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HomeMy WebLinkAboutMiscellaneous - 36 COLGATE DRIVE 4/30/2018N \ . Date ......(...la ll TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION IThis certifies that L'Iter............................................. lhas permission for as instadation inthe built of .................................................................................................................. 'a;4.L .......................... h dover, Mass. at...J.60 .... ... 0. Fee 40.40 ..... Lic. No.q3b.v; .. ..... ... .... . . GASINSPECT R Check A3p 0-1 DIRECT VENT HEATER DRYER FIREPLACE, FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM tSPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER INSURANCE COVERAGE I have a current liabilldyinsurance policy or its substantial equivalent which meets the requirements of MGL Ch.142 YES ONO 1j I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABU.tI'Y INSURANCE POLICY [ OTHER TYPE INDEMNITY BOND 0 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the j Massachusetts General Laws, and that my signature on this permit application waives this requirement CHECK ONE ONLY: OWNER 0 AGENT E SIGNATURE OF OWNER OR AGENT (. 1 hereby certify that all of the details and information I have submitted or entered regarding this application are bus and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application wall be in compl'ia P provision of the Massachusetts State Plumbing Code and Chapter 142 of the General taws. 7 . PLUMBER -GASH I ER NAME $'Cggl Er -P:7 gP,, LICENSE # 2052 SI NATURE MP © MGF 0 JP © JGF © LPGI CORPORATION [&#F,3-8-04---jPARTNERSHIP LLC Q# COMPANY NAME. FV�,,r� ADDRESS X03 t>.t� CITY 'ootzc te�Ea- i� _ _ _ STATE vhf ZIP crL TEL FAX CELL %,�/ 3 EMAIL MASSACHUSETTS UNIFORM APPUCATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY Noa':w _ .A.J�at�(c MA DATE _ is �jt s PERMiT# JOBSITEADDRESS _ 33a- _Cot-t-XAMM tea._ OWNER'S NAME_ ±oyF— lT OWNERADDRESS c.-_tA,s y 07z� M^LiTEI�_._ FAX T PEORT PRIRINT OCCUPANCYTYPE COMMERCIAL[]. ._ _ EDUCATIONAL ® RESIDENTIAL,2fMAR. 'Y NEW:Q RENOVATION:E] REPLACEMENT:V PLANS SUBMITTED: YES NOQ APPLIANCES 7 FLOORS- BSM 7 2 3 4 5 6 7 8 9 10 11 1.12 113 1 14 BOILER BOOSTER i CONVERSION BURNER _ A11f1V HTAI T I -..-. DIRECT VENT HEATER DRYER FIREPLACE, FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM tSPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER INSURANCE COVERAGE I have a current liabilldyinsurance policy or its substantial equivalent which meets the requirements of MGL Ch.142 YES ONO 1j I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABU.tI'Y INSURANCE POLICY [ OTHER TYPE INDEMNITY BOND 0 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the j Massachusetts General Laws, and that my signature on this permit application waives this requirement CHECK ONE ONLY: OWNER 0 AGENT E SIGNATURE OF OWNER OR AGENT (. 1 hereby certify that all of the details and information I have submitted or entered regarding this application are bus and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application wall be in compl'ia P provision of the Massachusetts State Plumbing Code and Chapter 142 of the General taws. 7 . PLUMBER -GASH I ER NAME $'Cggl Er -P:7 gP,, LICENSE # 2052 SI NATURE MP © MGF 0 JP © JGF © LPGI CORPORATION [&#F,3-8-04---jPARTNERSHIP LLC Q# COMPANY NAME. FV�,,r� ADDRESS X03 t>.t� CITY 'ootzc te�Ea- i� _ _ _ STATE vhf ZIP crL TEL FAX CELL %,�/ 3 EMAIL U625 Date.. .. ... ... ...... CTOWN OF NORTH ANDOVER PERMIT FOR WIRING -1. This certifies that ......... �.A.7` ....//..................................................... has permission to perform .. .......... /:.:�../X. STI .................... wiring in the building of ....Z1 ... Z17.1.1( ................... ................................. at A ..... (�/ e.. /'4......... 4�.. ....................... . North An/,over,,7Mass X) Lic. No. . ... ... ...... Fee.. ............ . .... .............. . ........ ELE K CTRICAL 1N9PCrOR 4ep Check # / -- Commoniveakk o/ t/laasachujeib Official Use Only cc�� c� Permit No. eUePartment o� fire �ervices BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1107] leave blank 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 OR TYPE ALL INFORMATIOA9 Date: _ a I � � City Town f:1 the �Mspector of Wires: By this applicati "Ji 1. gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Owner or Tenant Owner's Address Telephone T Is this permit in conjunction with a building permit? Yes ❑ No Y1 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ No. of Meters No. of Meters No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans --u" U ME 1•Totar v wires. No. of 1 Transformers i KVA No. of Luminaire Outlets No. of Hot Tubs Generators . KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ o. o mergeney Lighting rnd. rnd. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection andTot Initiating Devices 1 No. of Ranges No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons No. of Self -Contained Totals: .KW....... Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Loc Municipal n � No. of Dryers Heating Appliances KW Security ystems:* I Equivalent No. of Waterccs Heaters KW No. of No. of or Data Wiring: Si ns Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Tele o munications Wiring: T o. of Devices or Equivalent OTHER: ilacn aaamonat aetau y destred, as required by the Inspector of Wires. Estimated Value of Electrical Work: �. (HWhen required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. 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 force, and has exhibited proof of same to the permit issuing office. CHECKONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) Self Insured I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: ADT Security Services Inc. LIC. NO.: C-45 Licensee: Mark A. Brophy Signature LIC. NO.: C-45 (Ifapplicahle Pni— , t,. ;„ rho licence number Zine.) Address: 10 .�tn �? IDI-, 14O j� l� Si N H O - C/ Bus. Tel. No.: *Per M.G.L. c. 1 /, s. -')'/-61, security work requires Department of Public Safety "TS Lic. No. 00953 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's a ent. Owner/Agent Signature Telephone No. PERMIT FEE. $ ,11-;-_ v 303 Date .... /-/*`:73e7---/**`0--- 1.7 , 1.7, TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .............. 4.01.......... ................ has permission to perform ............... d ... .... W .......... S-fx"'.!7. . .................. wiring in the building of .......... kay.E .................................................... at ........ 3. e� 4n. 147Z ..... —�).d ........... North Andover, Mass. Fee �%:1:1:1:19:-.... Lic. No..(.14,./� . ................ .... ... .... 31�V Ak ....... ICAL lm"�c"*' Check # �l Com.on mweaR of Ma-machujei% Apartment of gire Servicee BOARD OF FIRE PREVENTION REGULATIONS Official Use Only 1 Permit No. Occupancy and Fee Checked [Rev. 1/071 leave blank 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 PRIM OR TYPEALL INFORMATIOA9 Date: City r ToJersigned h �1w To the IIn X torroof Wires: By this applicatl gives notic of his or her Intention to perform the electrical work described below. Location (Street & Number) ��,�� n'Qka e -hr-, .e Owner or Tenant Telephone N Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: j QjlX.() Vil 4a��c No. of Meters No. of Meters Cmmnlotinn nfthe fnllnwi> t,Aln r., , A. ,. ,,,,7 A„ it_ tti..------ c..ftrr. No. of Recessed Luminaires -_.._-. _ _.._ ...... .. ... No. of Ceil: Susp. (Paddle) Fans ......... ...w �.. rr u.rc.0 ✓ ...G V -"/ J., No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑In- E] No. of Emergency Lighting rnd. grnd. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Number ...... Tons ......... KW No. of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Connection No. of Dryers Heating Appliances Kw C Security Systems:* No. of Devices or Equivalent No. of Water KW No. of No. of a Wiring: Heaters Signs Ballasts No—.of evices or Equivalent No. Hydromassage Bathtubs No. of Motors Total IIP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: yO (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. 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 force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) Self Insured I certify, under the pains and penalties of perjury, that the information on this application is true and completes FIRM NAME: ADT 5ecurity Services Inc. LIC. NO.: C-45 Licensee: Mark A. Brophy Signature- 01 LIC. NO.: C-45 (If applicable, enter "exempt" in the license number line.) _ Bus. Tel. No.: 978-657-0443 Address: 155 West Street, 5uite 6 Wilmington MA 01887 Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lie. No. 00953 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ Lib. t /0 7462 Date . /1i� /4! ........ TOWN OF NORTH ANDOVER a PERMIT FOR GAS INSTALLATION This certifies that....................... . has permission for gas installation ...... f.... .............. . in the buildings of ..... `..r ............................ at C ................ North Andover, Mass. Fee. 3 � .... Lic. No. LAS INSPECTOR ! Check # %6 7 elvrl 1nrc W Z MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING CO Y City/Town:/V 0 VIN AAA ad dev , MA. Date: Permit# Building Location: 34� CGL fie. ?C- Owners Name: V1 ! Li �. 