HomeMy WebLinkAboutMiscellaneous - 295 FOREST STREET 4/30/2018 (2)X5
//
A
Date...
.;4,0
0 TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
4,
This certifies that ... ( ................ ...... * ................ ................
has permission to perform ..... z ......
wiring in the building of ....... F-Irtp,.U.C!5;�L . .........................................
7– 5 -.>—
at .............. j:2..f .............................................. N rth Andovel, MAPS.
I P9
Fee.3 Lic. No . .......... 1Z ............ .
Check #
'10551
Official Use Only
Commonwealth of Massachusetts
Permit No.
Department of Fire Services
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev.11/991 (leaveblank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the massachusetts Electrical Code (MEC), 527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORM TION) Date: tZ-q-11
City or Town of- --N. And ova, m A To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street & Number)
Owner or Tenant �5-i (
Owner's Address 571
Telephone No.b03-3-zJ-1z1q-3
Is this permit in conjunction with a building permit? Yes El No E� (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 UndgrdEJ No. of Meters
New Service Amps Volts OverheadE:1 Undgrd 0 No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: 6 54M I ah w Q�- 14 6) Gerw(,Ar
Con-letion nf the f-Ilowin -- 11 4' 4 L I -
No. of Recessed Fixtures
No. of Ceil.-Susp. (Paddle) Fans
may e wa ve !Lv e ector oy vy tres.
No. of Total
Transformers KVA
No. of Lighting Outlets
No. of Hot Tubs
Generators KVA
No. of Lighting Fixtures
Swimming Pool ove [] In-
1V5-- ToTIF-m—ergency Lighting
grnd. gryd.
Batte!J Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
I No. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
Initiating Devices
No. of Ranges
To
No. of Air Cond. Tons
—
No. of Alerting Devices
No. of Waste Disposers
Heat Pump
Number
'
[To --ns
No. of Self-Co-ntained
Totals:
iDetection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local El Mun'c'P?l El Other
I Connection
No. of Dryers
Heating Appliances KW
Security Systems:
No. of Devices or Equivalent
No. of Water
Beaters KW
No. of No. o f
Da ita Wiring:
Signs Ballasts
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
Telecommunications Win'ng:
No. of Devices or Equivalent
OTHER:
Attach additional detail itdesired or as required by the Inspector of Wires.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance ofelectrical work may issue unless
the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the pen -nit issuing office.
CHECK ONE: INSURANCE P/ BOND [I OTHER El (Specify:)
Estimated Value of Electrical Work: J�b �7(0 (When required by municipal policy.) (Expiration Date)
Work to Start: t �-?-) - I( Inspections to be requested in accordance with MEC Rule 10, and upon completion,
I certify, under theppins andpenalties ofperjury, that the information on this application is true and complet)_,
FIRM IN -1 1A �Aer�� fA)e
N -LIC. NO.:
LIC. NO.:
Licensee: in XSignature
(If applicable, enter "exempt" in th c se Pumbe lineq Bus. Tel. No.:J��-
Address: 1,5251 f2 & !2 P Alt. Tel. No.:
OWNER'SINSURANCFIVAIVIER.- I a, t the Licensee'does not have the liability insurance coverage normally
required by law. By rny signature below, I hereby waive this requirement. I am the (check one) [] owner owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE.- $ :-�v -
i
I
Date. .......
04.1 TOWN OF NORTH ANDOVER
'PERMIT FOR GAS INSTALLATION
This certifies that
has permission for gas installation
in the buildings of ..A�l
....................
at ... r .............. N,orth,Andover Mass.
Fee..Yl!:�� Lic. NoA-�.1�01' 4!�
Check# GASINSPECTOR
7964
PIYTI IPI=.O%
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING
City/Town: eA i Date: Permit#.
y.'
U)
.. ... ....... .... .... . ..........
Building Locatk .
