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HomeMy WebLinkAboutMiscellaneous - 41 CARTY CIRCLE 4/30/2018 (2) - / OA 41 C RTY CIRCLE yL/ 210/047.0-0035-0000.0 J I I G it J 1 1T } + , -- .,.fit .c•.tJM'"`r� `` r 4 t if, r p , ter."i{t ljI � •� .� / o t a 1 J � y AMP A A �)AI br.. l �T �® 8 ' �112�^c� ♦1„mss.• a f k• '� .� ! • � t J. f^ �Ii y- r J • / s I r Jill A ` - SR' .rt r 1 1 ' ..•,,sem. •..•., ' i^ � •'� ��1�� E �� s - 1 _ _ U 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: in accordance-with theprovisions of M.G.L.c.143,§.3L,the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed- on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.01 c. 166,§32,an • electrical permit shall be issued to the person,firm or corporation stated on the permit application.Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shallbe limited as to the time of ongoing construction.activity,and mayboAeemedbythe.inspector-of_Wires abandoned.and.inyalid-if he..—. or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for 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 Sections.74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote-job;growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certaiwpermits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwis a applicable expiration date,any permit or approval that was "in effect or existence'during the qualifying period beginning on August 15,2008.and extending through August 15,2012. ule 8—Permit/Date Closed: ��� * Dote:Reapply for new permit< ❑Permit Extension Act—Permit/Date Closed: �J Date....... NORTN TOWN OF NORTH ANDOVER PERMIT FOR WIRING SS "us i This certifies that .� has permission to perform ...,.. :-.......:. �:...w...............:........ -;............. w wiring in the building of......... 1'' a �-- ` C / ,North Andover Mass. at...y�.............. .............. _.. Fee l....... Lic.No':�t. ............ . ELECTRICAL INSPE Check # 9347 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 9,3 -/) r� Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( EC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ft ��J/0 City or Town of: NORTH ANDOVER To theInspec or of Wires: By this application the undersigned i s notice of his or her intention to perform the electrical work described below. Location(Street&Number) Owner or TenantPiest 1- T)L, Telephone No. Owner's Address �Q Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ( Lt'vi•�1 R ,� L1ti ,) �� Completion of the ollowin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets f No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In ❑ o.o Emergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches t No.of Gas Burners No.of Detection and Initiatin2 Devices No.of Ran es No.of Air Cond. Total RangTons -3 No.of Alerting Devices Heat Pum Number Tons KW No.of Self-Contained No.of Waste Disposers Totals Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: -_ Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value o Ele trical Work: ���� (When required by municipal policy.) Work to Start: C /-0 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C V RAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE&i BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: , K 'X10 LIC.NO.: Licensee: �� ' Signature' "� ^` LIC.NO.:3)3 f,`i (Ifapplicable,enter "exem n the license number line.) Bus.Tel.No.• i i - --'-,6 ,>S�> Address: /qS ( cJ 44)5 xt tom, S�' �U`E'.U.ff ?J /i•tt Alt.Tel.No.:41 tT S-I3 *Per M.G.L c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. i f Commonwealth of Massachusetts Official Use only Department of Fire Services Permit No. 9,3 -/) Occupancy and Fee Checked y` BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( EC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: V /� �0 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersignedi s notice of his or her intention to perform the electrical work described below. Location(Street&Number) U Owner or Tenant %, 3U Telephone No. Owner's AddressQ Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: a Completion of the ollowin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above El ❑ o.o mergency �g mg rnd. rnd. Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total g j Tons -3No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal El Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water No KW .of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent • No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: / Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value o Ele trical Work: ) (When required by municipal policy.) Work to Start: l -0 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C V RAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE a BOND ❑ OTHER ❑ (Specify:) 1 I certify,under the pains andpenalties ofperjury,that the information on this application is true and complete. t FIRM NAME: 0"1x 1 S — 4"- LIC.NO.: /SJ G)R�4 Licensee: AM v &- Signature LIC.NO.:3)33) 9 (If applicable,enter "exem�,p rn the license number line.) !