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HomeMy WebLinkAboutMiscellaneous - 40 MIFFLIN DRIVE 4/30/2018 I � IJ Date....4.... ..........I..I........................... T TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION (A Thiscertifies that ................................................................................ .. ................ Ihas permission for gas installation I......?\,-y�"n ...... in the buildings of.....(-1) V � k�--C � f� 3 .................... ...... ....... ...�3... ...... .................................... North Andover, Mass. Fee .... Lic. No. ....... ................................................................... GAS INSPECTOR Check# � f���d s MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK - CITY I North Andover MA DATE 4/1/2014 PERMIT# JOBSITE ADDRESS 40 Mifflin Rd OWNER'S NAME / OWNER ADDRESS I Same I TEL ,IFAXI TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONALF1 RESIDENTIAL[] PRINT CLEARLY NEW:❑ RENOVATION:El REPLACEMENT:© PLANS SUBMITTED: YESO No F1 APPLIANCES Z FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER - BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE _ � + FRYOLATOR + _ FURNACE .-- r. -- _— GENERATOR „ . GRILLE INFRARED HEATER � wl, -_ LABORATORY COCKS MAKEUP AIR UNIT OVEN ' POOL HEATER ROOM I SPACE HEATER r i ` ROOF TOP UNIT _. TE T UNIT HEATER U110YENTED ROOM HEATER WATER HEATER OTHER Replace Gas Meter and Pioino as Needed INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES ❑NO ❑ I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICYED OTHER TYPE INDEMNITYE] 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: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued foriii be i pliance with all P rtinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. ` PLUMBER-GASFITTER NAME Joseph Marino S G TRE MP❑ MGF❑ JP❑ JGF® LPGI® CORPORATION Q# RT E SHIP®# LLC❑# COMPANY NAME: RH White Construction Co ADDRESS41=Central CITY I Auburn I STATE LMLAJZIPJ 01501 TEL (508 832-3295 FAX 508-926-4347 CELL 508-832-4614 EMAIL JMarino@RHWhite.com ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES �L� 1 c : O tIMOfVWEAL.TH OF MA SSr4GH:klS "I' - = - - — lu. 1 --- PlU1�1jBERS AND ��A5FITT .RS 1 1=CEIE'ED AS'A-.Mrs►TER P.LUMBR=> - =( SUES Tli `A6Q1%E'LIGENSE 70 ~' JLfSE`P;N 'D. P�AR.ItO - - - '3::: &RRI'NGTON ST = = WIIR_G'EST`ER MA oi�'.�f R- 1111MIN COMM!f NWIEALTH OF MASSA-G i S_E_I S=:r We _ -:"PLU]tiliERS AND GASFITT'ERS`. _' Lf'CE1V5=E AS A JO-U.RNEYl11��-W-?-�:�7f[�i� � "ISSUES THE ABOVE"LICENSE 3"y`Fi4i2RI'NGTON ";:fA7il1GSTER _ NdA U 16,U: =.3.x0`9:. 04/03/2014 14: 04 5088326751 RH WHITE CONSTRUCT PAGE 02/02 CERTIFICATE OF LIABILITY INSURANCE page oQ 7, 08/29/20 13 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT 13ETVVEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditionsof the policy,certain policies may require an endorsement.A statement on this certificate does notcpnferrights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT willia o£ Maeaachusotts, Inc. PttUI c/o 26 co-Atury Blvd. NO-NE 877-945-7378 PAX 888-467-2378 P,, 0. Box 305191 -MAIL .No): Nngbville, TN 37230-5191 DortESS:Seita f iicate�Qw•iliia.Com INSURERS AFFORDING COVERAGE NAIL rt INSURED INSURERA: The Cliarter Oak rirg Inaurancg Company 25615-001 R. H. :Shite Concerxction Company, Inc, INSURERS:TrrQlAre property Caeualty Com;gany of Am 25674-003 41 t3treet 0. BQx P. 0. Box 257 INSURERC:Nati0AA1 Union Firs) Ineuranca Company of 19445-001 Auburn, MA 01501. INSURERD;Travglers ind&=r ty Company 25658-001 INSURER F,; INSURF,R F; COVERAGES CERTIFICATE NUMBER:202$7680 REVISION NUMBER; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUEJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIM17S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE wM POLICY NUMBER 04 SUB POLICY EPP POLICY EXP LIMITS A GENERAL LIABILITY VTC2000 977X9948-13 9/1/2013 •9/1/2014 EACH OCCURRENCE 2,000.400 $ COMMERCIAL GENERAL LIABILITY pp r� TORENTFD PR 18 3(&ocemonur) _ 300_000 CLAIMS-MADE OCCUR Mm EXP(Any one ereon 11 000 PERSONAL&ADV INJURY 3 2 00Q,000 GENERAL AGGREGATE S 4,000 000 RGEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OPACG $ -o- _ OOO POLICY PRO LOC BI AUTOMOBILE LIABILITY $ VTJCAP 977K955A-13 /1/201,3 9/7./2014 OMBINEDSINGLEI.IMIT X ANYAUTO aoccldent $ 2,000,000 ALI,OWNED SCHEDULED BODILY INJURY(Per person) $ AUTO$ AUTOS BODILY INJURY(Peraccldent) $ X HIREDAUTOS X NON-OWNED AUTOS g Co Ded X C911 ped eraccldent ^� C UMBRELLA UA OCCUR BE8766140 /1/2013 9/1/2014 EACHOCCURRENCF. s S"000,000 X EXCESS LIAR CLAIMS-MADE AGGREGATE DED $ RETENTIONS 10,000 S,000,00O D WORKERS COMPENSATION $ AND EMPLOYER8'LIABILITY VxltKUB 820SAISS-13 9/1/207.3 9/1/2014 $ U TOr{Y U D ANYPROPRIMB RfPARLUDE XECU7IVE N NIA VTC2RIIB 8203.A71A-13 9/1/2013 9/1/:014 E.L.FACHACCIDENT $ 1,000 000 OFFICER/MEMBER