HomeMy WebLinkAboutMiscellaneous - 485 FOREST STREET 4/30/2018 485 FOREST STREET
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EASEMENT \ 7-100
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S TOPOGRAPHICAL AS-BUILT PLAN
s OF
LOT 1A LONG PASTURE
IN
NORTH ANDOVER, MA.
PREPARED FOR:
OF NORTH
O.ARD OF HEAL. CRO WL EY CONSTRUCTION
SEP 19 SCALE: 1 " = 40' DATE: SEPTEMBER 16, 1999
k CHR/ST/ANSEN , SERGI
PROFESSIONALLANDSURVEYORS ERS
160 SUMMER ST. HAVERHILL, MA 01830 TEL. 978-373-0310
•
@1999 BY CHRISTIANSEN & SERGI INC.
DWG. NO. 94080023
i
� 1
N° �4 9 Date.....�r�./� �! �......
I f HOR7M'1
"�o� TOWN OF NORTH ANDOVER
10- A
PERMIT FOR WIRING
�,SSAc NuIt`,
This certifies that ........V a u.4... S..........�.--.�. C- in,
C
............. ........................................
has permission to perform ....... w .(.e.....W ..t!........ ,)..�.?. ..............
AP wiring in the building of...... !�.���.�5.... c C� .!�.. .......................................
at z......./,c1,{?�5..........».1............................. ,N6rth Ando ,Mass.
V
Fee....l�..:C�J... Lic.No...f.,!7r3. .............•. 6SPECTOR
............. ........
Check # -3307
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
.:,cation " 12r�zs
No Date
r MORTM ' TOWN OF NORTH ANDOVER
•.... a CL .:
Certificate of Occupancy $
.Building/Frame Permit Fee $
Foundation Permit Fee $
sAtNl15E
• 1t ;r Permit Fee $
Sewer Connection Fee
Q u Water Connection Fee $
7:V TOTAL $
Liaiidd Insp actor,
1291'3B t� 3�
1,700.00
��/.,��L..�C// i
Div. P (iic Works
�•_ -location
No: Date'
TOWN OF NORTH ANDOVER
p ti
y 3? ��,, ••• ppL
" a p Certificate of Occupancy $ „�►
Building/Frame Permit Fee $
s'^^°�'��' Foundation Permit Fee $
sACHUSt
Other Permit Fee $
•. Sewer Connection Fee $
Water Connection Fee $ -0
- ` . . TOTAL $
V• -
I> �Building'Inspector ? �r
HY
10.17 11700.
Div. Public Works
_ �_ C,ommonwealdt o/�assachwe(fj Official Usc Only
cc� mit No. (}
.1J¢part<nt¢te!a1„}Jiro servicee Per
BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked
(Rev. 11/99] (leave blank)
APPLICIATION `FoORtrPERMIVT,TO PERFORM ELECTRICAL WORK
l work to bc h the Massachusetts Electrical Code(MEC),527 CMR 13.00
(PLE11SEPRINT ININK ORTYPE:ILL INFORM,11'ION) Date:
City or"Town of: X a,LCy4h Ando Vel To the Inspector of Rres:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street R Nuntber)X Y95 Fb(es+ s+ .
Owner or Tenant {p� Telephone No.
Owner's Address
0_75yf
Is this permit in conjunction with a building permit? Yes No
❑ tW (Check Appropriate Box)
Purpose or BuildingLD ( llx Ni Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd ❑ 1\'0.of Meters
New Service Anips / Volts Overhead ❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
Coat letion oath wllorvinc table snap be n•aived by the lits ccior or wires.
No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans o• of ota
Transformers KVA
No. of Lighting Outlets No.of Ito(Tubs Generators hVA
No. of Lighting Fixtures Swimming Pool AboveEllu- 11t o.o mergence to tang
rnd. rnd. Batte Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARtYIS No. of Zones
No.of Switches No.of Gas Burners No.of Detection and
Lutiatino Devices
No.of Ranges No.of Air Cond. Tons No. of Alerting Devices
Heat pump Number Tons KW No. of Self-Contained
No.of Waste Disposers Totals: Detection/Alertino Devices
No.of Dishwashers Space/Area Heating KWLocal bIwnicipal,
j Connection Other
No. of Dryers = Heating Appliances I{ii; Security Svsteins:
No.of Devices or Equivalent
No. of Nater No.of No.of
Heaters KiV Data Wiring:
Sinus Ballasts No.of Dtevices or E uivalent
No.Hydromassage Bathtubs No.of tlIotors Total IIP 'Telecommunications Wiring:
No.oCllevices or E uivalent
OTHER: ,_
Attach additional detail if desired,or as required by the Inspector of Wires.
