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HomeMy WebLinkAboutMiscellaneous - 36 CHATHAM CIRCLE 4/30/2018I -- Location 3 y C �I 4`kAwl C ( v-\ No. LI Date Check # 0 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ 5 Foundation Permit Fee $ Other Permit Fee TOTAL / building Inspector .. , e" -,• NEW ENGLAND CLAIMS SERVICE, INC. ❑ Incorporated 1985 Reply To ,a,�r Reply To Mansfield, MA 02048 F.<;; 131 Dodge Street, Suite 6 P.O. Box 345 l.�s��A� Beverly, MA 01915 TEL. {508} 337-8058 $„k TEL. {978} 927-3000 FAX {508} 339-5835 FAX {978} 927-3002 wrandall@newenglandclaims.com Form of Notice of Casualty Under MASS. GEN. LAWS To: Building Commissioner or Inspector of Buildings City Hall North Andover, MA 01845 RE: Insured: O'Conn8I1. Patrici Property Address: 36 Chatham Circle Cause of Ldss/Date: Water 3/1 File or ClaimNo.�—8 51439 Loss to Building , Ch. 139, Sec 3B �1 JUN U 4 2013 TOWN OF NORTHAND01/r;ft Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. Section 3B. No insurer shall pay any claims (1) covering the loss, damage, or destruction to a building or other structure, amounting to one thousand dollars or more, or (2) covering any loss, damage or destruction of any amount, which causes the condition of a building or other structure to render section six of chapter one hundred and forty-three applicable, without having at least ten days previously given written notice to the building commissioner or inspector of buildings appointed pursuant to the state building code, to the fire department or arson squad of the city or town and to the board of health or board of selectmen of the city or town in which the same is located. If at any time prior to payment the said city or town notifies the insurer by certified mail of its intent to initiate proceedings designed to perfect a lien pursuant to section three A, or to jeeo,-1# section nine of chapter one hundred and forty-three, or section one hundred and twenty-seven B of chapter one hundred and eleven, the said payment shall not be made while the said proceedings are pending; provided, however, that said proceedings are initiated within thirty days of receipt of such notification. Any lien perfected pursuant to section three A, or to section nine of chapter one hundred and forty-three or section one hundred and twenty-seven B of chapter one hundred and eleven, shall extend to and may be enforced by the city or town against any casualty insurance policy or policies covering any loss, damage, or destruction pursuant to which the proceedings to perfect the lien were initiated. No insurer shall be liable to any insured owner, mortgagee, assignee, city or town, or other interested party for amounts disbursed to a city or town under the provisions of this section, or for amounts not disbursed to a city or town under the provisions of this section. Paul A. Dionne General Adjuster On this date, I caused copies of this Notice to be sent to the persons named above at the addresses indicated above by First Class Mail. Signature Date 0 z Q 99 CL Vo v z Oa 06 _ W oC O Z ul IL O0 z W 3: 1— O Q P s V. W C.� I W A 0 u Town of North Andover a� tAORTH Building Department �� y.`V /b 6� L 27 Charles Street o North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 by o OttArev [O[kICkI W k k ACNUSC, APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS i 1.2c• i LOT NUMBER SUBDIVISION ��>%��� L.; �•SS 7/�' DATE REQUEST FILED �zS�/�o DATE READY FOR INSPECTION FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED, WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING CONSERVA PLANNING D.P.W. DATE DATE DATE . a— D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED d� PRIOR T THEA SPECTION REQUEST DATE. / DPW-AUTHURIZATION 1r - O 1� O z L W W tv 0� a % V U y" M (� W C9 �� 0� f W r� ro M us co v U c� x oEn Q w w° V) w° C2 ---u CE O � �• O N �•a c o 3C mCL m c � �Yo �o N CD c ilk ZO m • N 0 0 Ai ` m Nyr c 2; M CQ- AM., C EN 75 L� Amo — y m �Z = O Q�cm ; a,cs m m O No �. co2•�z o: F- m �� vos c •c x o :m3 N 0 y oF- m � W CO o _ :s .0 .r. r r LL _ O O ui ••N •G.= O C z L N ca o • O v `m o m c g y d m.5 _ m o H � O !— t 0- d Z... m i J v 0 O U !:i t O 0 U) U) w w crw U) This certifies that / Date ' /7// � TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING has permission to perform ....i,,. :� ........... . plumbing in the buildings of ... t " c /� ......................... at ... .... f .. �... r.'.. , _ r !' ..... . , North Andover, Mass. 99 .� Fee.. .7-Aic. No.. Y�.! ..... .......... ...�(..... y .-4...... . PLUMBING INSPECTOR Check # 5CG MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) 1 V / NORTH ANDOVER, MASSACHUSETTS Building Location ( )h " 3 b Owners Name , Date 1 11 "'° 1 Permit 6 ` � Amount Qm-S51 n Type of Occupancy p t New 1911� Renovation 1:1 Replacement 1:1 Plans Submitted Yes 1:1 No ❑ Kly ILIJ' ------------------------- WISI:� „'MMo©MMMMNMMMMMMMMMMMMMMM� .,' t,' MMMMMMMMMMMMMMMMMMMMMMMM� .i„'mmmMMMMMMMMMMMMMMMMMMMMM� (Print or type) Installing Company Name 9,;� lea in . rl Check one: Certificate ❑ Corp. Partner. Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy u Other type of indemnity ❑ Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the M;ssach s is State Plumbing Code and Chapter 142 of the General Laws. By: Signature icen um er Title Type of Plumbing License City/Town icense TNUMDer Master [� Journeyman ❑ APPROVED (OFFICE USE ONLY n� Ha+rH ,y , e Town of NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT , PERMIT NO.: �)T('j PROJECT: �l%�l � ` l'��1 If FlT4�N-DATE: Y `d UNIT NO.: FLOOR: WING: BUILDING NO.: 3cf C44 Y-hmq ne-�- REMARKS: ` AOyh o,lc S ,(jA-�-h 0 o) �44/ Al'kat*-y A076-1/ Excavation - depth and soil conditions Framing - Other: Date: Date: Date: Inspector Inspector Inspector Footings and foundations and drains - Insulation - Other: Date: Date: Date: Inspector Inspector Inspector Electrical - rough - Plumbing and/or gas - rough - Other: Date: Date: Date: Inspector Inspector Inspector Electrical - final Plumbing and/or gas - final Other: Date: Date: Date: Inspector Inspector Inspector "7ire Dept - oil burner, tank, stove, smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: -Cof 0# Inspector Inspector Inspector Form #995 Action Press, 665-7000 Location /.0 3 Y- 3 6�(rt .c /6 No. ^� a ) Date Check # 191 TOWN OF NORTH ANDOVER Certificate of Occupancy $ lb O ( — Building/Frame Permit Fee $ Foundation Permit Fee $ O Other Permit Fee $ TOTAL $ 3 O b 1 - Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING -. - arr3' BUILDING PERMIT NUMBER: I DATE ISSUED: y SIGNATURE: Building Commissioner/IRTEtor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 3 oe l!�Ia/zw 1.2 Assessors Map and Parcel Number: l7 rl Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 21 r -d Zoning District Proposed Use Lot Areas Frontta e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Legyged Provided Re red Provided •� 3 1.7 Water Supply M.G L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public A Private ❑ Zone Outside Flood Zone Municipal On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record 31el, � tame t) Address for Service : C Signa _ Telephone 2.2 Owner of Record: Name Print Signature Telephor SECTION 3 - CONSTRUCTION SERVICES 3.1 LiceConstruction Su rviissor: License4fonstruction Supervisor: nv* Telephone 3.2 Registered Home Improvement Contractor Company Name Address Address for Service: Not Applicable 0 License Number Expiration Date Not Aonlicable ❑ Registration Number Expiration Date SECTION 4 - WORKERS COMPENSATION (11LG.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 building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ? Existing Building ❑ Repair(s) ❑ Alterations(s) 77 ition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to bee}FPICIL=US Completed b rmit a licant ON I . Building v ov cpv (a) Building Permit Fee Multiplier 2 Electrical 2 O v U (b) Estimated Total Cost of Construction 3 Plumbing v d Building Permit fee tat X (b) / 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Q Check Number SECTION 7a OW ORIZATIO TO BE COMPLETED WHEN OWNERS A ON TOR APPL 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. ld-Dl Si ire of Owner Date SECTION 7b O THORIZE GENT DECLARATION I, Owner/Authorized Agent of subject property Hereby declare that the state d information on the egoing application are true and accurate, to the best of my knowledge and belief Print Name Signature of Owner/Agent Date ` NO. RIES SIZE OR SLAB SIZE OF FLOOR TI1VIBERS 1 2ND 3 RD SPAN DINIENSIONS OF SILLS 7� DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING G l oe X MATERIAL OFC IS BUILDING O OL FILLED LAND IS BUILDING CORWCTED 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*********************** APPLICANT (10 c 71 ✓� PHONE ��� 915-y �v' LOCATION: Assessor's Map Number PARCEL SUBDIVISION C }% %iCl sr� ��f'S. LOT (S) 6� STREET C'/le C l ST. NUMBER-� I *****************************************OFFICIAL USE ONLY*********************************** 135COMMUMAPONS OF TOWN AGENTS: ATft XD- MINISTRATOR DATE APPROVED DATE REJECTED i COMMENTS- v TOW PLANNER COMMENTS FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMM DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT //'GAM Cl/ .-riS3-6 —0i FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 Jim N/F HILL Go. ...... 32.9 PROPOSED 00 UNIT FF=233.5 00 GF=232.0 PROP. BIT, CONC, PRIVE C14 PROPi. 81 0 CONC. DR,\/F GF=232.0 —ps 32.1' Pw or PROPOSED UNIT FF=233.5 �A OF 4f4 Z OT DO LAS E, L S ,�49'� Zi 0 3 CO 0) 0 S T Ve- SSIONAL 53,45' L=36.48'\ R=1 75.00 VT A— - 11 11 A A A PROPOSED PLOT PLAN DANA F. PERKINS, !no. X. - Consulting Engineers & Land Surveyors ............ LOT #11 1215 MAIN STREET - UNIT III ......... .................. ................. TEWKSBURY, MASSACHUSETTS 01876 ............. ............... CHATHAM CROSSING PREPARED FOR ................ RAY CORMIER NORTH ANDOVER, JfA 59 CHANDLER CIRCLE ...... ... ANDOVER, MA 01810 ........ . ..... ...... . ....... .. SCALE: 1"=20' DATE: JULY 24, 2001 JOB NO.51165-9PPI SHEET 1 OF 1 COPYRIGHT ' ' - 0.2001 BY ... DANA F. PERKINS, Inc. to U am a nomeowner perrtorming all wont myself. 01 am a sole proprietor and have no one working in any capacity � I am an employer providing workers' compensation for /' „ 4 i , i Company name: Address i'y employees working on this job. City: Phone #: L- / � o""o it t ��- , L-, - �/. Insurance Co Policy _# mmmmmiim Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement-maVU— 9rwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the @offs andel perMies of Print name ��i �� z,:,N Official use only do not write in this area to be completed by city or town official' ❑Check if immediate response is required Building Dept Contact person: Phone FORM WORKMAN'S COMPENSATION is true and correct. Date Phone # /75:2 ❑ Building Dept ❑ Licensing Board ❑ Selectman's Office ❑ Health Department ❑ Other Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax. (978) 688-9542 DEBRIS DISPOSAL FORM O �ttmo /6 �.N COR �R1TQo APa`y.t In accordance with the provisions of MGL c 40 s 54, and. a condition of Building permit-# the debris resulting from the work shall .be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl'1, sI50a: The debris will be disposed of in /at: .1/ Facility location t pplic Date NOTE: A demolition permit from the Town of.North Andover must be obtained for this project through the Office of the Building Inspector. .