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HomeMy WebLinkAboutMiscellaneous - 40 PALOMINO DRIVE 4/30/2018 I
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Location
loj,5A -d I-10 A 10,41 w a br,
No. `3 t Date
NORT►, TOWN OF NORTH ANDOVER
f 1
I
� a
' Certificate of Occupancy $ /
cN st Building/Frame Permit Fee $ `
Foundation Permit Fee $
Other Permit Fee $
TOTAL
Check ,, ! f
` Building Inspector
OCT-12-2000 09 : 13 AM MARCHIONDA&ASSOCIATES 781 438 9654 P. 02
- �D P 1691y, 1 .v 0
.perm 4 a - 1,-30-00
N2 96'3rW 71.48'
N2716'37-* 73 36•
LOT 5A
11414&r. 63.1'
eta s,v.
0.27 Ae.
18.31
18.5'
1`$
81106 q.
ays' TOP FOUNDATION � 0.28 Aq.
a-' ELEVATION-160.10 to
27.9' e
18.3' a
.6'
27 -toat4'
28.4' 29.8' 0-,s•4#3t'
R-376.00'
R-373.0ol e-18'61'10'
PALOMINO DRIVE
A�13K6 B3
R-42S.00' .� ••.
iA UP 4t
7A-06'3 STEPHEN M. ",MELESCIUC i-100.00
� p A-136,8'53"
No. 39049 ` R-426.04 o-43'£.'63"
R-{26.00'
vT
�p IZCpp WE HEREBY CERTIFY THAT WE HAVE EXAMINED
THE PREMISES AND THAT THE BUILDING IS LOCATED
THIS PLAN IS INTENDED FOR ZONING AS SHOWN. THE STRUCTURE SHOWN CONFORMS
PURPOSES ONLY_ IT WAS PREPARED TO THE ZONING LAWS OF THE MUNICIPALITY
FROM EXISTING PLANS AND RECORDS WHEN CONSTRUCTED. ALSO, ACCORDING TO THE
WITH THE STRUCTURES SHOWN LOCATED F.E.M.A./H.U.D. FLOOD INSURANCE RATE MAP,
BY AN INSTRUMENT SURVEY. THIS PLAN COMMUNITY PANEL NO. 250098 0015 C
SHOULD NOT BE USED FOR PROPERTY DATED 8/2/1993 , THE STRUCTURE IS NOT LOCATED
LINE DETERMINATION. IN AN ESTABLISHED 100 YR.FLOOD HAZARD ZONE,
CERTIFIED FOUNDATION FLAN
LOT 5A FOREST VIEW ESTATES MARCHIONDA & ASSOC.,L.P.
NORTH ANDOVER, MA ENGINEERING AND PLANNING CONSULTANTS
PREPARED FOR 62 MONTVALE AVE. SUITE I
PULTE HOME CORP. OF NEW ENGLAND STONEHAM, MA. 02180
257 TURNPIKE ROAD SUITE 200 (781) 4386121
SOUTHBOROUGH, MASSACHUSETTS 01721 SCALE:1 =20 DATE: 10/12/00
Location
No. c � Date
NORTH TOWN OF NORTH ANDOVER
3? • 0
41
Certificate of Occupancy $
'� b'•••°'E<�' Building/Frame Permit Fee $
JACNus
Foundation Permit Fee $
Other Permit Fee $
TOTAL $ fiSQ.
Check #
13
' `a 6 Building Inspector
s it i Dev Groupe Fax:978-5578160 Jun 13 2000 1243 P.02
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
TPLICATION TO CONSTRUCT REP.k2.RENOVATE, OR DF-MOUSE A ONE OR TWO FA,; MY DWELLING
V.�...
.— wv.e T .6."-�y
;UILDLNG PERMIT NUNMER. DATE ISSUED: W.
AGN ATURE: _
Building Commissioner or of Buildin Date
';ECTION. I-SITE 124YOR A^nON ! [ - ] Z.
1.1 Prepaty Address: 1.2 A&scza s Map and Pared NZ amber W. O
P410A NO 1 r-i'vt /Or C
Map Numbs Parcd,tumbc
F-6S't VIEW EStA71 s
1.3 Zoning 1IIfOfC =Oa: 1.4 Prvpaty Dua=mcns:
-
:on in-,Disuna Prov $e � Ld.area sf) Frcmi� K)
.6 BUILDING SETBACKS(ft)
Front Yard Side Yard Rear Yard
Required Pro--ide Regured Provided Required Provided
�.
!3
Su¢p tv M.G.LC.40. 54)
J. Flood Zone IammYtion: l.3 Seor I}spusal Sysie>b
3btic Ll P,-. Lo I Z=4 outside Flood Zoan `fnmicral Q Oa Site I?ispoul Syr--m 7
3ECTION 2-PROPERTY 0WNTMHM1 THOR=AGEi m
�.1 Owner of R-.,r-ord
Moo P-,-s LC st
Jame(Print) Address for Service: MIA (c
L 1
3 nature Telephone
?.3 Owner of R -ord:
0
Name Print .address for Service: z
M
signature Tcieohone
8EMON 3 - CONISTRUCTIOIY SERVICES
3.1 Licensed Construction Super:;sor: NotAppGcacie ❑
Licensed Construction Supervisor.
License Number
()All ons S t N00 vrrz #,-
Address 6—Z 3-Z�7
os-- OOa•;21CaS y Expiration Dare
fff131uTC Telephone
3.2 Registered Home[mprovcment ConLm=r Not AppLcable C ❑S
(Company Name M
Rcgistra-aen Number ]^
Address
Expiration Cate G
t
Me s i t i De v Group Fax:978-5578160 Jun 13 2000 1243 P.03
SEC PION 4-WORKERS COMPENSATION(XG.L C 152 § 25-z(6)
Workers Compensation fnsurance 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......1K No.......0
SECTION 5 Description of Proposed Work: check all a tkable
New Construction Existing Building 0 Repair(s) ❑ Alterations(s) ❑ Addition 0-
Accessory Bldg. 0 Demolition 0 Other 0 Specify
Brief Description of Proposed Work:
Gc�4r'JL7 I=a/VAAI= "Z ;I'/VQ& !A:: M11/ /�nniZ S'f0 X; l
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to beM.
Completed by t a -olicant =>_'�W I -
1. Building �- (a) Building Permit Fee
Multiplier
2 Electrical (b) Estimated Total Cost of (� 2
Construction
3 Plumbing 900( Building Permit f;�e
4 'Mechanical(HVAC) 9a-0 -
i Fire Protection
6 Total (1+2+3+4+5) 6— Check Number
SECTION 7a OWNER AU'T'HORIZATION TO BE COMPLETED WBEN
OWN-ERS
/AGENT OR CONTR[A,CT/O'R APPLIES FOR BUMDDI G PERMIT
I, >�_ fZ ��/t 6^� __ ,as Owner/?Liz Lorized Agent of subject property
Hereby authorize to act on r
ivtV ben lt: a tter elative to work authorized by this building permit application.
Si?na e o[ caner Date
SECTION 7 WNE . UTHORIZED_GENT DECLARATION
as Ou-e/ uthorized Agent of subject
property
Hereby declare chat the statements and information on the foregoing application are true and accurate,to the best of my knowledge
aiid-elief
Print NG /Z.P/d
Sisnature of O�vnzr/R,znt .
Dat—
9 MIKE I WIN=
NO. OF STORIES SIZE ,4i 2X3 4 ;l2 ZOKZ
BASE vCN-I OR SLAB /}' _^
SIZE OF FLOOR TEMBE.RS 1' fr 2' qtr L 3 JC Fr
SPAN
D2v ENSiONS OF SILLS .2 ArU
DIMENSIONS OF POSTS
DIRMENS[ONS OF G=ERS 'Z l Y y X 2 L
PEIGI-tT OF 90UNDATR)-\1 7—% t?IICIC SS /
SIZE OF FOOTli`fG .4 X <
L'vLATERIAL OFC O — /%/C.
IS BUILDNG ON SOLID OR FI�.LED L,kN-D
IS BUUI DNG CONNECTED TO tiyTURAL GAS L�+t
Mt—SM De / 13roup gun to 2uuu 12;�u r. 1J
1
Y FORK[ - U - LOT RELEASE FORK[
INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve the
applicant and or landowner from compliance with any applicable requirements.
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APPLICANT
, PHONE SOS-;rte-ax�a xsS�
ASSESSORS MAP NUMBER /O�', C LOT NUMBER. � �3
SUBDIVISION U2E5/��/lam��� LOT NUMBER
STREET C/X16 SI NUMBER �/G>
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OFFICIAL USE ONLY
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RECON2vlENDATIONS OF TOWN AGENTS
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DATE APPROVED �+ ZZ Oct
CONSERVATION ADNLINISTRATOR
DATE REJECTED
c�Nir�rrs —,
DATE APPROVED
TOWN P
DATE REJECTED
CONINfEN TS
DATE APPROVED
FOOD INSPECTOR- TH DATE- REJECTED
DATE'APPROVED 2- 00
SEPTIC INSPECTOR-HEALTH
DATE REJECTED
C OivMEN-iS
PUBLIC WORKS -SEWER/WATER CONNECTIONSC li?zr�Y( �t/4+�s f� '�:f/
DRIVEWAY PERNSI
DATE APPROVED
FIRE DEPARTINf1'NT -
DATE REJECTED
f 1,
COtvIIvffi_NTS
RECEIVED BY BUILDING INSPECTOR DATE
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1 II 1 5+00
1 1
1 1
L.P. \ \
- - 159XO
=150.7 \ \
-7r= 1 60.00 O \ \
— � CF= 152.50 Qo U\ \
16' BF- 151 .30 Ln
S6 HUNINGTON \\ \
7 \
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80T=154.5 �� \
152 (
cn
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IOT 6A
lrQT _5_A _ o���P °F��ss �
11 ,414 SF t
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PULTE HOME CORPORATION RESERVES THE RIGHT Td'MAKE FIELD CHANGES TO THIS PLOT PLAN
V,
IN ORDER TO ACHIEVE PROPOER SITE DRAINAGE, MEET SETBACK REQUIREMENTS, AVOID LEDGE OR
ACCOMMODATE THE CONSTRUCTION OF THE HOME IN THE MOST OPTIMUM WAY. THESE FIELD ADJUSTMENTS
sill
MAY BE MADE WITHOUT CONSULTATION WITH THE BUYER IN ORDER TO EXPEDITE THE CONSTRUCTION OF THE HOME,
PROPOSED SITE PLAN
LOT 5A FOREST VIEW ESTATES MARCHIONDA & ASSOC.,L.P.
NORTH ANDOVER, MA ENGINEERING AND PLANNING CONSULTANTS
PREPARED FOR
PULTE HOME CORP. OF NEW ENGLAND 62 STONONEHAAM, AVE. SUITE I
, MA. 02180
257 TURNPIKE ROAD — SUITE 200 (617) 438-6121
SOUTHBOROUGH, MASSACHUSETTS 01772 SCALE: 1"=20' DATE: 6/27/00
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PULTE HOME CORPORATION RESERVES THE RIGHT TO MAKE FIELD CHANGES TO THIS PLOT PLAN Osvvv,
IN ORDER TO ACHIEVE PROPOER SITE DRAINAGE, MEET SETBACK REQUIREMENTS, AVOID LEDGE OR
ACCOMMODATE THE CONSTRUCTION OF THE HOME IN THE MOST OPTIMUM WAY. THESE FIELD ADJUSTMENTS
MAY BE MADE WITHOUT CONSULTATION WITH THE BUYER IN ORDER TO EXPEDITE THE CONSTRUCTION OF THE HOME.
PROPOSED SITE PLAN
LOT 5A FOREST VIEW ESTATES MARCHIONDA & ASSOC.,L.P.
NORTH ANDOVER, MA ENGINEERING AND PLANNING CONSULTANTS
PREPARED FOR
PULTE HOME CORP. OF NEW ENGLAND 62 ON ,
STONEHAAMAVE. SUITE I
, MA. 02180
257 TURNPIKE ROAD - SUITE 200 (617) 438-6121
SOUTHBOROUGH, MASSACHUSETTS 01772 SCALE: 1"=20' DATE: 6/14/00
Mes it i Dev Group Fax:978-5578160 Jun 13 2000 1253., P. 18
BUILDING DEPARTNM-I- T
DEBRIS DISPOSAL FORb!
In accordance with the puwisions of vIGL c 40 S 54, a condition of Building Permit Number
Is that the debris resulting form this work shall be disposed of in a properly licensed solid waste disposal facility as
defined by MGL c 11, S 150A
the debris will be disposed of in:
Location of Facility
Sipmum orpermit Applicant
�atee
1=: Demolition permit from the Town of North Andover must be obtained for this project through the Offtce of
the Building Inspector
it
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19
13 2000.. . ...-....-.
setts
lt; De`.?...Gr°vp hof Massacidents
MPs . wealt al Acc
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The Go�me�t of in �t�gatio 15
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GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT
TOWN OF NORTH ANDOVERBUILDING DEPARTMENT
This form shall be used to assist the Building Department in their determinaUon of exempttolr under section
8.7.6 of the Town of North Andover Growth Management Bylaw. The applicant shall provide all of the
necessary information as requested below.
Permit Applicant Property aaddress Ma !Parce
Sad-7�7-coca x ash �X
Applicant's Phone Number Single Family Two Family
I the undersigned applicant for the above property attest that the attached building permit for which this form is completed'
does comply with the EXEMPTION section 8.7.6 oftheGrowth Management Bylaw.I also understand providing this form does not
absolve me or any party to this permit from the requirements of obtaining other.peratits required prior to the issuance of the building:
permit Further I understand that my interpretation of the exemption status is subject to review by the BuildingDcpaitment and.is only
officially accepted when the building permit is issned
Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above]ot,.in the building
permit application and associated attachments,complies with one or more ofthe following sections as indicated by check marls
This is an application for a building permit for the etlargemeut.restoration or reconstntction of dwelling in eaosteuce as
of the effective date of this bylaw,provided that no additional residential unit is created.
The lot(s)was I were created prior to May 6,1996 and are exempt from the provisions of section 8.7 of the Zoning Bylaw.
This application is for dwelling units for low and or moderate income families or individuals,where all of the conditions'. .
of 8.7.6 are met and cr represents dwelling units for senior residents,where occupancy of the units is restricted to senior citizens
through a properly executed and recorded deed restriction running with the land.For purposes of this section"senloT'.shall mean
persons over the age of 5 5.
This application is part of a development project which voluntarily agreed to a minimum 40%permanent reduction m
density(buildable lots)below the density permitted under zoning and feasible given the environmental conditions of the tract;with.ihe.'
surplus land equal to at least ten buildable acres and permanently designated as open space or farmland.The land to be preserved shiill.
be protected from development by an Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town or`c(lier
similar mechanism approved by the planning board that will ensure its protection.
This application represents a tract of land e_risting and not held by a Developer in common ownership with an adjacent'. '.
parcel on the effective date of this Section 8.7 and shall receive a one time exemption from the Planned Growth Rate and
Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the.pncel..
This application represents a lot which is ready for a buildingpermit(all other permits from all other-boards and
commissions have been received and the projed is in compliance with those permits),and the Development Schedule does not,.
accommodate issuing a building permit in that year.One building permit will be issued per year per Development until such time as,
the developmem schedule accommodates issuing building permits Applicant must submit an approved FORM U with this
EYEliPTION.
PLEASE PRO VIDE.lN Y AND ALL NFOR ViATION THAT WOULD ASSIST THE BUILDING DEPARTMENT N MAKING A.
DETER,VIINATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE EXEMPTIONS. .
BY SIGNING BELOW I ATTEST TO THE ACCURACY OF TEE IN- FORMATION PROVIDED AND THAT THE ATTACHED
BUILDING PERMIT IS ALLOWED AN EXEMPTION AS CITED ABOVE.
FURTHER I UNDERSTAND THAT THE SUBMITTAL OF MISLEADING OR INACCURATE NFOfl.MATION OR THE
CHECKLNG OFF OF A ABOVE E.{MMPTION WHICH DOES NOT COMPLY,WHETHER DONE TO MY XNO WLEDGE.OR'
NOT IS
GROUNDS FOR REFUSAT,BY THE BUILDING DEPART1vIENT TO ISSUE A BU LDNG PERNT[T.
APPLICANTS SIGNATITRE DA
THIS FOR1I1 TO BE ATTACHED TO THE BUILDING PERIVfIT APPLICATION
w ..
� yR`_ �'�r� .c•-1 � �°.--��rr � v.' �3 .a a i+,..n r-' ' d�i•'r�-Y�^'°,��
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MAScheck COMPLIANCE REPORT
Massachusetts Energy Code Permit #
MAScheck Software Version 2.01
Checked by/Date
CITY: Andover
STATE: Massachusetts
HDD: 6322
CONSTRUCTION TYPE: 1 or 2 Family, Detached
HEATING SYSTEM TYPE: Other (Non-Electric Resistance)
DATE: 6-16-2000
TITLE: Lot # 5A Huntington Elevation #1 Forest View
PROJECT INFORMATION:
Forest View North Andover, MA
COMPANY INFORMATION:
Pulte Home Corporation New England Division
NOTES:
Customer purchased elev. #1, one walk out bay, one additional window,
& a transom package.
COMPLIANCE: PASSES
Required UA = 527
Your Home = 527
Area or Cavity Cont. Glazing/Door
Perimeter R�Valuee R-Value U-Value UA
------------------------------- ---- -O-O51
---------------- --
CEILINGS1708 `�°�_'
WALLS: Wood Frame, 16" O.C. 2567 3 .0 0.0 211
GLAZING: Windows or Doors 537 0.330 177
DOORS 44 0.280 12
DOORS 20 0.160 3
FLOORS: Over Unconditioned Space 280 30.0 0.0 9
FLOORS: Over Unconditioned Space 1428 21.0 0.0 63
FLOORS: Over Outside Air 16 30.0 0.0 1
HVAC EQUIPMENT: Furnace, 80.0 AFUE
COMPLIANCE STATEMENT: The proposed building design described here is
consistent with the building plans, specifications, and other calculations
submitted with the permit application. The proposed building has been-
designed
een 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 12,.5.-. of the design load as specified in
Sections 780CMR 1310 a
Builder/Designer LLDate
i
MAScheck INSPECTION CHECKLIST
Massachusetts Energy Code
MAScheck Software Version 2.01
Lot # 5A Huntington Elevation #1 Forest View
DATE: 6-16-2000
Bldg.
Dept.
Use
CEILINGS:
1. R-38
[ ] Comments/Location (�
WALLS:
[ ] 1. Wood Frame, 16" O.C. , R-13
Comments/Location I-C3//J�
WINDOWS AND GLASS DOORS:
[ ] 1. U-value: 0.33
For wind--
without labe e -values, describe feature
# Panes �' Frame Types Thermal Break? [ Yes [ ] o
Comments/Location �f
DOORS:
[ ] 1. U-value: 0.28
Comments/Location
[ ] �
2. U-value: 0.16
Comments/Location v
I
FLOORS:
[ ] 1. Over Unconditioned Space,
Comments/Location
( ] 2. Over Unconditioned Space, gy21
Comments/Location i1 LI['(9 �J� � � �j /� J✓
[ ] 3. Over Outside Air, R-30
Comments/Location w w�
HVAC EQUIPMENT:
[ ] 1. Furnace, 80.0 AFUE or higher n
Make and Model Number !i
AIR LEAKAGEc- -
[ ] ( Joints, penetrations, and all other such openings in the building
envelope that are sources of air leakage must be sealed. When
installed in the building envelope, recessed lighting fixtures
shall meet one of the following requirements:
1. Type IC rated, manufactured with no penetrations between the
inside of the recessed fixture and ceiling cavity and sealed or
gasketed to prevent air leakage into the unconditioned space.
2. Type IC rated, in accordance with Standard ASTM E 283, with no
more than 2 .0 cfm (0.944 L/s) air movement from the the
conditioned space to the ceiling cavity. The lighting fixture
shall have been tested at 75 PA or 1.57 lbs/ft2 pressure
difference and shall be labeled.
i
I I
VAPOR RETARDER:
' ( ] Required on the warm-in-winter side of all non-vented framed
ceilings, walls, and floors.
MATERIALS IDENTIFICATION:
[ ] 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 shall be insulated per Table J4.4.7.1.
DUCT CONSTRUCTION:
[ ] All accessible joints, seams, and connections of supply and return
ductwork located outside conditioned space, including stud bays or
joist cavities/spaces used to transport air, shall be sealed
using mastic and fibrous backing tape installed according to the
manufacturer's installation instructions. Mesh tape may be
omitted where gaps are less than 1/8 inch. Duct tape is not
permitted. The HVAC system must provide a means for balancing
air and water systems.
TEMPERATURE CONTROLS:
[ ] Thermostats are required for each separate HVAC system. A manual
or automatic means to partially restrict or shut off the heating
and/or cooling input to each zone or floor shall be provided.
HVAC EQUIPMENT SIZING:
[ ] 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.
[ ] SWIMMING POOLS:
All heated swimming pools must have an on/off heater switch and
require a cover unless over 20% of the heating energy is from
non-depletable sources. Pool pumps require a time clock.
[ ] I HVAC PIPING INSULATION:
HVAC piping conveying fluids above 120 F or chilled fluids
below 55 F must be insulated to the following levels (in. ) :
PIPE SIZES (in. )
HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4"
Low pressure/temp. 201-250 1.0 1.5 1.5 2.0
Low temperature 120-200 0.5 1.0 1.0 1.5
Steam condensate any 1.0 1.0 1.5 2.0
COOLING SYSTEMS:
Chilled water or 40-55 0.5 0.5 0.75 1.0
refrigerant below 40 1.0 1.0 1.5 1.5
[ ] CIRCULATING HOT WATER SYSTEMS:
Insulate circulating hot water pipes to the following levels (in.) :
PIPE SIZES (in.)
NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS
HEATED WATER TEMP (F) : RUNOUTS 0-1" 0-1.25" 1.5-2.0" 2.0+"
170-180 0.5 1.0 1.5 2.0
140-160 0.5 0.5 1.0 1.5
100-130 0.5 0.5 0.5 1.0
----NOTES TO FIELD (Building Department Use Only) -------------------------
211 = � � '�-�� ' (�'a�''d
22.12 ; �h��s� X� �'� � �n1���1
�� '11 = J�f�� ��� �` 1��� t al� �z 1
z��zl = ��'���t x�� z z -z�a� Z
L� LI = �'����5 "2h> � Wa`'""�1/ice Z - J�lol f
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, CERTIFICATE O F INSURANCE ISSUE DATE: 6/16/00
THIS CERTIFICATE IS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURED COMPANIES AFFORDING COVERAGE
COMPANY A Pacific Employers Insurance Company
COMPANY B
COMPANY C
COMPANY D
COVERAGES
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 SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
EFFECTIVE EXPIRATION
CO TYPE OF INSURANCE POLICY NUMBER DATE DATE LIMITS
GENERAL LIABILITY GENERAL AGGREGATE
COMMERCIAL GENERAL LIABILITY PRODUCTS-COMPIOP AGG.
ON AN OCCURRENCE BASIS PERSONAL&ADV.INJURY
EACH OCCURRENCE
ADDITIONAL INSURED: FIRE DAMAGE(Any one fire)
MED.EXPENSE(Any one person)
AUTOMOBILE COLLISION DEDUCTIBLE
COMPREHENSIVE DEDUCTIBLE
LOSS PAYEE:
COMBINED SINGLE LIABILITY LIMIT
(Owned,Hired&Non-owned)
ADDITIONAL INSURED:
EXCESS LIABILITY EACH OCCURRENCE
AGGREGATE
WORKER'S COMPENSATION and WLR C4 301187A 5/1/00 5/1/01 STATUTORY LIMITS
................................................................................................................
A EMPLOYERS'LIABILITY EACH ACCIDENT $1,000,000
MA,NV SCF C4 3011881 5/1/00 5/1/01 DISEASE-POLICY LIMIT $1,000,000
DISEASE-EACH EMPLOYEE $1,000,000
PROPERTY REAL AND PERSONAL PROPERTY,INCLUDING WHILE
LOSS PAYEE: IN COURSE OF CONSTRUCTION:
PER OCCURRENCE LIMIT
MORTGAGEE: SPECIAL FORM(INCLUDING FLOOD AND EARTHQUAKE)
DEDUCTIBLE PER OCCURRENCE
OTHER
If DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Ij
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED e
BEFORE THE EXPIRATION DATE THEREOF,WE WILL ENDEAVOR
TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE
HOLDER NAMED TO THE LEFT.
AUTHORIZED
REPRESENTATIVE/ �h��C _
®RTH
Town oAndover�.:
No. ®
3e2Y _
C% LAKE - O ndover, Mass., 6-c3a'-DD
COCMICMEWICK �•
AORgreo A��\���
IT
FOR
EXCAVATION
FOUNDATION
THIS CERTIFIES THAT ... �V O N 0 r
..... .....
.. .... ........ . .......................... ..... ................................................
has permission to excavate and pour B.A ....foundation at 19 pQ �NQ.... ......... .
..........
for the purpose of.............S... . ..i�.�i�.... V 1!1�1..� .. w th.#.v ............... ... . . . .... ....... .. .
The person accepting this permit mu return to the office of the ilding Inspector a certified plot plan show
of building thereon before Foundation will be inspected. moose
� �O� ��D �•
VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS
The holder of this Foundations Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS
assurance that a permit for entire building structure will be granted.
y
4csP
..... .........................................................................
"" BUILDING INSPECTOR
NORTH
Town of Andover
No. 70
75
_ A o * dover, Mass., NO D
2COCHICMEWICK
ADRATED
S
BOARD OF HEALTH
i
PERMIT T Food/Kitchen
i
Septic System
i
BUILDING INSPECTOR
THIS CERTIFIES THAT............ . ... ... 40
. ......... ... .......* ......... 0��
............................................... Foundation
has permission to erect............... .................. . buildings on . . QAQ.....PA..�O.IN+1. .0... .• ' Rough
t
to be occupied as.I.Q� ,a.�. A.....f�.. ...... C�1............SIN� C Dwiga;� Chimney
provided that the person accepting this permit shall in every respect conform to the terms'6f the application on file in Final
this office, and to the provisions of the Codes and By-laws relating to the Inspection, Alteration and onstruction of
Buildings in the Town of North Andover. ' O 8 a io3 ' I e PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS
LESS CONSTRUCTI ST ELECTRICAL INSPECTOR
. 5 {;��IFEE& 13 �., • Rough
LIES FOS, rE7c* O Service
......... ...... .. ... ..... .. ....... ... ... ...
... ................
irr , �� �� ;y" `q UILDING 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 Det.
B !ling Value Calculation - for Property at.....
lotSQ_ forestF�ier�r� _ w 1. � �
Room Length Width Sq.Ft. . Cost per Sq.Ft. Total Cost
Kitchen 21 16 336.00 65 $ 21,840.00
Living Room 16 13 208.00 65 $ 13,520.00
Dining Room 16 13 208.00 k 65 $ 13,520.00
FamilyRoom 19 16 304.00 xr
19,760.00
Study 12 16 192.00 12,480.00
Laundry 12 6 72.00 65` $ 4,680.00
Garage 20 20 400.00 14,000.00
Entry 18 9 162.00 ,. 65; $ 10,530.00
Basement Finished 65 $ _
Deck - -
s
Screened Porch - �
Breakfast Nook 14 10 140.00 " n x65 $ 9,100.00
�,
Bedroom 1 19 17 323.00 , " `65j $ 20,995.00
Bedroom 2 19 13 247.00 z °h , 6S $ 16,055.00
Bedroom 3 6 13 78.0065 $ 5,070.00
Bedroom 4 12 12 144.00 ,'- 9,360.00
Bedroom 5 12 14 168.00 Y6 > $ 10,920.00
Bathroom 1 14 12 168.00 ` a f5 $ 10,920.00
Bathroom 2 5 8 40.00 r ;r 6S $ 2,600.00
Bathroom 3
Bathroom 4
Bathroom 5 F $
$ 195,350.00
Ae o 11)7 s c;2 V,-,7 /3,
7*64
A) (/0 0 _
� s