4 1 Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential m New: ❑ Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Ye s ❑ No ❑ elvrl 1nrc W Z CON LLJ CO Y ` m I_. Q I = O M 0 W W V N H 2 I— 0= co) Z oz H N z 0 W g m o w F- D .W pix T W O 1Q— S O N w~ w COL) W W W z 2 U1 O� D W w a p= W W Z J H H O Z J 0 u_ � = W FW- W W 1 L) o o uu. a o 0 z z a �a ox �>>> t" 0 ,\ SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3 FLOOR 4 IH FLOOR 5 FLOOR 6 FLOOR 7 IHFLOOR 44- 8 FLOOR �a�GtM Check One Only Certificate # Installing Company Name: `1' J � a ,� ❑Corporation Address:,5C 0 I L 0105 Cityaoww e-(Jl-U-ti State: d—o El Partnership � Business Tel: G0') 9L{q ►U 3 ,9 Fax: Irm/Company I Name of Licensed Plumber/Gas Fitter: J t �aL� _ INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes 9-N-01,❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy [� Other type of indemnity ❑ Bond ❑ 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. Check One Only ❑ Signature of Owner or Owner's Agent Owner Agent El By checking this box ❑; I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and 0-1- LV Vltl VC.7L VI my miumuuge anu mat au pmmomg worK ana mstaiiations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbina Code and Chanter 142 nf the rpnaml i awc � By Plumber Title ❑ Gas Fitter Signature of Licensed Plumber/Gas Fitter ❑ Ma3ter City/Town QdSurneyman License Number: APPROVED (OFFICE USE ONLY) ❑ LP Installer Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies ..... Y.......... :^ 4.*.... > .................... has permission to perform ................ ..�........................................... ................... wiring in the building of...-./;/ .......................................................... at .aG......... y 4� =� -� ,North Andover, ass. ...........................�.................CLECTRICAL Fee—' ........... L c. No3..%? , / . ......... . .......... . INSPECTO Check # J 8994 Commonwealth Of �M f MOfficial Use Only Department of Fire S Permit No. ��-9 Services - BOARD OF FIRE PREVENTION REGULATIONS [Occupancy and Fee Checked [Re 1/07 v. (leave blank ., APPLICATION FOR PERMIT TO PERFORM° ELECT.RI CAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT flV NK OR TYPE ALL INFORMATION) Date: City or Town of: NORTH ANDOVER To the Iector By this application the undersigned gives notice of is or her intention to perform the el� trical work f Wires: described below'. Location (Street & Number) 36 e0 a de Owner or Tenant � •C� I Owner's Address Telephone No. 2 LCM a — j Is this permit in conjunction with a building permit? yes Purpose of Building � NO ❑ (Check Appropriate Box) l Utility Authorization No. Existing Service Z&V Amps Volts Overhead Undgrd ❑ Na, of Meters New Service Amps _ / Volts Overhead ElUndgrd ❑ No. of Meters Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: Completion o the ollowin table in be waived b the Ins ector of Wires. F EReceEssedLuminaires No. of Ceil.-Susp. (Paddle) Fans No• of Total TransformersKVA utlets No. of Hot Tubs Generators KVA f Luminaires 3 Swimming Pool Above ❑ In- o, o mergency ig g d. rnd. Batte Units No. of Receptacle Outlets No. of oil Burners ( FIRE ALARMS No. of Zones No. of Switches 3 No. of Gas Burners No..of Detection and auaunun L• eviCeS o. of RangesNo. of Air CondTotal . ` Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number ons KW p Totals: ` ` '' ---- o. of Self- ontained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection ❑Other No. of Dryers Heating Appliances KW Security Systems:- - o. of Water No. of No. of Devices or E uivalent Imo' Heaters No, of Data Wiring: Signs Ballasts. No. of Devices or E uivalent 1 No. Hydromassage Bathtubs No. of Motors Total Hp Telecommunications Wiring: No. of Devices or E uivalent Estimated Value of Electrical W ire �� Attach additional detail if desired, or as required by the Inspector of Wires. !// t Work to Stark (When required by municipal policy.) INSURANCE y' Inspections to be requested in accordance with MEC Rule 10, and upon completion. 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 force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Licensee: �% _ LIC. NO.: v j�e% G Signature LIC. NO.: j % (If applicable, nter t he lice `y p , n Mb hne�) Address:` t Bus. Tel. NO.