-- ug_07-01 11:01A MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.01 Release 2 CITY: North Andover - STATE: Massachusetts - i NIDD : 632 2 CONSTRUCTION TYPE 1 or 2 Family, Detached HEATING :SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 8-7-2003 TITLE.: LOT #tj UNI A CHATHAM CIRCLE '�✓?�% PROJECT INFORMATION: " VON CORMIER CONST CORP 59 CHANDLER CIRCLE ANDOVER M. COMPANY INFORMATION: J&LT HE.�_TING & AIR_ COND 17 a1?L�NGTON ST DRACUT MA COMPLIANCE: PASSES Revired UA - 373 Voir Home - 362 P.021,-,-';` Permit, # Checked.-by/Date The heating load for this building, and the cooling load if appropriate, has been det-erm.±ned using the applicable Standard -Design Condtions found in the Code. The HVAC equipment selected to heat or coal the -building shall he no greater than 12 of e demon load as specified in Sections 780CMR 1310 Builder/Designer 4 Date 4:01e4p �� Area or Cavity Cont. Glazing/Door ----------------------------------- Perimeter R -Value R -Value U -Value CEILINGS --------------------------------------- 1388 30.0 0_.0 MALLS: Wood Frame-, 16^ 0. C. 1043 11.0' 0.0 WALLS: Masonry, Interior Insulation 280 11.0 a_0 GLAZING_ Windows, or Doors 273 0.330 GLAZING: Windows or Door$ 63 0.360 DOORS 39 0.4-60 FLOORS: Over Unconditioned apace lass 19.0 0.0 HVAC EQUIPMENT: Furnace, 92.0 AFUE COMPLIANCE STATEMENT: The proposed building design- described ------ here is cQnSq;,rent_ with the ru_i ding plans; sre.cif,ications, 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 det-erm.±ned using the applicable Standard -Design Condtions found in the Code. The HVAC equipment selected to heat or coal the -building shall he no greater than 12 of e demon load as specified in Sections 780CMR 1310 Builder/Designer 4 Date 4:01e4p �� �ug_07-01 11:01A _ Massachusetts Energy Code MAScheck S.cttware version 2.03 Release 2 LOT #9 UNIT A CHATHAM CIRCLE Bid3, Dept Use I] A CEILINGS: 1, R-34 Comments /Location, WALLS: l..Wood.Frame, 16" O.C., R-11 Comments/Location 2 _ ' Masonry; = Interior Insulation, R-11 Comments/Location P_03 WINDOTVIS ArT.Il GLASS DOORS: 1. U -value: 0.33 For windows without labeled U -values, describe features: f# Panes Flame Typo Thermal Break? [ i Yes [ ]- No l.otYalrients./ Loc.a t i oil 2. U -value: vv",36 For windows without labeled tf-valines, 'describe- features: # Panes Frame Type Thermal Break? [ } Yes [ ] No Comments/Location DOORS: 1. U -value: 0.46 Comments/Location FLOORS: I. Over Unconditioned Space, R-19 Comments/Location- HVAC EQUIPMENT: 1. Furnace, 92.0 AFUE or hither Make and Model Number 2. Air Conditioner, 10.4 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 a�aet one of the following requirements: 1- -1LYFe_-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 283, 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. dug -07-01 11:02A E ` P_05 PIPE SIZES (in.) NON -CIRCULATING CIRCULATING MAINS & RUNOUT HEATED WATER:TEMP (F): RUNOUTS 0-1" 0-.1.25" 1.5-2.0" 2.0+ 170-;180 0.5 1.0 1.5 2.0 i40-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 ----NOTES TO FIELD .(Building Department Use Only)------------------------- JCon Z o z I ° C cc a Con FM CC' 'A'��• `• 0 W / A, c u Q Q •r ci d m M c Q1 o p -se Ln 0 3 ,3 N o cu o�2 m'u " (� a co _�l 3aj 3 v1 � ve a o O o c H a C3. O x n�.r-.0 O Q ='� 0- C IM °' c '— 0 O � L c aj cn u� o W ° O �C 01 fD c XW 0.y•= ..00 o E HCL 0. 3 0 a LU °' t .00.o o �m Z ®� aj o:9cu �. g zk- o c, in z > �m V W M cz �¢ a w' v O w e cu v cn A CG b G O w x D0 O rx G U G i4 a w as a a x toW p w G w a 04w W p w v cn G x a d no GO rs: G w z w w w c m z cn Q O cn O z Eo �• O y O CJ C.) a� cmc :=o J Ci mac: E a 1 ,4% E ,o m too).. H O m lu: m co zy`z CSO =CG_�� N O O m ® Ncm m c o a :o � act m (�Q C or c� - 0. Z O . cc : .. 'coo c gis�c 'c = m :ago N � o Lju COymof- m t NJ C = = O = N O.0 dC 'E v m v y .Z� CS CLL3 m a m c g ti a m� cg = COD m.a 0 y �= CDcc 2 O a z 0 U 005 9 GO O 0 CD 0 CD oc M O G y O M CL O Q ev CL CO2 O O CL CO2 C O Cc - cc O CO)CL ISO 0 C13 CLCO2 C 0 U) U) T_ w w U) • TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMrOLISH A ONE OR TWO FAMILY DWELLING 6 �,`-f�+i j3BUILDING PERMIT NUMBER: / 1 DATE ISSUED: /. of SIGNATURE: Building Commissioneffl for of buildings Date aV,%-J IVly t-J11r, 111rUMMA11VP1 I 1.1 Property AddressF—A� - 1.2 Assessors Map and Parcel Number: C / Map Number Parcel Number 1.3 Zoning Information: / 1.4 Property Dimensions: 49 ProsFronta e (ft)Zonin District %- 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided i (1 J 1.7 Water Supply M.G.L.C.40. 54) I.S. a Information: 1.8 Sewerage Disposal System: Public U Private❑ Zone Outside Flood Zaa� Municipal On Site Disposal System ❑ SECT ON 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 er of Record _ xo Name lrit /-/ Address for Service: 2.2 Owner of Record: Name Print SECTION 3 - CONSTRUCTION SERVICES 3.1 Licens nstruction Supervisor: Licensed ction Supervisor: 1,4 Telephone 3.2 Registered Home Improvement Contractor Company Name Address / Ci 7d d Address for Service: Not Applicable ❑ License Number - l 2 -A; Expiration Date Not Applicable ❑ Registration Number Expiration Date 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 building permit. Signed affidavit Attached Yes .......0 No ....... ❑ SECTION 5 Descri tion of Proposed Work check all applicable) Construction Existing Building ❑ Repair(s) ❑ —[New Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed bypermit ap licant ( IFFIC AL CISE ON : . 