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Miscellaneous - 45 COUNTRY CLUB CIRCLE 4/30/2018
Date bkh"f�,QJ:T.,, TOWN OF NORTH ANDOVER r PERMIT FOR GAS INSTALLATION 3 This certifies that . . . . ...1.�? '. . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . qP.,.—P-? y. .. . . . . . . . . . . . . in the buildings of. . � I . . . . . . . . . . . . . I at . . . � nn ,, 1•-• . . . . . ( ( �.,..,.�:. .l. . 4 �.. . .�._.{�? No h Andover ss. Fee .'3. . Lic. No. 1 . . GASINSPECTOR Check# dS2 `I 1k, e� MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK t g- CITY QMA DATE ^ JPERMIT# JOBSITE ADDRESS OWNER'S NAIME � M1 —�-.-- G OWNER ADDRESS -- TE'i-...-----.,-- --- ]FAX TYPE OR OCCUPANCY TYPE COMMERCIAL n EUCATIONALC D ,--.1 RESIDENTIAL PRINT CLEARLY NEW, RENOVATION:[ REPLACEMENT:( PIANS SUBMITTED: YES F-11 NOn APPLIANCES-1 JLOORS--► BSM 1 2 3 4 5 �8 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER _J COOK STOVEI DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR J 1 _v v_f 1T -J _ . I C=-1 1 _,_ E v_! FURNACE GENERATOR GRILLE -- INFRARED HEATER _.... Ed JCS _ = f LABORATORY COCKS l _...! . ___.1 I f J _.1 MAKEUP AIR UNIT r OVEN POOL HEATER ._)rJ - -- ROOM/SPACE HEATER _.1 4 —J ----J o- ..__J L_ 1.. -._ f . - ! ..._ .:.I .,G..1 .-. I -:: J ROOF TOP UNIT --, ----J -_ J I . TEST LJ I UNIT HEATER J .. I 1 . __...1 L I _I _I ,i(�...___ t l I _ _.._i - 1 :._ UNVENTED ROOM HEATER WATER HEATER. __. _. _ - -- { J -� fir--1 .I l f f� - I�_I=J. _-1 F771 OTHER �'I _ - T_ - I I f I I 1 _ �� INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent whichmeets the requirements of MGL.Ch,142 YES D I I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVE BY CHECKING THE APPROPRIATE BOX BELOW i LIABILITY INSURANCE POLICY I �A OTHER TYPE INDEMNITY i' BOND [,Il OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that try signature on this permit application waives this requirement. I CHECK ONE ONLY: OWNER [j AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and Information I have submitted or entered regarding this application are true and accurate to the best of my knowledge i and that all plumbing work and Installations performed under the permit Issued for this application will be In co (lance with all Pertinent.provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER ASFJTTER NAME-5.__ __ -(- i s. ,.�_ LICENSE#L = SIGNATURE I MP .. . MGF EJI JP 0, JGF L LPGI 0 CORPORATION -__.. PARTNERSHIPF.]#[---_ _. - LLC D# COMPANY NAME: ADDRESS CITY 1� .1. .to _.-..._.. --- Ii 5TATE ZIP )TEL�... _ '_ FAX _. .. -. CELL EMAIL �1Q�P _�_. w� - 1 12�2�I1Z I u7'1N ►.c� 2. 6Yr i1 I Q COMMONWEALTH OF MASSACHUSETTS PLUMBERS AND GASI-ITTEN5R LICENSED AS A MASTER PLUMBER ISSUES THE ABOVE LICENISE TO: %:HRIS:TOPHER J MILOT 44 WOODLAWN ST TYNG.SBORO MA 01879-1325 150b2 . 05/01/14 160871 LICENSENO. EXPIRATION DATE SERIAL No. Fold,Ther,Detach Aiono All Per:'or;ions GENERATOR APPLICATION DATE: LOCATION; OWNERS NAME: c( ✓ac ��� GENERATOR kw 0 NO INSTALLATION OR (ROUND DISTURBANCE BEFORE APPROVALS* r CONTRACTOR: PHONE NUMBER: ELECTRICAL =RESID�El\li� COMMERCIAL TEMPORARY I LOCATION OF GENERATOR: *ZONING DISTRICT: *CONSERVATION APPROVAL ( a�.o� a,•in,.�u / Cid` �SvM.pf�os.szd wcn.�C, /0nn1vl l0q al a T -d 8L6L-tsb-8L6 quawdin63 s, uose0 Wdtbt, :aT ZTOZ 8T Dog Dec 18 2012 12: 44PM Cason 's Equipment 978-454-7978 p. 2 Q V7 b Date...'>..1.�...1..`.?�...:............ r►ORTH TOWN OF NORTH ANDOVER a PERMIT FOR WIRING 88gCHUS� This certifies that .......I ...................................................... has permission to perform ... p�-' ....................................................................... wiring in the building of............ .!R,......................................................................... at......... . ..c�..r��... ...�[ .......... orth Andover,Mass 1 Fee,��....- ':.........Lic.No.r�.... ...... .. kL ............. � f ELE CALINSPECfOR Check it ► 1 L. �' {1 commonwealth of Massachusetts Official Ye Only Permit No. Department of Fire Services Occupancy and Fee Checked aM BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/071 oeaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICALWOR All to p K work be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR (PLEASE PRINTWINK OR TYPEALL MFORW TIOA9 Date: City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 1. Q }� c>�V`2 Telephone No. Owner or Tenant Owner's Address Is this permit in conjuUrZ ' h bui ding permit? Yes ❑ No ® (Check AppropriateBnx) Purpose of Building ttt al Utility Authorization No. - Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters -4 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Ve • Completion of the following table maybe waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA KVA ch No.of Luminaire Outlets No.of Hot Tubs Generators 'v Above In- o.o mergency ig ting No.of Luminaires Swimming Pool rnd. ❑ rnd. ❑ Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones No.of Detection and No.of Switches No.of Gas Burners InitiatingDevices No.of Ranges Tons No.of Air Cond. Total No.of Alerting Devices Heat Pump Number" Tons",.,.."",KW,",.,,,... No.ofSelf-Contained , No. of Waste Disposers Totals: Detection/Alertin Devices y Municipal Other No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Heating Appliances KW uivalent Security Systems:Y No.of Dryers No.of Devices or E No.of WaterNo.of No.of Data Wiring: KW Ballasts No.of Devices or Equivalent Heaters Signs Telecommunications Wiring: Ivo.