EXCLUDED? Myendotary�j In beLIH) E.L.DIEtEABE-EAEMPI,OYF.E S 1,000,000 UE�BIiK�II+I IUN OF Ut'ERATIONS tleloW F..L.DISEASE-P0410YLIMIT S 11000,000 DESC RIPr10N OF OPERATIONS I LOCATIONS I VEHICLES(AtInch Acord 101,Addltonp 1 Remarke Schodula,It more ep see Is-m—Tu rs; CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, Evidence of InlYuzance AUTHORIZED REPRESENTATIVE coil:4197604 xp1:1694012 Cert:20287680 ©1988-2010ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Location No. C: C> Date NORTol TOWN OF NORTH ANDOVER t 1 0 � 9 'U Certificate of Occupancy $ -J °, �_ • S M CMUSk 9 �'7b''•°''tom Buildin /Frame Permit Fee $ s'JA Foundation Permit Fee $ `�y Other Permit Fee $ TOTAL $ y Check # � J �U Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT OR QEMOMM A ONE O ^" TG IU Seefim for OWidd Use OnI m BUILDING PERMIT NUMBER: �D DATE ISSUED: Q X e C� SIGNATURE: ...� BuildingCommissioner/I for of Buildings Date Z SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: q6 Miff(jh 0r , ax( . 0 B&II< 60,14 Loi OQGU•0 Map Number Parcel Number `v lP 1.3 Zoning Information: 1.4 Property Dimensions: (1 u e F-,kt((v owe((Ini� 1q. ?9q lbsr U Zoning^ Q- District Pr used Use Lot Ar s Frontage $ 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Re red Provide Required Provided Re aired Provided 26 , 31 ' I + b 17' { ",-Y 36 ' q3 ' 1.7 Water Supgty M.G.L.C.40. eragg 54) 1.5. Flood Zone Information: 1.8 SewDisposal System: Public i/Private ❑ Zone Outside Flood Zone Municipal On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record Sa( Va(6re 4 Marta Ike Tri Ao q6 Miff (( ,j Name(Print) Address for Service Signature Telephone 2.2 Owner of Record: Mime Print Address for Service: z Signature Telephone 90 SECeION 3-CONSTRUCTION SERVICES y 3.1 Licensed Construction Supervisor: Not Applicable ❑ GakayIe,, F( . T-o5Te-r Licensed Construction Supervisor: C if/ 671 O License Number mn Address // K � /��6 .� v-(sti 6�6— 1/ Expiration Dat � e � 3 SignatureTelephone r r 3.2 Registered Home Improvement Contractor Not Applicable ❑ sv Company Name m Registration Number r Address r Z 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.......❑ No.......❑ SECTION 5 Description of Proposed Work check av applicable) New Construction ® Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition 0 Accessory Bldg. 0 Demolition 0 Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed bypen-nit applicant 1. Building (a) Building Permit Fee Sd Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) x (b) I l y 4 Mechanical(HVAC) $ O OP 5 Fire Protection t t 5 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 1, S Z(ya -Go V G R e t TZkt G ,as Owner/Authorized Agent of subject property Hereby authorize G(n Z V (C 5 (A 1- a s Te-it to act on My behalf 'nAll�rtta ers rel=five ork,�uNorized by this building permit application. (3� � l Si nature of O\&iier Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, C 'Fa s-re?r as(fir/Authorized Agent of subject property Herehv declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge . and belief C(t --�-( es 14- - FesTer Print Name f Signature of Own er/A ent Date NO, OF STORIES Q e- SIZE BASEMENT OR SLAB se--cti(e Gc"T SIZE OF FLOOR TINMERS1 2 NU 3RD SPAN /(o DIMENSIONS OF SILLS DIMENSIONS OF POSTS 3 < « L 14 C, DDAENSIONS OF GIRDERS 6 HEIGHT OF FOUNDATION — 6 0 THICKNESS / SIZE OF FOOTING X / e MATERIAL OF CHEV NEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE e $ Growth MC-nagement Bylaw Exemption Statement Town of North Andover Euiiding Department This fort shall be used to assist the Building Cepartment in their determination of exemctions under sec:icn 8.7.6 or the Town of.North Andover Grcwth Management Sy!aw. Tile building applicant shall provide all of the necessari;nformaticn as requested below. Name cf A.cclicant on Euiiding Permit(below) Address of Frocerr/ fcr Feri;it(beicw) Reazoto L�U �� C tq D(l , fVlao and Parcel : Purpose of ppiicaticn (check below) Phone Number of Applicant • Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit 'cr which this form is =mpieted does comply with the E<EMFTION section 8.7.6 of the North Andover Grcwth Management Bylaw. I also understand providing this farm does not absolve me cr arty parry to this permit from the requirements of obtaining other permits required pier to the issuance c(the E"uilcing Permit. Further I understand that my interpretation of the E<EMPTiGN status is subiec:to review by the Suiiding Department and is only ofiically ac-rpted when the Building Permit ig issued. Based an section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as acpiied far on the above lot, in the building permit application and associated attachments, complies with one or more of the fallowing sections as indicated by a check mark. This is an application for a building permit for the enlargement.restoration,or