1. Building d(� (a) Building Permit Fee Multiplier 2 Electrical Z o e7Dd (b) Estimated Total Cost of Construction 3 Plumbin d Building Permit fee (a) x (b) IIRII12 4 Mechanical HVAC d 5 Fire Protection 6 Total 1+2+3+4+5 d Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authoriz to act on My behalf ' s relative to w y thi application. ���d�U� Sig aft of Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and beliff Print Name Si a e of O ent Date NO. O ORIES SIZE - C&QkjLff OR SLAB SIZE OF FLOOR TRVIBERS / ,l 1 2 3Ku SPAN DIMENSIONS OPSILLS DEvIENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS p SIZE OF FOOTING 2—o X MATERIAL OF C v d' el IS BUILDING O O OR FILLED LAND IS BUILDING 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*********************** APPLICANT �6� �[ fy TwS✓ LOCATION: Assessor's Map Number. PHONE PARCEL SUBDIVISION LOT (S) 6/ STREET ST. NUMBER-3Y *****************************************OFFICIAL USE ONLY*********************************** 139�CPMM APONS OF TOWN AGENTS: -----I ATION ADMINISTRATOR DATE APPROVED DATE REJECTED_ COMMENTS ( V 9 1- t..,11, 10 ER COMM FOOD INSPECTOR -HEALTH CTOR-HEALTH COMM DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT L RECEIVED BY BUILDING INSPECTO Revised 9\97 jm TE --0/ � 00 —^ -- J \ _ cx PROPOSED (o UNIT 2.0 PROP, BIT. CONC. PRIVE Ln CONC. DRIVE PW PROPOSED UNIT 10ALAS E. ES 30 STe U -----°—^A UY ~ � �-7��-------- \ / �� U �--------*-------°- ' ` Y�/ �PROPOSED FZ077 PZAJV DANA F. PERKINS, Inc.LOT #11 1215 MAIN STREET - UNIT IIITEVKSBURY, MASSACHUSETTS 01876CHATHAM CIROSSING PREPARED FOR:RAY CORMIERiVORTH AIVDOVER, &A 59 CHANDLER CIRCLEANDOVER, MA 018101 SCALE: 1"=20' IDATE: JULY 24, 2001 JOB NO.51165-9PPI SHEET I OF I COPYRIGHTO 2001 BY DANA F. PERKINS, Inc. ' is Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax. (978) 688-9542 DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and. a condition of Building permit.# the debris resulting from the work shall.be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl I, sI5Oa. The debris will be disposed of in /at: Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. Location: , - 6 /r City rz� • � P( G� /- Phone C;9 o G 0 am a homeowner performing all work myself. ElI am a sole proprietor and have no one working in any capacity L;' am an employer providing workers' compensation for my employees working on this jobb.. Comnanv name: Address .-'T /1 e, X -- Company name: Address City: Phone #: Insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statemy be forwarled to the Office of Investigations of the DIA for coverage verification. I do herby certify under th ains a enalties of Mu r at the i »pi6vided above is true and correct. Signature Date Print name `-e�L Phone #� �� Gl Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone #: ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION ,ug -07-41 11:01A MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version CITY: North Andover STATE: Massachusetts 11 Ur 322 CONS'rRUCI'ION TYPE: 1 HEATING SYSTEM TYPE: DATE: 8-7-2001- TITLE: -7_2001 TITLE: LOT ## UNIT A P.02 Permit # 2.01 Release 2 Checked.by/Date or 2 Family, Detached Other (Non -Electric Resistance) CF.ATF,AM CIRCLE PROJECT INFORMATION: Ys7ON CORMIE'R CONST CORP 59 CHANDLER CIRCLE ANDOVER MA COMPANY INFORMATION: J&J HE.�_TING & AIR- COND 17 a.RL Z NGTON ST DP.ACUT MA COMPLIANCE: PASSES ReT-ii red UA _ 373 Vni r Home - 3F7 �03G Area or Cavity Cont. Glazing/Door Perimeter R -Value R -Value U -Value CEILINGS 1388 30.0 U.0 MALLS: wood Frame, 16" O.C. 1043 11.0' 0.0 WALLS: Masonry, Interior Insulation 280 11.0 0.0 GLAZING_ Windows or Doors 273 0.330 GLAZING: Windows ar Doors 63 0.360 DOORS 39 0.460 FLOORS: Over Unconditioned Space lana 19.0 0.0 HVAC EQUIPMENT: Furnace, 92.0 AFUE --------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is rnns-i-tent 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 Energ?7 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 _cted to heat or coal the building shall he no greater than 125 e design load as specified in Sections 780CMR 1310 and J >1 Rtlilder/PeS1c7narPat_ \ug -07 sol 11:01A Massachusetts RnerTr code MAScheck Software- version 2.€3i ne1ease 2 LOT #9 UNIT A CHATHAM CIRCLE DATE: 8-7-2001 Bldg, Dept. Use r ] r ] I CEILINGS: 1. R-30 Comments/Location WALLS: 1. Wood Frame, 16" O.C., R-11 Comments/Location 2_ Masonry, Interior Insulation, R-11 Comments/Location P_03 WIATDOTAIS APT..D GLASS DOORS: 1. U -value : 0.31 For windows without labeled U -values, describe features-: # Panes manta• Typo Thermal Break? [ } Yes E i No Coarients/Location 2. U -value-: 0.36 For windows without labeled U -values, describe feature- s-# Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: 1. U -value: 0.46 Comments/Locati FLOORS: I. Over Unconditioned Space, R-19 Comments/Location HVAC EQUIPMENT: 1. Furnace, 92.0 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. W1hen installed in the building envelope, recessed lighting f ixtures shall tt&2et one of the following requirements: 1. 'Iyge 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 283, with no more than 2.0 cfm (0.944 L/9) 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. aug-07-4,01 11:02A P.05 ----NOTES TO FIELD (Building Department Use Only)------------------------- PIPE SIZES (in.) NON -CIRCULATING CIRCULATING MAINS & RUNOUT TREATED WATER TEMP (F): RUNOUTS 0-1" 0-1.25" 1.5-2.0" 2.0+ 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 160-130 0.5 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only)------------------------- 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 below. Cid- P rmcant Property address Map / Parcel 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 1 understand that my interpretation of the exemption status is subject to review by the Building 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 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 bylaw, provided that no additional residential unit is created. The lot(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 of the 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 UNDERST SUBMITTAL OF MISLEADING OR INACCURATE INFORMATION OR THE CHECKING OFF ABO MPTION DOES NOT COMPLY, DONE TO MY KNOWLEDGE OR NOT IS GR O FUSAL BY THE ING DEPAR SUE A BUILDING PERMIT. LICS TURF DA THIS FORIVf TO BE ATTACHED TO THE BUILDING PERMIT APPLICATION aj- z 4�� o w� o �� o 0OJ �\ _ O C -0 'C N m N —' CD fD tD 0 0 > > 0 c 3 EP 4! ' 5 y IA= ® CCD n y Q' m0 m : CD CD QCD 0 r. N y M > C rr 3 O v C o CL Q y of n C"I At > a=n o CDQ 0 CD � � d CL C CL L' 0 = aj O ,ny O'CC C > (A :c O :3C CD E To •+ C7 -1 1 M 77 :rH D nj N y Ql d ,n. rr ^ a ID tTl c� o CD ~ -Y :g Li Q (D0 -� v o ~ ID o CD y 9 d o 0. z U) m Cl) 0 m CO) .p Cl)*CD Z CD O ar d d CL =. o p CL. c CCD O •._ O CA C7� 0 CA CD O CD 3 y CD CA O 0 CD 0 CD C C?O d Z O �• ca Q co) S n O �. m ,a C4 »m � m c� ynCL 3 m z .O =r.0 H �. a) d -- tiM. T CL Er m ?m CO) O —40..' y p : O m m C a O n -� O co _ ...