
w
0
U)
w
CO
ir
w
w
Ir
w
w
CO
0
LEu
V)
cz
0
E-4
u
ro-
co
-13
c
z
x
to
::I
-C
u
co
r.
x
w
0
H
u
tic
cz
r.
1:4
0
H
w
E
—cz
Cc
bD
C3
r.
V)
0
E
C/)
1�
E
Z
CA
co)
cc
'a
cm
cm
ccl
CD
CD
Cf)
z
0
C/)
P-4
Cf)
z
0
u
C/)
Cf)
EMS
M -1-
u
0
E
0
CD
E
CD
L-
CL
C.)
cc
ca
CO2
CL
0
ts
co
CL
C40)
c
CD CM
CL
cc
CD
z ts
co
CL
COD
i
w
0
U)
w
CO
ir
w
w
Ir
w
w
CO
Cl
Cc
C3
r L
cc
4D
cc
c
EAX
ci.
C ca
2
:.s C CL
E E
C.3 0
t; cm
CD
CL
43
0
CD
U)
1
CD
C,
:10
a)
co
C4
E COD
CL C-'2
CD
c
C-1
C3
0 CL
sp
CO3 CD
U2
4D
CD -
CL
ca
Cc
LU
U)
co
E
cc;
U=
i L..
Q Li cm
CD
ci 0
C3 *:
CA) CX.
CD
CD CL= CA
.03
1�
E
Z
CA
co)
cc
'a
cm
cm
ccl
CD
CD
Cf)
z
0
C/)
P-4
Cf)
z
0
u
C/)
Cf)
EMS
M -1-
u
0
E
0
CD
E
CD
L-
CL
C.)
cc
ca
CO2
CL
0
ts
co
CL
C40)
c
CD CM
CL
cc
CD
z ts
co
CL
COD
i
w
0
U)
w
CO
ir
w
w
Ir
w
w
CO
APPLICANT IlqFORMATION
Location:
C!t)r �Mmj Telephone M
T& C===0,dtfi of X==h==
(Depanment of ind=tridAxLdents
600 Wasfiftlgt= St7W
,%(BostM WA 02111
Wm-kez-sl Compensation Inmranct Affidavit
�CL Lf4o&l�
ID I am a homeowner performing all work myself.
D I am sole proprietor and have no one worldng in my capacity_
M I am an empl . oyer providing workers' compensation for my employees woricing on this job
�Z
company Name:
Address:
City: C -7w Telephone #-.-
Ins=ce Company r~ 4W Policy
Please PRINT LenqblO�
0 1 am (rird'e one) sole proprietor, general contractor Or homeowner and have hired the c . ontractors 1Lqed below who have tie followm
9
workers, compmsationpolicies:
Company Naxne:
Address:
Telephone
City:
' Insurance Company:
Company Nam :
Address:
City:
Insurance Company*
Policy *:� —
Telephone M
Policy
Attach additional sheet if necessx—Y
Failure to secum- coverage. as required und--r Section 25A of MGL 15B can lead to the imposition of criminal penalries of a f3nr up to S1,500-00
and/OT"one years' irnprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fme of $100-00 a day against me. I
understand thata copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage Verification.
.1 do hereby certify under thepains andpenalties ofperjury that the information above is true and correct.
Signature: Cl) Date: 4zzz,/p -3
S44 L - . V
Phone#
Print Name: r) 26��1-101 �f—
Official Use ONLY - Do not write in this area
o Building Department
City or Town: Permit/License 0 Licensing Board
o Selectmen's Offic:e
o He2lth Department
C) Other
r) Check if Immediate response Is required
MORMAnON & INSTRUCnONS-
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation
for their employees. As quoted from the "laV' 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, construc tion
or repair work. on such dwelling house or on the grounds or building appurtenant thereto shall not because of
such einployment be, de=ed to be an employer.
MGL chapter 152 section 25 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, neither the commonwealth nor. any of its political subdivisions shall enter into any
contract for the performance of -public work until acceptable evidence of compliance with -the insurance
requirements -of this chapter have been presented to. the contracting authority.
Applicants
Please fill in the workers' compensation affidavit completely, by checking the.box that applies to your sitaation
and supplying company names, address and phone numbers as all affidavits may be submitted to the.
Department of Industrial Accidents for.confamation of insurance coverage. Also be sure to sign an . d 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'zompensation policy, please call.'the Department at the numbdr
listed below.