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:) �� Lk
(Expir ion Date)
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: V00C Inspections to be requested in accordance with NIEC Rule 10,and upon completion.
I certifj-, tttrtle!r the pains and penalties off tjerjttrj,,that the inforaration on this application is true and complete.
F1101 NAME: eveIQ i� PUG�ttS �2L tZ�C- �r.> LIC.NO.: _-�a
Licensee: 4'�MeS Signatur
au �- IC.NO.:
(If applicable,enter "crcurpt"in the license number R��
13us.Tel.No. 9 �— 53 -9 38
Address: �NtL( =teRe_ fit t� n I �n Alt.Tel.No.:
OWNER'S - SURANCE WAIVER: I am aware that the icensee does not have the liability insurance coverage normally
required by taw. By my signature below, I hereby waive this requirement. I all,the(check onc) ❑owner ❑ owner's agent.
Owner/Agent
Signature Telephone No. PI:Ril11T 1TE•E: S /�,5�
1
0
r
CERTIFICATE OF USE & OCCUPANCY
Town of North Andover
Building Permit Number ,C/ ` Date d
THIS CERTIFIES THAT
THE BUILDING LOCATED ON
MAY BE OCCUPIED AS
I / IN ACCORDANCE
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND
SUCH OTHER REGULATIONS AS MAY APPLY.
Of pORTp , CERTIFICATE ISSUED TO ��
ADDRESS
P i /
E
Building Inspector
i
t.
aover
own of
No.
943_ t dower, Mass., - 19
Z LAKE
CHICHEWICK
Oq 4 E DPP`
S E BOARD OF HEALTH
Food/KitchenPERMIT T D n
Septic System
RTHIS CERTIFIES THAT................................. l .. �. t.. .............. l ` BUILDING INSPECTOR
Foundation
has permission to erect................... . buildings on .......... ..... .. .......................... ....`........................ Rough .
to be occupied as........................................................ �. .. .�.............. 1�l1 .. .....� Chimney
provided that the person accepting this permit shall in every respect conform to the terms of- hplication on file in Final
this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of
`.uildings in the Town of North Andover. PLUMBING INSPC OR
IOLATION of the Zoning or Building Regulations Voids this Permit. ou h
PERMIT EXPIRES IN 6 MONTHS
ELECTRIC IN
UNLESS CONSTRUCTION ST j&` R,
..................................... ....:........... ......... ..........
BUILDING INSPECTOR
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove Rough
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT
Burner
Street No.
zz
l
I /
� N \
LOQ 1A \
AREA = 2.60 ACRES °�' LOT 2
� � 1
/ SEPTIC PUMP
(� Q TANK/ CHAMBER
o \ MAPLE TREE (TYP.)
l DECK 102—
s Tj
02 STI _
FN p. 108.92
08.
TOP
\ \"NINING
WALrt
O% � — _�06
FjV \ \
RETAINING VENTQi
WALL 1 I f
\LIGHT POLE-�
W
DRAINAGE
EASEMENT ' \ 100
PARCEL
s
10
ROq p _ ' — _VENT / LOT 7
_ % � —
E' DRAINAGE
EASEMENT $ N,EASEMEN-T
ClF®
��2 so`a ao�-
e y/
o� u G.
l S N TOPOGRAPHICAL AS-BUILT PLAN
5 OF
' 7tg6 LOT 1A LONG PASTURE
IN
NORTH ANDOVER, MA.,
PREPARED FOR:
CROWLEY CONSTRUCTION
SCALE 1 " = 40' DATE: SEPTEMBER 16, 1999
CHRIS TIA NSEN SERGI PRONAL LAND OSURVEYO SEERS
160 SUMMER ST. HAVERHILL, MA 01830 TEL. 978-373-0310
@1999 BY CHRISTIANSEN & SERGI INC.
DWG. NO. 94080023
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Office Use Only
lug
The CommonweaIfh of Massachusetts
Permit :b.
Department of Public Safety
Occupancy&Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 1200 3/90
(leave flank)
APPLICATION FOR PERMIT TO PERFORM ELEGTRICAL 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) Date
City or Town of Vy e )11410d 4-11� To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical Work described below.
Location (Street b Humber)
Owner or Tenant 1,J
Owner's Address ?-o-arlec—
Is this permit in conjunction pwith a building permit: Yes ❑ No (Check Appropriate Box)
Purpose of Building °'�Si C GC— Utility Authorization NO. 16O Lr—l—?