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety S ZLicense: Alt. TelLicNo, OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required b law. B m signature q Y Y Y below, I hereby waive this requirement. I am the (check one) ❑ owner ❑owner's agent Owner/Agent Signature Telephone No. PERMIT FEE: k?,J dd i I C'' ct: OSullivan Beam tion: Hoye Residence Beam Fnformly Loaded Floor Beam 12009 International Building Code(2005 NDS)] (2) 1.75 IN x 7.25 IN x 11.0 FT 2.0E -2900F - APA EWS LVL Stress Classes Section Adequate By: 1.0% Controllinq Factor: Deflection page ,} Joel Silverwatch Silverwatch Architects, LLC 224 Main Street Unit 3B a Salem, NH 03079 StruCalc Version 8.0.100.0 9/2/2009 1:27:19 PM CAUTIONS " Laminations are to be fully connected to provide uniform transfer of loads to all members DEFLECTIONS C n er Read Live Load 0.33 IN U396 Section Modulus: Dead Load 0.21 in 30.66 in3 Total Load 0.54 IN U242 9.57 int Live Load Deflection Criteria: U360 Total Load Deflection Criteria: U240 REACTIONS A B 110.01 in4 Live Load 1238 Ib 1238 Ib Moment: Dead Load 783 Ib 783 Ib 7892 ft -Ib Total Load 2021 Ib 2021 Ib 1819 lb Bearing Length 0.77 in 0.77 in 0 BEAM DATA Center Max. Reduction Based On Total Area: Span Length 11 ft 0 Unbraced Length -Top 0 ft Controlling Reduction Factor: Floor Duration Factor 1.00 0 Notch Depth 0.00 Design Live Load With Reduction: MATERIAL PROPERTIES 25 2.0E -2900F - APA EWS LVL Stress Classes Base Values Adjusted Bending Stress: Fb = 2900 psi Fb' = 3089 psi Cd=1.00 CF= 1.07 Shear Stress: Fv = 285 psi Fv' = 285 psi Cd=1.00 Modulus of Elasticity: E = 2000 ksi E'= 2000 ksi Comp. -I- to Grain: Fc -1= 750 psi Fc - -L= 750 psi Controlling Moment: 5557 ft -lb 5.5 ft from left support Created by combining all dead and live loads. Controlling Shear: 1819 Ib At a distance d from support. Created by combining all dead and live loads. Comparisons with required sections: Read Provided Section Modulus: 21.59 in3 30.66 in3 Area (Shear): 9.57 int 25.38 in2 Moment of Inertia (deflection): 110.01 in4 111.15 in4 Moment: 5557 ft -Ib 7892 ft -Ib Shear: 1819 lb 4821 Ib LIVE LOAD REDUCTION a9@1 Side 2 Floor Live Load FLL = 25 psf 25 psf Floor Dead Load FDL = 15 psf 15 psf Floor Tributary Width FTW = 7 ft 2 ft Wall Load WALL = 0 plf LIVE LOAD REDUCTION 4 Avetage Uniform Load: LL_Ave = 25 psf Floor Loaded Area: FLA = 99 sf Reduction Based on Total Area: R1 = 0 plf Max. Reduction Based On DULL Ratio: R2 = 0 pif Max. Reduction Based On Total Area: R3 = 0 Controlling Reduction Factor: R = 0 Design Live Load With Reduction: LL = 25 psf BEAM LOADING 4 Beam Total Live Load: wL = 225 plf Beam Total Dead Load: wD = 135 pif Beam Self Weight: BSW = 7 plf Total Maximum Load: wT = 367 pif N c� 0 0 ` c O N x O � C13O U p• CM � m c zo Iz c w c� w Psiw o cn bo o cI w w 0 as cn cn N L r uoQ J. S :mac CD �! x Q L t o N� O ` C) O ti O** m c C= E CD `� a L h H roi, m 3 O * '' •s H R O H co m m o y m CLm cpcaC c Q 0 Wca C 0 V H Z O Co r C O` O c m Sr - m C C Q L L= 3 0 m m N 40 y m NJ O ,� H• •a dt O c Z O `•• v •y O .E v • U m p® C Q y C m � ca J = cc` O O L Z °L CL O CO) � C I CM C C CO) � �W Q Vi W •� m m 0 CD � H= CL -1-6 Dca > .0 43 OL m o a CL CMQ C E 10 C = ccC V •�. c C Z0 CL � V V2 C C J+ CO2 D c� 0 0 ` c O N C13O U p• CM O m c L r uoQ J. S :mac CD �! x Q L t o N� O ` C) O ti O** m c C= E CD `� a L h H roi, m 3 O * '' •s H R O H co m m o y m CLm cpcaC c Q 0 Wca C 0 V H Z O Co r C O` O c m Sr - m C C Q L L= 3 0 m m N 40 y m NJ O ,� H• •a dt O c Z O `•• v •y O .E v • U m p® C Q y C m � ca J = cc` O O L Z °L CL O CO) � C I CM C C CO) � �W Q Vi W •� m m 0 CD � H= CL -1-6 Dca > .0 43 OL m o a CL CMQ C E 10 C = ccC V •�. c C Z0 CL � V V2 C C J+ CO2 D I Date. 0 �/.0 c( TOWN OF NORTH ANDOVER .a PERMIT FOR PLUMBING SSACMU`+� / This certifies that .. �.�.. . !....`.......�.?.` .................. . has permission to perform ... plumbing in the buildings of ...................... at ...3. .................. North Andover, Mass. Fee.//.7 . Lie. No. P/!/. r... ..... PLUMBING INSPECTOR Check 7 f,� 8200 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT 70 DO PLUMBING City/Town: /4< MA. Date. �'`� ® Permit# Loa Building Locatio : �� ,j Owners Name: I Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional New: EDResidential' (,� Alteration: ❑ Renovation: [/ Replacement: ❑ Plans Submitted: Yes ❑ No ED FIXTURES z I w. O Y Z to a z l} � _ w z w rn _ ? I— UJ FQ- co 0 Z ❑ N w Q �- to - rn o _a ►- LL ~ w W 0 ❑ ` til 0 C� :'' LL — W LL V l=.. 2 1 0 !— � 2 z H� W� J J z�� < Q Q cn O Q 0 H>> 0 O 0. Y Z U)� w W Q m m o o LL c� = Y g 0 U)U)j p • SUB BSMT. BASEMENT 'r I FLOOR I I 2 FLOOR 3 FLOOR ,4 FLOOR 5 FLOOR a 6 FLOOR 7 FLOOR 8 FLOOR In Company Name: I Check One Onl �- Y Certificate # Address; ' o ,� �,,[ y, =zLity/Town /� �.