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Miscellaneous - 409 WAVERLY ROAD 4/30/2018
Q' �' W m a L) U ti m O H O W N O N w L ❑ Z s W V) � C --.9 .0 Lli O yW V Z W W w H �1 fr cn .. Z O W Q❑z O Q LLJ U00 LZ ¢0ZMN ¢ I I cn ❑ xMZ 15 N - � N F— Y U o < x < Q). W2500 W N Z q CifLSI oZ m II m F- Z}� W FS �- Z j O _ :- V) W2 U) O ❑ W (n w�~ ¢p X Z p O � LL - rr "z1 Q ~ J z = t= p V 0z0 Z 00L N _.Ocnp W m a L) U ,. m O H O W N O N o L ❑ Z s W C --.9 .0 Lli O yW V W H � cn .. O Q LLJ U00 � Z Q � LO z rn O Q U W ~ CY Q W a L) ,. m H O W N O N W L" II x Z s C --.9 .0 O yW V LA 9964 Date ......... .......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING WIM"W * /* 7— Thiscertifies that ............................................................................................. has permission to perform .......... . ........... .............. wiring in the building of ............... 14 ........................................................ at ......... ......... ........................ C .................... . NorthAndovei, Mass evj— Fee.... Lic. No . ............. .................... ....... .. S;E . ...... Check # 3 4,7S- 7Z- ELi IC' "i EC�TOR��,/-- :;�012 iii'ass a ents 527 CMRIZ.00 Rule 8: Inaccordance-withthe7provisions ofM.G.L. c. 143� §.3L, the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and apprications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires aplointed pursuant to M 01 c. 166, § 32, an electrical permit shall be issued to the person, fu:�n or corporation stated on the permit application. Such entity shall be responsible for the notification ' of completion of the work as required in Kcr.L. c. 143, § 3L. Permits shall.be limited as to the time oflongoing construction actiVty, and maybedeemed-by-theJnspector-of-Wires abandoned-and-imalidme— or she. has determined tli�t the authorized work has not commenced or has not pro*gressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work Bhall be permitteMor reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by S ections.74 and 75 of Chapter 23 8 of the Acts of 2012. The purpose of this act is to proraot6job,growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain -permits and licenses concerning theYse or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effector existence' during the qu'alifying period beginning on August 15 2008.atid extendingthrough August 15,2012. 8 —PermitIDate Closed: 0 Permit Extension Act — Permit/Date Closed: for new permit W t otrrnoture. of ��,c;5z n„�T Ofaczl Use Ory 6 Checked and F d�c3 ee BOARD OF.FIRE PREVENT"ION RBGU!�aTIONS : I[IZev. 1/07] r%aveblaak APPLICATION FOR PERMIT TO PERFORM ELECTRICAL VVL�R' All work to be perfo=d in accordance with tte ivl sachusets r-1e-L-cxl Code (�C), �2 % ]200: ° (PLPASEPRIlTTIrti L'ORALL O TIOl� Date: l City or Town of: To the L-Lpector o fres. By this application the undersigned gives notice � of his ar her int.rmon to perform the electrical. work described below. Location (Street & Number) LI t) 6 h hl , !/_ 114,4 Owner or Tenant Own er's Address Telephone No.� jL)G Is this permit in conjunction with a bm7din ja ermit? Yes ❑ No -5a--- (Chec1 Appropriate Boz) Purpose of Building Utility Au-thorization No. Elis trig Service Amps / volts r`;:e-h,^ad J UDCigu-d ❑ No. of Meters New Service Amps / Volts Overhead d -- ❑ Un dvr- ❑ Na of Meters Number of Feeders and A.mpacity Location and Nature of Proposed Electrical Work: Ccmpl°tion of the following table rn_-y be waived by the Inspector of Fire, F_ No. of Recessed Luminaires No. ofCeiL-Susp. (Paddle) Fans IN U_ °i Total j Transformers No_of Luminaire Outlets No. of Hot Tubs KV k Generators KV -A,_ No. of Luminaires Swimming 9 move ❑ lu- Pool o- of mergency zdntina — -- -rod. Elm Batter v Units No. of Rzceptacle Outlets INo. of Oil Burners FIRE AL4RhYIS No. of Zones Igo. of S .ache✓ No- of Gas Burners No- of Detection and Tn itiatinz Devices I�-- iNo. ofRangts INo. of Air Cond. Total No. ofAlertin_aDevices IN -0- of Waste Disposers p IHeatPump I Number Tons JKW INo- of Self-Coutained Totals: j gDetection/_4lertinQDevices No. of Dishwashers Space/Area Heating KW Local ❑ lllnnicipai Connection ❑ Omer No. of Dryers lHeating Appliances KW ISecn — Systems:� No_ ofFater b'R Hea`ers INo. of No_ of ,i No. of �Djevices or E aient Datatrin� I Sizas Ball2sts No 0fDevicesorEgnivalent ,No.HydromassaaeBathtubs INo_ofMotors Total HP ITelecommnnrcatiohsWirin� i OTHER, wo_ of Devices or E uivaient r=mss ^ uuruuonacirc t y or as req=ed by the Ir, rpedor Fsun a V aloe Ie fi i �To a a t7 (When rey�ed by mtmicip, I policy_) :.. work to Sty = Inspections to be ance rc-ques�ted in accordwith M (_ Rule 10, and upon completion= on: 0VER- GE: Unless waived by the owner, no pew for the: performance of electrical work may issue unless the licersee provides pronfofHabil 'ym-surza. at � g `c=l`:.d op=azon' coverage orirs sues[zntial equ.ivaleat The uuldersi_ned c,-rd:F_es iH1± s3ch cove.2e is info, =, and hzs ex_,Loit?-d proof of same to the pert issuing off cc_ C Ck_ CNL: LvSL?_A_NrZ BO?T❑ OTr1-E'tt ❑ (Specify:) Se1L 11S� fired the pabs :V7Z perrt?_-S of p--- nrry; ih� iize irro rrl�Or or 1 s T%r. zr true mZd corrp>t Pl�M 41LE:_2C'± S`C _L.'r Ser-�ireS _nc L3C NO.:- C -gam licensee: Ma=?, 1. B=ch-Zr Signature �� ,� 5�S �_9 _ 1,1C. NO. C-45 --pt':)2e lic?