HomeMy WebLinkAboutMiscellaneous - 33 STONEWEDGE CIRCLE 4/30/2018pORTpy
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CERTIFICATE OF USE & OCCUPANCY
Building Permit Number 170 � Date A/— /8 - a 3
THIS CERTIFIES THAT
THE BUILDING LOCATED ON l o-�(3 9 c3,3 (5-10(v e IV eC� f C, () /--
MAY
--
MAY BE OCCUPIED AS l D J?d o P7, (S) 9a I vl 3 5 -fa I/ U N P f 2
s ,/UTle- 7AO7t ly �p&,��N C.�
IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING
CODE AND SUCH OTHER REGULATIONS AS MAY APPLY.
CERTIFICATE ISSUED TO �� / �p r C� (,v N�" v C �l d �✓
�c5 Tp A1,5 OA-) S 7—
Building Inspector
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Date.....t�..�.
v't.ao 16ry
o� TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
This certifies that .....tr..l ��.'...!E!!"'.►h.Q.��?`...!.!.lGl.!.! ! d.!�1....oF' l
has permission to perform..T. .....`e.l......: �'.C..V �.�e-................
wiring in the building of . 1. r-.........! 4�1
at ....3. ?.....Sah��J!Y e.......t- C,,/� P!North Andover, Mass.
............
00
Fee ... 5........... Lic. No. 1-;.47
ELECTRICAL INSPECTOR
Check # ,�
Official Use Only.
y�� Permit No.
Occupancy & Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS.527.CMR 12:00
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) Date
/V 6 /b -- 614 200 To the Ins or df Wires:
Town of North Andover
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number
Owner or Tenant
Owner's Address 5C)n 0 S�
Is this permit in conjunction with a building permit Yes ( No ❑ (Check Appropriate Box) k
Purpose of Building N3ew r1'`1) Utility Authorization No. ` v
Existing Service Amps Voits
New Service Amps Volts
Overhead ❑ Undgmd ❑ No. of Meters
Overhead ❑ Undgmd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
i
�1eMe - \(Z-12Fl u11R 0 Ce -s Me
INSURANCE COVERAGE. ursuant to the requiremen6ts of Massachusetts Gene al Laws
I have a current Liability Insur Policy including Completed Operations Coveragy or its substantial equivalent YES = NO =
have submitted valid proof of same to the Office YES = NO = If you have checW YE a indicate a type of coverage by checking the appropriate box
INSURANCE = BOND = OTHER (Please Specify)
Estimated Value of Electrical Work$
Work to Start Inspection Date
Signed under the Penalties of pedury�Q�My
FIRM NAME R `
LIC. NO. 3 (Q
NO. - -
Bus. Tel No.
Address AR Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have.the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this requ rement. Owner Agent (Please Check one)
No. PERMITTEE $
(Signature of Owner or Agent)
Total
No. of Lighting Outlets
No. of Hot fuse
No. of Transformers KVA
Above ❑
In ❑
No. of Lighting Fixtures
Swimming Pool gmd ❑
grnd ❑
Generators KVA
No. of Receptacles Outlets
No. of Oil Burners
No. of Emergency Lighting
Batte Units
No. of Switch Outlets
No of Gas Burners
FIRE ALARMS No. of Zone
No. of Detection and
Total
No. of Ranges
No of Air Cond
Tons
Initiating Devices
Heat Total Total
No. of Di sal
No. Pumps
Tons
KW
No. of Sounding Devices
No./ of Self Contained
No. of Dishwashers
S ace/Area Heating
KW
Detection/Sounding Devices
❑ Municipal ❑ Other
No. of Dryers
Heating Devices
KW
Local Connection
No. of
No. of
Low Voltage
No. of Water Heaters, KW
Signs
Bailases
Wiring
No. Hydro Massage Tuds
No. of Motors
Total HP
�1eMe - \(Z-12Fl u11R 0 Ce -s Me
INSURANCE COVERAGE. ursuant to the requiremen6ts of Massachusetts Gene al Laws
I have a current Liability Insur Policy including Completed Operations Coveragy or its substantial equivalent YES = NO =
have submitted valid proof of same to the Office YES = NO = If you have checW YE a indicate a type of coverage by checking the appropriate box
INSURANCE = BOND = OTHER (Please Specify)
Estimated Value of Electrical Work$
Work to Start Inspection Date
Signed under the Penalties of pedury�Q�My
FIRM NAME R `
LIC. NO. 3 (Q
NO. - -
Bus. Tel No.