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent d " OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. A INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless v the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify,under thepains andpenalties ofperjury,that the information on this application is true and complete. FIRM NAME: " LIC.NO.: Licensee: i �`e Signature LIC.NO.: �l (If applicable.enter " xempt" n the license number line ^ Bus.Tel.No.: Address: 20 1\ 1 75 WeS-,Toe /°14 0� � Alt.Tel.No.: 4�9-�179-o�NG *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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. ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance with the provisions of M.G.L.c.143,§3L,the t ' permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed 6 ? Q a on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L 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 shall be limited as to the time of ongoing construction activity,and may be deemed by the Inspector of Wires abandoned and invalid 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 certain permits and licenses concerning the use 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 effect or existence"during the qualifying period beginning on August 15,2008 and extending through August 15,2012. ❑ Rule 8—Permit/Date Closed: ***Note:Reapply for new permit ❑ ❑Permit Extension Act—Permit/Date Closed: Trench Inspection Pass[N Failed Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass M Failed Re-Inspection Required($.) ❑ Inspectors Comments: . Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass n Failed IN Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSPECTION: Pass r5l Failed 0 Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: FINAL INSPECTION: Pass(]' Failed Re-Inspection Required($.) ❑ Inspectors Comments: q _ 3 Inspectors Signature: U Date: DEB WEINHOLD ...TOWN OF MERRIMAC,MA. .......dweinhold@townofinerrimac.com The Commonwealth of Massachusetts Department of IndustrialAccidints Office of Investigations if 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers APPHcant Information Please Print Legibly Name(Business/Organization/fndividual): Address: Qo_S? �1 `7 City/State/Zip:`N e9, Phone#: a) Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.[ I am a sole proprietor or partner- listed on the attached sheet. F]Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. g, E]Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 3111 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance employees.required.]t loyees.[No workers' 13.❑Other comp.insurance required.) *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they Aire doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. Policy#or Self-ins.Lie.#: 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 requiredunder Section 25A of MGL c. 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 up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cert under the pains and penalties of perjury that the information provided above is true and correct. Sig-nature: Date: Phone#: 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): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - - Contact Person: Phone#: r� A l r Information and instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,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 is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing 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 than 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,§25C(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,§25C(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 out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(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 Town 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 the permittlicense number which will be used as a reference 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 home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum 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 Tel,#617-72.7-4900 ext 406 or 1-877rMASSAFB Revised 5-26-05 Fax#617-727-7749 www,m.ass.govldia 7777., UR 1/... A .0`!'*�.Arpy/xw-�yJTHE O p+w J Mj4�y j { (p��{� , fVf Fn kA' IY✓ �A.t lir {O..I' 5'04's �i!' '<. ., �. UPTEFI � v t; 5 /. 15 , ` GENERATOR APPLICATION DATE: LOCATION; 1,5-.aon� OWNERS NAME; os- e/ GENERATOR kw C�?u NO INSTALLATION OR GROUND DISTURBANCE BEFORE APPROVALS* CONTRACTOR: PHONE NUMBER: JK 9- ELECTRICAL GAS -'� •_ =RES16DIEN� COMMERCIAL TEMPORARY M ARY LOCATION OF GENERATOR: *ZONING DISTRICT: *CONSERVATION APPROVALLa) /0 n n (v► ■ T •� fa/ I�I Lf`L A/ f'• •11 III .4 T V1 k-1 c IIf1C9 I.1 JLL •77T 77117 OT narr L_ 7 r� o� c� _4-r4-_o1c I I�III A r n4.7 c II ALL 77r 7rn7 n Hart HOiM G . Town of �;_=��st''• NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT PERMIT NO.: PROJECT: 5E'-S JQIAA« IVO&MM DATE: UNIT NO.: FLOOR: WING: BUILDING NO.: LIS- REMARKS: TS- REMARKS: 11200MIA 3cS Excavation-depth and soil conditions Framing- Other: Date: Date: Date: Inspector Inspector Inspector Footings and foundations and drains- Insulation- Other: Date: Date: Date: Inspector Inspector Inspector Electrical-rough- Plumbing and/or gas-rough- Other: Date: Date: Date: Inspector Inspector Inspector Electrical-final Plumbing and/or gas-final Other: Date: Date: Date: Inspector Inspector Inspector Fire Dept- oil burner,tank,stove,smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: -Cof 0# Inspector Inspector Inspector Form#995 Action Press,685-7000 l Information Hydraulic Design y g o anon Sheet --- ----------------------------------------------------- -- ------------- #lding: e: MASTER SUITE 2 .SPK DESIGN Date 9-12-01 _12_01 ation: LOT 5, COUNTRY CLUB CIRCLE, NORTH ANDOVER, MASSACHUSETTS 1 System No. : 1 ' Contractor: F.P..S . FIRE PROTECTION SYSTEMS INC_ , Calculated By: GCR Contract No. :' -01-29 Construction: COMBUSTABLE Drawing No. : lofl Occupancy: RESIDENTIAL DWELLING Ceiling Ht . : 8 -- ------------------------------------------------------------ System Design Code: NFPA-13R Review Agency: N. ANDOVER FIRE DEPT- - -------------------- Area of Sprinkler Operation: 440 System Type: WET Density (gpm/sq.ft. ) . .10 -------------------------------------- Area per Sprinkler: 220 Sprinkler or Nozzle Hose Allowance gpm Inside: 0 Make: FIREMATIC Model : 11U" Hose Allowance gpm Outside: 0 Size: 1/211 K-factor: 5 . 6 Rack- Sprinkler Allowance: N/A Temperature Rating: 155 DEGREE Calculation Summary Gpm Required: 44 .91 Psi Required. 68 . 17 AT: BASE OF RISER Overhead C-Factor: 150 Underground-C-Factor: 140 0---------------------------------------------------------------------------- Water Flow Test Pump Data Tank or Reservoir Date: 8-16-01 Rated Gpm: Capacity: Time: 10 :00 A.M. Rated Psi : Elevation: Static Psi : 92 Elevation: Residual Psi: 80 Type: N/A -------------------------- Gpm Flowing: 1503 Elevation: 0 Well Proof Flow: ------------------------------------------------------------------------------- Flow Test Location: JOB SITE Source of Information: FLOW TEST Storage Details Commodity: N/A Class : Location: Storage Height : Storage Area: Aisle Width: Storage Method %Solid Piled: : %Palletized: %Rack: Single, Double, or Multiple Row: Pallet Type: Encapsulated? (Y/N) : Longitudinal Flue Spacing: Transverse Flue Spacing: Clearance from Top of Storage to Ceiling: izontal Barriers Provided(Y/N) : raulic Design Information Sheet --------------------------------------------------------------- Name: MASTER SUITE 2 SPK DESIGN Date: 9-12-01 Location: LOT 5, COUNTRY CLUB CIRCLE, NORTH ANDOVER, MASSACHUSETTS ------------------ ----------------------------------------------------------------------------------------------------------- SUMMARY OF HYDRAULIC CALCULATIONS FOR MASTER SUITS 2 SPRINKLER DR,SIGN 9-12-01 ------------------------------------------------------------------------------ Submitted by: F.P.S. Fire Protection Systems Inc. 100 Pulpit Rock Rd. Pelham NH 03076 603-635-7512 --------------------------------------------------------_--------------------------------------------------------------=------- GN SPECIFICATIONS WATER SUPPLY SYSTEM DEMAND FOR MINIMUM DENSITY nsity: 0.10 92.00 psi at 0.00 gpm 74.37 psi at esign area: 440.00 80.00 psi at 1503.00 gpm 44.91 gpm 17.62 psi Safety Factor) List of Fitting Abbreviations Code Description Code Description Code Description Code Description Code Description Code Description A Alarm Va B Elbow I M Q BK.FLW.PRE U B Butt'fly V F Deluge Va J N R V C Check Va G Gate Va K 0 S W D DryPipeVa H L LongTurnEl P T Tee X Example: Fitting abbreviation of 'T2EC' means: One Tee two Elbow and one Check Va ulated by:_G.C. ROBIDOUK Checked by: Page 2 500515* Copyright 1984,J.Crowley,Crowley Design Group,Inc.,731 DeKalb Pike,King of Prussia,PA 19406 12151337-7060 Hydraulic Calculations for MASTER SDITB 2 SPRINKLER DESIGN Job No:01-29 Date:9-12-01 Submitted by: F.P.S. Fire Protection Systems Inc. 100 Pulpit.Rock Rd. Pelham NH 03076 603-635-7512 S ry of sprinkler and hose flows R ired flow and pressure is based on sprinkler k-factor, area covered, and minimum nozzle pressure for a design density of .1 Supplied flow and- pressure is based on 74.37 psi ava-ilable at supply 91.98 psi is actually available Ref. K Required Supplied Excess Flog Required Supplied Pressure Excess Pressure Ref. Pt. Factor Flow Flow Percentage Pressure PT PV PN Percentage Pt. S1 5.60 22.00 22.00 0.0 4 15.43 15.44 0.00 15.44 0.01 1 S1 S2 5.60 22.00 22.91 4.1 t 15.43 16.73 0.00 16.73 8.41 t S2 • C ulated by:—G.C. ROHIDOUX Checked by: Page 3 500515* Copyright 1984,J.Crowley,Crowley Design Group,Inc.,731 DeKalb Pike,King of Prussia,PA 19406 12151337-7060 Hydraulic Calculations for MASTER SDITB 2 SPRINKLER DESIGN Job No:01-29 Date:9-12-01 Submitted by. F.P.S. Fire Protection Systems Inc. 100 Pulpit Rock Rd. Pelham NH' 03076 603-635-7512 ------------ --- - ------------------- - ------------ --------------------------------__- No. 1 Remote to supply Fps Path No. 2 at Point A3 - Ref Elev. Pressure (psir K. Flow- (gpm) Veioc Diam. Actual Fitting- Fitting Total Frict.Loss Elev:Loss Next Ref Pt. ft. Pt Pv Pn Factor Added Total fps in. Length Summary Length Length per.ft Total Psi (ft.) Press Pt. - ---------------------------- (C= 150 ) S1 24.00 15.44 15.44 5.60 22.00 22.00 13.63 0.811 8.00 E 2.00 10.00 .360 3.60 3.47( 8.00) 22.50 Al Al 16.00 22.50 22.50 22.00 13.63 0311 6.00 T 3.00 9.00 .360 3.24 25.74 A2 A2 16.00 25.74 25.74 22.00 13.63 0.811 11.00 11.00 .360 3.96 29.70 A3 A3 16.00 29.70 29.70 22.91 44.91 16.44 1.055 4.00 T 5.00 9.00 .374 3.37 33.07 A4 A4 16.00 33.07 33.07 44.91 16.44 1.055 2.00 E 2.00 4.00 .374 1.50 34.56 A5 A5 16.00 34.56 34.56 44.91 16.44 1.055 8.00 E 2.00 10.00 .374' 3.74 3.47( 8.00) 41.77 A6 A6 8.00 41.77 41.77 44.91 16.44 1.055 2.00 T 5.00 7.00 .374 2.62 44.39 A7 A7 8.00 44.39 44.39 44.91 16.44 1.055 15.50 T 5.00 20.50 .374 7.67 52.06 A8 A8 8.00 52.06 52.06 44.91 10.98 1.291 18.00 T 6.00 24.00 .140 3.36 55.42 A9 A9 8.00 55.42 55.42 44.91.10.98 .1.291 23.50 2E. 6.00. 29.50 .140. 4.13. 59.55 TOR TOR 8.00 59.55 59.55 44.91 10.98 1:291 6.00 E 3.00 9.00 .140 1.26 2.60( 6.00) 63.41 BOR BOR 2.00 63.41 63.41 44.91 10.98 1.291 2.00 2GQ 32.00 34.00 .140 4.76. 68.17 BFP BFP 2.00 68.17 68.17 44.91 7.85 1577 0.25 L 2.00 2.25 .062 0.14 68.31 U1 U1 2.00 68.31 68.31 44.91 7.86 1.527 75.00 GT 9.00 84.00 .062 5.19 0.87( 2.00) 74.37 D2 U2 74.37 AAAAAA' AAAA Path K-factor = 5.21 -------------- - - - ----------------------------------------------------------------------------------------------------------------- Path No. 2 Grid Line to A Main (Fed by Path No. i ) Re Elev. Pressure (psi) K Flow (qpm) Veloc Diam. Actual Fitting Fitting Total Frict.Loss Elev.Loss Next Ref ft. Pt Pv Pn Factor Added Total fps in. Length Summary Length Length per.ft Total Psi (ft.) Press Pt. S2 24.00 16.73 16.73 5.60 22.91 22.91 14.19 0.811 14.50 2T2$ 10.00 24.50 .388 9.50 3.47( 8.00) 29.70 A3 A3 16.00 29.70 AAAAAA AAAAA Path K-factor = 4.20 C ulated by:3-.C. ROBIDOUK Checked by: Page 4 500515* Copyright 1984,J.Crowley,Crowley Design Group,Inc.,731 DeKalb Pike,King of Prussia,PA 19406 (215)337-7060 Hydraulic Calculations for MASTER SUITE 2 SPRINKLER DESIGN Job No:01-29 Date:9-12-01 Submitted by: F.P.S. Fire Protection Systems Inc. 100 Pulpit Rock Rd. Pelham NH 03076. 603-615-7512 *ry of flows through piping Ref Flow Ref Actual Fittings Fitting Total Diameter C Friction Loss Velocity Pt. Pt. Length .......... Length Length Factor Unit Total Al <<< 22.001 <<< A2 6.00 T 3.00 9.00 0.811 150 0.360 3.237 13.63. Al >>> 22.001 »> S1 8.00 E 2.00 10.00 0.811 150 0.360 3.597 13.63 A2 <<< 22.001 <<< A3 11.00 0.00- 11.00 0.811 150 0.360 3.951 13.63 A3 <<< 44.908 <<< A4 4.00 T 5.00 9.00 1.055 150 0.374 3.366 16.44 A3 >>> 22-.907- >>> S2 14.50 2T2E 10.00 24.50 0.811 150 0.388 9.496 14.19 A4 <<< 44.908 <<< A5 2.00 R 2.00 4.00 1.055 150 0.374 1.496 16.44 A5 <<< 44.908 <<< A6 8:00 E 2.00 10.00 1.055 150 0.374 3.741 16.44 A6 <<< 44.908 <<< A7 2.00 T 5.00 7.00 1.055 150 0.374 2.618 16.44 A7 <<< 44.90R <<<r AB 15.50 T 5.00 20.50 1.055 150- 0.374 7.668 16.44 AB <<< 44.908 <<< A9 18.00 T 6.00 24.00 1.291 150 0.140 3.359 10.98 A9 <<< 44.908 <<< TOR 23.50 2R 630 29.30 1.291 150 0.140 4.128 10.98 BFP >>> 44.908 >>> BOR 2.00 2GQ 32.00 34.00 1.291 150 0.140 4.758 10.98 BFP <<< 44.908 <<<- U1 0.25 L 2.00 2.25 1.527 150 0.062 0.139 7.85 BOR >>> 44.908 >>> TOR 6.00 E 3.00 9.00 1.291 150 0.140 1.260 10.98 U1 <<< 44:908 <<< U2 75.00 GT 9.00 84.00 1.527 150 0.062 5.190 7.85 C ulated by: G.C. ROBIDOUX Checked by: Page 5 500515 Copyright 1984,J.Crowley,Crowley Design Group,Inc.,731 DeKalb Pike;King of Prussia,PA 19406 (215)337-7060 ! . 3 _ u �� Date.....4 �aORTFi TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSACMusEt This certifies that .......C. A..,.... ........�.. ..�.!`.�. �. t.'...C............. has permission to perform �..`.t i..,....S�/j�!!�. ........... �... wiring in the building of.......��'. .� >..� ...�# r.0 .... ��cfn C at..... .. . j ................0...,��... sNorth Andover,Mass! Fee. 0... ... Lic.No. ... W............. ....., ��.. cl/ ELECfRICALINSPECTOR Check # '000 y WHITE: Applicant CANARY: Building Dept. PINK:Treasurer For Office Use Only Co10sl7sorsttr (Rev.11/99) 01 tc/�� Permit Number: 1JeFarl sad• Jima siivicel Occupancy b Fee BOARD OF FIRE PREVENTION REGULATIONS pPPLIC111 A_ ,nr,n>«�T TO PF-"ORM ELECTRICAL WORK A \ M- v�er-.v vim CODE$27 CMR 12:00) LX (ALL wows ro tae Ptanrol— win+THE,,,r,a,,.OWSU PLEASE PRINT IN INK OR TYPE ALL INFORMATIQN Date: 2, r'� a _ 0 ,To the Inspector of Wires: City or Town of: __ _: By this application the undersigned gives notice of his or her Intention to perform the electrical work described below. Location: (Street&Number)_�.E C 0 UNTX t , Owner or Tenant: 1 L/ W O 0-0 //5Sa C I /�/ b Owners Address: �l/� G :S this permit in conjunction with a Building Permit? Yes o No o (Check�A Appropriate �x) Purpose of Building: Utility Authorization#: y -�' o Existing Service: Amps Volts Overhead❑ Underground.❑ #of Meters e New Service: Amps I Volts Overhead ❑ Underground.❑ #of Meters: Number of Feeders and Ampacity: Location and Nature of Proposed Electrical Work: No.of Coil.-Susp.(Paddle)Fans No. of Transformers Total KVA No.of Recessed FUtures No.Of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pod: Above ground o In Ground o #of Emergency Ughting Battery Units No:of Receptade Outlets No. of Oil Burners Fire Alarms #of Zones #of Detection b Initialing Devices #of Sounding Devices: .oNo.of Switches No.of Gas Burners #of Salt Contained Detection/Sounding Devices l-4o.of Ranges No. of Alt Conditioners TOTAL TONS: Local o Municipal Connection o Other o 7 Heal Pump Totals: Security Systems: No. of Waste Disposals Number. TONS: KW: No.of Devices or Equivalent Space(Area Heating: KW Data Wiring,No.of Devices or Equivalent: No.of Dishwashers Hing Appliances KW Telecommunications Wiring:No of Devices or No.of Dryers Equivalent: No. of Water Healers KW No. of Signs:__-----#of Ballasts: OTHER; #of Hydro Massage Tubs No. of Motors Total HP less waived by the owner,no permit for the perforrnaace of electrical work may Issue unless the licensee provides proof of liability Insurance INSURANCE COVERAGE:Un INSURANCE ding*completed operation'coverage or Its wbstantial equivalent. The undersigned certifies that such coverage Is In force,and has exhibited proof of same to the permit inclu issuing office. CHECK ONE: INSURANCE o BOND o OTHER o Please specify: Estimated Value of Electrical Work i (When required by municipal policy) Inspections to be requested In accordance with MEC Rule 10,and upon completion. Worts to Start: 1 certify,under the pains and penalties of poqury,that the Information on tWs application Is true and complete. Finn Name: CITY WIDE ELECTRIC LIC.# 578MR ANTHONY LEMIRE Signature: LIC.# 16650E Licensee: (N applicable,enter"exempt"In the license n mbar line) 4 JACKSON DRIVE HUDSON, NH 03051 Bus.Tel.#(603)886-9640 Ak.Ta.# Same AdCreci: OWNER'S INSURANCE WAIVER:i am aware that the Ucermsee do11 es not have the liability hauranee coverage normally required by law. By my signature below.I hereby waive this requirement. I am"(check one) owner a OR Agent o Telephone# PERMIT FEE:S V Signature of Owner/Agent: � 1 *Tp r Date.....! �(J V d- NJ v CJ NORTH °`t"`°;• '"o TOWN OF NORTH ANDOVER p PERMIT FOR WIRING '•S SS CHUS This certifies that C t-'/ d � has permission to perform ........ ................. ..... I wiring in the building of.... A-).�&/ �atU�' ` f NorthMass:--,- Fee-76 ....:T�.......... .......... .... ................... � Andover,Mass. Fee.. .................. Lic.No.. ... . ... .. ....... .... ..... ........... ELECTRICALINSPECTOR Check # 1 WHITE:Applicant CANARY: Building Dept. PINK:Treasurer CowurwrsW"h4 e���/ u! For Office Use Only (Rev.11/99) Permitt Number (J o Occupancy&Fee BOARD OF FIRE PREVENTION REGULATIONS APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK (ALL WO&K To aE 1,guoNtMED WITH THE MASSACHUMM ELSMICAL CODE 327 CMR 1122:00) PLEASE PRINT�I�N INn UK I TrtALL INF RMA I IV" Date: ( � U O a City or Town of: / .,To the Inspector of Wires: By this application the undersig/n�e�d gives n Lice of his o�her ention to perform the electrical work described below. Location: (Street&Number) `r�� (�f9 ���y' l /V'C A?— Owner ?Owner or Tenant: Owner's Address: I i Is this permit in conjunction/with a Building Permit? Yes o No o (Check Appropriate Box) Purpose df Building: �o�s� Utility Authorization#: a cR 3 r?,, 7S Exiting Service: Amps / Volts Overhead 0 Underground.0 #of Meters New Service:Old Amps/)i - C/Volts Overhead 0 Underground. #of Meters: Number of Feeders and Ampaclty: Location and Nature of Proposed Electrical Work: r���2 No.of Reussed Fixtures No.of GU.-Susp.(Paddle)Fens No. of Transformers Total KVA No.Of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures 3 61Swinvning Pool: Above ground a In Ground o M of Emergency Lighting Battery Units No.of Receptacle OutletsO No. of Ou Burners Fire Alarms 0 of Zones t 0 of Detection&Ing nitiating Devices L No.of Switches Q No.of Gas Burners of err of Setl Contained No. No.of Ranges / No. of Ale Conditioners TOTAL TONS/ Detection/Soundiry Devices Local o Municipal Connection o Other a No. of Waste Disposals Heat Pump Totals: Security Systems: Number. TONS: KW: No.of Devices or Equivalent No.of Dishwashers Space Uvea HeaUng: KW Data Wiring,No.of Devices or Equivalent: No.of Dryers / Heating Appliances KW Telecommunications Wiring:No of Devices or Equivalent: No. of Water Healers� KW No. of Signs: N of Ballasts: OTHER; N of Hydro Massage Tubs No. of Motors Total HP INSURANCE COVERAGE:Unless waived by the owner,no perrdt for the porfonnaace of.ilectrical work may Issue unless the licensee provides proof of liability Insurance including'completed operation'coverage or Its substantlai equivalent. The undersigned certifies that such coverage Is In force,and has exhibited proof of same 10 the permit issuing office. CHECK ONE: INSURANCE 0 BOND o OTHER o Please specify: Estimated Value of Electrical Work S (When required by nwnidpol policy) work to Start: Inspections to be requested In accordance With MEC Rule 10,and upon completion I certify,under the pains and pensid"of perjury,that the Information on this application Is true and complete. Firm Name: CITY WIDE ELECTRIC UC.N_ 578MR Licensee. ANTHONY LEMTRE Signature. LIC.N 16650E (H applicable,enter"exempt'In the license n mb r line) 4 JACKSON DRIVE HUDSON, NH 03051 BTel.r(603)886-9640 Address: ua, AK.Tel.r Same OWNER'S INSURANCE WAIVER:I am aware that the Licensee does rel have the liability kuurancs coverage normally required by law. By my sWretwe belorw,l hereby waive this requir~L I am the(check one) Owner o OR Agent o Signature of Owner/Agent: Telephone S PERiN1T FEE:S G 'd Date. .?. . �.. .?...... .. NORTH pf 4��io 1tip o� TOWN OF NORTH ANDOVER 4, D t -� PERMIT FOR GAS INSTALLATION �."SACHUSEt I This certifies that . . ,�?!. . .//. . . . . . . . . . . . . . has permission for gas installation . . . l.i. :. .` . . . . . . . in the buildings of . . .'. . . . . . . . . . . . ... . . . . r. . . . . . . . . . . . . . . . . . . . at X . . . . . . . . . . . . . . . . . . . . . . North Andover, Mass. Fee. . •'. . . . . . Lic. No.. , . . . . . . . . . . . . . . . . . . . . . :�. . . . . . . . . GAS INSPECTOR Check# J . J MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date NORTH ANDOVER,MASSACHUSETTS Building Locations L01' 4-; Cootc-ott .. bon, (W Permit# 3 L ` ArRount$ /2-J-1 — ' Owner's Name New a Renovation ❑ Replacement ❑ Plans Submitted ❑ 0 d a N N as a� o ° N H c7 w � w z F w a ° W o SUB-BASEM ENT B A S E M ENT 1ST. FLOOR 1 1 2ND. FLOOR 3RD. FLOOR a 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR ---+ (Print or type) n k one: Certificate Installing Company Name Corp. Address 4% Z�c * rA, ❑ Partner. Business Telephone on S_ c���^-1�� � Firm/Co. Name of Licensed Plumber or Gas Fitter 1 A k(A,, AA AA(l:t INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ® No❑ Ifyou have checked M,please indicate the type coverage by checking the appropriate boy- Liability oxLiability insurance policy ® Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: 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 installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By. Signature of Licensed Plumber Or Gas Fitter Title ® Plumber 1 t 35 City/Town ❑ Gas Fitter License Number Master APPROVED(OFFICE USE ONLY) ❑ Journeyman r ` , NO oTh OQ ix ,i RhO ♦ � Y K� 'r• �SSACHii`'E,c CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number THIS CERTIFIES THAT THE BUILDING LOCATED ON �0 �`S C) UN l'l' 0-16) 6 (i r MAYBE OCCUPIED AS Sf lu /`e- 117 iA/ Dj/ a)19 IN ACCORDANCE WITH THE P OVISIONS OF THE MASSAC SETTS STATE BUILDING s - 05' �34 �-hs CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. // �3 ..f a �/4 rf 14�h- CC CERTIFICATE ISSUED TO -�)v N w D O d A ss o C Jai lc�5�ov ed doa,251 /411)c do oeR MA - Building Inspector own of And No. - � dower, Mass. 17- la'1' 9A001 Oh, a? BOARD OF HEALTH PERMIT TO LD Food/Kitchen Septic System �G BUILDING INSPECTOR THIS CERTIFIES THAT... ...N..W. O .....A. . oc..... �•�T Foundation 1 �, 5 S Coini►y CIIu�O Cl ,� o .has permission to erect:........ .............................. buildings on ............. ........................... .......... Rough, 1�. Chi to be occupied as.11r�OO.m.I..1 Seks.3...S�'+..11.....A...�'�'lq.4r� �Lw 1�... ...... y�. mne provided that the person accepting this permit shall in every respectconform to the terms of the application on file in Final ��(� �//3/� - this office, and to the provisions of the Codes and By-Laws relating to the Inspection, oration and Construction of Buildings in the Town of North Andover. & Y/' la y 0*3, �- PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. ¢ ¢ `< //` - _ " 1;$" , g.ECTRI AL SPECT C g - ..�/ /......... rvice ........ ......... BUILDING INSPECTOR i 0 S INSPE Rough -` Display in a Conspicuous Place on the Premises — Do Not remove No Lathing or Dry Wall To Be Done FIRE DEPAR ENT Until Inspected and Approved by the Building Inspector. Burner i Street No. / 6 � Smoke Det. SEE REVERSE SIDE Town of North Andover piORTH o � q Building Department 1L6D ,6� ga;� »,s`6o 27 Charles Street o = �► North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 9 [G[A1[INWI[M A V CHUS APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS YS COL) C(ak C Je ' LOT NUMBER SUBDIVISION ()I-) by CGA/ G�/pL'�, DATE REQUEST FILED `� 6 DATE READY FOR INSPECTION 3 FIVE DAYS NOTICE PRIOR TO CLOSING DATE IS RE IJIItED (51 O ALL WORD AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS Taffi FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NO MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING CONSERVATION � DATE 411110e9, PL DATE oZ. D.P.W. —WATER METE DATE -�.. D.P.W. MUST INDICATE THAT THE NATER METER HAS BEEN INSTALLED PRIM TO.THE INSPECTION QUEST DATE. I ATURE/DPW AftHORIZATIO Date. p'."•O°TN TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ACHUSf This certifies that has permission to perform . . . . . *. 4 A/C�.° : .�. . . . . . . . . . . plumbing in the buildings of . . . .4 ., North Andover, Mass. r Fee(.�,�/, 7.- .Lic. No.. ./l.S... . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check # ' 61,135 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Building Location Lor 5 A-qKCCvco�tW C ut', Owners Name -kA*,-j Permit Amount l3 Type of Occupancy New 0 Renovation Replacement 1:1 Plans Submitted Yes ❑ No ❑ FIXTURES Ln SLRlE BAS>E1VMr ( i 1 i ISL H-" Zn HBM a. i r 3MHDM 4M 11DM SII3ROM 6IH HAOM 7II3 HDM SIHHfM (Print or type) Check one: Certificate Installing Company Name"nuc o C�aM`."Y— Q')4 CA'o Corp. Address '{SPartner. n.At-C,y - vena . Business Telephone orn R Finn/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 4 Other type of indemnity D Bond D 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 El 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 the Massachusetts State Plumbing Co e and Chapter 142 of the General Laws. By: igna ure or McenseurlumDer Type of Plumbing License Title City/Town -cense Rumoer Master Journeyman ❑ APPROVED(OFFICE USE ONLY S X15" a V1, ck i to Location / No. c��/ Date -�� r,U� i �oRTM TOWN OF NORTH ANDOVER Certificate of Occupancy $ �',s"••�''<� Building/Frame Permit Fee $ 3 CHus _ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # -321q U Building Inspector TOWN OF NORTH ANDOVER r BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING M BUILDING PERMIT NUMBER. a DATE ISSUED:y X SIGNATURE: .� Building Commissioner/I for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: N' Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 4 6V Zoning District Pio-posed Use Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R red I Provided Required Provided 192 L a7SR o 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public I Private ❑ Zone Outside Flood Zone ❑ Municipal On Site Disposal System ❑ _p SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Owner of Record Wyk wood �9fl��� � f���'r 1�.�Tm �'1���ott)s. ANJOVE/i, HA � Name(Print) Address for Service 'V Signature Telephone !/ d 12k" Q 2.2 Owner of Record: Name Print Address for Service: Si nature Telephone so SECTION 3-CONSTRUCTION SERVICES 3.1}�T')censed Construction Supervisor: Not Applicable ❑ • & N8&�Vc/ Licensed Construction.Supervisor: tP 03�P A015 +/ �� ^ /n License Number W R V iag, civ AQ . 43087 Addres a C��� Expiration Date pf ic Signature Telephone V 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number r Address z Expiration Date 0 Signature Telephone Y� SECTION 4-WORKERS COMPENSATION(NLG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit wiel--Wit in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......❑ SECTION 5 Description of Proposed Work check an applicable) New Construction V Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: /l fo©m - 3 7dt SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost Dollar to be QFFIC .USE ONLY ( ) Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier r5 D /V '�$SO.^� 2 Electrical (b) Estimated Total Cost of 02 $, B D to Construction i D� _ 3 Plumbing A , 0 00 Building Permit fee tel X (b) 4 Mechanical(HVAC) a 00 U C,;-) oC 5 Fire Protection Cl 1 300 6 Total 1+2+3+4+5 (v q a 30o, — Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 7 1, A L 0 r^L as Owner/Authorized Agent of subject property Hereby authorize o N 9 ,C 0 to act on My behalf,in all matte s r la ve to work authorized by this building permit application. �, � 6 h0l Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are tree and accurate,to the best of my knowledge and belief Print Name K Signature of Owner/A ent Date NO. O STORIES a SIZE (� f BASEMENT R SLAB SIZE OF FLOOR TIIVIBERS X/0 f fTZ 2 ol X/0 fi Z 3 . SPAN V4AJ00S DIMENSIONS OF SILLS DM ENSIONS OF POSTS S DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS " 7" f " SIZE OF FOOTING X MATERIAL OF CHIMNEY Eli T G IS BUILDING ON SOLID OR FILLED LAND SO IS BUILDING CONNECTED TO NATURAL GAS LINE FORM - U - LOT RELEASE FORM . TNSTRUCTIONS- 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. ....