=E mrm3er Line) �� --- WJL-ess: -_"T�0 U�-,,T=7- v tyE=ue iti=sew,DCa, 1�' 02090 Bus TeLNn.:781-3_-00 s.'� % L s workre��u� Deka Beni of� �tbiic �af�y =S` L ers_e: TeL No.: 8 L -S _=3 f, 0 OFYhR'SL?!SU v - Lic.No. 00953-__- Z? CE _=4h'.�R I zu aria i at W Lic m da s not �uvz ! Sb>liiy �Z'w cove2e normally r. qui by'L�w/ btiow. I he Eby ti�: ?_-=UCz_ I a= u,e (cL k one)❑ ❑ owner owner's a_-- Owne /A�ent� S;QuaLcre Teiepnoae _- 1 PFR,=FE: i NORTH ANDOVER BUM -DING DEPARTMENT 1600 Osgood Street North Andover Tel: 978-688-9545 Fax: 978-588-9542 BUSINESS FORM.FOR TOWN CLERK DATE: _ l / / 5-11V NAME: y� A Lf' ADDRESS: ZONWGDISTPUCT: l TYPE OF BUSINESS.- S BU I)INGLAYDUT PROVIDED: VES NO AVAILABLE PARKING SEAMS: ZONING B Y LAS" USAGE: YES NO EU ,DING INSPECTOR. BUSINESS FORM FOP -MVM CLERK 2.40 Home Occupation (1989132) An accessory use conducted within a dwelling by a resident who resides in the dwelling as his principal address, which is clearly secondary io the use- of the building for living pluposes. Home occupations shall 'include, "but not'limited to the :following uses; personal services such as furnished by an artist or instructor, but not occupation involved vtiffi motor vehicle repairs, beauty parlors, animal kennels, or the conduct of retail business, or the mauufachni ig of goods, which impacts the residential nature of the neighborhood. 4. For use of a dwelling in any residential district or multi•-fainily district for a home occupation, the following conditions shall apply: a. Not more than a total of three, (3) people may be employed in the home occupation, one of whom shall bethe, Mier ofthd home occupation and residing is said divolling; b. The use is carried on strictly within. the principal building; c. There shall be no exterior alterations, accessory buildings, or display which are not customary with residential buff fts; - d. Not more than twent31 five (25) percent of the existing gross floor area of ;the, dwelling unit , so used, not to exceed one thousand (1000) square feet, is devoted to 'such use. fn connection with such use, there is to be kept no stock in trade, commodities or products which occupy space beyond these limits; e. There will be no display of goods or wares visible from the street; f The building or premises occupied 'shall not be rendered objectionable or detrimental to the residential character of the neighborhood due to the exterior appearance, emission of odor, gas, smoke, dust, noise, disturbance, or in any other waybecome objectionable or detrimental to any residential use within the neighborhood; I_J l g. Any such building shall include no features of design, not customary in buildings for residential use. Signature 0 0 011 t CERTIFICATE OF USE & OCCUPANCY Building Permit Numbery 7 Date THIS CERTIFIES THAT Z,�,-- /C 0/ THE BUILDING LOCATED ON X69 IVAy -e)e L Y /2 MAY BE OCCUPIED AS Sl IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. 7 R ao m s; a . S /3A 74 s , o-? -51&// u ti d 'e'— CERTIFICATE ISSUED TO k ADDRESS % 3,-)/9 S Wo. 117 Building Inspector Im a 0 z 0 0 1 11 '" t" ui V �f ,� c • oo� o L a L Tlm oV VCL. : �cc o - CE ts om i O d GO' " N OA C� 7E� o m O w a cm :d y'a� E C� �.4 C cc C `J. C C* C y 12 ;dp: m �y m _ = O os kms@ acz '� � OCOD of m ; H • .: c CM c o c_ m c C x m y ��_� o r all � �E a w o •N o C3 CJ O O m C x A I co o, ca ca 0 A O O �E m m Cl CD CL ♦... Z O� c_vc0 a CL cmQ caC eccc d O D ,� C Z CD V VD O C C C CO2 0 U) U) Cc LU crLU U) O a 43 BZW O A z Oo, a� u � �vw v EV' C7 v o v Q 'U ,u", w° cn CboCy w° C U w z rA cn (f) ui V �f ,� c • oo� o L a L Tlm oV VCL. : �cc o - CE ts om i O d GO' " N OA C� 7E� o m O w a cm :d y'a� E C� �.4 C cc C `J. C C* C y 12 ;dp: m �y m _ = O os kms@ acz '� � OCOD of m ; H • .: c CM c o c_ m c C x m y ��_� o r all � �E a w o •N o C3 CJ O O m C x A I co o, ca ca 0 A O O �E m m Cl CD CL ♦... Z O� c_vc0 a CL cmQ caC eccc d O D ,� C Z CD V VD O C C C CO2 0 U) U) Cc LU crLU U) W s z CL o oIj LZ �; Cr O N vV C Qb' m C y Ea r Ri :tea N 1: A : � i► 0 ywo O me E 4D z N cm�p C. m J y IPA O fl N = C C • � � N O O A•E,� On :ave N m ; C! too WS f0,� `o o .� n F- Q O: h nC C = o : o = 3o IV � o n•' C#* M_S m = C ~ •,NA nt O C O 'E C2 4-N o CW.2 o 0 OF c F= CODy n 0020.Cc g F- r s n$m 5. T CD O E CD O z °' CL O y CD � C o, co CD m m 0 CD .0 CD CD L cc LM CL 0 CL C Q CA Z c cc v C CD 0 CL GO) y O C — C C _c d t U) ccW W WLLJ le o o x U a z w x ca o a W CcoCd�, o w° cin w° a�' U w n�' w a°' w n�' ii rA cin cn z CL o oIj LZ �; Cr O N vV C Qb' m C y Ea r Ri :tea N 1: A : � i► 0 ywo O me E 4D z N cm�p C. m J y IPA O fl N = C C • � � N O O A•E,� On :ave N m ; C! too WS f0,� `o o .� n F- Q O: h nC C = o : o = 3o IV � o n•' C#* M_S m = C ~ •,NA nt O C O 'E C2 4-N o CW.2 o 0 OF c F= CODy n 0020.Cc g F- r s n$m 5. T CD O E CD O z °' CL O y CD � C o, co CD m m 0 CD .0 CD CD L cc LM CL 0 CL C Q CA Z c cc v C CD 0 CL GO) y O C — C C _c d t U) ccW W WLLJ le Town of North Andover O& NaRry q� Building Department 3? 