Existing Service Z00 Amps 1 ZG / �(� Valts Ov2,:-?s,e � i1ndg7d o No. c lieters
New Service 200 Amps fZ D / 7`C0 Volts Overhead ❑ Undgrd❑ No. of peters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work 40,d r,/1 do-14111 &41" l✓i"—� k vw, L
L
No. of Lighting Outlets No. of Hot Tubs No. of Transformers KVA
No. of Lighting Fixtures Swimming Above In-
g Pool grnd. ❑ grnd. ❑ Generators INA
No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting
Batte Units
No. of Switch Outlets No. of Gas Burners FIRE ALARMS No.. of Zones
No. of Ranges Na. of Air Cond. Total No. of Detection.and'.
tens Initiating Devices
eat
No. of Disposals No. of Pumps Total Total No. of Sounding Devices
Tons KW _...
No. of Dishwashers Space/Area Heating KW No. of Self Contained
Detection/Sounding Devices
No. of Dryers Heating Devices KW Local❑ Municipal ❑Other
Connection
No. of Water Heaterr KW No, of No. of Low Voltage
Si ns Ballasts Wiring
No. Hydro Massage Tubs No. of Motors Total HP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial
equivalent. YES® NO❑ I have submitted valid proof of same to this office. YESEt NO
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE 03 BOND F] OTHER [] (Please Specify)
Estimated Value of Electrical Work S Expiration Date
Work to Start 1 Z /2 Inspection Date Requested: Rough ✓ Final //
2"
Signed under the penalties of perjury:
FIRM NAME RESPONSE ELECTRIC SERVICE, INC. r, r LIC. No. A15808
Licensee PETER MANZELLI II Signature _l LIC. NO.
Address - 362 SALEM sTREET MMIMD A 02155 f` Bus. Tel. No. (617) 395-7775
Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- �
stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit . C l� ,(
- application waives=this Owner Agent - .(Please check one) =
Telephone Na, PERMIT FEE $ 81
— -— _ ___
Date
E: c�• 6 5 7
TOWN OF NORTH ANDOVER
o §,
PERMIT FOR WIRING
4 i ;
,SSACMUS�
e
This certifies that R.fP Via. .0 ....... :.t C, .2.i CG.:(..: . ..
has permission to perform —.,.ct:� .4 ..t3.s Q:... ...k. ........ .....
wiring in the building of.....: ................................ y.....:_.
1-44
at......:f.l.. ........ d`, !�.....1..................................,North Andover,'Mass.
�.y ..C.�.1.... Lica No /f ..:
Fee.. ..:....:: .....:.: .:.. .....: ,.
ELECTRICAL INSPECTOR
1 /26/S 12:42 15.04 . PAID
WRITE: Applicant CANARY: Building.Dept. PINK:Treasurer
N26%5 Date................ op.........
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
,SSACMU-
This certifies that .f........':.....'"".: ........................................
has permission to
............... .............................
wiring in the building of......... ......................
at.....`zy ..�9�......................................,North Andover,Mass.
-e-0
ee ........... Lic.No.�'2Z�f ............................................................
ELECTRICAL INSPECTOR
12/10/9813:30 375-00 PAID
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
7F00Aff10NW LTH0FM MCHUSET1S Office Use only
DEPARTMffTOFPVBLICSAFM Permit-No. C 7�1/ [G�
BOARD OFMREPREVEM70NRWM770AS527CM INO / 3
Occupancy&Fees Checked 70
APPLICATION FOR PERMIT TO PERFORM ELE CAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Datg,�,�
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street&Number) LA'A ,
Owner or Tenant
Owner's Address
Is this permit in conjun with a building permit: Yesr7j'sfo (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead Underground E No.of Meters
New Service 2—CSZ_ Amps/0 077 Volts Overhead Underground No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total
"r KVA
No.of Lighting Fixtures ` Swimming Pool Above Below Generators KVA
`V round ground
No.of Receptacle Outlets n No.of Oil Burners No.of Emergency Lighting Battery Units