+'�,��°� El Corporation 10 Business Tel: ,�-r`�' ❑ Partnership Fax: —�irm/Company Name of Licensed Plumber: ��� .0I_� INSURANCE COVERAGE: I have a current liability insurance policy or Its substantial equivalent which meets the requirements of If you have checked Yes, please indica the type of coverage by checking the appropriate bo MGL. Ch, 142 Yes ❑ No E3A liability insurance policy p x below. Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does .� a in %4assachuseii5 General La4:s, and that my signature on this permit= appli�afion waives this requirement.uirc� h d ter 142 of the rif Y ,4 V Chap Signature of Owner or 0wner's A ent Check One Only Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate Knowledge and that all plumbing wort; and installations performed under the permit issued for this application will be in compliance Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws, to the best of my with all By Type of License: Title � � ❑ Plumber Signature of Licensed :P�Iumber City/Town aster { APPROVED OFFICE USE ONLY) ❑journeyman License Number: I --------------- i Project: OSullivan Beam Location: Hoye Residence Beam Uniformly Loaded Floor Beam [2009 International Building Code(2005 NDS)] (2) 1.75 IN x 7.25 IN x 11.0 FT 2.0E -2900F - APA EWS LVL Stress Classes Section Adequate By: 1.0% Controlling Factor: Deflection page Joel Silverwatch Architects, LLC / 224 Main Street Unit 3B Salem, NH 03079 StruCalc Version 8.0.100.0 9/2/2009 1:27:19 PM " Laminations are to be fully connected to provide uniform transfer of loads to all members DEFLECTIONS C n er LOADING DIAGRAM Live Load 0.33 IN U396 Dead Load 0.21 in Total Load 0.54 IN U242 Live Load Deflection Criteria: U360 Total Load Deflection Criteria: U240 REACTIONS A B LL Ave = Live Load 1238 Ib 1238 Ib Side 2 Dead Load 783 Ib 783 Ib FILL = Total Load 2021 Ib 2021 Ib 25 psf Bearing Length 0.77 in 0.77 in FDL = BEAM DATA Center 15 psf Span Length 11 ft FTW = Unbraced Length -Top 0 ft 2 ft Floor Duration Factor 1.00 WALL = Notch Depth 0.00 plf MATERIAL PROPERTIES 2.0E-290OF - APA EWS LVL Stress Classes Base Values Adjusted Bending Stress: Fb = 2900 psi Fb' = 3089 psi Cd=1.00 CF=1.07 Shear Stress: Fv = 285 psi Fv' = 285 psi Cd=1.00 Modulus of Elasticity: E = 2000 ksi E'= 2000 ksi Comp. -L 1 Grain: Fc -= 750 psi Fc --L= ' 750 psi Ito Controlling Moment: 5557 ft -Ib 5.5 ft from left support Created by combining all dead and live loads. Controlling Shear: 1819 Ib At a distanced from support. Created by combining all dead and live loads. lift Average Uniform Load: LL Ave = aidil Side 2 Floor Live Load FILL = 25 psf 25 psf Floor Dead Load FDL = 15 psf 15 psf Floor Tributary Width FTW = 7 ft 2 ft Wall Load WALL = 0 plf Average Uniform Load: LL Ave = 25 psf Floor Loaded Area: FLA = 99 sf Reduction Based on Total Area: R1 = 0 Max. Reduction Based On DULL Ratio: R2 = 0 Max. Reduction Based On Total Area: R3 = 0 Controlling Reduction Factor: R = 0 Design Live Load With Reduction: LL = 25 psf Beam Total Live Load: wL = 225 plf Comparisons with required sections: Read Provided Beam Total Dead Load: wD = 135 plf Section Modulus: 21.59 in3 30.66 in3 Beam Self Weight: BSW = 7 plf Area (Shear): 9.57 in2 25.38 in2 Total Maximum Load: wT = 367 plf Moment of Inertia (deflection): 110.01 in4 111.15 in4 Moment: 5557 ft -Ib 7892 ft -Ib Shear: 1819 lb 4821 Ib N2 2012 Date ....1p .3 ...�. c • "� TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that....... ...... T ....... G <o' a has permission to perform .....�. f; t o.c�l'Q..�.................................................. wiring in the building of ..........t..f..1=..,......11............................................... I ...... Mass,- at ....... ..�......��:r- , Fee�t.-.O,.6... LicNo.. I . �...... �!�!1�e :..... .�./� ELECTRICAL INSPECTOR... WHITE: Applicant CANARY: Building Dept. PINK: Treasurer . 1 l� I The Commonwealth of Massachusetts Office Use on aDepartment of Public Safety p Permit No. BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy 3 Fee Chocked-. 