� Bus.TelNo.:. / 7- 6 .�5�e Address: /�S" ( �lIL1 .tt yt, S�' +Upc�} )J ,/{FYI Alt.Tel.No.: � `fti7 X13 *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's gent. Owner/Agent . Signature Telephone No. PERMIT FEE. $ y The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Mass. 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual) Address/ W �'1 City/State/Zip: ���� / Phone#: l 90- 6 S 5_6,5 Are you an employer?Check the appropriate box: Type of project(required): 1. ❑ 1 am an employer with 4. ❑ 1 am a general contractor and 1 6. ❑New construction employees(full and/or part time).* have hired the sub-contractors ❑ Remodeling 2(7\1 am a sole proprietor or partner- listed on the attached sheet. 7. ,p and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers'comp.insurance comp.insurance.++ required] 5.0 We are a corporation and its 10. ❑Electrical repairs or additions • 3. ❑ I am a homeowner doing all work officers have exercised their 11. ❑Plumbing repairs or additions myself [No workers'comp. right of exemption perm MGL insurance required]t c. 152,§ 1(4),and we have no 12. ❑Roof repairs employees.[no workers' 13. ❑ Other comp.insurance required.] • *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contactors that check this box must attach an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing w s'compensation insuran e for my employees.Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: \� City/State/Zip: _ Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration(date). Failure to secure coverage as required under Section 25a of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of $250.00 a day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the inform ion ovided above is true and correct. Signature: Date: Print Name:A, ( • Phone 4:C�" 96 S Official use only Do not write in this area to be completed by city or town official City or Town: Permit/license#: Issuing Authority(circle one): l.Board of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#• I Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statue, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the forgoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees,However the owner of a dwelling house having not more that three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer". MGL chapter 152 section §25(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152 section§25(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificates(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the Members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Towns Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in theermit/license number which will be used as a reference p e erence number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses.A new affidavit must be filled out each year. Where a homeowner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. • The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 phone#: (617)727-4900 ext.406 or 1-877-MASSAFE fax#: (617)727-7749 Revised.11-22-06 www.mass.gov/dia f 4 f��� ��i6��1 �Ty �{4,� ��➢1€I�� � f..i�(a�I.�.�l��T r - OF ELETRICIANIS AS A REG .i0 ;RIVI,E'YINfN`ELECTRICIA iAROLD C CUR-TIS .85 WALTHAM'r ST +E,WiTON MA' 02465-135' 31389 E 07/31/10' 332113 "'C'VXkt!f„'P,iAvf EA 1�" V,1F lFRid, 103 Wl-7N TRE .,TDM1"�5, l i52bQ' A R? 1/ Q 3:321:12 Date. . f WORTN 1 Aft 3? TOWN OF NORTH ANDOVER p P ' PERMIT FOR GAS INSTALLATION AcHUS r r� d This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation .�� . . . . . . . . . . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . at . . ./. . . . :� `. . . .� . . . . . North Andover, Mass. Fee. . . . . ... . Lic. o�G//. . . .. . ' : . . . . . . . . . . . . . GA;�NI Check#,7�1� Ti 76 i MASSACHUSETTS UNIFORM APPLICATON FOR PERM U M DO GAS G (Type or print) Date T11 o NORTH ANDOVER,MASSA�`CH TTS 7 Building Locations ` C 1 S ��C L Permit# �� r C Amount$ �O Owner's Name New❑ Renovation ❑ Replacement Plans Submitted ❑ U a w o c oo z P z u w m �, z o a > w . F z H a > o > w W U x 7 a. W > w 7 z Q x 4 1 c °o w c� c x m o x 3 0 a U a > SUB -BA SEM ENT BASEMENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR REE I 8.TH . FLOOR (Print or type) Check one: Certific e In Iling Company Name— 1 ALL1+l 1/-1-11./ A C [ { rp. Address /� t ❑ Partner. usmess Telephone Firm/Co. Name of Licensed Plumber or Gas Fitter J L C INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 12 — No❑ If you have checked Yes,please n the type coverage b checkingthe appropriate box.Liability insurance policy Other type of indemnity Bon ❑ d ❑ Owner's Insurance Waiver: I am aware that the-licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent 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 installationsricensed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts Stat and Chapter 142 of the General Laws. By: Signator u��e��0 Gas Fitter Title Plumber City/Town Gas Fitter License Number rrMaster APPROVED(OFFICE USE ONLY) Journeyman I. 2d Date. . TOWN OF NORTH ANDOVER s _ s PERMIT FOR PLUMBING ,SSACNUSE� This certifies that . . . . . CCC ��`/ � �,>a 71. has permission to perform . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . at . y . . . . '1Y. ': . -:.. . . , orth Andover, Mass. . . Fee. . . . . . .Lu. No. . . . . . . . . . . ., A PLUMBING.ISPECTOR Check # V�d 8568 I r V MASSACHUSETTS UNIFORM"PLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Building Location I L Date Permit# Owner L.(e Amount r�p New ❑ Renovation 0 Replacement �— Plans Submitted Yes ❑ No FIXTURES ro og �SNM+I�T� M EE" FT 2M NJ" �1 IIlJQt 41H ROM 51H Now, 6M EU tz 81H FIOM M (Print or type) Check one: certificate Installing Company Name C IJU 41L,, `y C_ 4— l�r { , 1..:J `. Address L L O AVIU0 O U e ❑ Partner. Business Telephone y 3 ❑ Firm/Co. Name of Licensed Plumber: L Insurance Coverage: Indicate themsurance coverage by checking the appropriate box: Liability insurance policy ' �i Other type of indemnityElBond �+ hmsurance 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 s 'tted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and insta performed der Permit Issued for this application will be in compliance with all pertinent provisions of the Massachm to Plumb' Cod and Chapter1142 of the General Laws. By. rgna Title Type o �\ License �/ City/Town r e um r Master �,/� Journeyman ® ri APPROVED(omcF USE ONLY u 'V � '. Y Date 0 AORTil o;.'tiooL TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACMus� This certifies has permission to perform . .•. . . . . plumbing in buildings of . . . . . . . . . . . at . `�!. . . Com. . . . . . . . . . . . . .', North Andover, Mass. Fee-4?. . . . .Lic. oc,.'. . . . . . . . . . .�,�. . . . . .� . ,�'<. . . . . . . . . . . . f PLUMB(NG.i?SPECTOR Check # 16- 5 � 5 6 6-556 �A MASSACHUSETTS "UNIFORM APPLICATION FOR PERMIT TO DO PLUMBIN( (Type or print) A NORTH ANDOVER,MASSAC�S V ./ Y C l /�SCLL Date Building Location ! tQwn 'rs :` me r Permit# Amount � 7�. 6 Type of Qcu anc / c NewlulRenovation Replaceplent Plans Submitted Yes 0 No ❑ FIXTURES cfH 'z con a W F�1 a F W acznas SLRlM BAS VI+NT �FLOOR �FLoc� 4]H RD R 5M F1" 6TH FLOOR 7M FLOCIEt $IH FLOM (Print or type) Check one: Certificate Installing Company Name Corp. � Address � RF artner. 0 o3 Business Telephone Q 7 � rmVCo. Name of Licensed Plumber- Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 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 I three insurance Signature Owner ❑ Agent I hereby certify that all of the details and information I have submitted(or ent d ab ve qpplication are true and accurate to the best of my knowledge and that all plumbing work and installa' pe rf d ssued for this application will be in compliance with all pertinent provisions of the Massachn S State hapter 142 of the General Laws. By: Sjgnature >wsecl MUMMY e of Plumbing License Title � �� City/Town icense um er Master ❑ Journeyman APPROVED(OFFICE USE ONLY i Date.... -?....`3:1...... TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING $S CH This certifies that' ,..... .......2�..................... has permission to perform—'--d- -�— .............. wiring in the building of at.... As— orth Andover,Mass. Fee..................... Lic.No........... ...................... ELECTRICAL INSPECTOR Check # 5109 i Official Use Only Permit No. O Det o��r[Fille y Occupancy&Fee CheckedBOARD OF FIRE PREVENTION REGUNS 527 CMR 12:00 APPLICATION FOR PERMIT TOUPERFORM ELECTRICAL WORK j All work to be performed in accordance with th• Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type adl information) Date 3 0�/ To the inSpeCty of.M.—es: Town of North Andover �i The undersigned applies for a permit to perform the electrical work descri below. Location(Street&Numbe/r/ y� ( qgfy C,: F r Owner or Tenant vV 111%'fl m R o.s h l N e Owner's Address L5,qA6 lqS rq ?U i Is this permit in conjunction with a building permit Yes`X' No u (Check Appropriate Box) Purpose of Building/f/Cu7!eefgop m I?-"J f3A�h/2 J dellIP' Utility Authorization No. Existing Service0 Amps /10 Za Voits Overhead;iIc Undgmd 0 No.of Meters_ New Service Amps Voits Overhead 0 Undgmd 0 No.of Meters Number of Feeders and Ampacity i Location and Nature of Proposed Electrical Work 6 ! ONe 60nO s,,b r-C/,4woP u., fro©ruts 4o Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above 0 in 0 No.of Lighting Fixtures (g Swimming Poo( gmd C pmd 0 Generators KVA No.of Emergency Lighting No.of Receptacles Outlets ( No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Diposal No. Pumps Tons KW No_of Sounding Devices NoJ of Self Contained No.of DL)kwashers Space/Area Heating KW Detection/Sounding Devices 0 Municipal 0 Other No.of Dryers I Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wirin No.Hydro Massage Tuds No.of Motors Total HP OTHER: / 1D0 ,��Jfl N �1�S�1D/�� D+ol�cfJ IN•s�/��1X.