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HomeMy WebLinkAboutMiscellaneous - 45 WINDKIST FARM ROAD 4/30/2018Ul r- Date -I....).,...1 .................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that A ... ... . .... . .... .. . ... ...... .. ....... ... .... ... .... .. ... .. has permission to perform .........in. � A� J— ..................................................................................... wi;mg in the building of .................. (� .... ...................................................................... J.. rn-c .. . . . ........ r -i PC; - at .................................. .. North Andover, M S. Fdie.,'T-5..�—.... Lic. No. N.71 . ................. /:!� ELECTRICAL INSPECTOR, Check# 2- r; Commonwealth of Massachusetts Official Use only Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 07/09/14 City or Town of: North Adnover 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) 45 Windkist Farm Road Owner or Tenant Quentara & Steve Costa Telephone No. 781-484-7203 Owner's Address same Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building Single Family Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Pool -side Shed No. of Meters No. of Meters Completion of thefollowing table may be waived by the In ector of Wires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans 1 TransTotal Trsformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires 3 Swimming Pool Above ❑ in- ❑ rnd. grnd. o. o Emergency Lighting Batte Units No. of Receptacle Outlets 8 No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches 4 No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges g No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers p Heat Pum Totals: P Number Tons KW .......... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KWLocal ❑ Municipal F1Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water Heaters KW No. o No. o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Sub Panel 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: 7/11/14 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: 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 ® BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that lite information on this application is true and complete. FIRM NAME: Folsetter Electric, Inc. A� .11� / LIC. NO.: 20421A Licensee: Robert Folster Signatu LIC. NO.: (If applicable, enter "exempt" in the license number line.) "/ Bus. Tel. No.: 978-658-9975 Address: 30 Parker Avenue, Tewksbury, MA 01876 Alt. Tel. No.: 978-387-9709 *Security System Contractor License required for this work; if applicable, enter the license number here: 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: $ S Signature Telephone No. e i J The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Print Form " www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Folsetter Electric, Inc. Address: 30 Parker Avenue . Tewksbury, MA 01876 Phone #: 978-658-9975 Are you an employer? Check the appropriate box: 1.0 1 am a employer with 3 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.* required.] 5. ❑ We are a corporation and its 3. ❑ I am a homeowner doing all work officers have exercised their myself. [No workers' comp. right of exemption per MGL insurance required.] t c. 152, §1(4), and we have no employees. [No workers' comm insurance reauired.l Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑✓ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12. ❑ Roof repairs 13.❑ Other *Ay 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 are doing all work and then hire outside contractors must submit a new affidavit indicating suck TContractors that check this box must attached 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 workers' compensation insurance for my employees Below is the policy and job site information. Insurance Company Name:. Policy # or Self -ins. Lic. #: Peerless Insurance, Co. WC1235167 Expiration Date: 08/07/14 j�6 Site Address: 45 Windkist Farm Road City/State/Zip: N. Andover, MA 01845 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 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 certify under the pains andpenalties ofperjury that the information provided above�is true and correct Phone #: " a-""P-z7z7` '' Official use only. Do not write in this area, to be completed by city or town official City or Town: PermittlAcense # 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 #: A4 Date ......1..1. 9.10 ............... `.. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies thatV.,..................P..L 1S** . ... ... .....v�..�.................................... r r�, has permission to perform..,�...............�..........................�................................................ ::...wiring ng the building, of.... �..l.-...'`�.......,..,......................................................................... at .......l.....�...... u/ �-1 vL! .lir 'f'` f`1; North Andover, Mass. Fee'u....... Lic. No. lvy.. ............................................................................. ELECTRICAL INSPECTOR I Check # � . I �, " , 6p 'k ►n"'` C01"T?Gc m'e'tal i of Massachusetts Official Use Only Permit No. _ Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENIPON1 REGl1LATI01'1!S [Rev. 9/05 -- (leave blank APPLICATION FOR PERMIT.TO-PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: ./A 0yt W 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) S' Owner or Tenant Telephone No. - Owner's Address .f 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 ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: j � � ( A No. of Meters No. of Meters ComDletion of the fnllnwinv f�hlo mnv ho u o a 7 ,h / —1717.