3190 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All wc& to be peftffnw In &="U r = wM R» lu""Muxm t3.anal Cod.. SV (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date City or Town of' The undersigned applies for a permit to pe Location (Street & Numbed -36 Owner or Tenant —/'--l4b' r'�Cto I wrm me eiecmcai work described below. - �1G�fr ,pr. To the Inspector of Wires: Owner's Address Is this permit in conjunction with a building permit yes ❑ no ❑ (Ch -;k Appropriate Box) Purpose of Building_ S'' � �� 1 11oh C. Utility Authorization No. (Y (�41 Existing Service ! G� Amps /!a , 1O a Volts Overhead 9 Undgrd ❑ No. of Meters 1 New Service Amps / Volts Overhead ❑ Und rd ❑ S No. of Meters__ Number of Feeders and Ampacity jLocation and Nar^e of Proposed Electrical Wor �Ql1476------------------- No. of lighting Outlets INo. of Hot Tubs TA TOTAL No. of Li htin Fixtures Above In Swimmin Pool ❑ ❑ No. of Transformers KVA cmd. or Generators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting, Battery Units No. of Switch Outlets No. of Gas Burners Na. of Ranges No. of Air Conditioners TOTAL FIRE ALARMS No. of Zones No. of Detection and No. of Disposals HEAT TOTAL No. of Pumps TONS TONS TOTAL Initiating Devices No. of Sounding Devices ' iNo. KW No. of Self Contained of Dishwashers l Space/Area Heating KW Detection/Sounding Devices �— No. of Dryers _ l Heatin Devices KW unic� I �- Local ❑ on tion ❑ Other No. of Water HeatersKyV No. of No. of Signs Ballasts Low Voltage Wirin No. of Hydro Massa a Tubs No. of Motors Total HP OTHER: /oeof t--, pvP uj Ze, C/I l�� k e t,'T . /'Ydv stf��P O (� fie f fe c�•�-o>l. 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 O If you have checked YES, please indicate the type of coverage by checking the appropriate box. .INSURANCE ®. BOND ❑ OTHER ❑ (Please Specify) a (Expiratfop Date) Estimated Value of Electrical Work ,$_ Work to S'�7;9 --4-r9, Inspection .Date Requested: Rough . '/ Fina! Signed under -the penalties -of perjury FIRM 'NAME Licensee UC. NO Signature �A: f$ 4 C Address !� _L%. /�fr C � �' f11 •Pj`�yv.,.�. � ���r � f' LIC. NO.— Bus. tel. No -9,)" OWNER'S INSURANCE WAIVER: I am :aware that the licensee does not have the insurance coverage or its ubs ntial equivalent required y 3�© Massachusetts General Laws, and .that my signature •on this application waives this requirement. Owner Agent (Please check one) by ...,-_-...� Telephone No — _ Mro urr J 5 / Date ..................... TOWN OF NORTH ANDOVER OF PERMIT FOR GAS INSTALLATION A This certifies that ...+.'..?...................................... , has permission for gas installation ...................... in the buildings of .......................................... at ... `................:.........' :.... , North Andover, Mass. Fee....:.... Lic. No................... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLJCATION FOR PERMIT TO DO GASFI TING (Print or Type l >IV �► . Mass. Date (o Permit # 1) Building Location 34v LIFIV - U r Owner's N l !J� G New p Renovation [] Occupancy, Pians Submitted: Yes[] No [] Installing Company Name__ -� Business Telephone -122 2 76 4 Name of Licensed Plumber or Gas Fitter /% /C Check one: 54 Corporation ❑ Partnership ❑ Firm/Co. Certiik�de INSURANCE COVERAGE: I have a Curr ii b* Insurance policy or Is substantial equivalent which meets the requirements of MGL Ch. 142. Yes No O If you have checked yM please indicate the type coverage by cheddihg the appropriate bock, A Nabliity Insurance policy P(--, Other type of Indemnity O Bond O 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 OwnerO Agent O 1 hereby aeitiy 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 alt plumbing work and installations performed under the permit for thb will all pertinent provisions of the Massadhrsetts State Gas Code and Chapter 142 of the Laws. BY T of license: 2CC rrtle Plumber nature or as titer , er Ucense Number dn� Y Y �r�r�rr�rr����rrr�rrr��rr�noun ■rr�rrrrrr�rr�r�rrr�rrrr■®�r�■ ... ■rrrrrr�r��rrr��rrrr�:�rr�®r��■ a. ■�r�r��r�rrrr�r�rn�rr�i.��■ m, ... ■�rrrrrr�rrr��rrr�rrr��r��■ ... ■�r�r�rr�rir�rrirr�rr�rnrr�■ ® ■rrrrrrr�rrr���r�r�rr�r�r�r�■ ... ■rrr�rr�rr�rrr���rr�rrr■®r�r ... ■�rr�rrr��rr�rrr���r��■®rr■ ... ■■rrr�rrrrrrrr�rr�rr��rrrt��r�rr Installing Company Name__ -� Business Telephone -122 2 76 4 Name of Licensed Plumber or Gas Fitter /% /C Check one: 54 Corporation ❑ Partnership ❑ Firm/Co. Certiik�de INSURANCE COVERAGE: I have a Curr ii b* Insurance policy or Is substantial equivalent which meets the requirements of MGL Ch. 142. Yes No O If you have checked yM please indicate the type coverage by cheddihg the appropriate bock, A Nabliity Insurance policy P(--, Other type of Indemnity O Bond O 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 OwnerO Agent O 1 hereby aeitiy 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 alt plumbing work and installations performed under the permit for thb will all pertinent provisions of the Massadhrsetts State Gas Code and Chapter 142 of the Laws. BY T of license: 2CC rrtle Plumber nature or as titer , er Ucense Number dn� I aC VI c 0 a z U C Cd C � � ° in vE"i C Z C C U O G G G C C V I � ..7 M 41 tJ N 7 I 1� ,T I ^O l� Iz IQ r Iz ❑ F w O C C z z C O O ? u 1' 7_ Z. F cr. ❑ G C n - C, t V E1 Y^�1 1,r f � C 1 0 O kol aL d ° U C C7 F. F w c L14 a Z F uj til �i C �r N c U U U ` C ❑ ❑ C z! CI 4 aC VI c 0 a z U C Cd C � � ° in vE"i C Z C C U O G G G V ..7 cal 41 tJ N 7 z! CI 4 c Z c z a z U C U U = 4"' x E� o w C/)� a cn 0 w � or. � Uaa c a iu w a U U� W C2 u_ C� w O ►,, t o n: w W W w v m' z cn a: Q cn 4 : d c ..c � m 'd * E a 2 �o • � �0 0 u CM m c E mm a y C/) 5 _co Z W) cc o W ? ` E y ii U L • m o cn �crrn^^ vJ � W � ; = CA W mom m •V h Z G m 'cp c c Q Mcj � i Co.