� O O Z ICU 1 O y C3 Q W �c o 1•, H CL U2 0 Vl m O N C/) co nn :- b oa m CD e•7 z &, d = Q 10 C/) ��a Z Cp _ co aa�. „11J w m 0 e+. ` C4 O n 2 m 1y.� L"., ': (r) . -CD O z pCD ,� zy 14�.CD o CD �. CD cn0 e� =CD y ' d C r: C=* o Im JUT a C', C rZ o �\ _ til : c o o ca omiq 0 9 cn CD 0 cn •1 0 rn 7d O � 0 x C7 �n 7 � tD O x r y O Q � z p n O OQ C � cn�n ,O � 00 x C) C) d x CL O 0 0 I a 0 c 4 3.6 Date... .........� TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..............,1� .17 ..........l... P.C.............�.x..e.................... r has permission to perform ......... .. 2i�.!?..-'L................................... wiring in the building of .... v at ...... ....._ .....0h 7/ /�i.....0 North Andover Mass: Feed % .0 ..... Lic. No.�� .���...........�-... J ELECTRICAL INSPE R Check # 4 Commonwealth of Massachusetts Official Use Only ip ;. Department of Fre Services Permit No. 3 d O` BOARD OF FIRE PREVENTION REGULATIONS : Occupancy and Fee Checked / [Rev. 11/991leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accotdnm with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TY ALL IN ORW 17ON) ` Date: City or Town oh To the Lis etor of Wires: By this application the undersign d giv notice of r lie r ' tention to perform the electrical work described below. Location (Street & N p ber) Owner or Tenant Co let Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Chccl: Appropriate Box) Purpose of Building Utility Authorization No. Existing Senice Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed EIectrical Wort:: Overhead ❑ Undgrd ❑� No. of Meters Overhead ❑ Undgrd ❑ No. of Meters r',,,,..,te,;,... „r.r... r n.....:.......r.r_ _.,... r._ ..._:.._�'-..r.- r-----•---rcv:.�_ No. of Recessed Fixtures w /VaaV ....a No. of Cct7.-Susp. (Paddle) Fans nVa IGU VY VaG II1J Gi.1Vl V Il G.I. No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Shimming Pool Above ❑ !n- ❑ rnd. rnd. o. o mcrgency Lighting Battcry Units No. of Receptacle Outlets No. of Oil Burners FIRE AL.�RbIS No. of Zones No. of Switches ". No. of Gas Burners No. of Detection and Initiatine Devices No. of Ranges No. of Air Cond. Total Tons No. of Alertingb Devices No. of Waste Disposers Hcat Pump To Number Tons K�V No. of 'cif- ontained Detect ion/AlertimZ Devices No. of Dishwashers Spacc/Ama Heating KW Local ❑ Municipal C1 Other Connection No. of Dryers HeatingAppliances KWsecurity Systems: No. of Deices or Equivalent NO. o aterK,�V Heaters o. o o. of Signs Ballasts Data Wirin g• No. of Deices or E uivaicnt No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wirig: No. of Devices or E uivanlent OTHER: Attach additional detail if desired, or as required by the Inspector of 16ires. INSURANCE COVERAGE: Unless waived by the owner, no pennit for the performance of electrical 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 permit issuing office. - ---CHECK ONE: INSURANCE ❑ ` BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with NEC Rule 10, and upon completion. 1 certify, under th pains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: ADT Security Services 111 Morse Street, No#10 , MA 062 LIC. NO.: 1533C Licensee: John S. Bassett Signatu { IC. NO.: 1533C (If applicable, enter "exempt"hi die liceruenunrberUne.) _ Bus. Tel. No.: 781-278-1131 Address: Alt. Tel. No.: 781-278-1725 OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage nortially required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owncr/Agent Signature Tclel)lionc No. PERtiIIT FEE: 5 i 36 3 Date... � .../�.��".. �i. ,•�--{.-.. �o� TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ......... ...... has permission to perform ...................................................................... wiring in the building of .......... �4 �.!�..':...::....'.........�...... v ............................ at.. / ::........................... ........................................... �1 Torth Andover Mase Fee....%. �� : ... Lic. No. ............. .................. -z .............. 1/..........` ELECTRICAL INSPECTOR Check # �� �O f 1 Commonwealth of Massachusetts official Use only T Department of Fre Services Pcrtnit No. BOARD OF FIRE PREVENTION REGULATIONS .,Occupancy and Fee Checked V / [Rev. 11/991. lmve blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in acconLmw with the Massachusetts Electrical Code ( C 527 MR 12.00 (PLEASE PRINT IN INK OR TYP IN RtiIAT70 City or Town of: M Dater � - To the Inspec or o yYires: By this application the undersign d gives notice his o Iter int on to perfo the electrical work described below. Location (Street & Nu ber) " Owner or Tenant l' Owner's Address Telephone No. Is this permit in conjunction with a building permit? yes No (Chccl: Appropriate Box) Purpose of Building Utility Authorization No. Existing Scnice Amps / g Overhead verhead ❑ Undrd —'—" b ❑� No. of hlcicrs New Service Amps 1 Volts Overhead C]Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work• , i� I � .