- No'. of Recessed Luminaires --- No. of Ceil: Susp. (Paddle) Fans ---•— -—J -- .......,u vy a. ac. �..J GLIV/ VJ rllr CJ. No. of Tota Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators �tA No. of Luminaires Swimming Pool Above ❑ In- ❑ o. o mer's rg ng rnd. rnd. Batte Units No. of Receptacle Outlets No. of Oil Burners FFIREARMS No. of Zones No. of Switches No. of Gas Burners tection and atin Devices No. of Ranges No. of Air Cond. Tonal No. of Alerting Devices No. of Waste Disposers HeatPump um er I Tons I KW No. of Self-Co'niamed Totals: I Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ umcipa ❑ Other Connection No, of Dryers Heating Appliances KW Security ystems:* No. Devices Equivalent No. of Water Heaters KW o' o o' o of or Data Wiring: Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total QIP Te ecommumcations ir' No. of Devices. or .. uivalent ATHER: Aaacn aaautonal detail ydesired, or as required by the Inspector of Wires. E timated 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. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee providesproof of liabi ' insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coi rage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify) '1 I certify, under th ains and penalties o e 'ury, tha the formation on this application is true and complete. FIRM N16 wir I W% LIC. NO.: ftl Licensee:*AX Z - Signature LIC. NO.- (Ijapplic eiit "ex t" ' t ' `nae ber ne) Bus. Tel. No.. � at Addres . Alt. Tet. No.: *Securityystem Contractor License required for this work; if applicable, enter the license number here: 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 Sign�ture Telephone No. PERMIT FEE: y � 9 ,DR-:6t-e- ,,g,j O�e, ,��j4ove 12--5�:�tapcn The Commonwealth of Massachusetts - Department of IndustriglAccidents Office of Investigations 600 Washington. Street Boston, MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/ElectrricianslPlumbers Applicant Information Please Print LeiblY Name (Business/Orgaai'zation/Individual). I f 0, l a/ XV Irv, I ny Address: 06 �d � sir/� �iKQ �'lAq � City/State/Zip; Phone #: l d Are you an employer? Check the appropriate box: - 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (Mand/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and'have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. 5. ❑ We are a corporation and its [No workers' comp. insurance officers have exercised their required.] 3111 am a homeowner_ doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] ; employees. [No workers' comp, insurance required] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.0Roof repairs 13.❑ Other *Any applicant that checks box #f must also fill out the section below showing their workers' compensation policy information. i Homeowners who submit this affidavit indicating they ere 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 provicii workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: 16 ExpirationDate: i1 U i T . f'�► `'o"�'' City/State/Zip: Job Site Address. 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 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 tho DIA for insurance coverage verification. ' X do iaereby certify under rend pgna,41es ofperjury that the information provided above is true and correct. 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. PIumbing Inspector 6. Other f'. "+0n+PArcn1n, --- Phone a Location �i :a b, W No. Date NORTH TOWN OF NORTH ANDOVER ' L 9 Certificate of Occupancy $ sACHus `�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # • � ) / I �' J Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: ` DATE ISSUED: SIGNATURE: Building Commissioner/I for of Buildings Date I -- M JL'111.UN 1 -blip 1NkUKMAI1UjN 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Jem R2 Num P�Numb- 1.3Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use 1 Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard R red Provide R 'redProvided Required Provided 1.7 W&tN Slyply M.G.L.C.40. 54) Public Private ❑ Zone 1.5. Flood Zone Information: Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System K SECTION 2 - P UTHORIZED AGENT 2.1 Owner of Record IC 147 —a—tt %� OID 4lei 6oi�rVLbaZ1OIRIP Name ( :u) Address for Service QY Signz..ttre Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ �tG�k t�•2o _N �� Licensed Construction Supervisor: License Number 0 - �W Expiration Date Sig, lurephone 3.2 Registered Home Improvement Contractor Not Applicable 0 Registration Number 5dd Expiration Date Telephone I -- M / T SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6) . vir,vib %.umpcusauuu insurance amaav¢ must De 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 Workcheck altapplicable) New Construction ❑ Existing Building ' 1 Repair(s) ❑ Alterations(s) 9 dition ❑ 7 Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: (�n Kn r2 c-3- 5-=- 1A Vb" w 0 0, m= 1 1% Fe6c) rN 89,c�jOr-EN7- SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to beOFFICIAL Completed by permit applicant USE ONLY. 1. Building 15-15�r7 (a) Building Permit Fee Multiplier 2 Electrical 375 (b) Estimated Total Costof Construction 3 Plumbing OD Building Permit fee (a) X (b) / 6 ? . �-- 4 Mechanical HVAC /67Z. 51 5 Fire Protection 800 6 Total 1+2+3+4+5 