9ttttieo°ta o 27 Charles Street o North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 i my �' O ww .ra CO[wlC IWNw 1' -TAC HUS-' APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS ! �/ LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION 4 — / 9 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 THF/Sr T13UC,nTRE,,B�3GOT MEET ALL APPLICABLE CODES. SIGNATURE/' �/l// OFFICIAL USE ONLY ROUTING CONSERVA PLANNING D.P.W. — W� DATE DATE DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRI THE SPECTION RE UEST DATE. SI A / DPW AUTHORIZ I N24709 Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ................... This certifies that ... has permission to perform /,,) ...................... plumbing in the buildings of ..................... .................. 0 5, 6"-1 a t ................... . ........... , North Andover, Mass. Fee�-Pe) ...... Lic. No/0.111.... 21 ............ . ............... L P M ING INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location Y6 9 LTJ f4 V< W. ,%�e✓G sl�h a � Date �/- (' —" -Q 1 �- Permit # er7 A--,,-+ --31 - Type of occupancy New Renovation Plans Submitted Yes No ReplacementEl LJ 11 • MMI (Print or type) Zef j-c�� e- e (�d � Installing Company Name 0 Address / t / ,Ot) C Q x Check one: 1-1 Corp. E] Partner. 1-1 Finn/Co. Name of Licensed Plumber: 4-) d KA11 "V"( a ` 4 ' k A <-- Insurance Coverage: Indicate the tyRe of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ Certificate Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of Va chusetts State binge and hapter 14 of the General Laws. By: o icense um er Type of Plumbing License Title � S' ` 7 City/Town License Number Master a Journeyman APPROVED (OFFICE USE ONLY Date..................... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ................ 11P permission for gas installation .......................... in the buildings of North Andover, Mass. ..... ............ Fee.7� ..... Lic. NoA,�.""e�.. . .......... GAS INSPECTOR Check# -,,-2 3614 �1� MASSACHUSETTS ni TFORM APPLICATON FOR PCRNIiT TO DO GAS FT=C, yType or print) NORTH ANDOVER, MASSACHUSETTS Building Locations ,..,/ Owner's Name New 11�j' Renovation ❑ Replacement ❑ Permit # ,30 41 Amount S �%✓ e .sited C � �, Plans Submitted ❑ (Print or N, Ae_ Adress C'�CO��U ,V e. Business Telephone 3 63F3-4 --?9a9 Check one: Certificate Installing Company ❑ Corp. ❑ Partner ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter A /d INSUR.-ONCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No ❑ If V06 have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ 9 Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter I42 of the Vlass. General Laws, and that my signature on this permit application waives this requirement. Check one: Sienature of Owner or Owner's Agent Owner ❑ Aeent ❑ I herebv certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations pertormed under Permit Issued for this application will be in compliance with all pertinent provisions of the .--lassachw—fts State Gats Coe and Char 142 afthe Gen7l Laws. By: Title Ciry/Town APPPUVED (oEric:= usF )r i.vi r- Pienature of Lieensed Plumber Or Gas Fitter lumber -X9-1 $' ❑ Gas Fitter tcense iNumoer 'raster . ❑ Journeyman h� (Print or N, Ae_ Adress C'�CO��U ,V e. Business Telephone 3 63F3-4 --?9a9 Check one: Certificate Installing Company ❑ Corp. ❑ Partner ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter A /d INSUR.-ONCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No ❑ If V06 have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ 9 Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter I42 of the Vlass. General Laws, and that my signature on this permit application waives this requirement. Check one: Sienature of Owner or Owner's Agent Owner ❑ Aeent ❑ I herebv certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations pertormed under Permit Issued for this application will be in compliance with all pertinent provisions of the .--lassachw—fts State Gats Coe and Char 142 afthe Gen7l Laws. By: Title Ciry/Town APPPUVED (oEric:= usF )r i.vi r- Pienature of Lieensed Plumber Or Gas Fitter lumber -X9-1 $' ❑ Gas Fitter tcense iNumoer 'raster . ❑ Journeyman Date.z.—r_-�-/ "2e-"), N2 2856 ............................ TOWN OF NORTH ANDOVER JI 0'.. - PERMIT FOR WIRING T'his certifies that ............................ ......................................................... has permission to perform .......... 1;/ -Z- ............................................................. ........................................................................... wiring in the building of ......... . at ...... / ........ North Andover, Mass. ........................................ ........... Fee ............. Lic. No . ...... ..0 .... ..................... ................................ hLECI IUCAL INSPECTOR Check WHITE: Applicant CANARY: Building Dept. PINK: Treasurer TI&C0MM0NWE4LTH0FM SS4CHUSE77S Office Use onl DEPARTAIENTOMBLICS4FM Permit No. �v BOAW OFMEPREVEMONRWRATIOAS527CMR 12-M �v Occupancy &Fees Checked APPUCATION FOR PER .MIT TO PERFORM ELECTRICAL 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 Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street 6 Owner or Tenant Owner's Address To the Inspector of Wires: Is this permit in conjunction with a building permit: Purpose of Building S,� n l 9 ` `e Existing Service Amps/ Volts New Service Oo Ampa�oVolts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work es � No �kY✓1 t.