City or Towns
Please be' sure that the affidavit is complete and printed legibly. The Department has p7ovided a space at the
bottom of the affida7vit 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, The
affidavits. may be returned to the Department by mail or FAX unless other arrangements have been made.
The Office of Investioations woi2ld liketo thank you in advance for your cooperatio '
n and should you have any
questions, please do 'not hesitate to give us a call.
The Department's address, telephonie andfax number:
The Commonwealth of Massachusetts
Department.of Industrial Accidents
Office of Investigations
600 Washington. Street.
Boston, MA 02111
Fax # (617) 727-7749
Telephone # (617) 727-4900 ext. 406, 409, or 375
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
c 11, S 150 A.
The debris will be disposed of in:
,- C-�),-
(Location of Facility)
0. siggnature *oPer-mit -Applicant
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through,the Office of the Building Inspector
011
-el
B "now 'w
OWD OF
UUTIONS
License: CONSTRUCTION SUPERVISOR
Number: CS
069120
. 74
"Irthdate: 04/03/1959
EXPIres: 04/o3/2005
Tr. no: 10040
Res cted: 00
'OHN W LANZAFAME
30 TEMPLE DR
METHUEN, MA 01844
Adm�i
I
Chimneys Residential & Commercial Roofing All Types Of
Siding CHIMNEYS POINTED -REBUILT -CAPPED Expert Masonry Work
Mass Toll Free Roof Leaks Experis__*] Licensed & Insured
1 -800 -WAIT -4 -US Locally Owned & Operated Since J 9 76 ..... t License #034200
(924-8487) IKO ezff Woem 0r.,qvhv K We Work Year Round
RN P.- M-1 ra.
I
P Proposal Sutitted To Phone Date
7r0poS_,%P1_ I
2m
Street ' I/ C)s
6-3 � , (n� �
Job Name
2,
City, State & Zip tode
Job Location
Job Phone
�weDlrlpw,orr,
1 !2? j4fiC/-f/(C5- 1UP.
I
We Propose hereby to furnish and labor in accordance with specifications below, for the sum of-
�Z. ae'C'A UD( -5_- Dollars($ C'��060, 0 0
All material is guaranteed to be as specified. All work to be completed in a workmanlike Authorized
manner according to standard practices. Any alteration or deviation from specifications be- Signature:
low involving extra costs will be executed only upon written orders, and will become an U V
extra charge over and above the estimate. All agreements contingent upon strikes, accidents NOTE: This proposal may be
or delays beyond our control, Owner to carry fire, tornado and other necessary insurance.
withdrawn by us if not accepted within days.
Our workers are fully covered by Workmen's Compensation Insurance.
We hereby submit specifications and estimates for: ETI?, to
OLe2,
UC^/"/, /LJ 'r
Install 3 feet of special "Eave Seal" ice and water barrier protection along all bottom edges of roof
and top to bottom in each valley. If roof is §Lrigped, we will apply conventional ice and water shield
3 ft. high in the same locations previously described and tar paper will cover the
remaining bare wood. Any rotted or damaged boards will be replaced at per linear ft.
or V sz�,e-) per sheet of plywood.
LdInstall heavy gauge aluminum drip edges along every edge surface of each rooflinej
&Cover entire roof (s) with IK090year all asphalt, non -fiberglass, premium grade shingles
(Color of choice). /4kI4Tt-�SA_( _17AZt�,
&Replace all pipe boots where possible.
&Seal all flashings with clear Geo -Cel sealant. No black tar unless previously applied.
&Remove all work-related debris.
Contractor warrants roof against all leaks due to defects in his workmanship for 12 years under
normal circumstances.
UrLocal current references and proof of workman's compensation insurance gladly given.
J R e m a r k s: M _-Pq S 71" ' "--A 3 t� /J-tzl (I"t'Ll/14 314A3
/0� COT P�U- Cc�6 M /1?/ �96- -r- Lt-�T- Syf rd -1-1
Acceptance of Proposal - The above prices, specifications
and conditions are satisfactory and are hereby accepted.
You are authorized to do the work as specified. Payment Signature:
will be made as outline ove.
a4
X 05 Signature: -A
Date of Acceptance: /L
2894
0
A US
Date...
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ........ 4.P. ....... if � .......... 2 . .............................