0 40 Check Number SECTION 7a OWNER AUTHORIZATI N TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building pennit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, Zr'uA9�2 ejvav� as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Pri e Si ature of Owner en Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 ND3RD SPAN DM ENSIONS OF SILLS DM ENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE _ ._ NORT## Town Of North Andover Of4No ,��ti Community Development & Services 9 27 Charles Street \.o�-� :;,,•� * North Andover, Massachusetts 01845 fax 978-688-9542 Board of August 21, 2000 Appeals (978) 688-9541 Bill Dufresne Building Merrimack Engineering Department 66 Park Street (978) 688-9545 Andover, MA 01810 wrrservatiun Department Re: 45 Windkist Road (978) 688-9530 Health Dear Bill: Department (978) 688-9540 This is to inform you that the revised septic system plans dated 08/8/00 for the site referenced above has been approved for expansion. Public Health Nurse Ifan ou have questions, please do not hesitate to call the Board of Health (978) 688-9543 y y Office at 978-688-9540. Planning Sincerely, Department (978) 688-9535 Sandra Starr, R. S., C.H.O. Health Director SS/smc cc: Scarpa File 6. -1% William J. Scott Director (978) 688-9531 FORM U — LOT RELEASE FORM INSTRUCTIONS: This form is used 'to verify that all necessary approvals/permits from• • Ecards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. AFFLICANT FILLS OUT THIS SC-10-TION011. APPLICANTJ?\iGI'1A P_0 i�F_rJNCti . ` HONE 47o -24s5 LOCATION: Assessors Mac Number _ /�-F,4RCE_ SUEOIVISICN SLOT (S) STREET 49 I,_IS L FAe-yr RD \I ,ST. NuNusF- c 4'5 OFFICIAL USE ci- PIA y2ao,4 — .0 AV47 100 --t RECOMMENDA71CNS OF TOWN AGENTS: " Tv X2°0'" tN B A -A_10/ el/4-- NSE: cVATiCN ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE.APPROVED Y, t DATE REJECTED INSINS ECTOR-HEALTH COMMENTS a �y DATE APPROVED DATE REJECTED 114 Z PUELIC'WORXS-SENErFJWATER CONNECTIONS. DRIVEWAY PERMIT I/FIRE DEFARTNIENT RECEIVED EY EUILGING iNSPECT Revised 519; im or .ase'; .4^ u ^­', V_/Y�2,00cj 0 DATE t-1. L r -L - APR- 8-98 WED 15:b4 P.08/10 I T k t'-0" 10'-0" 10•,0" d'Q'• \\} -----------i/ o a d Via, I I I � I I a I I K }----- —� b N a y � � J VIR N 9' ' V id N Ss S i I I a I u a z I O� oii i b z I c ati I I --�- u`-------�J ry 1 !-,cc I''�'�' y a' I6'-0 s' loyz" �� sw0y21, _ � � 14'9•' Q �1 I �' r •a. le'O"9' O I TSN' P4 0011'OIA Gf FAWW/IL?WdOr q4'•d (m ______�.----___-_ _ ......,-____ 0 1 I 1 I � I I G'N�MDOGR ONiBfdDDM 1 I 1 I I I I NL�GOfd91p,C1[OWi1J.SMD I I I 1 I I \ auri town Volt" I:"m m bio M usaw w Lw I I I I 1 I I 1 A'v v 10 1 1 I I I A I 1 b I i rLl I 1 i�► I i I t -- I I I • � 9�1 1 a Q x111 I _I I I ml I r I u I I I 44-1 � 1 r-� yu I I '1'T• aTq" I L— a 1 j e4-22x0v[NM 1 r QI L_� r-__ _� ` - _-� - - - - -- --- -- I 4--- --- - OE/�M j i a i I d�'WpFXV'A(21WP) qmcar I I 5 i ��SSRIMGAtHM�erYx i I L ;saRtrmaaac - J 1� \ �s•o' 0 11 k. 111-91 Q �.4 w V O z 0 0 u 4 J O m u w E cn w A w a v Uw" Cd w a � w 0 a v u w w� i�. O z c� G w z w A a cw 6 cn o O cn :.s CD c w• C O vV, •per, � � :� O i 4rm ca $ CL • y cm c 2 m c COD O� m 0� m m d co ` y y t y i•: m 3 •• cm 0 m c • � _ 'fl y CeCo o • .L-. y E .40D m O av ` cm CD m; CC :w= OCI 0 c �' ? nct �o o m V �y O Z . C 0 n � 0 C 0 Q � y m C •O = m I 3 N o w y m$~ r COD CD •N dt W C O CD Z C.3 m Ome CR c g y m. m F O 2 _ A F.o A C O, O E Z O D ca h E CD O CL COO O C40) O CL�C y r�bl 3� O D L C. o a cmQ C � C cc J .0 O Z ts CDCLy C 0 L LI 0 L LI Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978)688-9545 Fax(978)688-9542 DEBRIS DISPOSAL FORM tAORTH 6 OL O In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, sl 50a. The debris will be disposed of in /at: Facility location Signature of Applicant 4-4`10 e Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. Member Diagram BOISE CASCADE - BC CALCTm 2000 DESIGN REPORT - US File Single - 5 1/4 x 16" V -L DF 2800 Name: Job Name - Customer Address - Specifier City, State, Zip - Code Reports - NER 442 Designer Steve Collins Company: Jackson Lumber Misc: scarpa Thursday, April 13, 200010:14 Untitled •1 •1 • lbs Total• •Length General Data Ref. Version: US Imperial Member Type: - Floor Beam Number of Spans - 1 Left Cantilever - No Right Cantilever - No Slope 0/12 Tributary 13-00-00 Repetitive n/a Construction Type n/a Live Load Dead Load Part Load Duration 40 PSF 12 PSF 0 PSF 100 Disclosure The completeness and accuracy of the input must be verified by anyone who would rely on the output as evidence of suitability for a particular application. The output above is based upon building code -accepted design properties and analysis methods. Installation of Boise Cascade engineered wood products must be in accordance with the current Installation Guide and the applicable building codes. To obtain an Installation Guide or if you have any questions, please call (800)232-0788 before beginning product installation. For glulam inquiries, please call (800)237-4013. Load Summary ID Description S Standard 1 2 3 4 Controls Summary Control Type Value Load Type Ref. Start End Live Dead Trib. Dur. Unf.Area Load Left 00-00-00 14-00-00 40 PSF 12 PSF 13-00-00 100 Unf.Lin. Load Left 00-00-00 14-00-00 0 PLF 80 PLF n/a 100 Unf.Area Load Left 00-00-00 14-00-00 30 PSF 10 PSF 13-00-00 100 Unf.Lin. Load Left 00-00-00 14-00-00 0 PLF 80 PLF n/a 100 Unf.Area Load Left 00-00-00 14-00-00 20 PSF 10 PSF 13-00-00 100 Moment 43306 ft -lbs End Shear 10016 lbs Total Deflection