■.....,.r....................■........................,...... ■..,,.MINS■ APPLICANT U) I SSD C/' ��,,C PHONE ��I'Y(9 ASSESSORS MAP NUM 3ER LOT NUMBER SUBDrwSION CO V,y Y �� ��0 • IAC LOTNUMBER S Q STREET C�t�11I GGt�/►) CI STREET NUMBER 4-5 ....................... . .. ............SOON.■.,...,....,,..,.■sons■■■... OFFICIALESE ONLY IN an was "Nomenessom on-Now onnummoss on an a ONS OF TOWN AGENTS RO ■ ■,,.,.,...■,■■.......■N....NNN.,..NN.,.r...■....' ..■ ■MI,,...,■ DATE APPROVED I I 0 VATIONADMINBTRATOR DATE REJECTED COM VIEENTS i DATE APPROVED TO R DATE REJECTED OIvIIviEN'IS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR-HEAL DATE REJECTED CONB ENTS - *PUBLIC WORKS-SEWER/WATER CONNECTIONS JN*o�d 0 DRIVEW P ZAP G DATE APPROVED DEPAR DATE REJECTED CONN ENTS RECEIVED BY BUU-.DING INSPECTOR DATE it ♦_ 1 I GTite "C�4art9n4nu�l� r��✓�laatar.✓ttrie�i I BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 062657 Birthdate: 02/2511957 Expires:02125/2002 Tr.no: 13815 Restricted To: 00 RONALD A BEDARD 2 WATER'S EDGE RD 's'�+! t108r APPLICATION FOR WATER SERVICE CONNECTION North Andover, Mass. _ `J!_'>' C: 19' Application by the undersigned is hereby made to connect with the town water main in t :fitz f V- f �',J �� Street, subject to the rules and regulations of the Division of Public Works. The premises are known as No. E`—�'L`t1 �f i �`�"J 'rl Street f � or subdivision lot no. -/75� ' i� Owner, Address Contractor Addreg Applicant's Signature 1 PERMIT TO CONNECT WITH WATER MAIN ,[ The Board of Public Works hereby grants permission to ! 1 /� ` :�''' #rt— � to make a connection with the water main at 0-- LI`' +��f ' � Street subject to the rules and regulations of the Division of Public Works. V T1� Board of Pgblic Works By �f_ t.r 7 Inspected by Date rj See back for rules and regulations V � E ` i z a The Commonwealth of Massachusetts Department of Industrial Accidents a � d W Office of Investigations << �� Boston, Mass. 02111 Worikers'Compensation Insurance Affidavit Name Please Print Name: w D f Location: IS CovzIlAY C ,(� � City .-A). R X) J •U'� 1`?� Q 11' %E Phone # I 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 my employees working on this job. Company name L0 Y A.�JA Address Ci v1 /Vf Phone Insurance Co.. Olt) �.t� G _ Polic # a Compgny name: . Address City Phone#: 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 Hcell..as_civil penaltiesin�hetnrm��_S.TOP_WORK_ORC?FR and..a fine_of,(.$9.DO.DD)atlay�gainst.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 herebycertify under Uiepains and penaltiesfifpedury that the information provided above is true and correct. / ' Signature WUDate 6 Print name /�OCL G� � /�f� Phone. Y official use only do not write in this area to be completed by city or town official' a Permit/Licensin ►# City or Town El Building Dept ?' ❑Check if immediate response is required p Licensing Board E] Selectman's Office Contact person: Phone#: Health Department Other 1700 APPLICATION FOR SEWER SERVICE CONNECTION North Andover, Mass. TT-- Application T—Application by the undersigned is hereby made to connect with the town sewer main in V subject to the rules and regulations of the Division of Public Works. f ((}� U The premises are known as No. V Lt , ` � �` �_ Street ' or subdivision lot no. _ Owner L1,7 Address Ip Contractor dress Applicant's Signature PERMIT TO CONNECT WITH SEWER MAIN The Division of Public Works hereby grants permission to A�;��oc a u 1 to make a connection with the sewer main at G � �( �f � �--- Street subject to the rules and regulations of the Division of Public Works.. �. . Division of Public Works l� Inspected by Date See back for rules and regulations 1 TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 E JINVILLIAM HMURCIAK, P.E. Telephone(978) 685-09SG DIRECTOR Fax(978)688-9573 f NQRT}1 0L r' p 7.TfO' p`iy �SSACHUS�t DRIVEWAY PERMIT } DATE c -Otte- K2 ZG 2b e) LOCATION OwL ej rd le 5 BUILDER phone OWNER PZ- A-::> r hone 179- �?5 THE NORTH ANDOVER SUPERINTENDENT OF OPERATIONS MUST BE NOTIFIED OF THE GRADE AND SETBACK FROM STREET . CALL THE SUPERINTENDENTS OFFICE BEFORE FINISH GRADING AND SURFACING FOR APPROVAL OF SUCH ENTRY. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. X A F1'L i GA tJ l�3 51c�'tVAY uetE � y R ' ' I : A.Scheck COMPLIANCE REPORT I = ss. chusetts Energy Code I Permit # i "11P-c,-'heck Software Version 2.01 Release 3 I I � I Checked by/Date TTTTE: 45 Country Club Circle -:TE: Massachusetts ?i1r 5641 =114STRUCTION TYPE: 1 or 2 Family, Detached ::EATING SYSTEM TYPE: Other (Non-Electric Resistance) D',TE: 6-25-2001 =. E '_-F PLANS: 6/25/01 _?z� IivFORl''ATIOPd: = _untry Club Circle N INFORMATION: i,wood Associates = :r, LIANCE: Passes i n?um UA = P? .r Horne = 676 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA -_------------------------------------------------------------------------------ ,l ;iP4=S 2304 38.0 0.0 72 "EILINGS 596 30.0 0.0 21 ^!ALLS: good FraIlle, 16" O.C. 3991 17.0 0.0 255 LAZING: Windows or Doors 627 0.350 219 20 0.390 8 FLOORS: Over Unconditioned Space 2158 19.0 0.0 101 HVAC. EQUIPMENT: Furnace, 90.0 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 _resigned 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 :hall be no greater than 125% of the design load as specified in '!'ections 780CMR 1310 and J4 .4. Euilder/Designer WyAW ��S �A Date ds o TITLE: 45 Country Club Circle PIAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 DATE: 6-25-2001 Bldg. 1 Dept. 1 Use 1 1 1 CEILINGS: [ ] I 1. R-38 Comments/Location [ ] I 2. R-30 comments/Location I I WALLS: [ l I 1. Wood Frame, 16" 0.C. , R-17 Comments/Location I I WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.35 For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location I DOORS: [ ] I 1. U-value: 0.39 Comments/Location I I FLOORS: [ ] ( 1. Over Unconditioned Space, R-19 Comments/Location i I HVAC EQUIPMENT: [ ] I 1. Furnace, . 