� �sr„/��t, INSURANCE COVERAGE. Pursuari to the requiremen6ts of Massachusetts General Laws ' I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES= NO have submitted valid proof of same to the Office YES=NO - If you have checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE - BOND - OTHER . (Please Specify) (Expiration Date) Estimated Value of.El ri 1 Work$ Work to Start 4 ' Inspection Date Resquested i Round Final Signed the enres f perjury: FIRM NAME' ea ,r ov 7-4 LIC.NOJT! License.5X—Ne--J A 74 Signatur N / LIC.NO. Bus.Tel No. Address Alt Tel.No._ OWNER'S INSURANCE WAIVER: I am aware that the Licenses doot have the insurance coverage or its substantial equivalent a.*.required by Massachusetts General Laws.And that my signature on this permit ae n application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ S^ (Signature of Owner or Agent) The Commonwealth of Massachusetts Department of i1dustrial Accidents Office of hyvestigations # Boston, Mass. 02111 Workers'Compens<tion Insurance Affidavit J, r..t til Please R int Name: Location: City Phone F1am a homeowner performing all work myself. 01 am a sole proprietor and have no one working in any capacity I am an employer providing.workers' compensation for my employees working on this job. Company name: Address _ s City: Phone#: Insurance Co. Polio# Company name: Address _ City: Phone#: r Insurance Co. Policy# . Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury.that the information provided above is true and correct. Signature Date Print name Phone# Official use only do not write in this area to be completed by city or town official' E Building Dept ❑Check if immediate response is required Building Dept p Licensing Board E] Selectman's Office Contact person: Phone#: r-1 Health Department I] Other FORM WORKMAN'S COMPENSATION Location Date L No, r NOR*� TOWN OF NORTH ANDOVER 2 x 3?0.`„ a �hoL A Certificate of Occupancy $ #a ' Building/Frame Permit Fee $ ;w ♦ s # �SswcHusEt4 Foundation Permit Fee $ Other Permit Fee $ . Sewer Connection Fee $ Water Connection Fee $ TOTAL $ TIBuilding Inspector :- 12436oinom ime 25.00 w���. CIDiv. Public Works i f'ERJ11T NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 440. 2 'f LOT NO. U<- ( 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE ZONE I SUB DIV. LOT NO. I I LOCATION ,i ��I 1%r °6 PURPOSE OF BUILDIN diu{/'� 'w A i OWNER'S NAME NO. OF STORIES !�_I SIZE'-` OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME . SPAN + DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINF.S-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY - IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE L�� IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST T. BLDG. COST PER fQ. FT. PAGE 1 FILL OUT SECTIONS 1 - 3 ES - - PAGE 2 FILL OUT SECTIONS 1 - 12 - EST. BLDG. COBT PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS }, PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED_ J�� BUILDING INBPKCTOR SIGNATURE OF OWNER OR AUTHORIZED AGENT - .. F E E OWNER TEL.N PERMIT GRANTED / .tel CONTR.TEL p Ire 19 CONTR.LIC.# H.I.C.# F NORT Town of over * Z s dover, MassLAX ., 19 COCM CKEWICK AD r_-mss�b AA T E D �G BOARD OF HEALTH PERMIT T Food/Kitchen Septic System 1� THIS CERTIFIES THAT.......................................4T.(.. . ...................2C.4 BUILDING INSPECTOR .!Vl l ....................... ...... ............... Foundation has permission to erect...............t....................... buildin on ..............4/..j............ .�4-R Y. ...................4•R.......• Rough tobe occupied as.................................-'.�?'�'1.P.......� 1 '.t.. ........................................................................................ 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST T Rough ................................ Service ... . .... ... .. . ........... . ........ UILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough No Lathing or Dry Wall To Be Done Final Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. Smoke Det. 4 LI $t Cid ', �� ro °� � s i 4 Location I `d R y e �'�G(� No. 110-7 Date 03 NORTF� TOWN OF NORTH ANDOVER F 9 + ; ; Certificate of Occupancy $ ��J'••°'E<� Building/Frame Permit Fee $ �cMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ � � Check # 6 c" 88 / Buildin6inspe'cttlr 4 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING mm, BUILDING PERMIT NUMBER. DATE ISSUED: / X SIGNATURE: ✓'�/ Buil&rg Commissioner/-Ifor of Buildings Date z SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: O 1417 3-1 1�/ A IQa qA)dfo d.Q r" MA, 6 t F3N_V Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: O Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Leq±ed Provided Required Provided 1.7 Water Information:M.G.L.C.40. 