'fi'l f/�-O'v
has permission to perform ..... // ... h.:�� ............... 5.'y ..................................
wiring in the building of ........... ... OIC4 .............................................
. e� — � k' I I k ... ... ... . ...
-% .... ( ......... ....... .. ... ....... —1U ' North Andover, Mass.
at ....... L ..............
'7
Fee...,.).� ........... Lic. No. ..............................................................
ELECTRICAL INSPECTOR
127/% 14:44 35.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File
J
A. -
&Mmonwmlo of Nuour4twetto
i9quirtment of Public 1&zifttLj
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
0'
Office Use Only
Permit 7NNo.
Ocwpncy & Fee CMcked qS
3/90 (leave blank) It
Ward
Area
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 -
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION), Dat
City or Town of To the Inspector of Wires -
The undersigned applies for a permit to perform the
. I
Location (Street & NuT�er) (*X -1
owner or Tenant
Owner's Address
Is this permit in conjunction with a building permit:
Purpose of Building
Existing Service —
Amps Volts
New Service — Amps I Volts
Number of Feeders and Ampacity
work described below.
Yes El NOE] (Check Appropriate Box)
Overhead
Overhead
- Utility Authorization No.
EJ Undgrnd El
El Undgmd El
No. of Meters
No. of Meters
Location and Nature of Proposed Electrical Work Installation of alarm systpm
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers Total
KVA
No. of Lighting Fixtures
Swimming Pool Above In-
grnd. EJ grnd- El
Generators KVA
No. of Emergency Lighting
No. of Receptacle Outlets
No. of Oil Burners
Battery Units
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS No. of Zones
No. of Detection and
Total
No. of Ranges
No. ofAir Cond. tons
Initiating Devices
Heat Total Total
1�umps
No. of Disposals
No. o Tons KW
No- of Sounding Devices
No. of Self Contained
I
No. of Dishwashers
Space/Area Heating KW
Detection/Sounding Devices
Lo Municipal D Other
rinection
No. of Dryers
Heating Devices KW
No. of No. of
ow Voltage
No. of Water Heaters KW
Signs Ballasts
IT
t - L
No. Hydro Massage Tubs
No. of Motors Total HP
OTHER:
FEB 2 ?
INSURANCE COVERAGE: Pursuant-Wtffe-7equ . ifements, of Massachusetts General Laws I have a current Liability Insurance Policy inciud-
Ing Completed Operations Coveragb'& Wi- -substantial equivalent. YES 0 NO 0 1 have submitted valid proof of same to the Office.
YES 0 NO 0 it you have checked YES. please indicate the type of coverage by checking the appropriate box.
INSURANCE X% BOND 0 OTHER 0 (Please Specify) (Expiration Date)
Estimated Value of Electrical Work $ 3-3 ), (90
Work to Start — c.0-11 q - q 10 Inspection Date Requested: Rough Final c2-10�
Signed under the Penalties of Pedu(y:
FIRM NAME
LIC.NO. 1231C
Licensee _Signature aD V KIX-141— W tn AA-ff , -LIC. NO.
Bus. Tel. No.617-431-5800
Address 60 �illiam 8t./Weiiesley, MA 02181 — Alt. Tel. No. 617---4TT-- 5 8 3 7
OWNER'S INSURANCE WAIVER- I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re-
quired bY Massachusetts General Laws. and that my Signature on this permit application waives this requirement. Owner Agent
(Please check one)
Telephone No. PERMIT FEE $ -3
C3
Co
-V
M
Co
07
M
I
M
C�
co
0
Co
<D
n
D3
rn
M
M
C->
�2
-/7- - 9�?
Date .............
3996
,jOR
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
Ar.D
mus
This certifies that ... 2z�
has permission to perform
plumbing in the buildings
at
Fee'�� ...... Lic. N r7�-W.c
..................
..................
V
North Andover, Mass.
5-1
. 1--� - �-- - -.-. .
PLUMBING INSPECTOR
WHITE: J��?-qjrt 14:24CANARY: AlMg DW.D
PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Date
Building Loc Owners Name o Permit #—L,-�qv
Amount
Type of Occupancy
New [Er Renovation 0 Replacement 1:1 PlansSubmitted Yes No
FIXTURES
(Print or type) Check one:
Installing Company Name j m 17 1 )jrjLL&!r 0 Corp.