recarstruc:icn of a dwelling in existents as of the effeczve date of this by-Jaw,provided that no additional residential unit is created. The lots)were/was created priar'.o May 5, 1956 are exempt from the provisions of this Section 3.7 of the Zoning Eyiaw. This apclicatlon is for dwelling units for low and/or moderate income families or individuals,where all of the ccnditions of 8.7.5.care met and/or represents Cwelling units for senior residents,where cccrpanc/of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this SeCan"senior"shall mean persons over the age of 55. �i This application is a part of a development prciec: which voluntarily agreed to a minimum dQ"J permanent reductfcn in density, (buildable lots),below the density, (buildable lots),permitted under caning and feasible given the environmental canditfons of the tract,with the surplus land equal to at least ten buildable acres and permanently designated as open spats and/or farmland.The land to be preserved shall be protected from development by an Agricultural Preservation Restricten,Conservation Restriction,dedication to the Tcwn,or other similar,nechan ism approved by the Planning Board that will ensure its protection. This appficntlon represents a traC of land existing and not held by a Ceveloper in common cwnershio with'an adjacent parcel an the effective date of this Section 8.7 shall receive a one-time exemetion from the Planned Growth Rate and Cevelopment Scheduling provisions far the purpose of constructing ane single family dwelling unit an the parcel. This application represents a lot which is ready for building permits,(i.e.all other permits from all other boards and commissions have been received and the project is in ccmpiianca 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 Cevelopment until such time as the Cevelopment schedule accommodates issuing building permits. Applicant must supply approved fort U with this VEMPTION. Please provide any and all information that would assist the Building Department in making a determination" that your application is allowed one or more of the above E<EMPTiONS. By signing below I attest to the accuracf of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further I understand that the submittal of misleadinc and cr inaccirate information, or the chec.cing off of an above item which does not comply, whether done to my knowledge or not, is grounds for refusal by the Building Cepartment to issue a Building Permit. Signature1/1— or Authonzed Agent who signed the Attached Building Permit J This form must be attached to the Building Permit upon application for such permit BUILDING DEPARTMENT DEBRIS DISPOSAL FORM In accordance with the provisions of MGI.c 40 S 54,a condition of Building Permit Number Is that the debris resulting form this work shall be disposed of in a properiy licensed solid waste disposal facility as defined by MGL c 11, S 150A The debris will be disposed of in: 0U (wk s ee— aUA SUT(6m M e-w eu( - Location of Facility Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector Y � 1 (q7-=-C"\t :r WVBoston i he Commonwealth of MassachusettsDepartment of lndustrial.Accidents Office cf lnvesdoations NlaSS. 02111 � Workers' Comcensaiion Insurarce.41f,' rt Flame F(ease Frim Name C --V•(•es FC,<7e7r rev' 1-ccaticn• A M-wr za�—Le- R1 Cit! t4Ac'I7 Jr,ue;r MA Q(C-y s Phone 9 `R 6&6 ' `{7 q 7 I am a hcmecwr,ef perrcmlinc all work myself. I am a sole prcprietcr and have no one ,,ucrkina in any capa&/ CI am an employer providing workers' compensation for my employees wcrkine en this job. Cemcanv name: Address CiN: Phcne Insurance Co. PCl'c! I Company name: Address CiN: Phone T' insurance Cc. FClici Failure to secure coverage as rerurac uncer Sec-:en 2a-\ or iblGL 152 can lead to the imccsidw ci cnmirsl penalties cf a nne up to S1,°CO.CO aneler one years'imor.scnment as we:l as c:wi penalties in the fcrm cf a STCF'P/CRK CRCE.R and a rine cf(51C0.00)a day=g3rnst me. I understand that a c:tzy cf .tris staement may ce fcr+varcec to the cffnca cr Invest:gsncns cf he GIA fcr coverage veriftnticn. I do heredy car*uncer rhe pains and penaldes of perjurf that'he inrermaticn provided accve is!,rue and ccrrect. Sianature Cate Print name Phone offic•21 use only eo net write in this area to t;e completer cy c:ty crown crnc:af C:ty or Tcvn P�rmrtll:c�ns�rc Building Dept [Check.f immediate rercnse is required Q Licensing Ecard Sa!ec;man's O�Ce C:.nrac:,:erscn: Phone : !-'ea!th Department Other N' _ 1111 Date .. ...-......—©D . ... .. .... ? of- #0 o °°m TOWN OF NORTH ANDOVER * D RECEIPT SS�CHUSE� This certifies that.....3444 1 .. .. ............. ....... . has paid....LL. 0� Z .Oa for...LL.� .. ................... ;... Received b .......................... Department.................... ...r/`. �F� �(J lc� o'...... ..jam.................... WHITE: Applicant CANARY:Department PINK:Treasurer N° 968 APPLICATION FOR WATER SERVICE CONNECTION North Andover, Mass.