54) 1.3. Flood Zone Infoation: 1.8 So_ rage Disposal System: Public 8/ Private ❑ Zone Outside Flood Zone B" Municipal F3 On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record 6�1I i% r'Gc eve- 13U s"e GL Gc. r4y C._-,fx, 1 o. " ej 0.4- r �r NN aa a(Pri ) Address for Service 5 -930 Signature Telephone 2.2 Owner of Record: (J" 12o tl -Au-r-l Gc—r y C,<C-C—<e . �t1y. J�eJdo��r- r�• 0 Name Print Address for Servic& p�q Si ature Telephone 90 SEC ION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable. ❑ �'oih7✓ CAJ�,4111 JIZ Licensed Construction Supervisor: �`� 33/2 License Number Mn Address �� 6 - a8- av�y � tr ig- ��3-313a Expiration Date -�Kignature rTelephone 3.2 Registered Home Improvement Contractor Not Applicable ' Company Name Registration Number r Address r Expiration Date Si nature Telephone Y I F . f SECTION 4-WORKERS COMPENSATION(XG.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 all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: 19dd C.- /q X azo q-00!A— -6-0 ` uG e_ be'�k P*:, h.,ovsC, SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be *(IFFICIAI'FUSE(}may Completed b rmit a licant , 1. Building — Buildin S U J J_ ')L) (a) g Permit Feef/ v0) Multiplier 2 Electrical3�v (b) Estimated Total Cost of `� Construction 7 V 3 Plumbing S"J '>o Building Permit fee(a)X (b) / �/ 4 Mechanical HVAC !O 7 5 Fire Protection 6 Total 1+2+3+4+5 (,e 3D m Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUIIDING PERMIT l> h/��/!'%�� // )�.s�•vy l as Omer/Authorized Agent of subject property Hereby authorize /,� �/�lml��// SI'✓ to act on My b half,it 11 matters rel e to rk razed by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, _9'g— __¢7 QQas Owner/Authorized Agent of subject prope Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print a/me// lz� / Si ature of Owner/A ent Date 777 ➢ S.i F' 14, NO.OF STORIES SIZE � BASEMENT OR SLAB SIZE OF FLOOR TIMBERSC = 1 2 RD 3 SPAN DIN ENSIONS OF SILLS DIMENSIONS OF POSTS DRAENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS I SIZE OF FOOTING X MATERIAL OF CHIIANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE I 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. /..l/ttii.11ili.11ii....ti!■ l.■■....■......it.iillllitlnii..■■.■■tlltl■■1■ APPLICANT //� /i/�� G- PHONL�� �z 1� ASSESSORS MAP NUMBER 1411 LOT NUMBER`,�L42_ SUBDIVISION LOT NUMBER STREET ����^/ / L ZZ_ STREET NUMBER 17111 $.tnitt.o■illi...tii.l■llnitl.....l..l...l..illlltt■■till■■lttllltitlitll.,i■ OFFICIAL USE ONLY RECOWAENDATIONS OF TOWN AGENTS Inti. ■.it It tiitt■ ■ilJ■...............................l...............■ DATE APPROVED�o<-/Z _ CO SERVATION ADMINIS TOR �- DATE REJECTED CONMIENTS DATE APPROVED TOWN PLANNER. DATE REJECTED CONUVIEENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED COMMENTS F&O ADDITICIIJ-.VPT 0R1tf PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY 3 ?/ Q� DATE APPROVED FIRE DEPARTNIE�( DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE i i North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) 2 &A ignatu a 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 _ a The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations ,a< Boston, Mass. 02911 Workers'ComA enation Insurance Affidavit S Name Please Print Name: Location: V1 C)Qs-1k C14de City Phone # 28 -X55 230 Q1 am a homeowner performing all work myself. . I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for try employees working on this job. Company name: Jo I-V c4d-dl JA 1 &dress a city: a lnsurance Co. POLey# -25-7011w,Q11w3 s-03 Comoarn name. , A.ddress Insurance Co. Pdicv# Fadu►e to secure,coverage as regwred Under Section 25A or MGL 152 can lead tathe irrsmition of cxirnir oir .or R.Arle upeto Sy.501 andlor one years'imprisorrrrentas svgl dies iolhelarma S7DP fine ofitltlEiDj�tiagie�gat I understand that a copy of this statement may be forwarded to the Office of imrestigaborm of the DA fcr coverage verification db hereby under Me pains and penspes of perjwy Mat Me ntawdw provided above its true and correct Signature Date a--0 3 Print name >v C �� 1 ��y PhMe Offk:W use only do not write in the area to be completed by city or town officiar Cdy or Town ' Bw7c n+g DoW OCheck Y immediate resp nse is►egulred p Li-ils n9 Bair p Solectman's 0 Contact person. Phone# n Health Departn Other j i %40RTH Of "°c I.,'qy O • A Town of North Andover Building Department '� ,q �- -•• �'� 27 Charles Street 9SSACHUSEtt� North Andover MA 01845 Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print. DATE ild��U3 JOB LOCATION r:rrr_le Number Street Address Section of Town "HOMEOWNER `/l C_A-r4vG;�G/ (T7,5),�,g 9 —5770 Numbdr Home Phone Work Phone PRESENT MAILING ADDRESS City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of 1 or 2 units and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section (108.3.5.1) DEFINITION OF HOMEWOWNER: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which of two there is, or is intended to be, a one family dwelling,attached or detached structures accessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official, a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 108.3.5.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned"homeowner"certifies that he/she understands the Town of No.Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requir ments. HOMEOWNER'S SIGNATURE:6��� APPROVAL OF BUILDING OFFICIAL Note:Three family dwelling 35,000 cubic feet, or larger,will be required to comply with State Building Code Section 127.0 Construction Control. Revised 4.30.03 Home owner Exemptions Form I I MAScheck COMPLIANCE REPORT I Massachusetts Energy Code I Permit # MAScheck Software Version 2.01 I I I Checked by/Date I I I CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 11-28-2003 DATE OF PLANS: 11/28/03 TITLE: CALDWELL COMPLIANCE: PASSES Required UA = 92 Your Home = 92 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA -------- --- CEILINGS 388 30.0 0.0 14 WALLS: Wood Frame, 16" O.C. 378 13.0 0.0 31 GLAZING: Windows or Doors 92 0.320 29 GLAZING: Skylights 12 0.430 5 FLOORS: Over Unconditioned Space 380 30.0 0.0 12 HVAC EQUIPMENT: Boiler, 85.0 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 design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 CALDWELL DATE: 11-28-2003 Bldg. l Dept. l Use I I CEILINGS: [ ] 1. R-30 I Comments/Location I WALLS: I l I 1. Wood Frame, 16" O.C., R-13 I Comments/Location I I WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.32 I For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location I I I SKYLIGHTS: [ J 1. U-value: 0.43 I For skylights without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location I I FLOORS: [ l 1. Over Unconditioned Space, R-30 I Comments/Location I HVAC EQUIPMENT: I ] I 1. Boiler, 85.0 AFUE or higher I Make and Model Number I I AIR LEAKAGE: I l I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or I 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 I conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I VAPOR RETARDER: [ l I Required on the warm-in-winter side of all non-vented framed I ceilings, walls, and floors. I I MATERIALS IDENTIFICATION: 1 Materials and equipment must be identified so that compliance can 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: [ ] Ducts shall be insulated per Table J4.4.7.1. I I DUCT CONSTRUCTION: l I All accessible joints, 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. I I TEMPERATURE CONTROLS: l 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: l Rated output capacity of the heating/cooling system is i not greater than 125% of the design load as specified I in Sections 780C1,1R 1310 and J4.4. I I ] I SWIMMING POOLS: I All heated swimming pools must have an on/off heater switch and I require a cover unless over 200 of the heating energy is from non-depletable sources. Pool pumps require a time clock. I l HVAC PIPING INSULATION: 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.) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" I 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 I COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant below 40 1.0 1.0 1.5 1.5 I l I CIRCULATING HOT WATER SYSTEMS: I Insulate circulating hot water pipes to the following levels (in.) : I PIPE SIZES (in.) I NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F) : RUNOUTS 0-1" 1 0-1.25" 1.5-2.0" 2.0+" tAORTji Town of Andover N o. 416 'I ROL, dover, Mass., low-"6/ 0 tL- LAKE COCHICHEMCI OOATED S U BOARD OF IjEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPEC OR V IL // THISCERTIFIES THAT................................................ ... ........................................... �52t�unda CA *1 cT has permission to erect.... buildings on ..... ....... . .4 Y ................. C/.�'!.......................... Rough Ar Chimney .... ... .. .... ... .... .. ... ... .... ..... to be occupied as..Re A.444o".*......................... ................... 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. 19 135P ' 0 & PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION AD ELECTRICAL INSPECTOR S *.J C Rough W ;004( ......6 ' 7 Service .. ....... ...F BUILDINGINSPi Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Fir Until Inspected and Approved by the Building Inspector. Burner DEPARTMENT Soto No, SEE REVERSE SIDE Smko Dm DATE: FRANK SGILES,PL.S S. OCTOBER 13, 2003 SCOTT L. GILES X. " �OFMgs FRANK S. GILES FRANK cy REVISIONS: SURVEYING G S u C ' No. N SCALE: I"= 50 DEERMEADOW ROAD NO. ANDOVE MA 01845 978 683-2645 o� 40� � t ) a0 sued ,. j e-mail :FrankGilesSurvey@atthi.com a� CERTIFIED PLOT PLAN OF LAND i ZONING DISTRICT R3 LOCATION SUBJECT PROPERTY 41 CARTY CIRCLE LEGAL REFERENCES NORTH ANDOVER, MA. MAP 47,PARCEL 35 DRAWN FOR 41 CARTY CIRCLE WILL BUSHNELL 41 CARTY CIRCLE REALTY TRUST W B&R A BUSHNELL, TRS i AREA=0.64 SEE PLAN#12868 BK. 4046,BK 11 DOS.1960 CARTY CIRCLE _g4 441 AL 125 4, ggo56'40" R' 1 D�G LLL L PROPOSED I . ., FOUNPA'('ION i L3ULKNF-An I;NTPYWAY f. r7p.AI N 1 i . 