....... . . . .
owners Name: v t
Type of Occupancy: Commercial Educational, Industrial: Institutional f�e �Idenri�al
New: b�- `Alteration:1 Renovation,
Replacement: Plans Submitted: Yes No.
PIYTI IPI=.O%
INSURANCE COVERAGE:
I have a current liability Insurance policy or Its substantial equivalent which meats the requirements of MGL. Ch. 142 Yes,
If you have checked Yes, please Indicate the type of coverage by checking the appropriate box below.
Bond
A liability Insurance policy: Other type of Indemnity
OWNER'S INSURANCE WAIVER: I am aware that the . licensee does not have the Insurance coverage required by Chapter 142 of the
Massachusetts General Laws, and that my signature on this permit application waives this requirement.
C.h.e, ck One Only
Owner Agent
Signature of Owner or Owner's Agent
By checking this box Lj; I hereby certify that all of the details and Information I have submitted (or entered) regarding this application are true and
-1 j 4t. & ii i to. —4, -4 1..*.1fnf1nna narfnrmarl iindar thp nOrmit Issued for this anallcation will be In
... 1. .... - j - -- .. - . . . . — I , ---
compliance with all),-prunent provision ow ine massacnuseuS QEdje r-jUjjjUjjj!j �WUW all� �11QVg — W1
:, * * / .1
.,Type of License:
ber
Plum
By;.do
!Q3
-nature of Licensed Plumber/Gas Fitter
Tillet Master
. . ..........
Journeyman
City/To �ni ;�:::- License Number:
............ I
LP Installer 1 d
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1 FLOOR
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3 KuFLOOR
4"rF—LOOR
5... FLOOR
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7- FLOOR
eFTLOOR
Check One Only Certificate #
Installing Company Name: . .... orporation
Address: city rrown 'State:
q d Partnership
o e:
Business Tel: "'Cell' . i Fak:.
... ..... ... .1 .�Firm/Co mpany
.............. . . ....... .................... .
-ancpri Pliinninpr1ras Fiffer-
INSURANCE COVERAGE:
I have a current liability Insurance policy or Its substantial equivalent which meats the requirements of MGL. Ch. 142 Yes,
If you have checked Yes, please Indicate the type of coverage by checking the appropriate box below.
Bond
A liability Insurance policy: Other type of Indemnity
OWNER'S INSURANCE WAIVER: I am aware that the . licensee does not have the Insurance coverage required by Chapter 142 of the
Massachusetts General Laws, and that my signature on this permit application waives this requirement.
C.h.e, ck One Only
Owner Agent
Signature of Owner or Owner's Agent
By checking this box Lj; I hereby certify that all of the details and Information I have submitted (or entered) regarding this application are true and
-1 j 4t. & ii i to. —4, -4 1..*.1fnf1nna narfnrmarl iindar thp nOrmit Issued for this anallcation will be In
... 1. .... - j - -- .. - . . . . — I , ---
compliance with all),-prunent provision ow ine massacnuseuS QEdje r-jUjjjUjjj!j �WUW all� �11QVg — W1
:, * * / .1
.,Type of License:
ber
Plum
By;.do
!Q3
-nature of Licensed Plumber/Gas Fitter
Tillet Master
. . ..........
Journeyman
City/To �ni ;�:::- License Number:
............ I
LP Installer 1 d
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N��. 2,� 2 Date
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Check # 17;17
14 L-29
/1' --Building ln&-'ector
TOWN OF NORTH ANDOVER
Certificate of Occupancy
$
Building/Frame Permit Fee
$
cmust
Foundation Permit Fee
$ X)
Other Permit Fee
$
TOTAL
el
Check # 17;17
14 L-29
/1' --Building ln&-'ector
m
4
R DEP T' 7 LE.