\ y (Check Appropriate Box) Utility Authorization No. Overhead Underground No. of Meters ., Overhead Underground No. of Meters No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total I KVA No. of Lighting Fixtures 1 Swimming Pool Above Below Generators KVA ground ground1 No. of Receptacle OutletsO No. of 0il Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners t FIRE ALARMS No. of Zones No. of Ranges /.S G No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Connections Other No. of Dryers 0.S Heating Devices KW No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER IrtstratneCo�aa� Rlrst,arttlothetaqtritana�ts�C�al�alLam I haw a mmnt Liability In aranx Pbticy mAidingCar0&OpaaficnsCa&aWorits surtbal e4liv*nt YES ® NO IhaNesubm9tedvalidptoofofsamelodte0l%YES n NO If}tuhavediedcedYES, pleaset thrtWofwmaWbydrekingtte II RANC£ ® BOND onR 0 (Pleasespecify> - L v �� �. k valueirai Wait $ Waktoslant _ �� D*Recltlested Rtx>gtt Final sighed underlie Pa3alties of FMMNAME 1�� sl�C' l �C-�� e—s �---- LiomseNa C) -(F6 �I �,seSv� 'o Signaaae �j BuskmTeLNa 60 '9"tea — V/, PP 2 �tx e (� 1\cI Ne (,j�-o 1J H 0 3k J�6 A><TeLNa OWNER'S WSURANCEWAIVER; IamawatedAttel-ioawd�Coual Lam a<idttetniysgnakwcndispel *Wpficmmwairesoristeqtagna>t. (Please check one) Owner Agent Telephone No. PERMIT FEE $ Location 1,t1A ()ngly J,�4 No. 6- Date TOWN OP NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ E30Z MUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 903 Check # 14 3 19 v - -7 7 Buil�ing Inspector E-, Q) 1i + �J Q w N Q w J W waf O .0 z 0Q N IY -i z Z 0 UW 0 N N m W O z O N II �- Q d. I H U Fx p U z 0 r II II II N Q 0 of <p ci � Q>- Q} m o w¢ V) LLL. (n � 0Z UJ 0 z 0 0 z m Z o F�c�� Z� W�zO 00 W NZ w W Q ���� O Z �' F MOO Cr LL- rAr ��� '�,OT£ + :; 5@ �� < w <_, 2 <';c+ Rao�cv � r IW- m ix,c� cn p� �94f '� ` `7 X09 P_ Q Z � a. N N- ` o m � � w �- w f�'�I W '� �' C p n ^4 UJH f- w= f- 2 ?� 0 LD pN V N Q ( � a ?- Z Q O LO 0 00 z O J O 0 J C� Z_ S' < D Q Q �t- 00 N z Q J d �Qi •Cit r► O Q 1 O o, ,L •8L — � M LdO <t r-6 ..- l N II T37- i O CE i .£'0'9Z — o a F- o w N N LLI w II x Zt V eq O rP4 V O I N2 2689 Date.&._... 2 ....... or) ........ TOWN OF NORTH ANDOVER PERMIT FOR WIRING "This certifies that e, ....................................... i .................................. has permission to perform ........................ wiring in the building of-.--. ............................................... ......................... . North Awdover, Mass. Fee� ... 0 .............. Lic. N,�_-, .......... I .................................................... Check # �-6K5& 9 ELEcrRICAL INSPEcrOR f WHITE: Applicant CANARY: Building Dept. PINK: Treasurer THEC0M110NWL4LTH0FhRMCHUSE77S Office Use only Q DEPART ffiW0FPUBLICS4fM Permit No. t� /U BOARD OFMEPREVEIVHONRWULA770AS527CMR 12-00 CO-- e& Occupancy &Fees Checked �PPLTCATIONFOR PFRMU TO PFRFORMFLFCRICAT. 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 i t N -L c;,c , Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) Owner or Tenant To the Inspector of Wires: Owner's Address J 1 7-- NO, A -0W d: f Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building \ rp g � i7--4.c:�2 SLnVV t:� Utility Authorization No. Db Existing Service Amps Volts Overhead M Underground No. of Meters New Service ZDO_ Amps /?d 2 q-CYolts Overhead �Underground No. of Meters T Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work —77,5 7-6777 No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground around No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW Connections a No of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER Irma-aroeCaaage Ptasuatbtheregtstanatssel�GataalLaws IhmaamertLnbdtybnlu=PohLymdudingCa a CoaaWcritsegivalait • YES NO Irta-,esubrnrttaava1idptoa(6fsmre1utheoffm YES Ifjuulmedia WYES,Ikase ethet peoE'omWbydx the li`RR4,NM BOND OTHER F-1 (Pl =Specify) Exp�iat Dai Estin&d ValuedFkand Waik $ WorktaSWI 1 z— hj)x6mDateRgjestad Ro# Final signed utda$ie Pay ties ofpajttry: FIRM NAME i_ 1doa�ee/� tl t,eA-b li JVlt��a.yA,:�- Sigrue Lioa>SeNo C z % 5�� Btsu�ssTelNa 1,0 3 fsZ 2c09 Armor X L�P�/�OQ� `� 1 = Pmt c-5 A-AG D k6!S� AIL TeLNa OWNER'S INSUAANCEWAIVER;I.arnm=hatthel-iffwdo not $reitstranewmWoritsmbsMr raleL wdettasm#WbyMmmdaseMCmaalLaws and that my sigrikeon this pmni application wanes this tag menat. (Please check one) Owner M Agent Q tri Telephone No. .PERMIT FEE $ Location 41,'6)9 ZVA t)CrC>1(Z eV( ' )JqQ No. Date TOWN OF NORTH ANDOVER 0 AL Certificate of Occupancy $ .#Building/Frame Permit Fee $ Foundation Permit Fee $ /00 Other Permit Fee $ TOTAL $ 16-0 Check # "44 Building Inspector BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: // DATE ISSUED: SIGNATURE: C Building Commissioner/Ingwor of Buildings Date az%- A]LVllq 1- al. 1E uir%jrUVIAIJIU1V 1.1 Property Address: 1.2 Assessors Map and Parcel Number: -- Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zonin Ihstrict Pr sed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 4-- 1.7 Water S M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sew a Disposal System: Public Private ❑ Zone Outside Flood Zone ❑ Municipal On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record ff 1 Nlelue, A �� Y�LOof !