- AD Application by the undersigned is hereby made to connect with the town water main in C Street, subject to the rules and regulations of the Division of Public Works.//� f The premises are known as No. ek `'"� f ➢` It ��I Ve- Street or subdivision lot no. gal. Owner Address Contractor Address 1 Applicant's Signature P PERMIT TO CONNECT WITH WATEru'e Works hereby rants permission to g�� eis The Board of Public o s y g to make a connection with the water main at Street subject to the rules and regulations of the Division of Public Works. Bo rd of,,Pulic Works By Inspected by Date See back for rules and regulations z 1511 APPLICATION FOR SEWER SERVICE CONNECTION North Andover, Mass. 1 Application by the undersigned is hereby made to connect with the town sewer main in �4e2 A `� Street, subject to the rules and regulations of the Division of Public Works. /� z>r �� , p� The premises are known as No. � �' " t�+ n —/ �� Street or subdivision lot no. l ' / J Ownje Address Contractor Address plicant's Signature PERMIT TO CONNECT WIT SEWER MAIN The Division of Public Works hereby grants permission to to make a connection with the sewer main at G;A11 ?c Street subject to the rules and regulations of the Division of Public Works.. ivision 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 Telephone(508)685-0950 Fax(508)688-9573 Of NORTH 9 O6,T�l0 ,6'6�O L. O A a�411t0 't�5 SA HUS DRIVEWAY PERMIT Date: LOCATION: A BUILDER: phone: OWNER: �� �✓a 4,"e I)e` ����D phone: The North Andover Superintendent of Highway Utilities&Operations MUST be notified of the grade and set-back from street established in any driveway entry onto any street or way maintained by the TOWN. Call the Highway Superintendent's Office, before finish grading and surfacing for approval of such entry. FAILURE TO COMPLY AND. OBTAIN APPROVAL VOIDS THIS PERMIT. Remarks: Approval: - m i 44 N '9v d m 0 � N W U �$c O 3 0 C O Z 0�l D rm- v o g ted,a gid'"° Iv$ CID aCD z •2PUl ! 4► m CL. .at of E I w 3-16-2000 2-30PM FROM DUTTON/GARFIELD 9786817570 P. 1 PROJECT MEMO TO-M10 MCGUIRE-BUILDING INSPECTOR-TOWN OF NORTH ANDOVER^ FROM:STEPHEN E,FOSTER-DUTTON&GARFIELD,INC. DATE:3/16/00 RE:ZONING MIKE: SEE ATTACHED PLOT PLAN(SHOWING PROPOSED NEW DWELLING)AND SURVEYORS PLAN FOR LOT LOCATED AT CORNER OF MIFFLIN DRIVE AND PUTNAM ROAD (YOU MIGHT HAVE ALREADY DISCUSSED THIS SAME PROJECT WITH EMI.CORRENTE) THE OWNER WOULD LIKE TO LOCATE THE HOUSE SO AS TO PROVIDE A 30 FOOT FRONT SETBACK ON PUTNAM ROAD AND A 20 FOOT SIDELINE SETBACK ON MIFFLIN DRIVE PRIOR TO THE COMPLETION OF ARCHITECTURAL PLANS FOR THIS BUILDING CONFIGURATION WE WOULD LIKE TO CONFIRM THAT THESE SETBACKS MEET NORTH ANDOVER ZONING BYLAW FOR THE R-4 DISTRICT THE LOT APPEARS TO HAVE ADEQUATE AREA(15,149 SF ACTUAL VS. 12,500 REQUIRED) THE SETBACKS APPEAR TO CONFORM TO ZONING WHEN FOOTNOTE#8 OF THE DIMENTIONAL REQUIREMENTS IS APPLIED KJNDLY REVIEW AT YOUR NEXT OPPORTUNITY AND CALL ME TO DISCUSS - F'&CJU THANKS FOR YOUR ASSISTANCE ON THIS MATTER X !s STEPE. OSTER,V.P.-PROJECT MANAGER C:\PROJECTIMP.M0316A 3-16-2000 2:30PM FROM DUTTON/GARFIELD 9786817570 P. 2 e3-15-M 1110 n 5m �W l I L UI Lc3 LZ 1:, �.c sr HSElk �ko A LOTS PIAN 16119 �RRECT S 14 ED ARE4 m 2Y.34 �3s fs --.•�. xx A A y � a �4yZlo� O co200 m F9 n S.18V5'40'w 113.66' 04IFFI-IN DRIVE THIS IS TO Cr:Rl,XY THAT I HAVE GONFOR iM H THE R(H.E'►AND REGULATIONS OF T �REMSTERS(le A EE'!>;S NV PREPARING 7749 • • 7 t . LOT R�L�AS E FORM FORM U - �Islpermits from' that all nece`Ssry acro!4 not relieve I used to veriy A� otrtained. This does c.` This form Ve �evan pplicable or requirzm,ents c—^ C TION. urisdiction ha Jy.. U �e�ar,rrents having J liance �vlth a do, ner prom comp Boards and r Ian and.or ��— the apFlicant I OUT TN1S FiL_ , e �Z o P�CNE ( d v QG�' z'Ca FARCc=� APPS !CAiiT j Z� G .0 ,v LOT LC(:A-'lCPl: ass2ssc�s flan `lumcer ST. NUiti1flER A ST L� tier FlClA1- USc 014Ly .. OF vTS. e, TOWN ACE RECOMM�yDA�IONS OF LVED 2'�, 1 DATE APPR Cr- DA REJECT CD TE c NSE:RVAT1GN ADMINISTITO C� N6 (tl- A�,Lllll I COMMS J DATE APPROVED DATE REJECTED STOW Ny COMMENTS ' DATE APPROVED INSPECTOR- �E4LTH DATE REJEC FOODTED DATE APPROVED c^ cT G R-}SEA LTN DATE REJECTcD SE=-Tic IN- r, COMMENTS S .SE•NE�ATER OONNECTiONS � � ` rUEL10'NORK , 1jvAY PERMIT cwvSa d FIRE DEFART�,IE?`IT .. � =LILJiI`lG ii IcPEC`t CR RE� 4 ' CERTIFIED PLOT PLAN LOCATED 1N NORTH ANDOVER, MASS. SCALE.