11 Partner
U Firm/Co.
Name of Licensed Plumber: � —16 ?-- �\ P, C C- � Iq "'1'a (
Insurance Coverage, Indicate the type of insurance coverage by checking the appropriate box: Bond
Liability insurance policy 0' Other type of indemnity El 11
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 F1 Agent n
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 anA installations rmed under Permit Issued for this application will be in
compliance with all pertinent provisions of the M K, chusetts State P bi e and Chapter 142 of the General Laws.
�j ng
A le" -
By: Nam: r I Eacensea riUMDer
Ty�e of Plumbing License
Title 2122
.Q
City/Town License Numoer Master Journeyman
APPROVED (OFFICE USE ONLY
MEN
OWN
001000010010
MWOMMON
N
00000010101MMIEN
001000101010000
15rel,
=3 I memo 19 to-$ 11
MMONNOWN010100100
0
000000001010
(Print or type) Check one:
Installing Company Name j m 17 1 )jrjLL&!r 0 Corp.
11 Partner
U Firm/Co.
Name of Licensed Plumber: � —16 ?-- �\ P, C C- � Iq "'1'a (
Insurance Coverage, Indicate the type of insurance coverage by checking the appropriate box: Bond
Liability insurance policy 0' Other type of indemnity El 11
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 F1 Agent n
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 anA installations rmed under Permit Issued for this application will be in
compliance with all pertinent provisions of the M K, chusetts State P bi e and Chapter 142 of the General Laws.
�j ng
A le" -
By: Nam: r I Eacensea riUMDer
Ty�e of Plumbing License
Title 2122
.Q
City/Town License Numoer Master Journeyman
APPROVED (OFFICE USE ONLY
DATE (MMIDDlYY)
:'ACORD. CERTIFICATE GF11ABILITY INSURANCE
3/30/99
PRODUCER (978) 887-8304
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
JAMES W. UGONE INSURANCE AGENCY
10 S. MAIN ST., SUITE 208
TOPSFIELD, MA 01983
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY FARM FAMILY CASUALTY INSURANCE COMPANY
A
INSURED
COMPANY
JOE DESCHAMPS PLUMBING & HEATING
B
25 STEVENS STREET
METHUEN, MA 01844
COMPANY
C
COMPANY
D
CqYERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED
BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER _7P
OLICY EFFECTIVE
DATE (MMIDDIYY)
POLICY EXPIRATION
DATE (MMIDDfYY)
LIMITS
A
GENERAL
LIABILITY
2005X
03-30-99
03-30-00
GENERAL AGGREGATE J$ 1,000,000
X-1
_r_1
PRODUCTS -COMP/OPAGG $ 500,000
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Lil OCCUR
PERSONAL & ADV INJURY $ 500,000
EACH OCCURRENCE $ 500,000
OWNER'S & CONTRACTOR'S PROT
FIRE DAMAGE (Any one fire) $ 50,000
H_
MED EXP (Any one person) $ 5,000
LIABILITY
COMBINED SINGLE LIMIT $
_,�UTOMOBILE
ANY AUTO
BODILY INJURY $
(Per person)
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY $
(Per accident)
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE $
AGE LIABILITY
AUTO ONLY - EA ACCIDENT S
OTHER THAN AUTO ONLY:
ANY AUTO
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY
EACH OCCURRENCE $
AGGREGATE $
UMBRELLA FORM
$
OTHER THAN UMBRELLA FORM
I
WORKERS COMPENSATION AND
WC STATU H-1
TORY LIMITS CETR
EL EACH ACCIDENT S
EMPLOYERS' LIABILITY
EL DISEASE - POLICY LIMIT S
THE PROPRI E' INCL
PART N E R S/EXTEOCRU/TIV E
OFFICERS ARE: EXCL
EL DISEASE - EA EMPLOYEE $
JOTHER
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESISPECIAL ITEMS
LIABILITY POLICY INCLUDES PLUMBING AND HEATING.