- n _ AA ' No. of Recessed Fixtures No. of Lighting Outlets No. of Lighting Fixtures No. of Receptacle Outlets No. of Switches No. of Ranges No. of Waste Disposers No. of Dishwashers No. of D r vers No. o atcr Heaters KW jno. No. Hydromassage Bathtubs OTHER: :dArca Heating KW Heating mo�eaon o die (ol..11"n table maybe waived by the Inspector Security Systems: No. of Devices or Equivalent SEE'addle) Fans No. of Total Transformers KVA Telccontnrunications Wiring: No. of Devices or Eouivalent Generators KVA Swimming Pool Arnd c ❑ 1 rnd. r -,Battery Units0. cncy Lighting " No. of Oil Burners FIRE ALARiIIS No. of Zones No. of Gas Burners No. of Air Cond. Total Tons Heat Pump Number Tons KtiV No. of Detection and Initiating Devices INo. of Alerting Devices No. of Self- _onminrri KW jno. No. Hydromassage Bathtubs OTHER: :dArca Heating KW Heating I Alunicipal Local ❑ Connection ❑ Other. ting Appliances KW 0 0. of Signs Ballasts Security Systems: No. of Devices or Equivalent Data Wiring: No. of Devices or Equivalent of Motors Total HP Telccontnrunications Wiring: No. of Devices or Eouivalent Attach additional detail ijdesired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical 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 forte„ and has exhibited proof of same to the permit issuing office. --- CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Spey_) Estimated Value of Electrical Work:t w (Expiration Date) (When n:Quired by municipal policy.) Work to Start: o� k p2 Inspections to be requested in accordance with NEC Rule 10, and upon completion. 1 certify, under tlt pax sand penalties ojperjury, that t/te information on this application is true and complete - Pa' NAME: ADT Security Services 111 Morse Street, NOW02 MA 062 LIC. NO.: 1533C Licensee: John S. Bassett SignatuT. D�� � IC. NO.: 1533C (Ifappl icabl e, enter "exempt " in die licetnse number ane.) Address: Bus. Tel. No.: 731-279-1131 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability Ainsurance coverage normally ormally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature -� Tclepitone No. PE- IWIT FEE: S c�)5, ® TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMyOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/I for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Mall Number Parcel Number /1.3 Zoning Information: ( lvO4Y 1.4 Property Dimensions: / Z�OOU /60 ZoningDistrict Proposed'Use- Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public VPrivate ❑ Zone Outside Flood Zone Municipal On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Name (P rite Address rvice Sig Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Tele one SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: S License Number DQ Expiration Expiration Date T ugnature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Tele one SECTION 4 - WORKERS COMPENSATION (MG.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 building permit. Si ned affidavit Attached Yes .......0 No ....... 0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ • c Accessory Bldg. ❑ Demolition 0 Other ❑ Specify Brief Description of Proposed Work: ?i IM*01IINEII&111Ylu/:UYa1XiTiI&I I Rife I019"i7.t&1 l Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building(a) _ O G 0 Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing e- e, c Building Permit fee (a) x (b) ~- 61S 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 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 O'�;iuef Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name of Owner/. Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 ST 2ND 3 FD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POST'S DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF' CIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Jr3 Lt - Ll n z00 OO o F- T) `n ` o g> w C N w :)(L R co ,O F dd Q O` Z z M im U O h N \V � Obi O N I F -co O Z 00 co U N 0 °° d £ s x CO 2 ?j �C u Z mLLJ F0 O w Q v) J �a _ < ` Q O Z F .. w OQ> i m m m C/) 0 m a y d Poll - CO) n 10 0 CD C2 Z y r CD CL y o C2 0 v CD CDCL o "G m CCD ccD o C� CD y av y —• o co CD S v y O 10 Z CD oCD C CD 10 E� E C C?�O d Z O -�yoa n o »m0 m n m c2 m C, m Z ti CD .*C a m =r.= h -1 a. a No O N 19 ? . o �O m y C y N O =CD : ea = > >CD CO 0. co O O CO3 V O N Cl o i c=GO r 7a 0 a ... ,+ to COL CD y s OM ca C��gr ot �Cr C �r H ' iy =r :9 :Q : Aftw, Go q 49 D. c a. m oma:+ � �. CD Go: � 1 d O.0 c � m dd' CL �o z c o gym: Q, cn O cn R o twro z C� G ::r` ' w �'' POz C Com" y ;v C �� z y� n � 7.7 C ::r„ - w Cl) 'd a. 81 O a z "C7 � CA � W ro ro ►rf x H 0 7d � z 0 :.c Crl omi 0 9 0 c o• wo�rH ,y i 0 o ; Town of •`�_t,�w�sc`' NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT PERMIT NO.: /a(03 PROJECT: U"es/` IMQ s f�iV DATE: UNIT NO.: FLOOR: WING: REMARKS: ,!� 160 in,, �2��'�3 , �'4- Sal , BUILDING NO.L150 — - Excavation - depth and soil conditions Framing - Other: Date: Date: Date: Inspector Inspector Inspector Footings and foundations and drains - Insulation - Other: Date: Date: Date: Inspector Inspector Inspector Electrical - rough - Plumbing and/or gas - rough - Other: Date: Date: Date: Inspector Inspector Inspector Electrical - final Plumbing and/or gas - final Other: Date: Date: Date: Inspector Inspector. Inspector Fire Dept - il burner, tank, stove, smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: —Cof 0# Inspector Inspector Inspector Form #'995 Action Press, 665-7000 Location-,3 c A u" CI r ' No. t4c2 Date 3 S ^ G Z �oRTN TOWN OF NORTH ANDOVER 3?