121MEN51ON5 l'F-I? VE NI2012: , p! ANS FOP, EQUAL 1 • 11QUAL 11 II If 11 41 C Vim{ i CIPC� i I _ NOPTH ANPO�t? AA, r-- ---------- L-L------------ I r- ------------ --------- --I 5C&F:i/4" - l'-0" t2At: I0/' ►l O3 II II I II I { { I I r-OUNPATiON III I 1 1 WALL A5 Ma'P. 5LA13: j I II 1 1 ( OUTL I NI; Or- 1 1 I I I III I nr�CK A30VI� I I tM5r Mt;N' 5A5H 1 { I ALIGN WITH WINDOW pF-I21METr_I, 0 I I I tXAI N MMOVE-: F45TIN6 r i , I I I DUI-KHF-AV I , It I II I f CONCp�T�......... -••-...I. I i i I I I PIF-I?5 11 Ii I I I JOINT 5F-ALANT. { I AT�pSTOI' I?x f { I OF, 51MILA2 I I IF-XI5TING 13ULKNE�Ab { I OPEWNG I i , I I I F OUPATION PLAN lP _. (VIr-) - 'Fo�, LF;" APA COMPt IANr 51NK, C3ULKNt<Al� C'( ANS FOf?C3AS�M�Nt1t? DlM�N51ON5 F-NTP.Y 41 CAM C I FCL� �o FO?1' NSI Nt„ NOl?1'H ANPOM ,MA, D.N. WINDOW - tOIL�t KONL�f? SC��;If�, , f� O,� PAt: 10/3!/03 " K-12103 _N "FPE-TWLL" 5HOWrf2 UNIt ::;::: V.1.�. DECK 51ZF- E & CONFIGUi?AflON WITH OWNrp z � I 0 = r � � f?f✓CK iN I N 0 I�-121DGF- DE�AM 5KYL IGNt Z I I <AFiOVF-> ,, I I I U II 5KYLl6Hr I I LANDING G WAm I`�l✓rF/- AUOVL V 1 CK ®f3�nP00M � I I f?A1L I NG � c�xisnn�> II l O� c p cros�n� I I 6ANn f?SF NOp_� � I 60 Fwd6,068 I n �C•� t �' I I 4�X 4 � I 7'-I ,, 53 ern do- _ El HF-API�P,: 7 �E I 0 2 - 1 3/ 4" X 7 1/ 4" • MICI20LAM LVL NF-W E-:XHAU5t FAN. 13A CL �® HAPP DUCT t0 -Xi -F,1Ol? I:F-MOVF �XISriNG WINDOW, FILL-IN KlfCNFN Opr�NING r0 MAtCH FX15tIN6 N N 0 CL MY FLOOD PLAN LIVING p00M N PLAN5 FOP N5HN�L� F�51P NCS 41 CARTY ClPCL� NOP,,TH ANPOM,, ,MA. 1'-0" 12M: 1O/'51/03 I?InG� V;NT OKYLIGNI ASPHALT SNINGLF-S ------------------------------ ---------------- ------------------------------- ---------------- --------------- ------------------------------ --------- ------------------------------ ------- --- --- - --------- e �xls�n>G ��oro n PLAN5 FOC? PU5HN� PT51P NCS I 41 CvTY CIpCL� NOf?TH AbOM ,MA, GUTTER AT I;AVE�5 5CA F:1/4" - V-0" PAt: 10/31/03 A30VI; bE�CK, POOP15, I;TC, 5KYL IGHT PATIO 120012 GUTTE 12 ----------------- --------- ---- ------------- ---- -------------- ---------- -__ _ --__ ___------- - ---- - ------------------------- __ i 1so�+ l oom asAo"a `-t"'1Nx IW N011b/1III WAJ NO�NV 1504 6!ZINVA-W!9 1 1 a;aw ZwNO�Q ?CIOd via ZI I � H51NIA 1A151 N61NIA dWdN N�NMO RIIM WN-ANOD JNI'IIb^d / -+- X 11 bZ 'SMOGINIM 'H'Gl MSN )1�C9�IZ NSINi� � d�1.11'1'J I I 2NU-SIX NDJ-dW 01I I MOQNIM 'H'Gl M-AN VA' MOdW HJ-dON !9NU-5IXA N:J-VW O-� SMOGINiMI�NL�S�� �I�I ldl5l+ I II V1" I IY.I JNIN-AdO NI 'IIIA DQNIM JNL-GIX-! -!nOWJN �0�SNd1d k e 2 X 10 AT 16" OC VENT 5/8" CDX F00r- 5N�ATHING P,IDGF- r,fAM: 2 - 1 3/ 4" X16" TYPICAL EAVES DETAIL: MICFOLAM LVL MATCH I;XI511NG FA50A & 50r-FIT A5PHALT 5HIN6Lr5 CON11NUOU5 SOFFIT VENT DOU13LF- TOP PLAT METAL DFIP I:DGF� P,-30C FIPE�PGLA5 ICI;/ WATF-F SHIELD INSULATION I" MIN, AIF 5PACF- Ar30V1% INSULATION, SKYLIGHT TYPICAL FXll-IPIOIP,WALL-, GUTT�P ` / 5VIN6 rXG O MATCH F15-nN S r3UIL-PING WP.AP YPI L CP\055 5 cc foo 1/2" CX PLYWOOP 5NF-ATHIN6 I/ 2" 6" 2 X 4 Ar 16 O.C. V P--13 F1r3FF6LA5 IN5ULAT10N FAILING I X 3 5TPAPPIN6 POLY VAPOR f3APJJFI2 1/2" CA" x 111 TYPICAL 511-1- DETAIL; PLA5H S ANCHOr C30LT5 Ar 4'O.C. 5/ 4" T&G PLYWOOD, SILL 5F-AL FOAM IN5ULATION NAIL & GLUE TO I%P�AMING.� POUf3 E� 2 X 6 TI2FA1EJ SILL TFr�:ATED WOOD DECK ------------ FIN15H 15f I'Look CONTINUOU5 P,1f3 ON JOI5r FINI5H GP.A17M ' \ TJI PFO 130 AT 16" O.C. WAI�FPFOO�ING < VrNDOF CONFIFM 12" 121A. POUMt)CONCMTF- PII✓P2. I 1 c: F-19 IN5ULATION SIZING) 'Is; 6ALVANIZFi?P05r ANCHOR 01-101, MIN, 4' Ft o5r COVEI? CONFIRM I2IM•715" MIN, 18" MIN, 3_711 WITH AppLIANCF i WALK-1NZZ :�•���:�: •� o 0 �. o I i',;.,...;.,.;.;.;.;.;.;.;•II H . . . . . . . . . . . . . . . .•.1.1.1.•.1.'. _ . . . . . TUP . . . . . . . . . . . . . . . . . . . . . . ... 1 t f -- ALL- CON5TRUCTION PEPCM2 521 5TANPA1?1:25 I'1%IP, AICNITF-C'RJM ACCF-55 r3OAI212 I I INPICAM5 30' X 98'' t3U5HN�LL F�51P NCS "CLAP RX) SpAC�" � I . . . . � . . . . . . .1 AS b�FfN6Y 521 NOP\V ANPOM\ ,Mr Location �G to. Date3 NORTH TOWN OF NORTH ANDOVER Certificate of Occupancy $ '—'----- Bu ld ig/Frame Permit Fee $ sACNus`� Foundation Permit,Fee $ Other Permit Fee $ f-J-,S-U Sewer Connection Fee $ Water Connection Fee $ ---- TOTAL $ )) i 1 4zS Building Inspector i 6624 Div. Public Works i OPERM-4 140. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. AGE 1 MAP 440. LOT NO. 2 RECORD OF OWNERSHIP iDATE BOOK PAGE — ZONE I SUB DIV. LOT NO. I LOCATIONr. 4 PURPOSE OF BUILDING � OWNER'S.NAME � n 1 � /�� NO. OF STORIES OWNER'S ADDRESS IC�V•/1V pvl vl�• BASEMENT OR SLAB - { ARCHITECT'S NAME l SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAMEV l 1 D J / ni A/ � SPAN _-- DISTANCE TO NEAREST BUILDIN Y/ DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST /'�1 , //.>3 + PAGE 1 FILL OUT SECTIONS 1 - 3 EBT. BLDG. COST PER 06. FT. 1 4 PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. i ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILE AND PPROVED BY BUILDING INSPECTOR DATE FI D BOARD OF HEALTH SIG refRy -IF OO , -E+R OR AUTHORIZED AGENT FEE d" Urkf C� PERMIT GRANTED OWNER TEL.# fC����r� PLANNING BOARD CONTR. TEL.