CERTIFICATE HOLDER
CANCELLATION. -
STEVEN AVEDISIAN
AVEDISIAN LANDSCAPING
70 SALEM STREET
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
METHUEN, MA 01844-1123
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPOhL THE COMPANY, ITS AGENTS OR REPRESEN7
AUTHORIZED REPRESENTAkkE 1
V
ACORD 25-S (1195) \ 1 __ \j @A(;URL)(;UKFUKAl
I . I . It 41
A&BUIL
I
OWN F NORTH ANDOVER
ING DEPARTMENT
APPLICATION TO CONSTRIJ/REPAIk1')'&'N0VATj
OR DEMOLISH A ONE OR TWO FAMILY DWELLING
I* SMM for Ofrmd ul� 010y,
BUILDING PEFMT NIMBER:
DATE ISSI JED. /0/
SIGNATURE:
A 14
Build& ComlWsionerqJ(sPWW of Buildings Date
SECTION 1- SITE I*ORM41ON
1.1 1 Property Adkess: 1
44A
0�f vs-
1.2 Assessors Map and Parcel Number:
M ap Number Parcel Number
1.3 Zoning Information:
Zoning Dktr ict Proposed Use
1.4 Property Dimensions:
Lot Area (sf) Frontage (ft)
1.6 BUILDING SETBACKS (ft)
Front Yard
Side Yard
Rear Yard
Required Provide
Re(pired Provided
Required Provided
1.7 Water SuupplyM.G.L.C.00.. 54)
Putilic 0 Private 0 Zone
1.5. Flood Zone Information:
Outside Flood Zone 0
1.8 Sewerage Disposal System:
Municipal 0 On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSUIP/AUTHORIZED AGENT
2.1 Owner of Record
p4n,
Name (Print�
- - IN ;� �/,
c-1— C>
Address Tor Service
Signature
Telephone
2.2 Owner of Record:
Name Print
Address for Service:
Signature
Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Licensed Construction Supervisor:
Address
Signature
Telephone
Not Applicable��
License Number
Expiration Date
3.2 Registered Home Improvement Contractor
Not Applicable 0
Company Name
Registration Number
Address
Expiration Date
Signature
Telephone
00
M
X
C
z
0
0
z
M
90
0
ic
M
z
G)
M
SECTION 4! WORKERS COMPENSATION (NLG.L C 152 § 25c(6) I
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this aff
in the denial of the issuance of the building permit.
Signed affidavit Attached Yes ....... 0 No ....... 0
SECTION 5 DescriDtion of ProDosed Work (check an waDficabie
New Construction [I I Existing Building 0 1 Repair(s) 0 1 Alterations(s) 0 1 Addition 0
Accessory Bldg. 0 1 Demolition 11 Other [I Specify
Brief Description of Proposed Work:
I SECTION 6 - FSTTMATED CONqTRITCTION COqT.q I
will result -1
Item
Estimated Cost (Dollar) to be
Completed b permit applicant
OFFICIAL USE ONLY
I . Building
(a) Building Permit Fee
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
-3 Plumbing
Building Permit fee (a) x (b)
-4 Mechanical (HVAC)
-5 Fire Protection
6 Total (1+2+3+4+5
z,2 v vy
Check- Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner/Authorized Agent of subject property
L/
Hereby authorize to act on
My behalf. illal tters relative to work authorized by this building permit applicati
S gpeturi Date
i I e—of � �ip
SECTION 7b OWNEIRJAUTHORIZED AGENT DECLARATION
1, 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
Signature of Owner/Agent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS Or 2 ND 3 RD
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DDvENSIONS OF GIRDERS
HLfGH`r OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CH11VINEY
IS BUUDING ON SOLID OR FILLED LAND
IS BUIJDING CONNECTED TO NATURAL GAS LINE
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
*****************************APPLICANT FILLS OUT THIS SECTION***********************
-74
T Zglo,� Z' ?V
APPLICAN CZ� PHONE
LOCATION: Assessor's Map Number LO / — PARCEL,,,?
SUBDIVISION LOT (S)
ST. NUMBER
STREET
V
USE
J REC)MMENDATIONS -OF TOWN AGENTS: I
J.A-4461-264 ` " -4Tfff!�'� �11-
CONSERVATION ADMINIST' OR DATE APPROVED
7 DATE REJECTED
?ra� -'5+td' i meefi'
COMMENTS -CC14 to
TOWN PLANNER
COMMENTS
'FOOD INSPECTOR -HEALTH
C, -s LQ -
SEPTIC INSPECTOR -HEALTH
COMMENTS
DATE APPROVED
DATE REJECTED
DATEAPPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED -
J Ttw �V- 4,J IN
I
�dok -"rj �3
0iQ-
PUBLIC WORKS - SEWER/WATER CONNECTIONS s
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE_
Revised 9\97 jm
0 A
/ d4j
ulations
Board of Buildin e
One Ashburton Ace m 130, 1
Boston, Ma -02108-1618
girthdate: 06/08/1962
TRUCTION SUPERVISOR LICENSE
License: CONS
058632 Expires: 06/08/2004.- Restricted To: 00
Number: CS
THOMAS P MCDE,RMOTT
20 WHEELER AVE
SALEM, N -H 03079
Tr. no: 25539 j ification.
Keep top for receipt and change of address not
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registration: 118788
Expiration: 04/21/2003
Type: DBA
TPM CONSTRUCTION
THOMAS MCDERMOTT
20 WHEELER AVE
SALEM, NH 03079 Administrator
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Number: CS OW32
Birthdate: 0&0&1962
Expires: Mnq/*3rtAA
Tr. no: 25539
Restricted: 00
THOMAS p MCDERMOTT
20 WHEELER AVE
SALEM, NH 03079 5.1.4
Administrator
Name
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
Boston, Mass. 02111
Workers'Compensation Insurance Affidavit
Please Print
ci!y Phone # 6,0 ) '2'(-:,
5Vam a homeowner performing all work myself.
I am a sole proprietor and have no one working in any capacity
F-1 I am an employer providing %iorkers! compensation for my employees working on this job
COMDanv name:
Address
city- Phone
Insurance. Co. Policv
Compagy name -
Address
Phone
insurance Co. Policv #
M
Failure to secure coverage as required under Section 25A or MGL 152 can lead to -the imposition of criminal penalties o7a fine up to $1,50o.00
andfor one years'imprisonment-as-vmfl-as-cixdlpwalfiesin-ibelDrm-daSTDP.VAORKDRDER-and-afine-cf-($1-00m)-ajdm.Kjainstn.-&— I
understand that a copy of this statement may be forwarded to the Office of I nvestigations of the DIA for coverage verification.
I do hereby certify under thq pains and penalhes ofper
jury that the information provided above is true and correct.
-Pbo-ne.# 6dy ?"96 S7 7
Print name
Official use only do not write in this area to be completed by city or town official'
City or Town Permit/Ucensinq
Building Dept
nCheck if iminediate response is requred 0 Licensing Board
n Selectman's Office
Contact person: Phone#.- Ei Health DePartment
n Other
hm.-a
16
97
'I A-
De- I
l'o C17- -�Jb tAt� e^4�A-7
C6)
R
MA
r�5D
-w-ac3lal
U)
m
m
M
m
m
m
cf)
m
Cl)
0
m
CO)
"0
CD
C") z
F-* o
CD
CL
-00
co
cr
CD 0
rw--.Nwd. �
E -L m
CD
CO)
"0
CD
c')
0
ra,
CI)
0
c
CA
a)
CI)
CD
0
CD
CD
CO)
CD
(A
z
CD
CD
C)
2 t,
C/)
n
0
z
cn
cn
tz
0
CD CA
0
C.) CL m
CA c)
CD
z
= w M — CA
0 = -p CD —
==r CL -0 CL 0
"** Fn—
Er CD " =r U) CA
CD .40 CD
0 5 CD CD
IE co 1 —1
CA C CD
zic 0
Ap
CE i
co 'S
,c
CD CD
CD
to
0 ;w
ca
=r
cr
CA COL to
< lb W=
4 r*4
ccc-,2L 9'CD co
CO)
CD
5
CD
Fw to a:
-0 CI)
CD
I :
lie%
CD
CD
C/)
CO)
CD
CD
C7 AMM
W
S
CD:
-Z
00
M
�q
(A
0
cn
z
o
w
>
g,
7"
-p
co
rD
x
(Isq
ZT,
ooq
zr
�p
n
x
0:
X
or
rL
0
z
cn
(A
rD
'o
C/)
ro
9
91
0
CL
P�
x
0
0
ot
0=3
0
4e,
6
z
0;
.s
� ts
Ci
C 0
2
9
:4
0
E-0
u
P CD
9
0
ZW
rD.L
0
Ll
0
C/)
�
Or.
�014
6
co
�r.
x
Cd
U)
-
—co
x
0
CCDL.. S
E
V)
cf)
0;
.s
C/)
z
r-4
Cf)
EMS
MI
4.j
E
CD
ts
CD
CL.
cm
CD
L-
CL
CD
Q
cc
CL
ca
C.)
CA
C.3
03
cc
COD
r�llw
co
03
CL
CL
cm<
cc
z ci
a)
CL
CA
w
0
C/)
w
U)
cr
w
w
(r
w
w
C/)
� ts
Ci
C 0
2
9
coo CJ
CO
9
P CD
C/)
z
r-4
Cf)
EMS
MI
4.j
E
CD
ts
CD
CL.
cm
CD
L-
CL
CD
Q
cc
CL
ca
C.)
CA
C.3
03
cc
COD
r�llw
co
03
CL
CL
cm<
cc
z ci
a)
CL
CA
w
0
C/)
w
U)
cr
w
w
(r
w
w
C/)
P CD
EC
rD.L
cc 22
CD
CCDL.. S
E
C�
La
ca
4D
cm
CA
0
cm
CD
CD 4D
CD
E
cm-
3:0 Z
EL
CD
0
4D
CDL.2 C�
16 =M
LU
E
CL:s
ci Oa
R
Z
cm
C.2
L-
CD
ci cm
CD.O*: =
ca
CL
4D -5 0:5
0 . g
CD
L- -E
4- CL4-
C/)
z
r-4
Cf)
EMS
MI
4.j
E
CD
ts
CD
CL.
cm
CD
L-
CL
CD
Q
cc
CL
ca
C.)
CA
C.3
03
cc
COD
r�llw
co
03
CL
CL
cm<
cc
z ci
a)
CL
CA
w
0
C/)
w
U)
cr
w
w
(r
w
w
C/)
GENERAL BUILDING NOTES/CHECKLIST- NOT LIMITED TO ITEMS BELOW
POST ALL LOT NUMBERS, ADDRESS, AND PERMIT (COPY OK)..or no inspections
INSPECTIONS: (Minimum) Excavation, Footing, Foundation, Frame, Insulation, Final.
FOOTINGS: Continuous Full 2x4 Keyway
Continuous strip footings for interior columns
FOUNDATION: Rebar as required
Anchor bolts or straps
Damproofing
Foundation drain - pipelstone/fabric filter/cover and outlet connection.
FRAME: Fireblock - over girts/plates between floor joist
Penetrations for plumbing, heat, elec, etc.
Walls at stair stringers.
Windbrace corners and center bearing partitions.
Size ridge to provide full bearing at rafter cuts.
Hip and Valley rafters - watch bearing at walls.
Ridge & Hip - Provide proper connections.
Cathedral roof rafters provide proper connections and use "Hurricane Clips" tie to plate.
Stair stringers - watch cuts and heal support.
Joist hangers - fully nailed w/ hanger nails.
Sill plates 2-2X6 (1PT) w/sill seal.
Girls - solid brick or steel plate bearing at foundations
YS" air space at sides in foundation pockets.
Lateral bracing at ends.
Certified calculations. required for Beams/LVL's Trusses.
Solid bearing support for Headers/Beams etc.
Check headroom clearances - stairways, under beams
Attic Access. (min. 22x3O w/3' headroom above).
Crawl space access. (min. 18x24).
Bath exhaust fans to have metal duct to exterior (not in soffit).
Firecode S/R wood frame of "0" clearance fireplaces & stoves
Window Schedule or Every Habitable Room Must Have:
Natural light equal to 8% of floor area.
1/2of required glazing shall be openable.
Bedrooms required min. 20x24 egress window or door.
Vent attic spaces - "proper vent", soffit and required ridge vents.
Firecode under stairs if used for storage
FIREPLACES: Separate permit required.
Inspections at Footing - Smoke Chamber - Finish
Smooth parging, clean joints, 8" solid @ combust. Surf.
DECKS: Separate permit required:
Lag to house, provide flashing.
Rails min. 36 " high, Baluster max space 5" on center.
Over 8' above grade, use 6x6 posts w/lateral bracing.
Lag all posts and rails.
Pier footings down 48", Conc. pad at stair base.
FINISH: Handrails returned to wall/newall post.
Guardrails required alongside open cellar stairs.
Exterior grading complete.
Certificate or occupancy required prior to occupying structure.
Temporary Stairs required for inspection.
Re -inspection fee - $25-00 (Be Ready).
Certificate of occupancy required prior to occupying structure.