>Q12 ( ( n f A)0o� 119Jbu,2 Name (Print) Address for Service : X95 -yid l Signature Telephone .l 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ ,J / e Licensed Construction Supervisor: D 4 CLicense / Number Address 7 / Expiration Date 666 Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name't9 y /1/— Registration Number Add 114 yl /%' Expiration Date Slnam Telephone SECTION 4 - WORKERS COMPENSATION (AG.L C 152 & 2506) 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 Descripffon of Proposed Work check all applicable) New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) ❑Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: )� ror / e SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant =OFFTCIAL'USE ONLY 1. Building 47,01 000 (a) Building Permit Fee Multiplier ' S 2 Electrical 5-060 (b) Estimated Total Cost of Construction / 3 Plumbing ® Building Permit fee te) X (b) _ 4 Mechanical (HVAC) 000 5 Fire Protection 6 Total _(1+2+3+4+5) ode) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, 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 OWN AUTHORIZED AGENT DECLARATION 1, dLl + o 4 as Owrier/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 'r- I / Print Name Si ature of dKKerA2e5t Date, NO. OF STORIES 7 SIZE BASEMENT OR SLAB SIZE OF FLOOR TRVIBERS 2 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS k z DIMENSIONS OF GIRDERS J % HEIGHT OF FOUNDATION 7t'4.,2 THICKNESS l SIZE OF FOOTING ' X -- X MATERIAL OF CHIIvvINEY IS BUILDING ON SOLID OR FILLED LAND p /,,,a IS BUILDING CONNECTED TO NATURAL GAS LINE �.s MEW p®t4I FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that allnecessary 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. .......................................`.................................... APPLICANTJ G?�4, _ PHONE q�-2 7- Z ASSESSORS MAP NUMBER .Z, LOT NUMBER f; y �-L / ,Zt SUBDIVISION LOT NUMBER I r� f 4 STREET ... LCL 1,/,GS"l �i....�[f ............ STREET NUMBER ................ ..:.. OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS l..■ ......McERE........................................................... V " DATE APPROVED CORVATIONADNWSTRATOR Q DATE REJECTED COMMENTS Nb DATE APPROVED �iZ 9 / Oy TO LANNER `—� DATE REJECTED CONWIENTS (( d DATE APPROVED FOOD INSPECTOR - HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR - HEALTH DATE REJECTED COMMENTS PUBLIC WORKS - SEWER / WATER CONNEC N DRIVEWAY PERMIT O a DATE APPROVED FIRE DEPAR DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATF BUILDING DEPARTMENT DEBRIS DISPOSAL FORM In accordance with the provisions of MGL 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: dZ/191, -- S* Of Permit pplicant /bate NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector The Commonwealth of Massachusetts Department of Industrial -Accidents Cf; ice cf Investigations Boston, Mass. 02 111 Wcrker.3' Compensarien Insurance .Afflidavit r Flame Re -ase Pint —� ISI (-H-v /y r tl�- Phone T ?I 5—k -/K/ V 4 (� L—!EZr I am a homeowner performing all work myself. ❑C`eck .f immediate response is required ❑ L'censin0 Board ❑ selecrman's O ,tce I am a sole prcprietar and have no one ,.A�crkine in any capadty (� l S�� COy►/d,E �,' r Q cr/ C I am an emcieyer crcvidin� workers' compensation f r my employees working on this job. In / nv n Phone T - Insurance Co. (.fie1,011 Polici T /^, 02 1 Ei I Comoanv name: Address Cit,r Phcne j. Insurance Co. Polio T Failure to secure c ;verace as recuirac under Sec:ian 25A ar MGL 152 can lead to the imecsiiicn cf c:imiral penalties & a nne up Ito S1, °CO.CO andlor one years' imonscrment as •veil as civil penalties in the form c a STCP'NCRK ORCER and a rine cf (S1CO.CO) a day against me. I understand that a c #y ci ,tris statement may ce fcrNarced to the Office of Investigations cf :he GIA fcr coverage verificztien. do hereby cerriry u ar the Fal and?�:enties or peau that :he %//rf�.aticn provided accve s .sue and ccrrec:.�`)Sionatur JG` nc e / V Print name �' Fhone [� �� l Offiic•al use only Cc not write in this area to tre completed cy c: -,y cr town cff aai C`ty or Town Permit/Ucensirc Building Cept ❑C`eck .f immediate response is required ❑ L'censin0 Board ❑ selecrman's O ,tce Conic: pe son: Phone m C health Department Other GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT TOWN OF NORTH ANDOVERBUILDING DEPARTMENT This form shall be used to assist the Building Department in their determination of exemption under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The applicant shall provide all of the necessary��/`information as requested below. Permit Applicant Property address Map / Parcel Applicant's Phone Number Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the building permit. Further I understand that my interpretation of the exemption status is subject to review by the Building Department and is only officially accepted when the building permit is issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement, restoration or reconstruction of a dwelling in existence as of the effective date ofthis bylaw, provided that no additional residential unit is created. The lot(s) was / were created prior to May 6, 1996 and are exempt from the provisions of section 8.7 of the Zoning Bylaw. This application is for dwelling units for low and or moderate income families or individuals, where all of the conditions of 8.7.6 are met and or represents dwelling units for senior residents, where occupancy of the units is restricted to senior citizens through a properly executed and recorded deed restriction running with the land. For