L/394 (0.426") Live Deflection U595 (0.282") Max. Defl. 0.426" (Limit: 1 ") Span/Depth 10.5 % Allowable Duration 85.5% @ 100% 62.8% @ 100% 60.9% 60.5% 42.6% NOTES: Design meets Code minimum (L/240) Total load deflection criteria. Design meets Code minimum (U360) Live load deflection criteria. Design meets arbitrary (1 ") Maximum load deflection criteria. Minimum End bearing length is 2-5/8". Loadcase Span Location 2 1 - Internal 2 1 - Left 2 1 2 1 2 1 1 Page 1 of 1 BCI® and Versa -Lam@ are registered trademarks of Boise Cascade Corp. BOISE CASCADE - BC CALCTm 2000 DESIGN REPORT - US Thursday, April 13, 200010:20 Single - 7" x 11 7/8" V -L DF 2800File Name: Untitled Job Name - Customer Address - Specifier Designer Steve Collins City, State, Zip - Company: Jackson Lumber Code Reports - NER 442 Misc: scarpa Member Diagram Standard Load - 40 PSF 112 PSF Tributary 13-00-00 AL 4420 lbs LL 4420 lbs LL 1508 lbs DL 1508 lbs DL General Data 0/12 Version: US Imperial Member Type: Floor Beam Number of Spans 1 Left Cantilever No Right Cantilever - No Slope 0/12 Tributary 13-00-00 Repetitive n/a Construction Type n/a Live Load 40 PSF Dead Load 12 PSF Part Load 0 PSF Duration 100 Disclosure The completeness and accuracy of the input must be verified by anyone who would rely on the output as evidence of suitability for a particular application. The output above is based upon building code -accepted design properties and analysis methods. Installation of Boise Cascade engineered wood products must be in accordance with the current Installation Guide and the applicable building codes. To obtain an Installation Guide or if you have any questions, please call (800)232-0788 before beginning product installation. For glulam inquiries, please call (800)237-4013. Total Horizontal Length -17-00-00 Load Summary ID Description Load Type Ref. Start End Live Dead Trib. Dur. S Standard Unf.Area'Load Left 00-00-00 17-00-00 40 PSF 12 PSF 13-00-00 100 Controls Summary Control Type Value Moment 25192 ft -lbs End Shear 5237 lbs Total Deflection L/304 (0.671 ") Live Deflection U407 (0.5") Max. Defl. 0.671" (Limit: 1") Span/Depth 17.2 % Allowable Duration 65.5% @ 100% 33.2% @ 100% 78.9% 88.3% 67.1% NOTES: Design meets Code minimum (L/240) Total load deflection criteria. Design meets Code minimum (U360) Live load deflection criteria. Design meets arbitrary (1 ") Maximum load deflection criteria. Minimum End bearing length is 1-1/2". Loadcase Span Location 2 1 - Internal 2 1 - Left 2 1 2 1 2 1 1 Page 1 of 1 BCI® and Versa -Lam® are registered trademarks of Boise Cascade Corp. The Commonw6alth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print r ► s Location: L 4 Z r= r_0cy woo () 12c) City f,300 vee K�& . C)1 $'l() Phoneyk- 4%D-ekel 0 am a homeowner performing all work myself. =I am a sole proprietor and have no one working in any capacity ® 1 am an employer providing workers' compensation for my employees working on this job. Company name: 0, L) Q l G S PAce Address L47 0 bD c) 2_0 City:IJ r�)aJa--c- �J )A L O Sr! I Phone #: q,7 t -4 0 - Zb SS' Insurance Co. Lg&-t oil-) Policv # WC? - Dl l qq l Company 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 well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. ,� v Print name �` (C4 A P -D Phone # ri ? k, - Official use only do not write in this area to be completed by city or town official' ❑ ❑Check if immediate response is regwred Building Dept ❑ Contact person: Phone #. ❑ FORM WORKMAN'S COMPENSATION Building Dept Licensing Board Selectman's Office Health Department Other �ommcovuueal�% o�✓�ixaaac�u�Cla ''' BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 043767 Birthdate: 07/29/1951 Expires: 07/29/2001 Tr. no: 3629 Restricted To: 00 RICHARD L KENNEY 147 GREENWOOD RD ANDOVER, MA 01810 Administrator x 17� . ONE IMPROVEMENT CONTRACTOR i Registration: 101011 Expiration,' 06/25/2002 Type: Individual RICHARO L KENNU � ch rd Kenney Greenwood Rd ADMINISTRATOR Andover. MA O 810 00 Date: Pruosal Customer: Chris & Jennifer Scarpa Date: 2/15/00 45 Winkist Farm Rd. N. Andover, MA. Job: Project Manager Scope of Work: Basement Renovation 1, Demo: 2. Insulation: 520. 3. Blueboard & Plaster:2,150• . , 4. Doors:; 1,200. 5. Trim / Vanity/ Stair Ends: 1,610. 6. Ceramic Tile: 530. 7.C61in2 with exposed Sprinkler heads. 3,500. 8. Electrical: 4,375. 9. Sprinklers: 800. 20. Plumbing: 3,800. 11. HVAC: 1,525.' 12. Painting 2,800. 13. Built-in TV Cabinet: 2,600. We propose hereby to fiunish materials and labor - complete m accordance with specifications above, for the sum of T..,..„�.� C:.. T1.n»c+n�t� Ni�n*sa TinT�s]s•r n(�(� ``.l► 2(_090_ 00 Date: t t l l O f ® O O 01 18 O �1 le O! O i I-C O O N ry O� O O O O O O 0, I O O (fi v c$� y-8 o � p +/ y c IA Date .. t Z. (. T� 2' , b',�"Sti73Dt� TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that.......... ............................... has permission to perform .. ��–�'�...... . wiring in the building of .�� .�... ..1......... ...� . ... ...., N� Andover, Mass.k1 Tee.tic. No.. C......... -.f ........ Check ��3Z—ELECRICAL INSPECTORG� 1315 t,4 .?leo VY 7Y/ Commonwealth of /Massachusetts € Department of Fire Services a BOARD OF FIRE PREVENTION REGULATIONS q (Please add zip codes & electrician's cell contract # & bid permit # if applicable.) Official Use Only Permit No. l C S.1 Occupancy and Fee Checked Zev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12,00 (PLEASE PRINT IAT INK OR TYPE ALL INFORMATION) Date: / /-- / (o City or Town of. /U - dG IJ- eQ To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to erform the electrical work described below. Location (Street & Number) �Sr � /VLot `��+ v liw 911 (Check AUAroUriate Box) Owner or Tenant S Owner's Address 41'r /., JJ Is this permit in conjunction with a building permit? Yes ❑ No ❑ Telephone 1$o. Purpose of Building Utility Authorization No. Existing Service Amps / Volts New Service Amps / Volts Ndin�er of Feeders and-Ampacity Location and Nature of Proposed Electrical Work: Overhead ❑ Undgrd ❑ No. of Meters Overhead ❑ Undgrd ❑ No. of Meters �l S i ervi Completion of the 'ollo- table bg ' d b h No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans may e waive y t e laspector of Vires. No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ rnd. rnd. o. o mergency rg i ng Battery 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 Initiatin Devices No. of Ranges No. of Air Cond. Total Tons No. of A10 -ting Devices g No. of Waste Disposers Heat Pump Totals: Number ........................................................................ Tons KW No. of Self -Contained Detection/Alertin Devices No. of Dishwashers Space/Area Heating KW Local Municipal El ❑ Connection Other No. of Dryers No. of Water KW Heaters Heating Appliances KW No. of No. of Signs Ballasts Security Systems:Y No. of Devices or Equivalent Data Wiring: g' No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: —.0 Attach additional detail if desired., or as required by the Inspector of if"fres. Estimated Value of Electrical Work: cltgo - When required by municipal policy.) Work to Start: &'A a Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVE GE: 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 ❑ BOND ❑ OTHER X (Specify:) Self Insured I certify, under the pains and penalties of perjury, that the info..rma iot on this application is true and complete. FIRM NAME: ADT LLC DBA ADT Security LIC. NO.: C-172 Licensee: Thomas J. Lee �ti,g nature � LIC. NO.: C-172 / �- F (If applicable. enter "exempt" in the l�' ense number line.)`- � �� Bus. Tel. No.: � t)3 `> c� y 5��� Address: CL t r t � ern 'i cll�_ \VS. , to 4 0'"S0 4 C? Alt. Tel. No.. * Security System Contractor License required for this work; if applicable, enter the license number here: 001779 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 Signature Telephone No. FPERMIT S'E'E. $ � '� 1y2Ctcg lIVYVAI —1 0 11t h�JP :COMMONWEALTH OF MALS (.'HUSE T 9 -I s°" e a�Hi'oa, w4Y�lr ,' o ELECTRICIANS A: REGISTERED SYSTEM CONTRAC70 ISSUES THE AROVE LICENSE -10: "A.D7 LLC. DBA ADT SECURITY: "'. THOMAS J LEE.. 410 :UN,IVERSITY AVE WESTWOOD MA 02090-231 172 C 07/31/13 201§341 YN M=old, fhrn Detach Along All Pe of -dons Date .............. ... ' TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .. �.°.-'�''�''1 has permission for gas installation ... • •v• in the buildings.... at ..�� .f���-.`��•. , North Andover, Mass. Fee Lic. ........... C; GAS INS�g&OR Check # Ili MASSACHUSETTS UNIFORM APPUCATON FOR PERNllT TO DO GAS FITTING (Type or print) NORTH ANDOVER, MASSACHUSETTS B uilding Locations\ (? D �1 • + �Wv� �\0� ~`�� Owner's Name )C Ne Renovation ❑ Replacement ❑ Date \k1k Permit # / Amount $ C��(1 CSS SGa� a Plans Submitted ❑ Q`r (Print or type Name Addres l•--���y �� aC d Business a ep one �1$> �Jl.. eek one: Corp. Certificate Installing Company ❑ Partner. ❑ Firm/Co. Name of Licensed Plumber or Gas FitterV INSURANCE COVERAGE Checl ne: I have a current liability I surance policy or it's substantial equivalent. Yes . NoO If you have checked yes, p se indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the hest of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in Cornpliance -,with all pertinent provisions of the klassachuseterSi itc GasoQode ark�,ChaX-r 142 of the General Laws. L\PPROVED (OFFICE USE ONLY) Signature ofLicvnsL(tAimber'dr Gas��er 3 Plumber 1 Gas Fitter LicenSc um er Master Journeyman • JST. FL 0 OR fiTH. FLOOR (Print or type Name Addres l•--���y �� aC d Business a ep one �1$> �Jl.. eek one: Corp. Certificate Installing Company ❑ Partner. ❑ Firm/Co. Name of Licensed Plumber or Gas FitterV INSURANCE COVERAGE Checl ne: I have a current liability I surance policy or it's substantial equivalent. Yes . NoO If you have checked yes, p se indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: 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 hest of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in Cornpliance -,with all pertinent provisions of the klassachuseterSi itc GasoQode ark�,ChaX-r 142 of the General Laws. L\PPROVED (OFFICE USE ONLY) Signature ofLicvnsL(tAimber'dr Gas��er 3 Plumber 1 Gas Fitter LicenSc um er Master Journeyman t N2 ►,.;� Date......:.. F.../... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... .. / J ......'`� :. .. ............ has permission to perform . J... :................ . �, ..................... wiring in the building of ............................................ .......................... at ...........' 1"`'" �............................. .North Andover, Mass. Feee.?. P . �...... Lic. No 1F..Ve r . ............................................................... ELEcrmcALINspEcrOR 07/28/98 08:40 M-00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 657 NwssweW45577 VO -4 .. e 4;D -d& sem, BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Only Permit Na Occupancy & Fee Checked APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number. Date To the Ind ect�res Owner or Tenant 44, A., i /-J .