90.0 AFUE or higher Make and Model Number I I AIR LEAKAGE: [ l I Joints, penetrations, and all other such openings in the building 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 gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. I VAPOR RETARDER: i t [ ] I Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. I I MATERIALS IDENTIFICATION: [ ] ( Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values, glazing U-values, and heating equipment efficiency must be clearly marked on the building plans I or specifications. I ! DUCT INSULATION: [ ] I Ducts shall be insulated per Table J4.4.7.1. I DUCT CONSTRUCTION: [ ] I All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. The HVAC system must provide a means for balancing air and water systems. I TEMPERATURE CONTROLS: [ ] I Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: [ ) I Rated output capacity of the heating/cooling system is not greater than 125°% of the design load as specified in Sections 780CMR 1310 and J4.4. 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-deplet.able sources. Pool pumps require a time clock. I H\1AC PIPING INSULATION: ( ] I HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in. ) : PIPE SIZES (in. ) HEATING SYSTEMS: TEMP (F} 2" RUNOUTS 0-1" 1.25-2" 2.5-4" I Low pressure/temp. 20i-250 1.0 i.5 1.5 2.0 1.0 Low temperature 120-200 0.5 1.0 �'� Steam condensate any 1.0 1.0 1.5 COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant. below 40 1.0 1.0 i.5 1.5 I I CIRCULATING HOT WATER SYSTEMS: [ ] I Insulate circulating hot water pipes to the following levels (in. ) : I PIPE SIZES (in. ) NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS I HEATED WATER TEMP (F) : RUNOUTS 0-1" 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 I 1.0 1.5 2.0 140-160 0.5 I 0.5 1.0 1.5 I 100-130 0.5 I 0.5 0.5 1.0 i ----NOTES TO FIELD (Building Department Use Only) ------------------------- 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. w N Oleo ` Y Arso�rA�EsG� ',� c� 44C Permit Applicant Property address 'Map/Parcel 0// Applicants 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 ofthe Growth Management Bylaw.I also understand providingthis 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 ofthis 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 ten 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 tr9ct 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 onetime 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 EXEMPTION WHICH DOES NOT COMPLY,WHETHER DONE TO MY KNOWLEDGE OR NOT ISGROUNDS FOR REFUSAL BY THE BUILDING DEPARTMENT TO ISSUE A BUILDING PERMIT. �lzs lo , APPLICANTS SIGNATURE DATE THIS FORM TO BE ATTACHED TO THE BUILDING PERMIT APPLICATION Site Plan V ' Lot 5,— Country Club Estates North Andover, MA 1 CO ,tae, scale. 1 — 40 Dote. 6/20/01 •%` _ � I I % 1 % • 1 + �.. 1 �b 'D -r — A I ♦ ♦ 1 . G •�. 1 Hyccnt e j 1 83 �r++t + r t I AR" 1 • pa�n� 1 G "tt � HouID WOKK ----- ♦ , � Doti 1 1 �i 1 P d ♦ ,. t 1 % I ` _ 1 E10 ` e Alf ll rRAT.f/i `,�,' �' • +, 1�` , � I ' ` 1 r SEE . •.x ++.• � ` ` 1 ` ` J ` %` � a �..�r�` ` -. otion Co j ` �w 040Mw— ` C R` �3p' •�� 1 dim' M �_ zGrf1/•••• wetknd ellrr.: ,•-•1 Y`�t-178• � 1 `� � �-•176• `♦ - %% 1 ♦ •. , ` 174••' ```•- `--•-•• �ytN OF JOHN M. �y i•-•--•• _ MORIN 22A-.• f� Or,Bar `-.._-.-• o CML No.39 Atip. 836 j mS20 �� `� ' % 10NAL ♦ �• Tbomas E. Neve Associates, Inc ' 3 ` I � �.•-�.� Engineers - Surveyors - Land Use Planners ♦ 164 ` 447 Old Boston Road - U.S. Route 1 T OO7 OCOC ORTH Town o - Andover.. . 0 i o ndover, Mass., O - LAKE COC HICHEWICK ADRATED p'V I �SSAC HUS�� I T FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT ..W.4.W.W..�� OCI.....AsAo; ... .W-.T4 P.0 A Wa.comc has permission to excavate and pour foundation at ..41s ..�V �* .C.1% C, r• for the purpose of.. .•. .. ATh �.. ... ��....� � ........................... . .... The person accepting this permit must return to the office of the Building Inspector a certified plot plan show of building thereon before Foundation will be inspected. L A/Ar a $ #s o& 4 VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. BLDG. PERMIT{E) �a 3: , LESS FDA FES r ....-.. DUE FRAME PERMIT" $ J 0 23, BUIL.DLNG MSPE,C OR NORTH E Town 0 ..: over p 70 No. a . dover, Mass., RATED S H BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT... ... . w..��...QA....A .���...�. r TocPA. ....�...1tcf�rn� Foundation has permission to erect.............. g � 5. s VA C 1V� CI 1�. ....................... buildings on ...................................... .... .................. Rough to be occupied as.i.jroof./..3�S... �T4/. 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, eration and Construction of Buildings in the Town of North Andover. 16 AY/'�144 y 0*3. — PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR / C.0 Rough ' ........................................................................ Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner • Street No. SEE REVERSE SIDE smoke Det_