-I"=30' DATE:5/1/2000 Scott L. Giles R.P.L.S. Frank. S. Giles 50 Deer Meadow Road North Andover, Mass. �G �v2 0 s� 0� 20 0 O � 0 1Ib, G��' �5kl. % R=20.00' L=31.42' GO Q �N I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE THE OFFSETS OF THE BUILDING INSPECTOR ONLY SHOWN COMPLY y� AND SUCH USE IS FOR THE o WITH THE ZONING DETERMINATION OF ZONING 0E5 BYLAWS OF .13972 4 NORTH ANDOVER CONFORMITY OR NON-CONFORMITY I ss��f�1STElt� +� WHEN BUILT WHEN CONSTRUCTED. <LAO I I i MAScheck COMPLIANCE REPORT I Massachusetts Energy Code ( Permit # MAScheck Software Version 2 .0 I I I I Checked by/Date I CITY: Lawrence STATE: Massachusetts HDD: 6235 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 5-2-2000 DATE OF PLANS: 5/1/00 TITLE: NEW RESIDENCE PROJECT INFORMATION: REITANO RESIDENCE 40 MIFFLIN DRIVE NORTH ANDOVER,MA. COMPANY INFORMATION: CHARLES FOSTER BUILDER NOTES: REFERENCE DESIGN BY EMIL CORRENTE COMPLIANCE: PASSES Required UA = 422 Your Home = 402 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA - --__ CEILINGS 2536 30. 0 0.0 89__ WALLS : Wood Frame, 16" O.C. 1760 13.0 3.0 125 GLAZING: Windows or Doors 207 0.350 72 DOORS 20 0. 350 7 FLOORS: Over Unconditioned Space 2288 19 .0 109 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4. BiAildet/Designer Date • MAScheck' INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.0 NEW RESIDENCE DATE: 5-2-2000 Bldg. l Dept. l Use I CEILINGS: [ ) I 1 . R-30 Comments/Location I WALLS: [ ] I 1 . Wood Frame, 16" O.C. , R-13 + R-3 Comments/Location i I WINDOWS AND GLASS DOORS: [ ] I 1 . U-value: 0.35 For windows without labeled U-values, describe featur s: l # Panes v Frame Type Thermal Break? [ Xes [ ] No Comments/Location I DOORS: [ ] I 1 . U-value: 0. 35 Comments/Location f FLOORS: [ ] 1. Over Unconditioned Space, R-19 I Comments/Location I I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. Recessed I lights must be type IC rated and installed with no penetrations I or installed inside an appropriate air-tight assembly with a 0.5" I clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ ] I Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. I I MATERIALS IDENTIFICATION: I ] I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. 1 DUCT INSULATION: [ ] I Ducts in unconditioned spaces must be insulated to R-5 . I Ducts outside the building must be insulated to R-8.0. I DUCT CONSTRUCTION: [ ] I All ducts must be sealed with mastic and fibrous backing tape. Pressure-sensitive tape may be used for fibrous ducts. The HVAC system must provide a means for balancing air and water systems. 1 TEMPERATURE CONTROLS: [ ] I Thermostats are required for each separ t 'VhC system. A manual or automatic means to partially restrict ut off the heating Rated output capacity of the heating/cooling system is { not greater than 1250 of the design load as specified { in sections 780CMR 1310 and J4.4. I MISC REQUIREMENTS: [ ] I 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)------------------------- ORTIy Town o : . ndover O 0% No.a 0G Y o, ndover, Mass., O LAKE COCMICMEWICK A00;?ATEO P? ,�5 9SSAC HU-5 FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT ......V.. ... ........> r.I.. O7.0.9.0............................................ has permission to excavate and pour foundation atOZ' /0 ............. ... .................................. . .............. .. for the purpose ' .Sta�I..�e....P.!�!011!y The person accepting this permit must return to the office of the Building Inspector a certified plot Ian show of building thereon before Foundation will be inspected. 40" 07 #04 / 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. BLDG. PERMIT FEE � • � LESS FDA FEE C r t,1% , G t i ..... . ;,, F PEF�M1.T BUILWNG INSPECTOR NORTH Town of Andover No. Z a b dover, Mass. COC NIC KE WICK � � � ' ADRA T E D P'*p 5 S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT... . . .. ..al..m....�' „ .. BUILDING INSPECTOR I�1�o.x�a.... ....o��uo.................................................................. �/ Foundation has permission to erect..........�........................... buildings on ..."7.0....�I��. "l A�AoP .,,.7)R.*,,..,..,.............. Rough to be occupied as....6....ROP.M .a�...-&A o.a.b c!J.,AA.ch�'�...45�!4 �C �wC��lrV 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 relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. M a/ #Od/ — PLUMBING INSPECTOR VIOLATION of the ZoningBuilding or g Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTI N STS Rough ..... ................................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal 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 Det. -oA) C2eV'aj— P, IS34Y 13 g o l x Y 6a D � 6 o a — �cC- d D o d CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number 'c� v Date /c) THIS CERTIFIES '�iTHAT THE BUILDING LOCATED ON AID M 1 t/'F Lfl K) MAY BE OCCUPIED AS 7�'�. �2: A Nn C c.V e-- lA% IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. oT"q o CERTIFICATE ISSUED TO '1 d � v1L. Pet] U � A q f ftp.