�iG� O i'y� owners Address i b % M is this permit in conjunction with a building permit Yes I No ❑ (Check Appropriate Box) Util'ttY Authorization No. Purpose of Building_ Existing Service—Amps Voits Overhead ❑ Undgmd C1 No. of Meters j New Service a00 Amps (A Al 6Voits Overhead ❑ Undgmo6s- No. of Meters r i Number of Feeders and Ampacity Locadcn and Nature of Proposed Electrical Wort( l� tifff 1 f l 4, fi! sw S�/Vf cs 2C4&2 A,/. INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Uability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YESrAI—CNO = If you hive checked YES please indicate the type of coverage by checking the appropriate box INSURANCES—BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Work$ Work to Start Inspection Date Resquested Rough Final Signed imetartha PanaMrAA of nar1(lrv' A n i FIRM h LIC. NO. LIC. NO. v Address ,3 l Ly 7"/ �I, t rf f^� Bus. Tel No. Alt Tel. No. 7 OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE S_ -- (Signature of Owner or Agent) Total No. of Uqht8nq Outlets No. of Hot fuse No. of Transformers KVA Above ❑ In ❑ No. of Lighting Fixtures SwimmingPool gmd ❑ gmd ❑ Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Bunters Battery Units No. of Switch Outlets No of Gas Bunters FIRE ALARMS No. of Zone No. of Detection and Total No. of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No. of DiposaJ No. Pumps Tons KW No. of Sounding Devices No./ of Seif Contained Detection/Sounding Devices ❑ Municipal ❑ Other ` '14 of Dishwashers Soace/Area Heating KW No. of Dryers Heatinq Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Badases Wiring No. Hydro Massage Tuds No. of Motors Total HP INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Uability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YESrAI—CNO = If you hive checked YES please indicate the type of coverage by checking the appropriate box INSURANCES—BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Work$ Work to Start Inspection Date Resquested Rough Final Signed imetartha PanaMrAA of nar1(lrv' A n i FIRM h LIC. NO. LIC. NO. v Address ,3 l Ly 7"/ �I, t rf f^� Bus. Tel No. Alt Tel. No. 7 OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE S_ -- (Signature of Owner or Agent) No 1.SG Date ../............... ............... TOWN OF NORTH ANDOVER PERMIT FOR WIRING i This certifies that .....'.Y.'...:.r. :�........r ��.................:........................... has permission to perform '..f:-�..�-� ........................................................... wiring in the building of.-.:...:.....-.- :.......:.......!.....% ................ `...........................................� `;-" I4orth Andover, Mass. at....................................... Fee. ............. Lic. No. !: C' ............... ELECTRICAL INSPECTOR 07/30/98 09:27 35.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer r 5 07 X55,4 +rus��7s �� a6 P -d& S144 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Only Permit No_ / '? & 0 Occupancy & Fee Checked I% 21,Wt, APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR :00 (Please Print in ink or type all information) Date To the Ins or ofWires: Town of North Andover The undersigned applies for aperrmit to perform the electrical work described below. Location (Street 1 & Number ! s— 60 /"M -(� Owner or T 0 Owners Address / is this permit in conjunction with a building permit, Yes f9- No C3(Check Appropriate Box) Purpose of Building i`-� IC& 60(/ Utility Authorization No. Existing Service Amps Voits Overhead ❑ Undgmd ❑ No. of Meters New Service Amps Volts Overhead ❑ Undgmd ❑ No. of Meters Number of Feeders and Location and Nature of Proposed Electrical OTHER (J✓/ G1 !NIU" IN URANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws / I ham a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES NO = have submitted vayd pr same to the Office YES 1-1NO = If you have checked YES please indicate the type of coverage by checking the appropriate box INSURANCE {(BOND = OTHER = (Please Specify) 00 (Expiration Date) Estimated Value f ectri W $ Work to Start U Inspection Date Resquested Rough Final Signed under the es of perlu C� FIRM NAME /%SU %Vi4/,n i1 LIC. NO u censee A, Qt� v S1, / ✓ h Signature !���% LIC. NO. �N7y /� Bus. Tel No. % cP— 9,2 — ` Address a% f i / u hQr `' ' �W i ' ` Alt Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE b�— (Signature of Owner or Agent) Total No. of Light8ng Outlets No. of Hot fuse No. of Transformers KVA Above ❑ In ❑ No. of Lighting Fixtures SwimmingPool gmd ❑ gmd ❑ Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Bumers Battery Units No. of Switch Outlets No of Gas Sumers FIRE ALARMS No. of Zone No. of Detection and Total No. of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No. of Diposal No. Pumps Tons KW No. of Sounding Devices No.l of Self Contained No. of Dishwashers S ace/Area Hearing KW DetectiorvSounding Devices ❑ Municipal ❑ Other No. of Dryers Heatinq Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Bariases Wiring No. Hydro Massagg Tuds No. of Motors Total HP OTHER (J✓/ G1 !NIU" IN URANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws / I ham a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES NO = have submitted vayd pr same to the Office YES 1-1NO = If you have checked YES please indicate the type of coverage by checking the appropriate box INSURANCE {(BOND = OTHER = (Please Specify) 00 (Expiration Date) Estimated Value f ectri W $ Work to Start U Inspection Date Resquested Rough Final Signed under the es of perlu C� FIRM NAME /%SU %Vi4/,n i1 LIC. NO u censee A, Qt� v S1, / ✓ h Signature !