purposes of this section "senior" shall mean persons over the age of 55. This application is part of a development project which voluntarily agreed to a minimum 40 % permanent reduction in density (buildable lots) below the density permitted under zoning and feasible given the environmental conditions of the tract, with the surplus land equal to at least tet buildable acres and permanently designated as open space or farmland. The land to be preserved shall be protected from development by an Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town; or other similar mechanism approved by the planning board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 and shall receive a one time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for a building permit ( all other permits from all other boards and commissions have been received and the project is in compliance with those permits), and the Development Schedule does not accommodate issuing a building permit in that year. One building permit will be issued per year per Development until such time as the development schedule accommodates issuing building permits. Applicant must submit an approved FORM U with this EXEMPTION. PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A DETERMINATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE EXEMPTIONS. BY SIGNING BELOW I ATTEST TO THE ACCURACY OF THE INFORMATION PROVIDED AND THAT THE ATTACHED BUILDING PERMIT IS ALLOWED AN EXEMPTION AS CITED ABOVE. FURTHER I UNDERSTAND THAT THE SUBMITTAL OF MISLEADING OR INACCURATE INFORMATION OR THE CHECKING OFF OF A ABOVE EXE ON ICH DOES NOT COMPLY, WHETHER DONE TO MY KNOWLEDGE OR NOT I RO FOR REFUSAL THE ING DEPARTMENT TO ISSUE A BUILDING PERMIT. PLI IGNA DATE THIS FORM TO BE ATTACHED TO THE BUILDING PERMIT APPLICATION ✓�ze �amimo�r.�.ueacC�i n��✓UGa6a�u,�,�cae�6 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 053176 Birthdate: 02/15/1958 Expires: 02/15/2001 Tr. no: 7046 Restricted To: 00 STEPHEN M SMOLAK��I 762 DALE ST NO ANDOVER, MA 01845 Administrator 1 575 APPLICATION FOR SEWER SERVICE CONNECTION North Andover, Mass. Application by the undersigned is hereby made to connect with the town sewer main in U eec/&1' 41 PO4/ Street, subject to the rules and regulations of the Division of Public Works. The premises are known as No. Street or subdivision lot no.`Z— h 77 0 pa -(02 Owner Address Contractor Address App ica Signature PERMIT TO CONNECT WITH SEWER MAIN The Division of Public Works hereby grants permission to to make a connection with the sewer main at 4AZ subject to the rules and regulations of the Division of Public Works.. Inspected by Date e, Street Division of Public Works By v� See back for rules and regulations 15 �nn t3 e� r� rt r < G ,.r+ .� .�.vi.. �.b�e��.,.f�.�.-•-?v,..��Fry-,�.,.y'..k-�`�...1. ++..,��;:P„a....b,.,�y:� . �t .. �v.i .,, �...�> .. :. 4'ti'� I l RULES AND REGULATIONS FOR GOVERNING THE INSTALLATION OF SEWER SERVICES I. No unauthorized person shall uncover, make any connections with or opening into, use, alter, or disturb any public sewer or appurtenance thereof without first obtaining a written permit from the Division of Public Works. 2. All costs and expense incident to the installation and connections of the building sewer shall be borne by the owner. The owner shall indemnify the (town) from any loss or damage that may directly or indirectly be occasioned by the installation of the building sewer. 3. A separate and independent building sewer shall be provided for every building; except where one building stands at the rear of another on an interior lot and no private sewer is available or can be constructed to the rear building through an adjoining alley, court, yard, or driveway, the building sewer from the front building may be extended to the rear building and the whole considered as one building sewer. 4. Old building sewers may be used in connection with new buildings only when they are found, on examination and test by the (Superintendent), to meet all requirements of this ordinance. 5. The size, slope, alignment, materials of construction of a building sewer, and the methods to be used in excavating, placing of the pipe, jointing, testing, and backfilling the trench, shall all conform to the following requirements. The sewer shall be 6"diameter SDR 35, PVC pipe. Minimum slope shall be 1/8" per foot. The minimum depth of sewer shall be four feet below finish grade. Sewer pipe shall be installed on a stable trench bottom of hard durable crushed stone to a minimum (6) inch depth below the pipe. After the pipe has been installed, crushed stone shall be brought up to the crown of the pipe. Care shall be taken to carefully grade and compact the stone, and prevent pipe displacement. The remainder of the trench shall then be backfilled in one foot lifts with mechanical tamping after each lift. 6. Whenever possible, the building sewer shall be brought to the building at an elevation below the basement floor. In all buildings in which any building drain is too low to permit gravity flow to the public sewer, sanitary sewage carried by such building drain shall be lifted by an approved means and discharged to the building sewer. 7. No person shall make connection of roof downspouts, exterior foundation drains, or other sources of surface runoff or ground water to a building drain which in turn is connected directly or indirectly to a public sanitary sewer. 