- c .O :a o D w c �zs.= c +- ` ocgo CL= LIJ c .; o ` V_i O• m :2 0:6 Q A E y o arm I il y coy .E a. ..r Q Q co CO) Q .Q y 0 m .0 ev d D LLI _0 U) Lij U) IrW w CC U) x t tSr.' MW v to„.,' C•i ay N {-..+�. ,�?.mr'ak4 A.`y*`s:F` sz .'� rSr'ak 4,,,,`., s"``i ..••� �' �Y.t i1 "+y �` .`F *a;h �, ♦ ,�a yr t .� _ h"'t x,,'fi'$L3 »r li_: is .y r r a '.� '”, ;,'�. -`x, n� (� * Y . .;. � O � ex - �• 00 ; + a r.' n3 {. . to 4n N _ t; ID J y � va1kty�V rad., Zr RK �,,.�,;•� ,gyp wn- ;. � r �- .,�,�: p � _�� � ,�, �� �, � All �r`a a'��r !' r sa•' . �. - + r s.'L; �F� yyboJ a u '<-5-�y.���... tea. i »r I � #'c I � Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 27 Charles Street North Andover, Massachusetts 01845 WILLIAM J. SCOTT Director (978)688-95;1 AORTH ° 4 �SSACHUSG Fax (978)688-9542 In accordance with the provisions of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. The debris will be disposed of in: (Location of Facility) I l Signature of Permit Applicant Date I NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector ' BOA.RD OF APPEALS 688-9541 BtTILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PL aNN-KING 6881:9535 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02991 Workers' Compensation Insurance Affidavit Please Print Name: Location: City Phone 0 am a homeowner performing all work myself. 01 am a sole proprietor and have no one working in any capacity F7I am an employer providing workers' compensation for my employees working on this job. Company name: Address City: Phone #: Insurance Co. Policy # Company name: Address City: Phone #: Insurance Co. Policv # 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 may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone # 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 ❑ Lincensing Board ❑ Selectman's Office Contact person: Phone #. ❑ Health Department ❑ Other AUTOMOBILE LIAB Fax:6034326414 Sep 10 '99 1355 P. 02 ANY AUTO 09/10/99 PRODUCER THIS CERTIFICATE ISSUED AS MATTER'OF INFOR— 'FINANCIAL INSURANCE MAT10N ONLY AND CONFERS NO RIGHTS UPON THE SERVICES, INC. CERTIFICATE HOLDER; IT DOES NOT AMEND, EX-- PO BOX 950 TEND OR ALTER COVERAGE AFFORDED BY THE POL— DERRY, NH 03038 ICIES BELOW. COMPANIES AFFORDING COVERAGE; (603) 432-6414 COMPANY (FAX) 432-3852 LETTER A ASSURANCE CO. OF AMERICA COMPANY INSURED LETTER B GUARD INSURANCE PRO BUILDER & SALES CO. COMPANY C/O FRED PAPPALARDO LETTER C 71 BRIGHTWOOD AVENUE COMPANY NO. ANDOVER, MA 01845 LETTER D OTHER COMPANY LETTER E COVERAGES: THIS CERTIFIES THAT INSURANCE POLICIES BELOW HAVE BEEN ISSUED TO THE ABOVE INSURED FOR POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR DOCUMENT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE HEREIN IS SUBJECT TO ALL TERMS OF SUCH POLICIES. CO TYPE OF POLICY POLICY POLICY ALL LIMITS IN LTR INSURANCE NUMBER EFF DATE $XP DATE THOUSANDS A GENERAL LIABILITY SCP33599045 08/18/99 08/18/00 GEN AGGREGATE $1,000 X COMMERCIAL GENERAL LIABILITY PR—CMP/OPS AG $1,000 CL MADE XOCCURRENCE PERS&ADV INJUR $500, OWNER'S & CONTRACTORS PROTECTIVE EACH OCCURANCE $500, FIRE DAMAGE $500 MEDICAL EXPENS $109 AUTOMOBILE LIAB ANY AUTO CSL $ i ALL OWNED AUTOS BODILY INJURY (/PERS) SCHEDULED AUTOS $ i HIRED AUTOS BODILY INJURY (/ACCID) NON -OWNED AUTOS $ GARAGE LIABILITY PROPERTY DAMAGE EXCESS LIABILITY EACH AGGREGATE OCCURRENCE OTHER THAN UMBRELLA FORM $ $ B WORKERS' COMPEN— PENDING ISSUE 08/21/99 08/21/00 STATUTORY SATION AND $100, (EACH ACCID) EMPLOYERS' LIABILITY $500, (DIS—POL LIM) $100, (DIS EA EMPL) OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS JOB: 36 COLGATE DRIVE, NO. ANDOVER, MA CERTIFICATE HOLDER ==-------------- CANCELLATION BUILDING INSPECTOR SHOULD ABOVE POLICIES BE CANCELLED BEFORE NO. ANDOVER, EXPIRATION DATE, COMPANY WILL ENDEAVOR TO MA MAIL 10 DAYS WRITTEN NOTICE TO CERTIFICATE FAX #978-688-9542 HOLDER (AT LEFT); FAILURE TO MAIL NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE: FORM 25-S (11/85) I� 'Y 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. FILLS OUT THIS SECTION*********** APPLICANT �X0_r ,-9CCC S / l-1 !, eti PHONE LOCATION: Assessor's Map Number % PARCEL / SUBDIVISION ( I LOT (S) STREET C o I Q AZ 'Die, ST. NUMBER 3(o USE RECOMMENDATIONS OF TOWN AGENTS: 9')(39' 17orcI1 CON ERVATION ADMINiS ORATOR DATE APPROVED 61,14401% DATE REJECTED r COMMENTS fin. r �� �U �� ; i OZ) r TOWN PLANNER COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWERIWA T ER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm Location U cNo. �/1/ Date /�. -7,) TOWN OF NORTH ANDOVER Certificate of Occupancy $ - ° : Building/Frame Permit Fee $ . Foundation. Permit Fee $ Ac us t. Other Permit ee $ Sewer Connection Fee $ Water Connection Fee $ �TAL /5 5 �° $ Building Inspector 6662 Div. Public Works ES1,[Pe:NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4.40. LOT NO. I 2 RECORD OF OWNERSHIP DATE BOOK !PAGE ZONE SUB DIV. LOT NO.—I LOCATION r �� PURPOSE OF BUILDING OWNER'S NAME y,� S���C__�.•1l1��/`�� NO. OF STORIES / SIZE OWNER'S ADDRESS 3 6 G° dG��c /�/J BASEMENT OR SLAB /15T�./L2ND ARCHITECT'S NAME SIZE OF FLOOR TIMBERS 3RD �� BUILDER'S NAME 1"�!/��i/ SI�L�G/ yam, / (i SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET ` POSTS DISTANCE FROM LOT LINES - SIDES REAR h " " GIRDERS AREA OF LOT /' moi/ FRONTAGE ! HEIGHT OF FOUNDATION 2� �� THICKNESS IS BUILDING NEW ! SIZE OF FOOTING k+� X IS BUILDING ADDITION ,//� MATERIAL OF CHIMNEY M IS BUILDING ALTERATION IS IS BUILDING ON SOLID OR FILLED LAND -!r f WILL BUILDING CONFORM TO REQUIREMENTS OF CODE f / IS BUILDING CONNECTED TO TOWN WATER x� v BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER '(/ �% IS BUILDING CONNECTED TO NATURAL GAS LINE ,V 1!�:) I , INSTRUCTIONS SEE BOTH SIDES PAGE i FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 t ' ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING tATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR � DA ILED ATURE Or NER OR AUTpbptED AGENT FEE zi��y PERMIT GRANTED OWNER TEL. q 60��—r7/6 19 /1,-- CONTR. TEL N CONTR. LIC, 4 f�. 3 PROPERTY INFORMATION LAND COST EBT. BLDG. COST e j�i7D ®B EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY �I Y BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN wws WlmY gn>•t fGiVR 1 OCCUPANCY SINGLE FAMILY STORIES _ MULTI. FAMILY [OFFICES _ APARTMENTS CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE i HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL I FIN. B'M'TAREA _ 1/1 1/2 % FIN. ATTIC AREA _ N_O B M'T FIRE PLACES _ HEAD ROOM ! MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 22 J 3 DROP SIDING CONCRETE I_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDNWI) _ ASBESTOS SIDING COMMON _ STUCCO ON FRAME ATTIC STRS. & FLOOR CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I- I POOR _ i ADEQUATE NONE 5 ROOF 10 PLUMBING WOOD SHINGES 11 HEATING KITCHEN SINK SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES STEEL BMS. 3 COLS. TILE FLOOR WOOD RAFTERS TILE DADO _ RADIANT H'T'G UNIT HEATERS BUILDING RECORD 12 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. 3 COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ltt 13rd I ELECTRIC NO HEATING I I ' I -� i / F I � r 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 local or state law,I regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: ZOi1A/ Phone 68�'�'71o" >a 4011_ 10�lf ?---- LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) % Street �6��/f7 ,�/� St. Number 3C GoC� ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Conservation Administrator Comments Date Approved Date Rejected Date Approved Town Pla er Date Rejected Comments Food Inspector -Health Septic Inspector -Health Comments Public Works - sewer/water connections - driveway permit � re Department Received by Building Inspector Date Approved Date Rejected Date Approved Date Rejected Date e,ee Ilk yl w a o c x w° C 0 w z0. z CA w° CL E U «f w z z �+�, �a, o w O z W C/)w is w A W. y v rA ro Z v cn 0 o cn uj om T O r4 4-J W O O O O v Z O Q O y O C 0 cm CODCD p 'C M CDE co m co �co L CL CD L _R O Q0. MQ CO2 VC J 'a D CO) Z CD CL u v2 O C — R CO2 0 J z EZ v �a, o O :a C2 C., C3 C7 CL. Cc co is ca N CFca c Cn ♦ .oa �., ca . Q E CD O z . c .. wc•� 0 0 �� E 0 C cec a -U 03 N CD is �-j = N � y N m O R W U 4%L:CLU � Cn ' o L cn As coo 44: a.) m Hcc v z 0 O cm n � h m C C =ICE � m o o ►— mCOD G IV a� N m z W C •Naz •...�L .OMD O .� .E C ca -o � .N Z O VL - p m C 1— a. *� m T O r4 4-J W O O O O v Z O Q O y O C 0 cm CODCD p 'C M CDE co m co �co L CL CD L _R O Q0. MQ CO2 VC J 'a D CO) Z CD CL u v2 O C — R CO2 0 J z EZ v Yr i 1 i •.ate •� � •r. a � -� .i' � I/' - I \• ._ � •• '- tet- \. ,� y .. ,• -�. IL I -$fxj.o ` — I I I