� SOL N 9 ♦ i ; i Certificate of Occupancy $ ,S'••'° E<�' Building/Frame Permit Fee $ J �C NUS " Foundation Permit Fee $ Other Permit Fee $ Q TOTAL $ 8 Check # I '15340 uilding Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING 77 7777,77 BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/I for of Buildings Date SECTION I- SITE INFORMATION 1.1 Property Address: C. '42c /Y 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: i2.1 /�V R /-V Zoning District Proposed Use 1.4 Property Dimensions: /Z civ �� v Lot Ar6 (sf) Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided /00 ` 1.5. Flood Zone Information: 1.7 Water SupplyM.G.L,C.4Q,; ,54)Z ; Public Private ''C %b t Zone Outside Flood Zone 1.8 Sewerage Disposal System: Municipal On Site Disposal System ❑ SEC I N 2 - PROPERTY OWNERSIIIP/AUTHORIZED AGENT 2.1 Owner of Record l -z - Name (P Address for Service: O d Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Lrcens onstruction Supervisor: S n Address" Signature Telephone Not Applicable ❑ '—% 3 License Number / 2{ 'e,ZAP,-- �� Z Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone 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 building permit. Signed affidavit Attached Yes .......0 No ....... 0 SECTION 5 Description of Proposed Work check all a Hcable New Constru on stg Pvilding ❑ Repair(s) ❑ Alteriitigns(s� Cly Addition ❑ Accessory Bldg. ❑ Demolition ❑ Odw tt'o ecify . A.- t"l I$ �!_ " '. Brief Description of Proposed Work: ` "` 4 I SECTION 6 - ESTIMATED CONSTRUCTION COSTS I Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building (l ar'd (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) Jj3 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 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 I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Signature of Omer/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 3kD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POS'T'S DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CI-IIN NEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 0 • §§ co to �® ® k §\ \Irm f z3k $ § G 7 2= 0)o $ �/ � o z coo n § § k j k S\ z- .� \ § o \ \ / .{ o » �, ® z c w i ya>:.:■o< > !i / % ƒ�< C/) M m m 0 m CO) CD n Z CD O CL r a� aC0 OIc p a� CT ` CCD O C. CD av to CD tii 10 CD O Cos ty LX - a CO) n� 0 CO) d CD 0 P.O. CD CCD a, CO) CD CO2 I �i- CD 0 CD C c?10 010 � s = O �• N O Q fOA ao m ti � m n m C7 aa.a m Z H.M c 3 = S -O ca •O� ._-► so der m tiCL '11 CL ? m .•� � d Mn m O m ti p O O O a > > Go* m O mgo O O y' C.) co 'L7 c =r H te-j a_ Q CL CL : :s c CD yCL 3[;.CDc; H ti. ?y O O � a C y CD CO) � W :A `IOLZCO) CDCA low r S O? o=: GOD: Oi m 0- 0 0 ITIT w a- �x '� ; a- r r� m ' rto W t wC x a to°�' El C z Onq 0 c n Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .........:....:. ...........:................................................................. has permission to perform.....................................................I.......................... 1 wiring in the building of ............. ........................ .............................................. at..:....................................:.t:..::.:.:.::...:...:..::-'......... , North Andover, Mass. n Fee .................... Lic. No........... r. r Check # i ..... ... ............ ........................... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer The Commonwealth of Massachusetts :iI I r 7 3 j= Fci Department of Public Safety BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 i.!.,Z7 Y. * Office Use Only Q Permit No. _�y/1L_ Occupancy 6 Fee Checked 3190 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK AN work to be performed in accordance with the Mawachuwn3 ElWncal Code. 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date 10 1-31 / 01 City or Town of NFIRTH ANDOVER To the Inspector of Wires: The undersign d applies for a permit to perform the electrical work described below. Location (Street S Number) T,C)T## 11 CHATHAM CIRCLE i#36 & 34 CHATHAM CIRCLE Owner or Tenant CORMIER ANDOVER CONSTR . CORP . _ Owner's Address 59 CHANDLER CIRCLE -ANDOVER, MA* ( 978) 470-01 89 Is this permit in conjunction with a building permit yes R] no ❑ (Ch -;k Appropriate Box) Purpose of Building 2 UNIT CONDO/DWELLING Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service 2 - 2 0 0 Amps_J2D_i2 4 0_Vofts Overhead ❑ Undgrd 12 No. of Metws-2 Number of Feeders and Ampacity .__--- Location and Nature of Proposed Electrical Work WIRE 2 unit condo w/smokes OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES NO ❑ I heave submitted valid proof of same to this office. YES ❑ NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE [K BOND ❑ OTHER ❑ (Please Specify) — -4.10 2 ' (Expiration Date) Estimated Value of Electrical Work Work to Start Inspection Date Requested: Signed under the penalties of perjury: "FIRM NAME ANDREW F SHEEHAN ELECTRICAL CE LIC. NO. All 498 Licensee Andrew F.Sheehan Signature LIC. NO,A11498 Address 249 Pine Hill Road/ Che1msford^Ma_01824 Bus. tel. No( 978)256-8740 Alt- Tel. NCn7R-sit2-r;ASi2 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE $-,? S) (Signature of Owner or Agent) TOTAL No. of lighting Outlets 180 No. of Hot Tubs No. of Transformers KVA No. of Lighting Fixtures 90 Above Swimming Pool grnd. In ❑ rnd ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets 50 No. of Oil Burners Battery Units No. of Switch Outlets 40 No. of Gas Burners 4 FIRE ALARMS No. of Zones No. of Detection and TOTAL No. of Ranges No. of Air Conditioners 4 TONS 10 Initiating Devices No. of Sounding Devices HEAT TOTAL TOTAL No. of Disposials 2 No. of Pumps TONS KW No. of Self Contained Detection/Sounding Devices No. of Dishwashers 2 ace/Area Heating KW 10 Municial 0 El No. of HeatingDevices KW Local Connection Other No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. of Hydro Massae Tubs 2 1 No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES NO ❑ I heave submitted valid proof of same to this office. YES ❑ NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE [K BOND ❑ OTHER ❑ (Please Specify) — -4.10 2 ' (Expiration Date) Estimated Value of Electrical Work Work to Start Inspection Date Requested: Signed under the penalties of perjury: "FIRM NAME ANDREW F SHEEHAN ELECTRICAL CE LIC. NO. All 498 Licensee Andrew F.Sheehan Signature LIC. NO,A11498 Address 249 Pine Hill Road/ Che1msford^Ma_01824 Bus. tel. No( 978)256-8740 Alt- Tel. NCn7R-sit2-r;ASi2 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE $-,? S) (Signature of Owner or Agent) Date. Z.