Address AR Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have.the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this requ rement. Owner Agent (Please Check one)
No. PERMITTEE $
(Signature of Owner or Agent)
Location ^�3 4 33
No. Q Date
TOWN OF NORTH ANDOVER
_ n
# ; : Certificate of Occupancy $
Building/Frame Permit Fee $ 3j a
SSACMus
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # SQ
15807
/ Building Inspector
AUG -22-02 T H U 12 :32 S_ E_ C u m m i n 9 s Assoc i as t e s P. 0 2
PIC, V\ v6t 1 4 n t)'�
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SZ C~AlOS S ASSOCIA rES
P.O. Box W7 brow, ALM IM"
rJafiffl0 iE (801A48"Off FAX (008)-W"M
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TAX MAP 210 BLOCK 106-9
LOT 3
STONEWEDGE CIRCLE
NORTH ANDOVER, MA.
PREPARED FOR:
BELFORD CONSTRUCTION, INC.
1049 TURNPIKE STREET
NORTH ANDOVER, MA. 01845
DATE: AUGUST 16, 2002
SCALE 1" = 80'
I HEREBY CERTIFY TO TOWN OF NORTH
ANDOVER, MA BUILDING DEPARTMENT
THAI THE EXISTING FOUNDATION
DRAWN ON THIS PLAN IS LOCATED AS
SHOWN AND THAT IT DOES COMPLY TO
THE MINIMUM BUILDING SETBACKS TO
PROPERTY LINES.
MIN'MUM SETBACKS:.
FRONT — 30 FEET
SIDE — 30 FEET
REAR — 30 FEET
,L
Ok
LOT 3
LOT AREA=!83,820 SF
CBA=63,514 SF
I
Town of North Andover µORTH
0* q�
1Lto �
Building Department g�, »°*, o
27 Charles Street 0-=
North Andover, Massachusetts 01845 * _
(978) 688-9545 Fax (978) 688-9542 441
. Tq 0^C_ y7
7.�A•T.- rte, A
APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION
r --
ADDRESS
LOT NUMBER SUBDIVISION]
DATE REQUEST FILLED
DATE READY FOR INSPECTION
FIVE (5) DAYS NOTTCE PRIOR TO CLOSING DATE IS REQUIRED
ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME
FRAME. A RE -INSPECTION FEE OF -FIVE ($25.) DOLLARS WILL BE
CHARGED IF THE S D S T ALL APPLICABLE CODES.
SIGNATURE_
ROUTING-
D.P.W. —WATER ME
DATE
D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED
PRI TO( INSPECTIONQUEST DATE.
SIGNATURE /-DPW AUTHORIZA
Date .....
......................
VkORTN
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
Thiscertifies that .7..................................................................................
has permission to perform ...... ;.� ..................... I ...................................................
wiring in the building of .:�� .....i .................................................
at.43.—.-.-12 ..................... . ....... . North Andover, Mass.
.... .. ...... ........
Fee...�k .......... Lic. N(r-?41
ELECTRICAL *''"***'*
Check#
VO4 4 Pa&- Sart'
BOARD OF FIRE PREVENTION REGULATIONS .527 CMR 12:00
Official Use Only
Permit No.
Occupancy & Fee Checked
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) Date
To the lnspdctor ofWires:
Town of North Andover
The undersigned applies for a permit to perform the electrical work described below../
Location (Street & Number J 1 UIVI �_(��(rLC c (LC1 i!