#_3�,3- ._ t� 19 _ CONTR.LIC. DSJr��3 . BOARD OF SELECTMEN l BUILDIN N'f oPEcroR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY _ STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 8 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HA DW D PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL I FIN. 8'M'TAREA _ '/ 1/7 '/, FIN. ATTIC AREA _ NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 22 J 3 DROP SIDING CONCRETE I_ WOOD SHINGLES EARTH ASPHALT SIDING HARD\N'D ASBESTOS SIDING _ COMMGN _ VERT. SIDING ZPH. TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK N MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME T SUPERIOR I� POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING Y GABLEHIP BATH (3 FIX.) �- GAM8REL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY - WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC I 13rd NO HEATING 1 i� 4 Haverhill Maiden Framingham .Brockton,MA (5061373-1ee6 (6171=.7160 (506)8724M (511e)see-1171 VALLEY PREMIUM SOLID VINYL SIDING �a Quincy,MA Nashua,NH Portsmuulka NH INSTALLED BY FACTORY TRAINED TECHNICIANS v wtMoow a atotMo tNC (6171479-1211 (603)880.1510 (603)436.7546 MASS REGISTRATION #100792 NATIONAL TOLL FREE 1-800-370-1886 DATE— 9 / _/ — SOURCE Sm Co SULTA T HOME TEL. �5 08 (&7 57710 WORK TEL. MRJMRS. THIS AGREEMENT, made and entered intoZtiff;/-1717 enVALLEY WINDOW & SIDING, 50 White Street, Haverhill, MA 01830 hereafter referred to as a.contractttor AND )/j/gQy�S4 u ,�l /y��, ADDRESS/STREET 7�y 7(A- CITY Al'CIA'•L IC9 STATE MCI ZIP 011FOX hereafter referred to as owner. THE SAID CONTRACTOR hereby agrees that it will furnish all labor and materials necessary to install the following described work at premises located at:.JOB ADDRESS CONTRACTOR agrees to start described work on/or about X weeks after final fittings and complete described work in about working days. 5 1 fj U DELAYED INSTALLATIONS: DO NOT START INSTALLATION BEFORE I J CONTRACTOR shall.not be held liable for delays due to causes beyond control. The following work includes all labor and materials needed to complete your job in aklvorkmanlike manner. Special Instructions: Area to be sided W 40 _4ofn e- Insulation to be used Ar:t:gwy.14d Size 9:�= .� SidingBrand u r. '�A1,J'�Ub Color {c vL C t/4 le Siding Style t iyC ,uo J-Channel Color Corner Post 4 Color doar_ u Trim Coil ❑ Aluminum P.V.C. Trim Color �J p > Fascia treatment Soffit treatment VXUkd i_✓d WORK NOT TO BE PERFORMED BY VALLEY Window treatment CuS �ca� Door treatment Shutter brand /10125-' . Amt. Color Gutter Style /I/�''�' Color Customer Initials Pipe Style Nc''u" Color TOTAL INVESTMENT$ ?� E-Z Blocks des Amt. Color White DEPOSIT$ 9S Dryer Vents N� Amt. Color white BALANCE due on completion$ j Gable Vents yeS Size Color THE OW ER SHALL PAY FOR THE WORK In Cash or Check upon Completion ❑Valley Will Make Bank Arrangements ❑ By Bank Modernization Loan ❑ Owner Will Make Bank Arrangements You may cancel this agreement If It has been signed by a party thereto at a place other than the address of the seller, which may be his main office or branch thereto,provided you notify the seller in writing at his main office or branch by ordinary mail posted,by telegram sent,or by delivery, not later than midnight of the third business day following the signing of this agreement.See the attached notice of cancellation form for an explanation of this right. ! All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices.Any alterations or,estimate deviation from above specifications involving extra cost will be executed only upon Authorized Signature written orders and will become an extra charge over and above the estimate.All n agreements contingent upon strikes, accidents or delays.beyond our control. DATE 43 Owner to carry fire,tornado and other necessary insurance.Qur.wbrkers are fully covered by Workman's Compensation Insurance. `ti NOTE This proposal may be withdrawn by us if not accepted within 2 days. An interest charge of 11h% per month (18% per year) will be Date of Accepts L212Nq :4 added to any amount unpaid after 30 days from invoice date. sena In the event of default in payment of this order or any pan thereof and the account b referred to i an attorney for collection,the purchaser agrees to pay reasonable attorney fees. Signa 7 �. ItyORTH a . Townof O `16 )3 No. 4 _ H o LCA dover, Mass., ��^/� 19�� U COCHIC IC HE WK R� A°RATED PPS\ � '9S BOARD OF HEALTH a Food/Kitchen .PERMIT T D Septic System 49 4 BUILDING INSPECTOR THIS CERTIFIES THAT.........../ A... .�. !.�i.�.1i .ox-4.0-4-4.4 ..................................... Foundation has permission to erect.00.400 0.40......... buildings on .q./....1.04 . 7erim�s .....0.1./�4.40. Rough g to be occupied as...S..I.. .I...�'�I.�il....�i. s.�!�... 1.16 ..�.. Chimney provided that the person accepting this permit shall in every respect conform to theof 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ..r*............ .. ... . . ... Service BUILDING INSPE TOR Final ' Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a .Conspicuous Place on the Premises — Do Not Remove F nagh No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT