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HomeMy WebLinkAboutMiscellaneous - 4 NANTUCKET DRIVE 4/30/2018 _� i��nTu c�,CoCT v�►v6 mA.P 4-7 Location No. Date NORTH TOWN OF NORTH ANDOVER sd Certificate of Occupancy $ 'ss�►c ousBuilding/Frame Permit Fee $ ZO 4/Z Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 5 C � �� J Building Inspev r 3949 Date.................................. f AORT" "ao� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �sS^c►+usE� This certifies that �:.. ........................... ............................................... has permission to perform ..:....: wiring in the building of:.................................................................................. at...�.Y.................................... ...............,,........ , orth Andover,Mass. r Feed.. . .............. Lic.N /'�9�' . GELECTRICAL INSPECTOR Check # /0 i -------------- Official Use Only Permit No. ver ld 4;D-4ZP-S46 ry Occupancy&Fee Checked.t7�7 BOARD OF FIRE PREVENTION REGULATIONS.527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 C R 12: (Please Print in ink or type all information) Date 711 ®-z- To the In pect r of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below Location(Street&Number ;4 Owner or Tenant Owner's Address Is this permit in conjunction with a building permit Yes 6No ❑ (Check Appropriate Box) // _ Purpose of Building ' 'em Utility Authorization No. 0[O S Existing Service Amps Voits Overhead ❑ Undgmd ❑ No.of Meters New Servic� 200 Amps_1�Voits (— 3O Overhead ❑ Undgmd No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work V i Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ No.of Lighting Fixtures Swimming Pool gmd Clgrnd ❑ Generators KVA No.of Emergency Lighting No.of Receptacles Outlets v No.of Oil BurnersBattery Units No.of Switch Outlets �® No of Gas Burners FIRE ALARMS No.of Zone � Total No.of Detection and No.df Ranges 2-� No of Air Cond Tons Initiating Devices Heat Total Total No.(),f Di sal No. Pumps Tons KW No.of Sounding Devices t No./of Self Contained / 2 No.of Dishwashers Z/ S ce/Area HeatingKW Det Sounding Devices Municipal ❑ Other No.of D rs v HeatingDevices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES= NO = have submitted valid proof of same to the Office YES= NO = if you have checked YES please indicate the ty Of Qv ge by checking the appropriate box INSURANCE = BOND = OTHER =, (Please Specify) 1 y pFx ion DIP) Estimated Value of Electrical Work$ 7' ;--Final,Work to Start Inspection Date Resquested J W P�Final Signed underth en (ties of erj FIRM NAME S . LIC.NO. l� Lkensee Signature LIC.NO. � /_-/ �y/;� J v` M l.�llLk I / y Bus.Tel No. Z2^ S 5 O Address ""r " y o �psG .// Aft Tel.No. J -0'-5& OWNER'S INSURANCE WAIVER: 1 am aware that the Licenses does not have.the insurance coverage or Its substantial equivalent as required by Massachusetts General Laws.And that my,signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMITTEE $ (Signature of Owner or Agent) ANDD VER STREET ( PUBLIC 60' WIDE ) 110.42' L=39.53' EXISTING STONE WALL � R=25.00' 20.8' t ta.o'o o ts.o' 0 42.4' t 15.5' " 9.0' 0 Q cv EXISTING L ^N 1.0' FOUNDATION OT, ' 1 00 Tl W 3.o AREA= o �W N1.0, TOP FOUNOATIONF228 .59, 1,3,552 pi f S.F. o �� Q r', 9 I Z "�J 25.5\ CD 9.0' Qcl t4 30.2' ta.o' ts.t' t 136.12' 18.9 ! Lu o o G• LOT 13 O V Alf THOMAS G. & MARI, N/LL 4 N/f THOMAS G. & MARIE RILL Nf EDWARD G. JOAN f. MAILNOT LOT 12 ►� O N/f ELUOT R. 000N � LORETTA JOBATT I HEREBY CERTIFY THAT THE FOUNDATION ON LOT 1 IS LOCATED AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE ZONING BY-LAW OF THE �����N OF TOWN OF NORTH ANDOVER. GREGORY, $G R. CORCORAN h ... � No. 38034 PROFES 10( L SURVEYOR A9oF y DATE:...... CE'RTIFIE'D PLOT DANA F. PERKINS, Inc. :..... Consulting Engineers &land Surveyors PLAN OF LAND IN 1215 MAIN STREET o UNIT 111 TEWKSBURY. MASSACHUSETTS M876 N.ANDOVER, MASSACHUSETTS PREPARED FOR: COR I R— M E AN 0 D VER CONSTRUCTION CORP. CHATHAl CROSSING 59 CHANDLER CIRCLE ANDOVER, MASSACHUSETTS SCALE: 1"=40' DATE: APRIL 16, 2002 JOB NO.51165—IA SHEET 1 OF 1 COPYRIGHT©2002 BY DANA F. PERKINS, Inc. i Location v)Ay No. f Date d� NaRTM TOWN OF NORTH ANDOVER 3? ° • O • L� U Certificate of Occupancy $ � Building/Frame Permit Fee $ '�CMUS s Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Q'A Check # 14 i Building Inspector i TOWN OF NORTH ANDOVER �'PJA BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERSUED�rz,s+�� �' � '•� —, ' �� -^�` ''�.. -� MIT NUMBER: D • SIGNATURE: Building Commission6iAfor of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 07 Map Number Parcel Number V 1.3 Zoning h►fonnation: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area so Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R red Provided 2a 1.7 Water Supply M.G.L.C.40.§54) 1.5. Flood Zone hdomution: 1.8 Sewerage Disposal System: Public ❑ Private 0 ZOIIe outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record N me rint) Address for Service Gov Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licen Construction Supervisor: Not Applicable ❑ Licensed Cefstruction Supervisor: r License Number Address d lam/ Expiration Date Si-nature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address o� Expiration Date Sr nature Tele hone 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......ajL No.......❑ SECTION 5 Description of P o osed Work check all applicable) New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be , ' OFICIAL USE C3NLY s' n Completed by permit applicant 1. Building (a) Building Permit Fee Z 0 69Ud Multiplier 2 Electrical (b) Estimated Total Cost of �d Construction 3 Plumbing ,y d �� Building Permit fee tel X(b) 4 Mechanical HVAC 5 Fire Protection IfC 6 Total 1+2+3+4+5 O vlJ Check Number SECTION 7a OWNER AUTH DRIZA ON T67BE 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 &grra—ture of Ox r A ent Date NO. OF STORIES SIZE OR SLAB j SIZE OF FLOOR TIMBERS I sr 2ND 3 RD SPAN DIMENSIONS OF SILLS 2 DIMENSIONS OF POSTS /.A r7 DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS d`� SIZE OF FOOTING X MATERIAL OF C IS BUILDING ON OJJD FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE U i ne Lommunwuauti ui /v/i,�ic t iuzsCuj l d Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: - Location: Ci ` � � Phone # G '50,eg l aI am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity i �A !5- tl a I am an employer providing workers'compensation for my employees working on this job. Company name: ki Address City: Phone#. a Insurance Co. Policv.# , i C_o-mpany..name: Address City: Phone#: . Insurance Co. . Policv.# Failure to secure coverage as required under Section 25A orMGL 152 can lead to the irnposi6on of criminal penalties ofafine up to$1,500.00 and/or one years'ithprisonmentas W.ell-as_ci.mi.,penattiesin-ffiafwnnf-aSTQP.IN.4RK-OREEtk.and.a ine-ofl$IDOM)—a-day2q+ Mnstme. understand that a copy of this statement may ded to the Office of Investigations of the DIA for Coverage verification. I do hereby certify under th nE s a yes of e ' that p Z-;;above is frue and correct y f Signature Date � r Print name Phone# Official use only do not write in this area to be completed by city or town official' City or Town_ Permit/Licensing Building Dept ❑Check if immediate response is required ❑ Licensing Board ❑ Selectman's Office Contact person: Phone A ❑ Health Department ❑ Other it ac .�. ��R3 > r�n Rta `+'C akbA a••:x'iP •`;:>:ry..:o:o:aco:e%«on.'.;:,;. ; k �r� t �Aco RD �+K^#e 03107101 Fred rbc br a xkV n PRODUCER i�rr.?.S ..>)>.t n.°'.... %ox,9X+.•:::31�c'� ,t. Ii^ �< 'x 978-458 1865 r^ ar O 101 Fred C, ChurCli, InC THIS CERTIFICATE IS ISSUED AS A MATTER OF.INFORMATION •t. ONLY AND CONFERS NO RIGHTS UPON THE CER vicATE One Merrirrlack Pldta HOLDER. THIS CERTIFICATE DOES N0T AMEND, E END OR P.O. Box 1866 ALTER THE COVERAGE AFFORDS: 8Y THE POLICIES SELOw. Lowell, NIA 01853.1865 COMPANIES AFFORDING OovERAGE COMPANY INsuREn A Hartford Insurance Company Cormier Andover COMPANY Construction Corp. 59 Chandler Circle COMPANY r _ Andover MA 01810 V COMPANY ^ - x7111111 v D 1fo.S�R x,.,7x�3fZ£exa• +rt>nvt�sl� �k� ^'£.R ug� ,,,,��x�4%' Rgy °�!`Plr+`: %' Rf a THIS IS TO CERTIFY THAT TH ': R Rt�>z1`.11,S,.b�r.£A%I`. R!,R '� E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED To;;EIM1ISURED NAMEDk_AB ..Y �" r i sy INDICATED,NOTWITHSTANpiNG ANY REQUIREMpNT,TERM OfiR £; , OVE FOR THE POLI �. CERTIFICATE MAY$E ISSUED OR MAY PERTAIN, THE IN$URANCE AFFORDED$Y THE POLICIES DESCRIBED HEREIN IS SUBJECT E ALL TWHICHHE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED$Y DES RIB CCONDITION OF ANY CONTRACT OR OTHER LAIMS. WITH RESPECT TO THE THIS COPAID TYPE ITA OF INSURANCE POLICY IOUMBER POLICY FmCTIVE POLICY E7PINATION TE fMM/DD"I DATE LMM/w") UMITS A GENERAL LJA9ILITY 081iEN8S 1390 X COMMERCIAL GENERAL LIABILITY 1127101 1127/02 GENERAL A GLiREGA( F ; 2000000 <LAIMS MADE D OCCUR PRODUCTS-COMP/OP AGG i 2000000 .X' OWN ERS k CONTRACTOR'S PAOT PERSONAL 31 ADV INJURY 6 1000000 EACH OCCURRENCE i 0000DO FIRE DAMAGE IAny one file) b 300000 AUTOMOBILE LIABILITY MED EXP(Arq one Peri n) 6 ANY AUTO 100 0 COMBINED SINGLE LIMIT d ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY FRREO AUTOS (Por persao) 6 NON-OWNED AUTOS BODILY INJURY LPOracciQenU 6 P GARAGE LIABILITY PROPERTY OAMAUE $ ANY AUTO AUTO ONLY-EA ACCIDENT 6 OTHER THAN AUTO ONLY: EACH ACCIDENT EXCESS L4L mtyy AGGREGATE UMBRELLA FORM EACH OCCURRENCE 6 OTHER THAN UMBRELLA FORM AGGREGATE A WORKERS COMPENSATION AND 981NEIE8129 EMPLOYERS•LIABILITY 10/14/00 10/14101 X WC STA 0TH. THE PROPRIETOR/ fL EACH ACCIDENT PAATNERS/EXECUTIVE WCL f 100000 OFFICERS ARE: EXCL FL DISEASE.POLICY LIMIT 6 500000 OTHER EL DISEASE•EA EMPLOYEE zu0000 DESCR7►TION OF OPERATION6lLOCATIONb1VEH7C1ESIbPEpAL ITEMS it mmm- ; R5io'�!{I e'pb ,`%. •yt'i:.xn� :xy ,y x. ....�' �.nwq�jw>'��y� � k�l:% Town o! North Andover C"C(UD ZFF �::•.z�`::.�xk�x. SHOULD ANY OF THE a6pyE DESCRIBED MUCIES >3E CAIICELLED 1SEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVDA TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LIFT, 67VT FAIWAE TO MAIL SUCH NOTICE SRgL IMPOSE NO OBLIGATION OR UAsvTY OF ANY KIND UPON THE ---ANYI ITS 1ArTKTXOA AEPRESENTATtvES. ! RUTH ENT TIVE I ` r,• i;�i •'�r�:��rYxwS,l.ixrii:K>e`$:as.n::'<'a i:;t:S:i d3?( �tv:�'' gr.•:^wd ^ . ..:);o>'�.:1R sR... 9'ic"..:3.....3Ecw>:L,4'afkaAkah+sf..s;•:a%:ao.>�CA:ius��r ::<.� MAR-07-2081 09:38 9'78 454 1865 TOTAL P.02 III 97i P.02 r MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2.0 Checked by/Date CITY: Lawrence STATE: i assac liuseLt$ HDD: 625 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE : Other (Non-Electric Resistance) DATE: 5-16-2001 DATE OF PLANS : 5-11-01 TITLE : CONDOMINIUM PROJECT INFORMATION: RAY CORMIER ��NANTI!JCKE'�j,DRIU.E COMPLIANCE: PASSES Required UA = 268 Your Home = 263 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 1132 38 .0 0 . 0 34 WALLS : Wood Frame, 16" O.C. 989 19 .0 3 .0 53 GLAZING: Windows or Doors 185 0 .350 65 GLAZING: Skylights 35 0 .410 14 DOORS 21 0 .350 7 DOORS 84 0 .350 29 FLOORS : Over Unconditioned Space 1282 19 . 0 61 HVAC EFFICIENCY: Furnace, 83 .0 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been, designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building; and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 12516 f t, ign load as specified in sections 780CMR 1310 and J Builder/Designer Date �'© t •MASchAk -INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2 . 0 CONDOMINIUM DATE: 5-16-2001 Bldg. Dept . TTc ,, CEILINGS : [ ) 1 . R-38 Comments/.Location WALLS : [ ] 1 . Wood Frame 16" O.C. R-19 + R-3 Comments/Location WINDOWS AND GLASS DOORS : [ ] 1 . U-value : 0 .35 For windows without labeled U-values, describe features : # Panes . Frame• Type Thermal Break? { ) Yes { 3 No Comments/Location SKYLIGHTS : [ ] 1 . U-value: 0 .41 For skylights without labeled U-values, describe features : # Panes Frame 'Type Thermal Break? { ] Yes. { ] No- Comments/Location DOORS : [ ) 1 . U-value: 0 .35 Comments/Location [ ] 2 . U-value: 0 .35 Comments/Location FLOORS: Over Unconditioned Space, R-19 Comments/.Location HVAC EQUIPMENT EFFICIENCY: [ ) 1 . Furnace, 83 . 0 AFUE or higher Make and Model Number THERMOSTATS : [ ) Adjustable thermostats required for each HVAC system. AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air-tight assembly with a D .5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors . MATERIALS- IDENTIFICATION: [ �1 Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating, and cooling equipment and service water heating equipment must be provided. Insulation R-values, glazing U-values, and heating equipment efficiency must be clearly marked on the building plans or specifications . DUCT INSULATION: [ ] Ducts in unconditioned -spaces must be insulated to R-5 . Ducts outside the building must be insulated to R-S-0 . DUCT CONSTRUCTION: [ ] All ducts must be sealed with mastic and fibrous backing tape. Pressure-s-ensitive tape may be used for fibrous ducts . -The HVAC system must provide a means for balancing air and water systems_ TEMPERATURE CONTROLS: [ l Thermostats are required for each separate HVAC system. A .manual or automatic means to partially restrict or shut off the heatina and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ 7 Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified P in sections 780CMR 1310 and J4.4 . it MISC REQUIREMENTS: [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems . ----NOTES TO FIELD (Building Department Use Only) ------------------------- i BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 063515 Birthdate: 12/16/1967 Expires: 12/16/2002 Tr.no: 5058 Restricted To: 00 RAYMOND Y CORMIER 15 MEADOW VIEW LNC'' % ANDOVER, MA 01810 Administrator P. 01 Jul -19-01 03: 17P N/F ARELNE SHENKER 100.OB' LOT # 1 tn N/F JEFFCO, INC 13,552 f S.F. 18.8 wOf W 21.0' r•, o PROPOSED PROPOSED v UNIT UNIT 0 APPRO Pw N EXIST. FF=228.5 WATER FF=227.0 M Z O O S P w PDX > GF=225.0 GF=227.0 y m o SEAN a \ oz � I a0 M4S PROP. BIT. DOUG SErn CONC. DRIVE :; EES to DRIVE - a .s� 1 224 76.12' 3 NA�NTUC EDGE OF PAVEMENT v REVISED 7/17/01 - MOVE PROPOSED UNITS PROPOSED PLOT PLAN DANA F. PERIIIN8. Inc. Consulting Engineers & lend Surveyors LOT #1 1215 1WM STREET UMST ISS TEWKSBURY, MASSACHUSETTS 01976 CHATHAM CROSSING PREPARED FOR: JEFFCO, INC. NORTH ANDO vER, MA DUNDEE PARK ANDOVER, MA 01810 SCALE: 1"=20' DATE: MAY 24, 2001 JOB N6.51165-9P SHEET I OF 1 COPYp16NT O 2001 sr im" r. PERKMS. Inc. Town of North Andover Building Department o� 5- y6 o°c 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax.(978) 688-9542 t5 gcHus�� DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, anda condition of Buildingermit-# the debris P is resultin gfrom the work shall be disposed of in a properly licensed solid waste disposal facilityas defined b MGL . y GL cll s150a: The debris wvl a disposed of in/at: Facility loca on Signature pplicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. APPLICATION FOR WATER SERVICE CONNECTION `Z ea® North Andover, Mass. JU l i Zv ` Application by the undersigned is hereby made to connect with the town water main in V-4 � J 7700-V— L=—z— subject subject to the rules and regulations of the Division of Public Works. The premises are known as No. rc �(��` or subdivision lot no._�✓ © 1�Y�6 Owner Address Contractor Address Applicant's Signatur I Z�v `�$`�t ►�IASS FEC 4-d o C>-,, r, l PERMIT TO CONNECT WITH WATER MAIN The Board of Public Works hereby grants permission to' �1 C C>2 M t LIL to make a connection with the water main at + ,y. �.��. V 0 V— L= subject to the rules and regulations of the Division of Public Works. Boar of Public Works By Inspected by Date See back for rules and regulations TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 J.WILLIAM HMURCIAK, P.E. Telephone(978)655-095 DIRECTOR Fax(978)688-9573 � NORrh 32 Q tato q 6, 6rbti Q O L � T p • � c i• 9 # SAE ckus DRIVEWAY PERMIT DATE LOCATION 4— A U C—V—Cf D177 . c BUILDER hone 9 a OWNER < < hone THE NORTH ANDOVER SUPERINTENDENT OF OPERATIONS MUST BE NOTIFIED OF THE GRADE AND SETBACK FROM STREET . CALL THE SUPERINTENDENTS OFFICE BEFORE FINISH GRADING AND SURFACING FOR APPROVAL OF SUCH ENTRY. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. X � � 1708 APPLICATION FOR SEWER SERVICE CONNECTION 2 ocp f North Andover, Mass. 14 2. l _j_g Application by the undersigned is hereby made to connect with the town sewer main in 1A.4,L1'Tl,C-�� C— subject to the rules and regulations of the Division of Public Works. The premises are known as No. 4= 1 4z, lsl t t s,`-14 y-7 rZ-1 (AE Street or subdivision lot no. 2!> ®c) A -Ab yaiZ– Owner Address -O-Pty 14VL Qua l Contractor Address pplicant's Si re 1C�®® 14 A=CC PERMIT TO CONNECT WITH SEWER MAIN The Division of Public Works hereby grants permission to 7R Ay ( __c.wA L c a to make a connection with the sewer main at 4 Com!Aly i V c- (e C.,77 �� Street subject to the rules and regulations of the Division of Public Works.. n of Public Works B Inspected by Date See back for rules and regulations i 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. *****************************A'PPLICANT FILLS OUT THIS SECTION*********************** APPLICANT PHONE-?Y LOCATION: Assessor's Map Number PARCEL Z SUBDIVISION LOT(S) STREET�!'���Q� ST. NUMBER ************************************OFFICIAL USE ONLY*********************************** REC ND OFT WN AGENTS: NATION ADMINISTRA OR DATE APPROVED G DATE REJECTED COMMENTS (V "7 f (O CJ �,; TOWN,PL NNER DATE APPROVED ) DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS- SEWER/WATER CONNECT DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm ORTH Town o ndover No. 07110% NO, ndover, Mass.,LAKE COCHIC HE WICK ADRR T E D P,OL C5 SSA C H LJ`5 FOR EXCAVATION. AND FOUNDATION THIS CERTIFIES THAT ..... lf?.V... ..�I s.... .......Ahvrw....................................................... *04#0 C 94"/& 4),co has permission to excavate and pour foundation at V ,yAN for the purpose of.!> roo�� a�. ! i47x►/... // /�7�*IQ�MQ�.....�� ......... .......... ........... ............. . ....... ................. .. ....... The person accepting this permit must return to the office of the Buil ing Inspector a certified lot Ian show of building thereon before Foundation will be inspected. ' P ' P p VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. C ..... .............................. BUILDING INSPECTOR NORTH Town of Andover 0 V% No. *2 7 8' 17-cpm 0 c-L A dover, Mass., m co c IQ 0'z?ATE C' P'? BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........ ......................)....................... ................................... Alert Foundation A has permission to erect............... ..................... buildings on .... .... Rough to be occupied as... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relatingInspection, Alteration and Construction of Buildings in the Town of North Andover. Al 9/Cp/ ;?;4) V#7- am— PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR C Rough '# r.. .. .. .- Service ........ ..... V......ff.......... .................................... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Dec. 4025 Date..��..1f �....... V40 #I °f�•``° '°1"° TOWN OF NORTH ANDOVER A PERMIT FOR WIRING This certifies that ........ 41n,67 ....2c.........51.5....................... has permission to perform ......... y w,44........... .. .................. wiring in the building of.... llp-�'. ................ .. '. ................... ,f... fir ..fc�.C. �. . �� at..'... ...... .............. .,forth Andover des. f .. Lic.No.... Fee...� �.�.'X7C/.............. ... .�'�... ..,.................. INSP &TOR Check # . / IR _ Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/991 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC 5 7 C R 12.00 (PLEASE PRINT IN INK OR TYPEL INF RMATION) Date: Qp City or Town of. 14121dV611- To the Inspector cff Wires: By this application the undersigned gives_notice of his or her intention to perform the electrical work described below. Location(Street&Nu be ., Owner or Tenant Telephone No. 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❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security system t Completion o the ollowin table maybe waived by the Inspector of Wires. ti No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA Above oo No.of Lighting Fixtures Swimming Pool ❑ In- . mergencyig mg rnd. rnd. EDBatte Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.of Detection an Initiatin Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained y Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal E] Other Connection No. of Dryers Heating Appliances K�,�t Security Systems: No.of Devices or Equivalent y o.of WaterKW No.o No.o Data Wiring: Heaters Si ns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,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 force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of EI ctri 1 Work: (When required by municipal policy.) Work to Start: d1 Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify, under the ain andpenalties ofperjury,that the information on this application is true and complete. FIRM.NAME: LIC.NO.: 1 Licensee: John S. Bassett Signature LIC.NO.: 1533C (If applicable,enter"exempt"in the license number line) Bus.Tel.No.: 603 594 5928 Address Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Li see 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: $ i 1; r 4043 Date......... f NORTH'1 TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUS� This certifies that — has permission to perform :..r... ....f..f.......-� ............................................ wiring in the building of...i '_.. ................................................................... �.......... ,North Andover,Mass. Fee.... ........ Lic.No.rC� 3 ..�:.. C, .1077 ......................... Jam/ ELECTRICAL INSPECTOR Check # ��� ��y-���� v Commonwealth of Massachusetts - Official Use only Permit No. Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/991 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 27 CM 12.00 (PLEASE PRINT IN INK OR TYP AL INF RMATION) Date: City or Town of: To the lnspec or of ires: By this application the undersigned- ivies"no ice of is or her.nte ion to perform the electrical work described below. Location(Street&Number) , Owner or Tenant ` Telephone No. — 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❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security system Completion of the followin table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ In- ❑ o.of Emergency Ligliting rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.of Detection an Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Dis osers Heat Pump I.Numbe Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices I No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: i No.of Devices or Equivalent No.of Water Kms, No.o No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total.HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,oras 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 force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value ectric 1 Work: (When required by municipal policy.) Work to Start: o9zo,\Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify, under the pain and penalties of perjury, that the information on this application is true and complete. FIRM NAME: LIC.NO.: jr- Licensee: r-Licensee: John S. Bassett Signature -G34&9 LIC.NO.: 1533C (If applicable, enter"exempt"in the license number line.) Bus.Tel.No.: 603 594 5928 Address: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Li • see 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: S I a µ4iiTH . O ,ra.oa.e iyb QMp �SneHs CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number Date THIS CERTIFIES THAT THE BUILDING LOCATED ON MAY BE OCCUPIED AS 1,ed o m s, 02 '�� L3.4- `lis oZ � �// �Ali c� IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO _Do c, l S 4 h ,e. A--) Building Inspector NIRT, Town of over 0 .w �. No. 79 o� CoCH�� dover, Mass., ADRAT E D S H E BOARD OF HEALTH n Food/KitchenPERMIT T D s r Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.........�.Q.tJ . ..� ..�.... ....... .��r� Foundation �I has permission to erect...............�..................... buildings on .....�.. !IN ..... .............. ... ./P.; .P ... ..... Rough /UL/� to be occupied as... ...... !?l.S� ..48A i/... . .4411.1 .A.c��c�........ �x i � � provided that the person accepting this permit shall in every respect-conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating tote Inspection, Alteration and Construction of Buildings in the Town of North Andover. y*7/a/ 0 IL/ PLUMBING INSPEC;E�R VIOLATION of the Zoning or Building Regulations Voids this Permit. �u �—��0 2, PERMIT EMPIRES IN 6 MONTHS 3 UNLESS CONSTRU NST TS E CTRIC sP c R C ............. ................................................. BUILDING INSPECTOR Final ' Occupancy Permit Required �d to Occupy Building Y � q g G INSPECTOR O� 9ou �✓ Display in Conspicuous Place on the Premises — Do Not Remove _U 3 spy a p & � No Lathing or Dry Wall To Be Done FIR DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. / t��� NORTH Town of North Andover Building Department 27 Charles Street o ti North Andover, Massachusetts 01845 4 (978) 688-9545 Fax (978) 688-9542 op cociiiw.cw 1• '� CHus���� APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS> LOT NUMBER SUBDIVISION DATE REQUEST FILED 3 o,4,3 DATE READY FOR INSPECTION TEN (10)DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED 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 D.P.W. —WATER MET DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATME/DPW AUTHO ION r _