Owner or
Owner's
a
Is this permit in conjunction with a building permit !' Yes L No ❑ (Check Appropriate Box) ((��
Purpose of Building � tQ J kb k. Utility Authorization No. Q` \ Q 3 CO
Existing Service Amps Voits
New Service a.%-) Amps a �ft U Voits
Overhead ❑ Undgmd ❑ No. of Meters
Overhead ❑ Undgmd IC No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
i
ER:
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws
I have a current4iability Insurance Policy including Completed Operations Coverage or its substantial equivalent E NO =
i e T proof of same to the Office YES = NO = if you ha c k Y£ please indicate the of c rage by checking the appropriate box
INSURANC —OND = OTHER = (Please Specify)f`
(Expiration Date)
Estimated Value of Electrical Work$
Work to Start Inspection Date Resquested Rough Final
Signed under the Penalties of perjury: p
FIRM NAME 1"�AMMJA �ef�CIL �_p �/ LIC. NO. Z5�����
Bus(Tel No. V
Address Me- C A An Tel. No.g% a ?=2,
g 6 3
OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this repufrement. Owner Agent (Please Check one)
Telephone No. PERMITIFEE $ ///
(Signature of Owner or Agent)
Total
No. of Lighting Outlets
No. of Hot fuse
No. of Transformers KVA
Above ❑
In ❑
No. of Lighting Fixtures
Swimming Pool grnd ❑ grnd ❑
Generators KVA
No. of Emergency Lighting
No. of Receptacles Outlets
No. of Oil Burners
Battery Units
No. of Switch Outlets
No of Gas Burners
FIRE ALARMS No. of Zone
No. of Detection and
Total
'Jo. of Ranges
No of Air Cond
Tons
Initiating Devices
Heat Total Total
No. of Di sal
No. Pumps
Tons
KW
No. of Sounding Devices
No./ of Self Contained
Detection/Sounding Devices
❑ Municipal ❑ Other
!Vo. of Dishwashers
Space/Area Heating KW
No. of Dryers
Heating Devices
KW
Local Connection
No. of
No. of
Low Voltage
No. of Water Heaters KW
I Signs
Bailases
Wiring
No.. Hydro Massae Tuds
I No. of Motors
Total HP
ER:
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws
I have a current4iability Insurance Policy including Completed Operations Coverage or its substantial equivalent E NO =
i e T proof of same to the Office YES = NO = if you ha c k Y£ please indicate the of c rage by checking the appropriate box
INSURANC —OND = OTHER = (Please Specify)f`
(Expiration Date)
Estimated Value of Electrical Work$
Work to Start Inspection Date Resquested Rough Final
Signed under the Penalties of perjury: p
FIRM NAME 1"�AMMJA �ef�CIL �_p �/ LIC. NO. Z5�����
Bus(Tel No. V
Address Me- C A An Tel. No.g% a ?=2,
g 6 3
OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this repufrement. Owner Agent (Please Check one)
Telephone No. PERMITIFEE $ ///
(Signature of Owner or Agent)
ILI
Location 3 3 3 S�6,)eU ¢ie- Cl
No. Date 6-4- U
TOWN OF NORTH ANDOVER
Certificate of Occupancy
$
=�'` �'�s ••�•°' E<� Building/Frame Permit Fee
s�CHus
$
Foundation Permit Fee
$
%0
Other Permit Fee
$
TOTAL
$
Check #
15671 Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
^{� � ««aa,. 5 'dew". i! 'cq �� ,� N yb. ♦N ,�� � �. Z
b. •:V'.. i' ',. .b�N ,2 �'x, '?'rt��x , �:ta.ea.ef -^s'.±,
DATE ISSUED: �a 6 ` Q O�
BUILDING PERMIT NUMBER: 740 17
SIGNATURE: e
Building Commissioner/122eector of Buildings Date
SECTION 1- SITE INFORMATION
1.1 Property Address:
1.2 Assessors Map and Parcel Number:
3
Map Number Parcel Number
1.3 Zoning Information:
'1q z S11041"1--
Zoningbistrict ProposedJeS6
1.4 Property Dimensions:
i
/757
Lot Area/sfr Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard
Rear Yard
Required Provide R red Provided
RecFired
Provided
34) 1 �— (I —+ 1�0
�zle2
+ '/ 4��
1.7 Water Supp iy M.G.L.C.40. 54) 1.5. Flood Zone Information:
Public Private ❑ Zone Outside Flood Zone
1.8 Sewerage Disposal System:
Municipal On Site Disposal System ❑ i
SECTI N 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
Name (Print) Address for Service:
Signature Telephone
2.2 Owner of Record: -y— f
VIC
are Print Address for Service:
Signature Tele hone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licenss%edd �Construction Supervisor:
Licensed Construction Supervisor:
Address ►e�. C
(50 d i O
Signature Telephone
Not Applicable ❑
License Number
Expiration Date
3.2 Registered Home Improvement Contractor
Not Applicable ❑
Company Name
Registration Number
Address
Expiration Date
Signature Telephone
00
M
X
Z
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M
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a
SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 & 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the build6 permit.
Signed affidavit Attached Yes ....... Er No ....... ❑
SECTION 5 Descri do of Pro osed Work check all
applicable)
New Construction
Existing Building ❑
Repair(s)
❑
Alterations(s) p
Addition ❑
U P
Accessory Bldg. ❑
Demolition ❑
Other _ ❑ Specify `
Brief Description of Proposed Work. -
ork:
A00 n, 3
00n,3 i'I—T'-hS
S z%l vtic��2
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item
Estimated Cost (Dollar) to be
{3FFICIAIUSE
ONLY ;
Completed by 2ennit a licant
1. Building
(a) Building Permit Fee`
..........
50 OF
Multiplier
p� n
2 Electrical
(b) Estimated Total Cost of
Construction
3 Plumbing
Bu_ildin&Pdimit.fed raj X (b)
/ 5�5
4 Mechanical HVAC
5 Fire Protection
6 Total 1+2+3+4+5
Check..N*ber
SECTION 7a OWNER AUTHORIZATION TO BE COM F—F-T )-WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner/Authorized Agent of subject property
Hereby authorize t 'R r-
to act on
My behalf, in all matters re ative to work authorized by this building permit application.
v Z
Si nature of Owner
Date
SECTION 7b OWNER/AUTHORI DAG NT DEC TION
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
{-Y) aaic
Print Nam -
Si ature of Owner/Agent
Date
NO. OF STORIES
SIZE .�. i
BASEMENT' OR SLAB
SIZE OF FLOOR TIMBERS Pi
2 3 X
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION
THICKNESS
SIZE OF FOOTING
X
MATERIAL OF CHEVINEY
IS BUILDING ON SOLID OR FILLED LAND 6
IS BUILDING CONNECTED TO NATURAL GAS LINE
_ ►-QRM U .- LOT RELEASE FORM'
- INSTRUCTIONS: This form is used to verify that all necessary a
Boards and. Departments having jurisdiction have been obtained. This doepermits frog
the applicant and/or landowner from compliance with any applicable or req
�lirements.s not vE
*****************************APPLICANT ILLS OUT THIS SECTION
**********************,
APPLICANT -,R - PHONE'��-
Z
LOCATION: Assessor's Map Number PARCEL
SUBDIVISION
LOT (S)_
STREETTpiiP,4�7ST. NUMBER
--_
MENDATIONS
�s' 6
VATION ADMIN
F TOWN AGENTS:
COMMENTS
TOWN PL -AER
FOOD
TH
SEPTIC INSPECTOR HE LTH
COMMENTS
TOR DATE APPROVED
DATE REJECTED
Soy c
S 6�'cn rJ/if3c�`
Co;n4ro r e -P
1 r
ATE APPROVED
AE EJECTED 91
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTO
Revised 9\97 jm
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-DATE--_ ____DATE
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GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT
TOWN OF NORTH ANDOVER BUILDING DEPARTMENT
This form shall be used to assist the Building Department in their determination of exemption under section
8.7.6 of the Town of North Andover Growth Management Bylaw. The applicant shall provide all of the
necessary information as requested low.
� Gh
Permit Applicant Property address Map / Parcel
�igg r rr9 9 q30
Applicant's Phone Number 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 EXEMPTION section 8.7.6 of the 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 Budding Department and is only
officially accepted when the budding 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 ofthe following sections as indicated by a check mark.
This is plication fora building permit for the enlargement, restoration or reconstruction of a dwelling in
existence as a effective date of this bylaw, provided that no additional residential unit is created.
The lo(s) was /were created prior to May 6, 1996 and are exempt from the provisions of 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 are met and or represents dwelling units for senior residents, where occupancy of the units is
restricted to senior citizens 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 part of a development project which voluntarily agreed to a minimum 40 % permanent
reduction in density (buildable lots) below the density permitted under zoning and feasible given the environmental
conditions ofthe tract, with the surplus land equal to at least ten buildable acres and permanently designated as open
space 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 Developer in common ownership with
an adjacent parcel on the effective date of this Section 8.7 and shall receive a one time exemption from the Planned
Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit
on the parcel.
This application represents a lot which is ready for a building permit ( 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 accommodate issuing a building permit in that year. One building permit will be issued per year per
Development until such time as the development schedule accommodates issuing building permits. Applicant must
submit an approved FORM U with this EXEMPTION.
PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A
DETERMINATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE EXEMPTIONS.
BY SIGNING BELOW I ATTEST TO THE ACCURACY OF THE INFORMATION PROVIDED AND THAT THE ATTACHED
BUILDING PERMIT IS ALLOWED AN EXEMPTION AS CITED ABOVE.