� /.,?16r TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION This certifies that ............................................ r ' has permission for gas installation ..........:................. in the buildings of .......................................... at .................................. . North Andover, Mass. Fee.-/.� d v. Lic. No........... .....................:.... GAS INSPECTOR Check # 7 r L� 0 MASSACHLTSRT- S UNIFORM APPUCATON FOR PERM TO DO GAS FfrDNG (Type orprint) NORTH ANDOVER, MASSACHUSETTS Building Locations 1 1 h T t Ox a Oka lm ( kj. Ay, ., r Owner's Name New 0-- Renovation ❑ Replacement ❑ SUB -BASEMENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR (Print or type) ,1 Name Y�tl Date Q-/ -0 I 01,5S 1'✓/ Permit# 3 "Ij b Amount $ i J h Ova° ( a�m�Pl' CCl✓IS . Plans Submitted ❑ o w H � w &0 � w N z H x x a w z d W d yz�F" F" Cn Name of Licensed Plumber or Gas Fitter 7111 i Check one: Certificate Installing Company Corp. Partner. [aFirm/Co. INSURANCE COVERAGE I have a current liability Insurance policy or it's substantial equivalent. Yesck If you have checked yes, please indicate the type coverage by checking the appropriate box. 13— No Liability insurance policy lzr Other type of indemnity 1:1 Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent 13 I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber a j.i an Gas Fitter tcenseum er r 71 Master Journeyman � x z o $ H x > z a o WQ Name of Licensed Plumber or Gas Fitter 7111 i Check one: Certificate Installing Company Corp. Partner. [aFirm/Co. INSURANCE COVERAGE I have a current liability Insurance policy or it's substantial equivalent. Yesck If you have checked yes, please indicate the type coverage by checking the appropriate box. 13— No Liability insurance policy lzr Other type of indemnity 1:1 Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent 13 I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber a j.i an Gas Fitter tcenseum er r 71 Master Journeyman Location Loi 11 3 4 -31, l 11 4411494 `"r, No. i Q to 100k Date r TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ b� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # )850 ` S 'l 2 7 AA A!, ( CL� Building Inspector EXISTING BUILDING LOT / 12 LOT / 11 31•�� 09=15,394 f Sf. 20.1' co.0 ;n 44.0' ;n [o.0 EXISTING FOUNDATION c3 TOP OF FOUNDATION=234.37'' M 44.0' 9.0' b 4 5.5' v. v v .n X5.5' (5o' WISE � CIRC'L N�f THOMAS G. & MARIE HILL Nlf BRUNO C. PECIET/ER & M00 -C BwvS ' 19.2' LOT # 10 I HEREBY CERTIFY THAT THE FOUNDATION ON LOT 11 '. ��� IS LOCATED AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE ZONING BY-LAW a���� Of 1 SS L e OF THE TOWN OF NORTH AND VER. o GREGORYR. y CORCOR 4N ti 4o o SS- .......... .. ....... ........... No. 38034 I , PPoOFES 1.011 �/'N'4'i`S"URVEYOR.. SS1DATE:..... ..Z�?Np SUR, CE'RTIFIE'D PLOT PLAN OF LAND IN N.ANDOVER, MASSACHUSETTS CHATHAM CROSSING SCALE: 1"=40' ' DATE: OCTOBER 26, 2001 DANA F. PERKINS, Inc. Consulting Engineers k Lend Surveyors 1215 MAIN STREET a UNIT Ill TEWKSBURY, MASSACHUSETTS 01076 PREPARED FOR: CORMIER-ANDOVER CONSTRUCTION CORP. 59 CHANDLER CIRCLE ANDOVER, MASSACHUSETTS JOB NO. 51165-11 1SHEET 1 OF 1 COPYRIGHT 0 2001 BY DANA F. PERKINS, Inc. A-ff3 Ilk N O q L,J 0 0 u7 In O EXISTING BUILDING LOT / 12 LOT / 11 31•�� 09=15,394 f Sf. 20.1' co.0 ;n 44.0' ;n [o.0 EXISTING FOUNDATION c3 TOP OF FOUNDATION=234.37'' M 44.0' 9.0' b 4 5.5' v. v v .n X5.5' (5o' WISE � CIRC'L N�f THOMAS G. & MARIE HILL Nlf BRUNO C. PECIET/ER & M00 -C BwvS ' 19.2' LOT # 10 I HEREBY CERTIFY THAT THE FOUNDATION ON LOT 11 '. ��� IS LOCATED AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE ZONING BY-LAW a���� Of 1 SS L e OF THE TOWN OF NORTH AND VER. o GREGORYR. y CORCOR 4N ti 4o o SS- .......... .. ....... ........... No. 38034 I , PPoOFES 1.011 �/'N'4'i`S"URVEYOR.. SS1DATE:..... ..Z�?Np SUR, CE'RTIFIE'D PLOT PLAN OF LAND IN N.ANDOVER, MASSACHUSETTS CHATHAM CROSSING SCALE: 1"=40' ' DATE: OCTOBER 26, 2001 DANA F. PERKINS, Inc. Consulting Engineers k Lend Surveyors 1215 MAIN STREET a UNIT Ill TEWKSBURY, MASSACHUSETTS 01076 PREPARED FOR: CORMIER-ANDOVER CONSTRUCTION CORP. 59 CHANDLER CIRCLE ANDOVER, MASSACHUSETTS JOB NO. 51165-11 1SHEET 1 OF 1 COPYRIGHT 0 2001 BY DANA F. PERKINS, Inc. A-ff3 Town of North Andover a& tkaRTH 1t`TO 16, �0 Building Depurtment a� 27 Charles Street 0" North Andover, Massachusetts 01845 -V (978) 688-9545 Fax (978) 688-9542 COCNIGMWKM V AC HUStit�� APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS — r C Ilf7.40-1 r,"'t-C/r -_ LOT NUMBER % l SUBDIVISION DATE REQUEST FILED az DATE READY FOR INSPECTION 0/i/0 Z FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING �z11Aa&00 CONSERVATIONDATE PLANNING DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED I. % pORTy pt ipso .e1,yo f Ar. i Y 4SSACHUSEt -CERTIFICATE OF USE & OCCUPANCY Building Permit Number /a�&"6 Date THIS CERTIFIES THAT THE BUILDING LOCATED ON c-� MAY BE OCCUPIED AS , / 0 )v c / 62,54-V/ // ¢#4ch,1 IN ACCORDANCE WITH THE PROVISIONS OF MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY.. % CERTIFICATE ISSUED TO Xe-') C Building Inspector .. . , o. CO 0 m C/) CO0 m C CO) 'v CD 0 Z jp O CL r. A) SU ry y d CO) y n C CL —• y v C� CD �II N Q .� ~ Q .T d N 3. m H = O d ti CDm o yma� 3 m Z .o �mam�• y ? m CR CL m No O sCID: a _ > > m y m n V �i om i o y; � : O fry N 0 o• to CCD mCD H :N O O C � CCD VJ �N,,.. O H `0 �y3 v CO o m n n O O': Wra : CL=: Ci ICU) O �.\ CciO C O !4 91 ca H 0