TOWN OF NORTH ANDON%R
BUILDING DEPARTMENT
apkEtvio "014STIADMUPAMMOVAT" BEAM= AMORMOVAMILYMUaffi—
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I %RMn%.k. WINRIMUS U.10MINSATION MG.L C IS2 I 25M I
VoAm Comlm"fien Insurance Z=it must be OOMPWW ;Z bmited2th CIS 8,P;1Q7A. Fada rovade this &M&vit will result
in tho&ftial Cron isawnwof" dim powgit,
4" Yes A& NO ....... cl
skmal AAWA� AM
SIECTION 5 aft*116'a, a P-"-4 W -CA 2RIPMULL
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lotla 0 apWify
Brief Ifaiiiiptim of Pmpowd Wwt,
jo-r---e
c;2 '-e
OF
I -L
R:C�Tj_ohl A.- RSTrKAnD CONSTRUMON COSTS
I rnat Mnllml to tie
CormleW by 2iMt i0icct
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2 Electliald
(b) Eodnigod TOVA Cog. of
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BUjI&V POM -it The (b) 40 -1
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F.RC=N 7a OWNRR MITHORIZATION' T091 COMPLIETRID WWXN
OWN1910-MM OR CON
=9 PWMIT
OR APP
�/A Asent of s 4crty
Hereby autImia
to aot 0
Ns h4WiM
M) tcwf, in 81,1 M14eTw1ailve
by penTAt applicatim.
awlam
Slalo 7b OWNEWAUMORMD AGENT DLgIAMTION
—As Ovmarlmthonzed Apmt of M*Jaa
Hereby 4cvc_j&m th c;3ua, ImmaA3 wid' mv uw and accarate, to The bw of my imowleUe
lmd belief
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Dam OF SILLS
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I DIUMIONS OF KOTS
CA'
FORM U - LOT RELEASE FORM
Fm.z
c;7 -
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 1—�AL-rll 91 PHONE
LOCATION: Assess&s Map Numberhi- lw--B PARCELII'MI'1206 77
SUBDIVISION, LOT (S)
ST. NUMBER --Z25
USE
RECOMMENDATIONS OF TOWN AGENTS: pew qW
CONSERVATION ADMINISTRATOR DATE APPROVED
DATE REJECTED
COMMENTS
UA I t KtJt'U I tU
COMMENTS
FOOD INSPEq�2R-HEAL11:1-- DATE APPROVED
DATE REJECTED
�A IN4�Pii itTOR-HEAL-TH DATE APPROVED -7 1 X 1 /Z> U
/C DATE REJECTED
a//&6
COMMENTS e_z,> ) 11 - � . A,- �
� 1z "I -- I
')2�NECTIONS
PUBLIC WORKS - SEWERIWATER C Z/�
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE
Revised 9\97 jm
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
Name Please Print
Name: _ffe 4 Z_ 2
Loration:
City I.VV (4�4�/
F7I am a homeowner
work myself.
I am a sole proprietor and have no one working in any capacity
#
71 1 am an employer providing workers' compensation for my employees working on this job.
Com9any name: Av 4.
Address
City: Phone #:
Insurance Co. Policv #
Address
City:
Phone #:
Co.
Poligy #
-Insurance
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.cimil.penalties in.the form -of aSTOP.WORK ORDER and a fine of ($100.00) a day against me. I
understand that a copy of i s ement maybe forwarded to the Office of Investigations of the DIA for coverage verification.
i do hereby cart* ndlper
pains an n ' of p 'ury that the information provided above is true and correct.
natu
Date
Print name
Phone # 97
Official use only
do not write in this area to be completed by city or town official'
City or Town
Permit/Licensing
EJ Building Dept
[]Check if immediate response is required [:] Licensing Board
F1 Selectman's Office
Contact person
Phone Health Department
Other
c
TOWN OF NORTH ANDOVER, MASSACHUSETTS
DIVISION OF PUBLIC WORKS
384 OSGOOD STREET, 01845
SWILLIAM HMURCIAK, P.E.