���% LIC. NO. �N7y /� Bus. Tel No. % cP— 9,2 — ` Address a% f i / u hQr `' ' �W i ' ` Alt Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE b�— (Signature of Owner or Agent) No 4� 1577 Date TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING � his certifies that....................T...................... . has permission to perform-.,/' ....................... plumbing in the buildings of .................. s / ` A� Andover, Mass. Fee-:� ...... Lic. No'-. r) - / / .rte' Z ......... . / PLUMBING '4SPECTOR Check # 2,5 41 WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building of Name Date GtJ Permit # Amount New Renovation EJ Replacement Plans Submitted Yes No FIXTJRES .................. MAR (Print or type)�r n _ Check one: Certificate Installing Company Name r) 2i% Corp. Address -26 / Partner. Business Telephone llkfirm/Co. Name of Licensed Plumber: ICI -G cl Insurance Coverage: Indicate the a of insurance coverage by 6hecking the appropriate box: ❑ Liability insurance policy Other type of indemnity El Bond Insurance Waiver. I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner F1 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 and Permit Issued for this application will be in compliance with all pertinent provisions of the Massac uset to Plumbing C;ar;Chapter 142 of the General Laws. City/Town APPROVED (OFFICE USE ONLY 01 Type of Plumbing License ` License — um e'i -o r '6 Master Journeyman ❑ Date. ... NORTH TOWN OF NORTH ANDOVER pyaa.ao ,e 11.0E p PERMIT FOR GAS INSTALLATION P i This certifies that .....s `.. .: has permission for gas installation •.C. ,. !� .:!?• ............ in the buildings of ........`.... • . . 11►at ..' ::..1:::`....... .:... /6.,,.--.: —,North Andover, Mass. Feer... '".. Lic. No...:,W)..... 09/17/98•i -65..... 00' • •PAID• GAS INSPECTOFC WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATIO FOR PERMIT TO DO GASFITTING (Print or Type) /� Mass. Date—/_19 �� Permit # Building LocationOwner's Name W i ( II (�Q�FfvJ►S "� >••'•f S WIA& '� FaP YI A Type of Occupancy 2S i 6va 14 G New ❑ Renovation ❑ Replacement ❑ Plans Submitted: Yes[] No ❑ Installing Company Name Eastern Propane '&b.S Inc Address 131 Water Street Danvers, MA 01923 Business Telephone___ Name of Licensed Plumber or Gas Fitter �,eV.\ cy-\ Check one: Certificate Corporation ❑ Partnership ❑ Firm/Co. owns NEI 0 on MEMO iENiiiiiiiiriiiiiiiiiniiii Installing Company Name Eastern Propane '&b.S Inc Address 131 Water Street Danvers, MA 01923 Business Telephone___ Name of Licensed Plumber or Gas Fitter �,eV.\ cy-\ INSURANCE COVERAGE: I have a currn liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes IN No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy A 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Ge er /Laws. Tof License: v� �✓ Plumber Signature of Licensed Plumber or Gas Fitter Title asfitter Master License Number C City/Town Journeyman APPROVED OFFICE USE ONL Check one: Certificate Corporation ❑ Partnership ❑ Firm/Co. INSURANCE COVERAGE: I have a currn liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes IN No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy A 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Ge er /Laws. Tof License: v� �✓ Plumber Signature of Licensed Plumber or Gas Fitter Title asfitter Master License Number C City/Town Journeyman APPROVED OFFICE USE ONL r C 3 r z O m m z D r z N V m A -I O z N X m A x m N v m r O O z O In m A m a N m 0 z r 1 w i, M9 HORTF� 3:.•_`� .. a0L SSACHUS� This certifies that Date. . C>y A �? � ca s TOWN OF NORTH ANDOVER M PERMIT FOR PLUMBING YI RI ? �1.. . -../. ..f .............. �. has permission to perform .... .A � R.'1.e._...............$ TT— plumbing in the,buildings of .. �.. ........................... . ,.,,,,at .. U. }...... r.... >. f .................. . North Andover, Mass. Fee ......... Lic. No.. �. �'.?� .............................. PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 014 ON MASSACHUSETTS UNIFORM APPLICATION FO PERMIT TO DO PLUMBING ype or print) v i�-•Qv r .r MASSACHUSETTS ,3uilding Locations �-i .� =1 =k& KA, LL %,w. f►,- A Date I —'A-1 q f - Permit # op Amount 4J + Owner's Name C New © Renovation ri Replacement Plans Submitted FIXTURES (Print or type) Check one: Certificate Installing Company Name Galinsky Plumbing & Heating Inc. ® Corp. 1906 Address P.O.Box 1701 Haverhi 1] . NLA Ol wu Partner. Business Telephone 978-374-1743 Finn/Co. Name of Licensed Plumber: Stephen C Galinskv Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy UX Other type of indemnity a Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insuranc Signature Owner ri 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 ,Ilumbirsg C and it pter4l oAe General Laws. ,D (OFFICE USE ONLY Type of Plumbing License L1464umber IMaster ® Journeyman ❑ 1, C x.00 9215 FAIA gull In ctor . Div. u is Works �k ocation Z moo. ' _ Date :o - r. TOWN OF NORTH ANDOVER Certificate of Orcypancy $_ .�� Buildin /FramPermit Fee $ tj sACHUSt Foundation Permit F Fee $ � .-.erPermit Fee $ n I Sewer Connection Fee $ Water Connection Fee $ loez 00 TOTAL $ 1, C x.00 9215 FAIA gull In ctor . 