FURTHER I UNDERSTAND THAT THE SUBMITTAL OF MISLEADING OR INACCURATE INFORMATION OR THE
CHECKING OFF OF A ABO MPTION WHICH DOES NOT COMPLY, WHETHER DONE TO MY KNOWLEDGE OR
NOT IS G FOR fU AL THE BUILDING DEPARTMENT TO ISSUE ABUILDING PERMIT.
APPLICANTS SIG DATE
THIS FORM TO BE ATTACHED TO THEtBUILDING PERMIT APPLICATION
North Andover Building Department
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54, a condition of Building Permit
Number' is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL
c11,S150A.
The debris will be disposed of in:
(Location of Facility)
Signature of ermit plicant
Dto
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector
MAScheck COMPLIANCE REPORT
Massachusetts Energy Code
MAScheck Software Version 2.0
CITY: Lawrence
STATE: Massachusetts
HDD: 6235
CONSTRUCTION TYPE: 1
HEATING SYSTEM TYPE:
DATE: 6-19-2002
or 2 family, detached
Other (Non -Electric Resistance)
DATE OF PLANS: 6/19/02
TITLE: 33 Stonewedge Circle
PROJECT INFORMATION:
Campbell Forest
COMPANY INFORMATION:
Belford Construction
COMPLIANCE: PASSES
Required UA = 708
Your Home = 645
Permit #
Checked by/Date
Area or Insul Sheath Glazing/Door
Perimeter R -Value R -Value U -Value UA
CEILINGS
1821
30.0
0.0 64
WALLS: Wood Frame, 16" O.C.
3324
13.0
3.0 237
GLAZING: Windows or Doors
648
0.350 227
DOORS
42
0.350 15
FLOORS: Over Unconditioned Space
1814
19.0
86
BSMT: 8.0' ht/6.0' bg/2.0' insul.
100
10.0
16
HVAC EFFICIENCY: Furnace, 86.0 AFUE
COMPLIANCE STATEMENT: The proposed building design represented in these
documents 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 a design load as specified in
sections 780CMR 1310 and 4.
Builder/Designer Date
(177
BOARD OF BUILDING REGULATIONS
License: CONSTRU
CTION SUPERVISOR
Number: C3 014197
Birthdate: 04/24/1957
Expires; 04/24/2004 Tr. no: 19084
Restricted:., 00
MARK F RAE
85 JOHNSON ST
NO ANDOVER, MA. 01845 �i f
N
a
0
C.)
LU
jr
wj
J.WILLIAM HMURCIAK, P.E.
DIRECTOR
TOWN OF NORTH ANDOVER, MASSACHUSETTS
DIVISION OF PUBLIC WORKS
384 OSGOOD STREET, 01845
DRIVEWAY PERMIT
Telephone (978) 685-0950
Fax (978) 6889573
DATE
LOCATION '5 " v
BUILDER hone
OWNER /61-e� -5 >� hone
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.
1160
APPLICATION FOR WATER SERVICE CONNECTION
North Andover, Mass.
r
Application by the undersigned is hereby made to connect with the town water main in i i Street,
subject to the rules and regulations of the Division of Public Works. _
The premises are known as No
a, e d 412 (f_ rc- & Street
or subdivision lot no. ��? 97 _�7c� ,.� 75 Z
/4r/ 6'��l
Owner Address
Contractor
PERMIT TO CONNECT
The Board of Public Works hereby grants permission to
to make a connection with the water main at
subject to the rules and regulations of the Division of Public Works.
Inspected by
Date
Address
A �icant's Sig ature
ATER�AIN
nrC%(2
Street
and of Public Works
By C
See back for rules and regulations
1797
APPLICATION FOR SEWER SERVICE CONNECTION
North Andover, Mass. ally
Application by the undersigned is hereby made to connect with the town sewer main in I� Street,
subject to the rules and regulations of the Division of Public Works. 14
The premises are known as No. Street
-33
or subdivision l/ot/!o. chi
Owner Address
Contractor
Address
pplicant's Si ure
PERMIT TO CONNECT WITFnWER
The Division of Public Works hereby grants permission to /4
to make a connection with the sewer main at
subject to the rules and regulations of the Division of Public Works..
Inspected by
Date
Street
Division
of Public Works
By
See back for rules and regulations
AY
U
N.T.S.
NOTE_ 1.) ALL DRIVEWAY APRONS TO BE PAVED WITH 3" aTUMWNOUS CONCRETE.
2.) DRIVEWAYS SHALL NOT BE INSTALLED IN LOCATIONS WHERE STONE BOUNDS ARE PROPOW8.
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