8. The applicant for the building sewer permit shall notify the (Superintendent) when the building sewer is ready for inspection and connection to the public sewer. The connection shall be made under the supervision of the (Superintendent) or his representative. 9. All excavations for building sewer installation shall be adequately guarded with barricades and lights so as to protect the public from hazard. Streets, sidewalks, parkways, and other public property disturbed in the course of the work shall be restored in a manner satisfactory to the (town). 1010 APPLICATION FOR WATER SERVICE CONNECTION North Andover, Mass. Application by the undersigned is hereby made to connect with the town water main in ( /tom subject to the rules and regulations of the Division of Public Works. / The premises are known as No. ef 53 tldq&,e! >Cda Street, Street or subdivision lot no. 12- / / ' 601- f ke 15vn 26 Z are -¢l% Owner Address Contractor Address F` Applica s Signature PERMIT TO CONNECT WITH WATER MAIN The Board of Public Works hereby grants permission to to make a connection with the water main at 1/1 subject to the rules and regulations of the Division of Public Works. Inspected by Date e t Street Board of Public Works By :7ZL9C . See back for rules and regulations U) Pt [ t� r i cl f vZr �3'7�e uta V e/'rkt 4vt� I dliC t RULES AND REGULATIONS GOVERNING THE INSTALLATION Of WATER SERVICES 1. No persons shall tap or in any way tamper with water mains which are part of the distribution system of the Town of North Andover without a valid permit from the Division of Public Works. 2. All water services shall be installed a minimum of five feet below the finish grade. 3. No water services shall be backfilled without inspection by a representative of the D.P.W.—Telephone 687-7964. 4. Service connections shall be 1" type k copper tubing. 5. All fittings shall be brass flange type Mueller or equal H 15202 Corporations H 15212 Curb stops H 15402 Three part unions H 8185 stop and waste valves 6. Curb boxes shall be installed at the property line and shall be of the Erie Type with 4�/z foot rod and brass plug type cover. J.VVILLIAM HMURCIAK, P.E. DIRECTOR TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 'co , DRIVEWAY PERMIT Telephone (978) 685-0950 Fax (978) 688-9573 DATE Avc LOCATION 4)aVe✓ BUILDER phone OWNER 54e4ekl5'm-o t eo� -- hone 5 THE NORTH ANDOVER SUPERINTENDENT OF OPERATIONS MUST BE NOTIFIED OF THE GRADE AND SETBACK FROM STREET. CALL THE SUPERINTENDENT'S OFFICE BEFORE FINISH GRADING AND SURFACING FOR APPROVAL OF SUCH ENTRY. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. MAScheck COMPLIANCE REPORT Massachusetts Energy code MAScheck Software version 2.01 Release 3 TITLE: Classic House Plan: S-56/12744 CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 8-4-2000 PROJECT INFORMATION: 26 x 36 Colonial - 1,976 sq. ft. COMPANY INFORMATION: Smolak Builders 978.685.4141 NOTES: RIVCO "Town & Country" window units COMPLIANCE: Passes Maximum UA = 327 Your Home = 326 Pe rmi t # Checked by/Date Area or Cavity Cont. Glazing/Door Perimeter R -Value R -Value U -Value UA ------------------------------------------------------------------------------ CEILINGS 936 30.0 0.0 33 WALLS: wood Frame, 16" O.C. 1768 13.0 0.0 145 GLAZING: Windows or Doors 194 0.380 74 GLAZING: Windows or Doors 13 0.560 7 GLAZING: Windows or Doors 20. 0.560 r 11 DOORS 20 0.350 7 DOORS 33 0.540 18 FLOORS: Over Unconditioned Space 936 30.0 0.0 31 HVAC EQUIPMENT: Boiler, 82.0 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 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 desi load specified in � Sections 780CMR 1310 and J4.4. Bui1de TITLE: Classic House Plan: S-56/12744 MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck software version 2.01 Release 3 DATE: 8-4-2000 Bldg. Dept. use [ ] CEILINGS: 1. R-30 Comments/Location WALLS: 1. wood Frame, 16" O.C., R-13 Comments/Location WINDOWS AND GLASS DOORS: 1. U -value: 0.38 For windows without labeled U -values, describe features: # Panes Frame Type Thermal Break? [ Yes [ ] No Comments/Location �I-7ouvn� �n/� 'D'oc9 I�c�AK 2. U -value: 0.56 For windows without labeled U -values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location (� 3. U -value: 0.56 For windows without labeled U -values, describe features: # Panes Frame Type Zhermal Break? [ ] Yes [ ] No Comments/Location VEEP- Y7c=)o (C _ DOORS: 1. U -value: 0.35 Comments/Location C7 -I d� 2. U -value: 0.54 comments/Location FLOORS: 1. Over Unconditioned Space, R-30 Comments/Location HVAC EQUIPMENT: 1. Boiler, 82.0 AFUE or Make and Model Number higher AIR LEAKAGE: joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. when installed in the building envelope, recessed lighting fixtures shall 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 I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I VAPOR RETARDER: [ ] I Required on the warm -in -winter side of all non -vented framed I ceilings, walls, and floors. I MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R -values, glazing U -values, and heating I equipment efficiency must be clearly marked on the building plans I or specifications. I DUCT INSULATION: [ ] I Ducts shall be insulated per Table 74.4.7.1. I DUCT CONSTRUCTION: [ ] I All accessiblejoints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. TEMPERATURE CONTROLS: [ ] I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I HVAC EQUIPMENT SIZING: [ 7 I Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified I in Sections 780CMR 1310 and 74.4. I SWIMMING POOLS: [ ] I All heated swimming pools must have an 'on/off,heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require.a time clock. I HVAC PIPING INSULATION: [ ] I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in.): I PIPE SIZES (in.) I I 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 I Low temperature 120-200 0.5 1.0 1.0 1.5 I Steam condensate any 1.0 1.0 1.5 2.0 I COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 I CIRCULATING HOT WATER SYSTEMS: [ ] I Insulate circulating hot water pipes to the following levels (in.): Y PIPE NON -CIRCULATING HEATED WATER TEMP (F): RUNOUTS 0-1" 170-180 0.5 140-160 0.5 100-130 0.5 SIZES (in.) 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VI\:3WVI L - 4 -) GJ 4J C X GJ C W L0GJW4Jcd F -3L -'up -0L- 0vIaJcLn3a) >- vI 060 >- M 0 aJ E U tn'a •r L aJ aJ L- U U a4J E Ur -4- H334)H�L F- O O 4J -J= QIJJV1O0U x U t31 c •r O r r O 4- aJ t 4J O 4J tn aJ a .r- CL ra aJ VI 4J w3 c~n 4J 0 t r -I u I O Ln o 0 Ln Ln •Nr•iN Hr -I N N Ln 1 Ln O Ln N Ln ^N.rl r•I H 0 H •� r-4 v W r --I Ln O O HO r♦ r♦ r• -I V) a� az0Ln0 ice r40r-I N LLL O O v Ln O N N >% 2: r -I O cd � O� Ln O O r1 Ln O O rl O Ln 3 1 O a L GJ aJ 4J O .. 4J L cd . . VI\:3WVI L - 4 -) GJ 4J C X GJ C W L0GJW4Jcd F -3L -'up -0L- 0vIaJcLn3a) >- vI 060 >- M 0 aJ E U tn'a •r L aJ aJ L- U U a4J E Ur -4- H334)H�L F- O O 4J -J= QIJJV1O0U x U t31 c •r O r r O 4- aJ t 4J O 4J tn aJ a .r- CL ra aJ VI 4J w3 c~n 4J 0 t r -I u Location -Z, 2 Aa) No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # =�,2&-- 14449 Building lnspet!q�,- TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVAT5 OR DEMOLISH 4%A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: y"'� DATE ISSUED: SIGNATURE: Building CommissioneE/ ,t& of Buildings Date SECTION 1- SITE INFORMATION X1..11 Property Address: l l/C e,, e, �4 y(J r 1.2 Assessors Map and Parcel Number: 1,14 9 ap Number Parcel Number 1.3 Zoning Information: Zoning District Pr .sed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R red Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) Public 0 Private 0 1.5. Flood Zone Information: Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Nyamtint) f Address for Service Signa a Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 LAensed Co struction Supervisor: Lmcensd Construction Supervisor: Address Signature / Telephone Not Applicable ❑ License Number �7 Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name Registration Number Address Expiration Date Signature Telephone SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 2506) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work(check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant C#TF'ICIAL USE "ONLY .• 1. Building pp 000 (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) s 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 O'0 0 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIESFOR BUILDING PERMIT 1, �GYt (� as Owner/Authorized Agent of subject property Hereby authorize to act on My �ffi1 mrs rela ' e to r authorized by this building permit application. Si nature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, As Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Signature of Owner/A ient Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 ND 3 SPAN DIN ENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHEIANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE i °" � ✓/ar. -�amma�u�etc���. o�✓��ad�a��tdelld r BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR I Number. CS 053176 Birthdate: 0211511958 Expires: 02/15/2001 Tr. no: 7046 I { e _ Restricted To: 00 I STEPHEN M SMOLAK 762 DALE ST "`', NO ANDOVER, MA 01845 Administrator i FORM - U - LOT RELEASE FORM 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. �71AV7 ....................APPLICANT � PHONE %l (, LL�/1y1 ASSESSORS MAP NUMBER :2- _ LOT NUMBER %.9� 2 SUBDIVISION NUMBER STREET q0, / �R /L/ 1 STREET NUMBER Y6 n/ �.......................................................................... OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS -IN*.../...........%%........................................................... t� . L-- ( 0` S U DATE APPROVED IV -406 CONSERVATION ADMINIISTRATOR 1 1/ NOak DATE REJECTED Oak COMMENTS �� ��5 e + ( OQ ��^' SO 6+116 - i 3 TOWN PLANNER CONDAENTS FOOD INSPECTOR -'HEALTH SEPTIC INSPECTOR - HEALTH n PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE 0 FMM4 x Q O �Se p JL Cf' Q (% Li o U z o O 7 Ui L U _ m C 1 0 w Cr °�° QG C LL o w U U Li 4L C 4 [. x p U z z V LL Ci z w d w c� CG n J f • ;;C O C U O N O V V ' d C O C w � O co Ea L m c m o ci a N 0 o 0 C c N tC m m N y � 3 CD y y O C O �♦ a E D v Q0.0u co y mCD CD ; C: c ca N d Cm • m .s � ca,• - Z o ev c cmc o Z m mN � a0 C/3 $ �_� m r� c W cmm CO) G C Z W E U�U� o C-1) m m " m coo a Q. c = cc .'C., H '� C t- c $ o. - m I H H .co i coCL C O V CL H O O v .51 CO) C 0 ev C T CC CL N_ L O Q COO) is C' CM C O .0 D :2 CIO m W U) W m ui w cz LIJW U)