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OF F I NF- HOAAE� S rrrr : AfIC FLOR F MING PLAN �Y: fOPP ROOM P 11 Pw,fcr Me:X0: e���'' L— L— 0 A �'" vl' I �'� T1 x"- WINPK15T FAPM5 1.01' — 3 1 / 811 r 1 l —0i 1 nA : s��r, OF FINF— HOM�5 Errm�: GOOF F MING PLAN r wN�r: 1'0nI2 NOOpt�f? �v 0 I'KRO iLf tIiLE; 5CP X: DAtE; ff f: 8 I. L- B A\M 11_r_ TO -r WINR15T FMM5 0f - 3 1/4 - I' -p i3UILb�[: OF FINF- HOME -5 Ef"" PULPING 5�CION TOM? HOOMP, '° 1 O I L- U_ �. "� 1I�. 11� `�'�' o �crmi �; WINPQ5f FAP\MS .1.01 -3 sc, :1/4" 7Tll. ll. 13LNL2r1: OF FINN- HOMF-5 ffervu: f3UII.nIN6 5�C110N 1'022 HOOpF-l2 MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.0 CITY: Lawrence STATE: Massachusetts HDD: 6235 CONSTRUCTION TYPE: 1 HEATING SYSTEM TYPE: DATE: 4-22-1998 or 2 family, detached Other (Non -Electric Resistance) DATE OF PLANS: APRIL 22, 1998 TITLE: PROJECT INFORMATION: WINDKIST FARMS LOT - 3 NORTH ANDOVER, MASS COMPANY INFORMATION: WILLIAM BARRETT HOMES 1049 TURNPIKE ST. NORTH ANDOVER, MA 01845 1 I 1 1 1 1 Permit # ; 1 I Checked by/Date ; 1 1 1 COMPLIANCE: PASSES Required UA = 846 Your Home = 834 Area or Insul Sheath Glazing/Door Perimeter R -Value R -Value U -Value UA ------------------------=------------------------------------------------------ CEILINGS 2628 38.0 0.0 79 WALLS: Wood Frame, 16" O.C. 30.96 15.0 3.0 207 WALLS: Wood Frame, 16" O.C. 614 19.0 3..0 33 GLAZING: Windows or Doors 823 0.480 395 FLOORS: Over Unconditioned Space 1808 30.0 59 FLOORS: Over Unconditioned Space 720 30.0 23 BSMT: 8.0' ht/7.0' bg/0.0' insul. 104 0.0 23 BSMT: 8.0' ht/4.0' bg/0.0' insul. 26 0.0 11 BSMT: 8.0' ht/4.0' bg/4.0' insul. 28 19.0 4 HVAC EFFICIENCY: Furnace, ----------------------------------------------- --------------------------------------------------- 86.0 AFUE --- ------------------ COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of.the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard.Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1310\and J4.4 'i Builder/Designer Date �� i E FORM U - VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out /this section***************** APPLICANT: �iU �iSI �C Lz Phone��Z - _c� ) LOCATION: Assessor's Map Number Parcel 4LYIel _ Subdivision �Lot(s) _ Street J`— �,9�`/I St. Numbers ************************Ofcial Use Only************************ RECOMMENDATIO OF WN EN Date Approved Conservation Administrator e Date _ Rej ected Comments Plaifner Comments Food Inspect alth S iss1`fiector-frealth Comments Date Approved Date. Rejected Date Approved Date Rejected Date Approved - A/ 14ZZ2_ Date Rejected Public Works - sewer/water connections�j%o�g - driveway permit G Fire Repartment' ( p Received by Building Indpector Date 03/13/98 13:27 FAX 508 6889556 NORTH ANDOVER Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shalt bsused to assist the Building Department in their determination of exemptions under section 8. T6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Na a of Applicant on Building Permit (below) Address of Property for Permit (below) Map and Parcel ; Purpose of Application (check below) !W o u, r -of Applicant: Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the Building Peimit. 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 iZ 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 recanstrucbcn of a dwelling in existence as of the effective date of this by-law. provided that no additional residential unit is created. The lat(s) were/was created prior to May 6, 19% are exempt from the provisions of this Section 8.7 of the Zoning This application is far dwelling units for low andlor moderate income families or individuals, where all of the, conditions of 8.7.6.c•ere met and/or represents Dwelling units for senior residents, where occupancy of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the Land. For purpaaes of this Secaian 'senior" shall mean parsons over the age of 55. This application is a part of a development prol■ct which voluntarily agreed to a minimum 60% permanent rcaucdon in density. (buildable lots), below the densly. (buildable lots), permitted under toning and feasible given the envirortmental condltiorts of the tract, with the surplus land equal to at least ten buildable acres and permanently deslgnated as open saace and/or farmland. The land to be preserved shall be protected from development by an Agricultural Proservatlon Restriction, Conservation Restriction• dedication to the Town, or other similar mechanism approved by the Planning Board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Seaton 8.1 shall receive a onetime exemption from the Planned Growth Rate and Development Scheduling provisions far the pumase of constructing one single family dwelling unit on the parcel. This appticadon represents a lot which is ready for building permits.(i.e, all other permits from all other boards and commissions have been received and the project is in 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 Oevelooment until such Nrne as the Development Schedule accrmmodates issuing buildigg permits. Applicant must supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination that your application is allowed one or more of the above 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 1 understand that the submittal of misleading and or, inaccurate information, or the checking off of an above item which does not comply, whether done to my knowledge or nor, is grounds for refusal by tate Building Oepartment to issue a Building Permit. SIFig a at ne uta ed Agent wn ed the Anamed Building Permit Gale This form must be attached to the Building Permit upon application far sucn hermit. i 4 Z001