� ADDRESS 40 M� Nt V udding I pector l' CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number :� o Date dc).., THIS CERTIFIES THAT THE BUILDING LOCAXED ON IYD M! I"/L! MAY BE OCCUPIED AS ';lOJ.Ili141M+ IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS Ap S MAY APPLY. NV 04oT"q tj CERTIFICATE ISSUED TO W d ���TaAl., O P ADDRESSAA ,JCA`""S� Iry Building I pector NORTH Town of 4 - over O err.. ti��y', •�( ' No. Z d to _�— lA E coyer, Mass., MAO IfsCoCMyCHEWICK <�A0RATE0 FiCC, .. S BOARD OF HEALTH Food/Kitchen PERMIT T 1) Septic System BUILDING INSPEC'T'OR THIS CERTIFIES THAT...N..a1...m....+.InAtla..... L!/....O��D...... ire '4' ........................................................... Foundation,t `J3 has permission to erect................... buildings on Rou hoa « - ............... ...R off..Fay.o�..balL.A7 , .C.. ... .IN� ...Pw�.11�/V Chimney 3 . A to be occupied as... y provided that the person accepting t is permit shall in every respect conform to the terms of the application on file in Final CCg, ry-, 4-eQ't this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. �0 a1 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. �u PEPMj EXPIRES IN 6 MONTHS UNLESS CONSTRUCTI N ST TS Ro ELECTRIP. 000 ..... .. .. ..... BUILDING INSPECTOR 0/ Fina � /�� Occupancy Permit Required to Occupy Building GAS 6INSP TOR � . Display in a Conspicuous Place on the Premises — Do Not Remove Rough �i No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street.No.. Smoke Det. SEE REVERSE SIDE '� CERTIFIED PLOT PLAN Pei?m 1�� LOCATED IN NORTH ANDOVER, MASS. C d A SCALE.-I"=30' DATE,6/6/2000 Scott L. Giles R.P.L.S. G Frank. S. Giles 50 Deer Meadow Road North Andover, Mass. . -oG 01, '9Z s Qj 'Pc5` /o ro 100po 5� 1 b� Qj LOT 6 s 3r PLAN 1657 N.E.R.D. R=20.00' X00 15,148 S.F. L=31.42' 0 CORRECTED AREA I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE 0� THE OFFSETS �P�tH OF THE BUILDING INSPECTOR ONLY SHOWN COMPLY AND SUCH USE IS FOR THE a . WITH THE ZONING DETERMINATION OF ZONING E3 BYLAWS OF ' � ���70 NORTH ANDOVER CONFORMITY OR NON-CONFORMITY s�0��ISTERE�J@y WHEN BUILT WHEN CONSTRUCTED. q1 LANti ��a �a TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT OR RIMMSMW A ONE O �- G This Seleti"for OffikW IIse Ogi BUILDING PERMIT NUMBER: DATE ISSUED: X � SIGNATURE: �c Building Commissioner/I for of Buildings Date z SECTION i-SITE INFORMATION z 1.1 Property Address: 1.2 Assessors Map and Parcel Number: '/6 N I f l i h 1)e- c 2-( iJ aLl< 6� -1 I i 06�C1 Q Map Number Parcel Number `v 1.3 Zoning Information: 1.4 Property Dimensions: (1 Cdre_�_ cwttl. zv , (L l : 39q Ib t V Zoning^District Proposed Use Lot Arta(so Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided r 311 I:5-4 1 1 '1' -E s,3-` 36' v 3 r 1.7 Water Supp M.G.L.C.40. 54) 1•3. Flood Zone Information: 0 1.8 See Disposal System: Public Private ❑ ZOne Outside Flood Zone Municipal On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Owner of Record 1fTd LA � Y6 /Nl i f (f n1 Q 1, I i Name(?rint) Address for Service Signature Telephone - ` 2.2 Owner of Record: Name Print Address for Service: Z Signature / Telephone SEC:'ION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ G k iayler / o 5 / e-r Licensed Construction Supervisor: /V1 6 71 O KA R4, A1-Ahd6(Jcr MA License Number Address _ y' Ll �f Expi ti—Date' 61 SignatureTelephone - r 3.2 Registered Home Improvement Contractor Not Applicable ❑ S® Company Name M Registration Number r"a Address r Z Expiration Date G) Signature Telephone Y� 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.......❑ No.......❑ SECTION 5 Description of Pro osed Work check all a livable New Construction ® Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: cc,N l-1�OCT Q o e' �st SECTION 6-ESTIMATED CONSTRUCTION COSTS . Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee � , SO Multiplier 2 Electrical (b) Estimated Total Cost of 8 Q, Construction 3 Plumbing Building Permit fee(a)x (b) l l S p OP 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 ft 6 as Owner/Authorized Agent of subject property Hereby authorize C,(x2--w (e--5 (<� - 1-" c (C v{ to act on My,behalf 'n all matters relative t ork uthorized by this building permit application. -Si nature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION as Cir/Authorized Agent of subject properly Herebv declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge . and belief it Prins Name���� signature of Owner/Anent Date NO. OF STORIES 0 ' SIZE BASEMENT OR SLAB u4 e GcT- SIZE OF FLOOR TRVIBERS (6 l 2 3 SPAN 161 DMENSIONS OF SILLS 346 T DINIENSIONS OF POSTS �2, i DIMENSIONS OF GIRDERS 6 « )C � HEIGHT OF FOUNDATION — 6 �` TCKNESS HI / SIZE OF FOOTING X 6 MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND S Q t t IS BUILDING CONNECTED TO NATURAL GAS LINE e �, i t , No Date.... ........:..................... ! NORTH TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ass^cwusE� This certifies that :.................................................. ...................................... has permission to perform ................4............................. ............................... wiring in the building of..*,,T. ............................................................................. �// at .. �� '................ .North Andover,Mass. Fee......: ........... Lic.No.............. ....� t................:.....:....:.:...................... ELECTRICALINSPECTOR Check # 3 WHITE: Applicant CANARY: Building Dept. PINK:Treasurer ate.\ HECOMMONWEUTHUFA14&" 1U.S`E77N Office Usseonly BEPARTAfi7VT0FPUBUCS4= Permit No. ct BOARD OFFMPREVEMONREGUlA170AS5270M12-00 Occupancy&Fees Checked 77- f APPLICATTONFOR PE?Afl T TOPERFORMELE=CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 1 f'(0 O Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. MAP PARCEL Location(Street&Number) Owner or Tenant Owner's Address -S-/ O-CC Is this permit in conjunction With a building permit: Yes[:�No r7 (Check Appropriate Box) -TL-.tPNA Purpose of Building i9f S Utility Authorization No. Existing Service Amps / Volts Overhead 0 Underground M No.of Meters New Service `Z-y0 Amps r ,j/-L-Cc)Volts Overhead r-7 Underground 0/ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work + tom`-=�() �5,L-A.J\-C c No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total ,to KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA `Oground ground No.of'Receptacle Outlets a No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets t l (' No.of Gas Burners No.of Ranges No.of Air Cond. + Total ( FIRE ALARMS No.of zones L Tons 4� No.of Disposals ` No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices 1 No.of Self Contained Detection/Sounding Devices Z No.of Dryers HeatingDevices KW Local Municipal Other lCormccuons No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP • OTHER• o _ fiMrd=COM .RmntttDdrieglzmxr dNtmadsseltsCvnaalLaws �/ IhaNeaamemI blityhis== 6bgyn1t�C.crT1 CowraF or its sk6writel egmaiat YES NO I1mestfiTmWdNWdpudofsa=totheOfce YES ' ✓ ' NO r7 IfywhaNedniodYFS,pl=mdc*thet FctmwrWbyd�tgthe INSURANCE �BOND M MHERgpupialebcx —+ (Please Speafy) 1 EstimaMdVa1wdE1aZcal Wade$ WaktoStazt bl oo Ir>SpacnIateReqxsted Rottgtt Final SigmdurdX-Tr i ofpajuy: FUO,� L4--' cam-f VL c I c S IioaneNo c fo Lioaisae /teLLl�r A`- � Lie eNo 2 kC�� BtaalessTelNa O 3i5 b S� AIL Tel.Na OWNERS24SUR NCE WAIVER;Iamaw&etha d-Adensedoesm0aNetheitstaame critssub a eg�asmgmedbyMm�GdugLaws audthatmysigr abjernthispmMapplictimwdiuslhisreq.>IIan (Please check one) OwnerAgentEl t'J < OV Telephone No. PERMIT FEE$ < Signature o wner or Agent Date. -X t, No ",O 07: qac TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SSACMUS� This certifies that . .,�. . . . �.-r? . . . . . . . . . . . . . . has permission to perform . . . . . . ... . . . . . . . . . . . . . . . plumbing in the buildings of . . ;. r. r . . . . . . . . . . . . . . . . . . . at . !.•. . . . : . : . . . . . . . . . North Andover, Mass. Fee. , . . Lic. No.l .'. `! . . . . . . . . . : . . . . : .'. . ;:,. . . . . . PLUMBING INSPECTOR Check # L' % j WHITE. Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PE T TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS I,� Date C9 v Building Location 6 `n /",I , Owners Name G O Permit# Amount Type of Occupancy 31 ,�G D to P New Renovation El Replacement Plans Submitted Yes No El FIXTURES wCn x a Q Q" E� -, W H d W 1.., ''" d U aCr w a Zn W A a s w W W a 16 H d F w w r Z r d d F. a Q m SCIR4VE / IIk9RW T ta Fri l i ZU MOM M FyoaR aHi R9 R 5M HJOC R 61H F-OCR 7M FLOCIR s>H Film (Print or type) r Check one: Certificate Installing Company Name , C[i�� /- / 13�J � El Corp. Address q 3 606 ed A7CU Al a— FlPartner. e, /q,4. Business Telephone 37-30 (o Z/ El Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 9--- 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 ins lations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the MassacKs,4ts State Pl bhapter 142 of the General Laws. By: sip ot Linseaum er ype of Plumbing License Title S 7�o ' 3 City/Town icenseFlumoer Master F1 Journeyman 0/ APPROVED(OFFICE USE ONLY I_I Date. . . .... .. ... . . ........ OORTM TOWN OF NORTH ANDOVER pf "'S. I. 0 PERMIT FOR GAS INSTALLATION ,"SAC SEt � J This certifies that . . . . . . . . . . . . . . . . . . _:f:; . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . = . . . . . . . . . . . . . . . . . . . in the buildings of . . . . . . . . . . . ... . . . . . .`!. . . . . . . . . . . . . . . . . . . . . . at ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. North Andover, Mass. Fee. . . . . . . . . Lic. No.. . . _�. . . . . . . . . . . . ... . . . . ... . . . . . . . . . / GASINSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer /7sr MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO GAS FITTING j T Type or print) Date 7 � GNU 19 NORTH ANIQOVER, MASSACHUSETTS F I ---b �a Building Locations IAO hill / )C1"/7 BR, Permit# i Amount S f Owner's Name 54H 1�el j4N D i New Renovation ❑ Replacement F-1 Plans Submitted ❑ n ,N m n Cn Z C w N Z z C Zz G (� Cn z _ w _ Cn z -t SU 3-6 :1SEY1 ENT BASE ,v1 ENT IST. FLOOR 2N D . FLOG R 3RD . FLOOR 4T H . F L O C K 57 5 . FLOOR----- 6T LOOK6T 1i F L O O R 7T11 . FLOOR 3Tfi . FLOOR ; (Print or type) 'T f 2/, A Check one: Certificate Installing Company Name �J�'J,S��t� l/ r t ro '� ❑ Corp. Address :7 L000o(XO11) Ave ❑ Partner. Business Telephone 7 '�� ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalpnt. Yes Nom If you have checked ves,please indicate the type coverage by checking the appropriate box. 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 Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Sienature of Owner or Owner's Agent Owner ❑ AQent ❑ 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 ins Ilations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Llassac s tts State,Gas apd hapter 14" of the General Laws. � y` By: Sig ature of Licensed Plumber Or Gas Fitter j Title 1-5umber7v- 3 l City/Town ❑ Gas Fitter Icense I umoer I ❑ Master i r7 Journeyman APPROVEDn (()Eer: O USE NI.YI f I I i A AX Say State Gas Company CVN � GAS INSTALLATION AUT ORIZ ION � Date a- Issued to _ Address For Installation of: BTU Input Restrictions BSG Representative PERMIT ISSUED BY INSPECTOR This Portion of Authorization To Be Returned to BSG. Inspection Has Been Made of the Following Gas Equipment: ❑ Heating System (BTU Input ) ❑ Range ❑ Water Heater ❑ Clothes Dryer ❑ Room Heater Location All Work Has Been Done In Accordance With The Massachusetts State Gas Code And Is Ready For Use. INSPECTOR NO POSTAGE NECESSARY IF MAILED 'IN THE UNITED STATES BUSINESS REPLY CARD FIRST CLASS PERMIT NO.721 LAWRENCE,MA POSTAGE WILL BE PAID BY ADDRESSEE BAY STATE GAS COMPANY ATTN: SALES DEPT. 55 Marston Street Lawrence, MA 01840 III III►►►II I►►I►►i►►I►►I►II►I►►I►I►►I►►►il►►i►poll II Location No. CGS Date MORTh TOWN OF NORTH ANDOVER � 9 Certificate of Occupancy $ �sJACMUSE� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ /n TOTAL $ Check # —�_•-L ` Building Inspector CERTIFIED PLOT PLAN PekA LOCATED IN NORTH ANDOVER, MASS. C 6 A SCALE.-I"=30' DATE:6/8/2000 Scott L. Giles R.P.L.S. G Frank. S. Giles 50 Deer Meadow Road North Andover, Mass" �G �2 s� 5y "90 a� LOT 6 PLAN 1657 N.E.R.D. ��� R=20.00' �0 15,148 S.F. ��.Q, L=31"42' CORRECTED AREA ,ya 2� lox,/ o 66 41 ' 0 I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE THE OFFSETS EAT Of OF THE BUILDING INSPECTOR ONLY SHOWN COMPLY ooS s AND SUCH USE IS FOR THE WITH THE ZONING ES H DETERMINATION OF ZONING ,13972 4' 0 NORTH A BYLAWS OF CONFORMITY OR NON-CONFORMITY s��fGISTER��JQ�``� WHEN BUILT WHEN CONSTRUCTED. ��< LAMS ��e �o I I I I CERTIFICATE OF USE & OCCUPANCY Town Of North Andover Building Permit Number Date �D a� -(D 4 THIS CERTIFIES THAT THE BUILDING LOCATED ON l IT11 A.) R( V MAY BE OCCUPIED AS S(A-) ('IL—FA4u( tV DW-5-41M IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO �'�VVI d �- ��t fa-A-' ADDRESS CHO7t' Building I pector i NORT1y U. ". I -ndover Town of No. 2a4 1L LAo '� dower, Mass. �— to COCMICMEWICK ' ' �QO RA TED p ��C S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT-15.0.M *AAV 47.....�r/....01 AJd ��M,��� I ........................................................................ Foundation !�'°''� has permission to erect........................................ b ildings on ... ....,N�.�. �C I N...... ....... Rou hE � to be occupied as.....6... Ql? oZ.. a . /...0�..bTal1AAAAh.ed...S.�!V�. ...PI�t��/�lA� ci,imne � 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 to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. pd� PLUMBING INSPECT VIOLATION of the Zoningor Building / ''_ � `��'-- Bu d ng Regulations Voids this Permit. ou G PERMIT EXPIRES, IN 6 MONTHS UNLESS CONSTRUCTION ST TS R ELECTRIJ, /..# ... -................................... ............. .... / BUILDING INSPECTOR Fina Occupancy Permit Required to Occupy Building GAS 6INSP TOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough I 1c , G 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 Det. ^� � " SS o N � r 9 t Town of North Andover NORTH q O �v + ,6 Building Department �,? 9t; ` �'•*6 0 27 Charles Street o North Andover, Massachusetts 01845 * ,� (978) 688-9545 Fax (978) 688-9542 T ° CO[NL1CW K• 1' AT Ss �SSACNU`r�� APPLICATION FOR CERTIFICATE OF OCCUPANCY/ INSPECTION && , v9g7 ADDRESS 7 M 1 � i f i N DY-1 t Y-1r V--P, LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION 0 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 rexl�_ OFFICIAL USE ONLY ROUTING — ,1 CONSERVATION DATE �V PLANNING I' DATE D.P.W. —WATER METER DY_ T.T� DATE Io-19 -60 D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO T INSPECTION REQUEST DATE. 7� SIGNA / W AUTHORIZATION