DIRECTOR
/9
� 5
DRIVEWAY PERMIT
Telephone (978) 685-0950
Fax (978) 688-9573
DATE A/ 1,5'
LOCATION /7/5
B U I L D E R �?It r1l ��v phone
0 W N E f 17C M 7/�/ phone
THE NORTH ANDOVER SUPERINTENDENT OF OPERATIONS
MUST BE NOTIFIED OF THE GRADE AND SETBACK FROM
STREET. CALL THE SUPERINTENDENT'S OFFICE BEFORE
FINISH GRADING AND SURFACING FOR APPROVAL OF
SUCH ENTRY.
FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT.
Growth Management Byfaw Exemption Statement
Town of North'Andover Building Department
This form shall be used to assist the Building Oepartment in their determination of ex emptions under section 8,7.6 of the
Town of,North Andover Growth Management Bylaw. The building applicant shall provide all of the necessarl information
as requested below.
Nam of Applicant an Building P,,aFmit (below) Address of Property for Permit (below)
oT
L�5
_R
Map and Parcel: Purposaof A
,Wcation (check below)
ugiber of lica t , ,><—,Single Family Two Family
P" 6, gs- ��T
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_1710N section 8.7.6 of the North Andover Growth r
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
Department and is only offidally accepted when the Building Permit is 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 associated attachments, complies 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 reconstruction of a dwelling in
existence as of the effective date of this by-law, provided that no additional residential unit is created.
The Ict(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 and/or moderate income families or individuals, where all of the
conditions of 8.7.6.care met and/or represents Owelling units for senior residents, where occupancy of the units is
restricted to senior persons through a property 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 40cla permanent
reduction 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 space and/or farmland. The land to be preserved shall be protected from development 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 Ceveloper in common ownership with an
adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth
Rate and Oevelopment Scheduling provisions for the purpose of constructing one single family dwelling unit an the
71 par
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 Oevelopment Schedule
does not a=mmodate issuing a building permit in that Year, one building permit will be issued per Year per
Cevelopment until such time as the Cevelopment 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 b I h information provided and that the attached building permit is
allowed an Vow PT"Itell tacstcietZcac� �--e-Fur-t er I understand that the submittal of misleading and or
inaccurate il a.ti � or the ec , ng off of/an above item which does not comply, whether done to my
c
knowl� dg or c oun r sal by e Building Department to issue a Buildin
I �gn_- u*bnze0'Ag`e"hc signed the Attached Building �5e_rmit Cate
This form must be attachedA the
p8luilding Permit upon application for such permit.
57-
t
MAScheck COMPLIANCE REPORT
Massachusetts Energy Code Permit #
MAScheck Software Version 2.01
1 Checked by/Date I
I I
CITY: North Andover
STATE: Massachusetts
HDD: 6322
CONSTRUCTION TYPE: 1 or 2 Family, Detached
HEATING SYSTEM TYPE: Other (Non -Electric Resistance)
DATE: 6-7-2000
DATE OF PLANS: June 6,2000
TITLE: Lot B, Forest St.
PROJECT INFORMATION:
28'x4O' Colonial, 16' Family Room
COMPANY INFORMATION:
Ralph R. Joyce
COMPLIANCE: PASSES
Required UA = 624
Your Home = 541
Area or
Cavity Cont.
Glazing/Door
Perimeter
R -Value R -Value
U -Value
UA
-------------------------------------------------------------------------------
CEILINGS 1222
30.0 0.0
43
CEILINGS: Raised Truss 90
30.0 0.0
3
WALLS: Wood Frame, 16" O.C. 3272
11.0 0.0
292
GLAZING: Windows or Doors 379
0.320
121
DOORS 40
0.350
14
DOORS 38
0.490
19
FLOORS: Over Unconditioned Space 1521
30.0 0.0
49
HVAC EQUIPMENT: Furnace, 86.0 AFUE
HVAC EQUIPMENT: Air Conditioner, 10.0 SEER
-------------------------------------------------------------------------------
COMPLIANCE STATEMENT: The proposed building
design described
here is
consistent with the building plans, specifications,
and other
calculations
submitted with the permit application. The
proposed building
has been
designed to meet the 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 J4.4.
Builder/Designer
Date
0
0
MAScheck INSPECTION CHECKLIST
Massachusetts Energy Code
MRScheck Software Version 2.01
Lot B, Forest St.
DATE: 6-7-2000
Bldg - t
Dept. I
Use
CEILINGS:
1. R-30
Comments/Location
2. Raised Truss, R-30
comments/Location
Insulation must achieve full height over the exterior wall.
WALLS:
1. Wood Frame, 16" O.C., R-11
Comments/Location
WINDOWS AND GLASS DOORS:
1. U -value: 0.32
For windows without labeled U -values, describe features:
Panes Frame Type Thermal Break? Yes No
Comments/Location
DOORS:
1. U -value: 0.35
Comnents/Location
2. U -value: 0.49
Coz-aments /Location
FLOORS:
1. over unconditioned Space, R-30
Comments/Locati-ion
HVAC EQUIPMENT:
1. Furnace, 86.0 AFUE or higher
Make and Model Number
2. Air Conditioner, 10.0 SEER
AIR LEAKAGE:
Joints, penetrations, and all other such openings in the building
envelope that are sources of air leakage must be sealed. When
installed in the building envelope, recessed lighting fixtures
shall meet one of the following requirements:
1. Type IC rated, manufactured with no penetrations between the
inside of the recessed fixture and ceiling cavity and sealed or
gasketed to prevent air leakage into the unconditioned space.
2. Type IC rated, in accordance with Standard ASTM E 263, with no
more than 2.0 cfm (0.944 L/s) air movement from the the
conditioned space to the ceiling cavity. The lighting fixture
shall have been tested at 75 PA or 1.57 lbs/ft2 pressure
difference and shall be labeled.
L J
W
W
I VAPOR RETARDER:
Required on the warm -in -winter side of all non -vented framed
ceilings, walls, and floors.
MATERTALS IDENTIFICATION:
Materials and equipment must be identified so that compliance can
be determined. Manufacturer manuals for all installed heating
I and cooling equipment and service water heating equipment must be
provided. Insulation R -values, glazing U -values, and heating
equipment efficiency must be clearly marked on the building plans
or specifications.
DUCT INSULATION:
Ducts shall be insulated per Table J4.4,7.1.
DUCT CONSTRUCTION:
All accessible joints, seams, and connections of supply and return
ductwork located outside conditioned -space, including stud bays or
I joist cavities/spaces used to transport air, shall be sealed
using mastic and fibrous backing tape installed according to the
manufacturer's installation inst , ructions. Mesh tape may be
omitted where gaps are less than 1/8 inch. Duct tape is not
permitted. The HVAC system must provide a means for balancing
air and water systems,
TEMPERATURE CONTROLS:
Thermostats are required for each separate HVAC system. A manual
or automatic means to partially restrict or shut off the heating
and/or cooling input to each zone of floor shall be provided.
HVAC EQUIPMENT SIZING:
Rated output capacity of the heating/cooling system is
not greater than 125% of the design load as specified
in Sections 780CMR 1310 and J4.4.
I SWI11WING POOLS:
I All heated swimming pools must have
an on/off
heater
switch and
reauire a cover unless over 20% of
the heating
energy is from
non-depletable sources. Pool pumps
require a
time clock.
HVAC PIPING INSULATION:
HVAC piping conveying fluid8 above
120 F or chilled
fluids
below 55 F must be insulated to the
following
levels
(in.) -
PIPE
SIZES
(in.)
HEATING SYSTEMS: TEMP (F)
2" RUNOUTS
0-l"
1.25-211
2.5-4"
Low pressure/temp. 201-250
1.0
1.5
1.5
2.0
Low temperature 120-200
0.5
1.0
1.0
1.5
Steam condensate any
1.0
11.0
1.5
2.0
J COOLING SYSTEMS:
i Chilled water or 40-55
0.5
0.5
0.75
1.0
refrigerant below 40
1.0
1.0
1.5
1.5
CIRCULATING HOT WATER SYSTEMS:
I Insulate circulating hot water pipes to the following levels
(in.):
?IPE SIZES (in.)
NON -CIRCULATING CIRCULATING 1,1RINS RUNOUTS
HEATED WATER TEMP (F): RUNOUTS 0-1" 2. 0+11
110-180 0.5 1.0 1.5 2.0
140-160 0.5 0.5 1.0 -5
100-130 0.5 0.5 0.5 1.0
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Location --2 515 , ,R �— -
No. �,.j L6 2 - Date 0c)
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
IC23 0,
S
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Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # IqAc2
A
1 6 3 RV
Building Inspector
Sent bj'.G Jul -24-00 13:27 from 9763723960-�508 6853148 Page
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CERTIFICATE OF USE & OCCUPANCY
Town of North Andover
Building Permit Number Date
THIS CERTIFIES THAT
THE BUILDING LOCATED ON A10J �4
MAY BE OCCUPIED AS 3 IIL)a)e T,4112, IN ACCORDANCE
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND
SUCH OTHER REGULATIONS AS MAY APPLY.
Q 4 7A) r-,2 5 -td Z)�� R
01 T CERTIFICATE ISSUED TO Re P4 e-
7/
ADDRESS 9-"
49
cmus Building Inspector
TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE
7/19/01
This is to certify that
the individual subsurface disposal system
constructed ( X ) or repaired ( )
by
William Sawyer
at
295 (Lot B) Forest Street
has been installed in accordance with the provisions of Title V of the State Sanitary Code
and with the North Andover Board of Health regulations.
The Issuance of this certificate shall not be construed as a guarantee that the system win
fimction satisfactorily.
-J7
Board of Health Inspector
Town of North Andover
,00,w—
%A OR Th—%%,,
Building Department
27 Charles Street 0
North Andover, Massachusetts 0 1845 4
(978) 688-9545 Fax (978) 688-9542
0" ATED f-
ACHUS
APPLICATION FOR CERT]IFICATE OF OCCUPANCY NSPECTION
ADDRESS C>
LOT NUMBER SUBDIVISION
DATE REQU EST FELED Z'
DATE READY FOR INSPECTION 7M,,�, Zol
FIVE (5) DAYS NOTTCE PRIOR TO CLOSING DATE IS REQUIRED
ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN TFUS TIME
FRAME. A RE -INSPECTION FE E OF TWENTY-FIVE ($25.) DOLLARS WILL BE
CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES.
SIGNATURE
OFFICIAL USE ONLY
ROUTING
CONSERVATION A, DATE
PLANNING DATE
D.P.W. — WATER 41— Z- AT E
D.P.W. MUSTTje'r E THA WATER METER HAS BEEN RITALLED
sp CT
T INSPECTION QUESTDATE.
P" 07
/ DPW/AUTHOWATION
?-/?- crr
3- 5 7 Date. . ............
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that,�-, ............... 2!�� ..........
has permission for gas installation ...............
in the buildings of :4"� ........................
... .......
at ... ........................... North Andover, Mass,
Fee,& Lic. N&ZY e� .........
GAS INSPECT01i
W�ITE: Applicant CANARY: Building Dept. PINK: Treasurer
P MASSACHUSETTS UNWORM APPLICATON FOR PERNUT TO DO GAS FTFMG
�Tlype or print) Date -13 192 , 00
NORTH ANPO'YER, MASSACHUSETTS,
Building Locations —6—
f� Ic—, Owner's Name
Newo Renovation F-1 Replacement r-1
PIA�ubmitred
-1-11
; Perm
2'u4n t 0,0
:Print or type)
,kddress
6
3usiness T
1�ame of Licensed Plumber or Gas Firter
Check one: Certificate Installing Company
F� Corp.
Parmer.
Firm/Co.
NSUNNCE COVERAGE Check one:
have a iurrent liability Insurance policy or it's substantial equivair-rit. Yes ic,
f you have checked ves, please indicate the type coverage by checking the appropriate box.
-iabiliry insurance policy Other type of indemnity Bond
eEf . 11 ID
Dwner's Insurance Waiver- I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the
vlass. General Laws, and that my signature on this permit application waives this requirement.
3ienarure of Owner or Owner's AgenE
hereby certify that all of the details and information I have
)est ofmy knowledge and that all plumbing work I ins7
:ompliance- with all pertinent provisions of the \,Ia Chu
Check one:
Owner A2ent
d 0 r entered in above application are true and accurate to the
-�i
e ed under Permit Issued for this appiication will be 'in
3as e and Chapter 142 of the General Laws.
Bv: Signature of Licensed Plumber Or Ga.s Filter
1 .1911, -
Title Plumber
-irv/Town Gas Fitter 717-1se iNumue-
Master
A Joumevrnan
PPPO'vTD MFFICE WSE ()NL Y)
Date. .
No 4. 5 7 S
40 74
4, TOWN OF NORTH ANDOVER
0
PERMIT FOR PLUMBING
'7SACHUS
This certifies that v
...........
has permission to perform
.............
plumbing i� thhe buildings of
at ............... North Andover, Mass.
F e e-?e� L i c. N o /10 -r-' Ft ... ...
V . �G
SPECT`0*R*
Check # 36�511
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM A-PPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSET-IS
Locati
22;2 �
Building ��Kf�
Owners Name K' j 0 I/C IL
reTI
i5 --
Date
Permit
Amount .301
V
New 0 Renovation Replacement Plans Submitted Yes No
NEED-OFFM
all 1114
(Print or type)
Installing Company.
Address
6
Check one:
ElCorp.
11 Partner.
Vj Firm/Co-
Name of Licensed Plumber.
Insurance Coverage: Indicate thg type of insurance coverage by checking the appropriate bo)c
Liability insurance policy ki Other type of inde . innity El Bond
Certificate
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
I hereby certify that all of the details and informat
best of my knowledge and that all plumbing work
M�
compliance with all pertinent provisions of the E
By: 71-1
Title
City/Town 1(
APPROVtD (OFFICE USE ONLY
Agent [-�
s M (or entered) in above application are true and accurate to the
ta o ed under Permit Issued for this application will be in
U I mbi����142 of the General Laws.
Type� of Z1,qmb
�g License
Mast Journeyman
Town of North Andover
. Office of the Conservation Department
Community Development and Services Division
Julie Parrino
Conservation Administrator
June 16, 2003
William Ferrucci
295 Forest Street
North Andover, MA 01845
RE: Driveway Paving
Dear Mr. Ferrucci:
27 Charles Street
North Andover, Massachusetts 01845
Telephone (978) 688-9530
Fax (978) 688-9542
This letter is in regard to your request to pave your driveway which is currently
graveled. Upon. review of the former Wg.(242-985) for the development of your
property� there appears to be no prohibition on an impervious driveway surface. The
Conservation Department is hereby giving you permission to pave your driveway only.
The common drivewayis not allowed to be paved under this approval letter. The
limits of pavement must not exceed the outline of the existing gravel driveway. Please
refer to the attached highlighted sketch indicating which portions of the driveway are
allowed to be paved.
If you have any questions, please feel free to contact me.
Sincerely,
tion Administrator
cc: NACC
242-985 file
BOARD OF APPEALS 688-9541 BLJILDING688-9545 CONTSERVATION688-9530 HEALTH688-9540 PL.ANNING688-9535
V
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FIRMIAGENCY:
SUBJECT:
PROJECT LOCATION:
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TELEPHONE #:
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