No.of Switch Outlets
No.of Gas Burners
No.of Ranges / No.of Air Cond. Totaln FIRE ALARMS No of Zones
Tons 7
No of Disposals / No.of Heat Total Total No.of Detection and
Pumps Tons KW Initiating Devices
No of Dishwashers / Space Area Heating KW No.of Sounding Devices
No.of Self Contained
Detection/Sounding Devices
of Dryers Heating Devices KW Local Municipal Other
Connections M
Ng_of Water Heaters / KW No.of No.of
Signs Bailasis
No Hydro Massage Tubs No.of Motors Total HP
OTHER
IrmranceCo�kr g PUN1.31totheregtmeTWMO MWSadl�Gettaal laws
I haw a turret Liabq*haitatce Policy trtdttd%Carplete OprArins ComaWor ds ststartial e4 ivakit YES Er NO
Ihaw ahnstedvaMproofofsarnelotheOfae.YES U NO � lfjouhaw clhedcadYES,p6seffdc*thetWofw&aWbYctrckingthe
appiqriaie box
INSURANCE r-71 BOND F-1 OT[-&R (Plee&Specify)
Drage
Waktostatt f l V o Eskr"edValue dBewical Wait$ —/j�� o�
ht<pecfimD*Fgirested Rtxrgtt Feral
Signed U-dffTie Pa�,ItM pa�tey: '
FIRM NAME. O 1M W\ � � l � w� LicaiseNa
L=fee Sigrote Lica>seNo �Zv`T
BtsirmTel.Na Ifel—q 3 3
Ad sL Alt Tel Na
OWNER'S INSURANCE WAIVER,ianawarethatthe Li=w d=lixg the Kam=a earts sibWrtaletasteamedbyMamadxsemGalealLaws
aid that my sigrailirear this pamit appticatiort wanes this raeutltt
(Please check one) Owner Agent a
Telephone No. PERMIT FEE$
3/9 GaCQ
� ORT q
Q �tUIL0 06y �o
O ti M
Y
O$ coc.ocw°wKw v1
5
SgcHus'���
APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION
ADDRESS/LOCATION OF PROPERTY : ���� llgreu/ s;— � �f /�9/q a
Alla r7
DATE REQUESTED FILED/READY FOR INSPECTION ? �'
i
CLOSING DATE ON PROPERTY: 9/ cqq / l
FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED
ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME
FRAME. A RE-INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE
CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES.
SIGNED _A VA9L
ROUTING Eq
CONSERVATION
PLANNING (J
DPW -WATER METER
NOTE
DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED
PRIOR TO SUBMITTAL OF THE OCCUPA /INSPECTION REQUEST
DPW
Signature
File: OC forth revised 6/8/98
'_�-•--•c---�€°�'�+:.�F,-.:�—�--^:++.--T,�--�-'� -� ...._. ,. - Dat/.,t^Iafr+:�+�'ii
. -
3007
�R
r r HORTh�,< .'tio TOWN OF NORTH ANDOVER
p PERMIT FOR PLUMBING
/ e J
This certifies that . . . . . . . . . . . . . . . .�� �� . . . . . . . . . . . .
has permission to perform . . . . . . . . . .
plumbing in t e buildings of `5. . . ? . . . . . . . . . . . ... . . . . . . .
at. ��. 7� .
�._. - No A over, Mass..
Feo-37.5. . ... .Lic. No..G2.71?12. . . . . . . ..
PLUMBING INSPECTOR
41/04/99 13:31
ggg 375.E Pf
WHITE Applicant CANARY: Building Dept PINK Treasurer
_<.a-...tea '�'-.T�' � ,_-v-.-'x=y--l'�k;::}:+qu�%3-;3�=�M.,s�.�'�rw'�-- ,=.n'z/S...o...!q#,a�"��r ;�.h:�.ry.+�.,.+�� .._ bT�+•s.%.......a.=;x-:�•+:5+.-;....%..::ia
goa oua�� MASSACHUSETTS UNIFORM APPLICATION` FOR PERMIT TO DO PLUMBING
(Print or Type)
MASS. Date /�- / �,. 19
Building Permit # 07
Location, ��� ���
Owner's
t -- -- Name
New p "" Renovation ❑ Replacement ❑ Plans Submitted: Yes ��No ❑
FIXTURES Building Permit No.
z � i
VI N 0 Z ' I I Z > N
in '3 I Y U I I w w
vwiZ nl IQ � � I � K 2IH i iZ � O Z Z.IZ a D
w U I F
< LL' � �nIY < N U' al _ 3 X
W D wi < Vf O fIQ JZD Jaz � QOJ LL
w 2 Q 1 2 3 O Z = 3 Y an ap F Q Y w LL Y w
~ .> !F O N N ^ F Z Q. 0 Z Z Q F
3 Y a I m J Q O Q J < K Q I O < ~
3 x � i� � LL c� o < 3 W m 0
SUB-BSMT.
BASEMENT
1 ST FLOOR IA I I L7,1/ I/ If I j I I 1 I I I I I_I_I _I_ I I I I I I II_II I
2ND FLOOR
3RD FLOOR
4TH FLOOR
5TH FLOOR I I I I I_I_I I _III I I
6TH FLOOR
7TH FLOOR I I I I I I I I I I I I I I I I I
8TH FLOOR
y
Check one: Certificate
Installing Company Name ,��9PW [Corp.
Address .3 cAlMBF.Ps ❑ Partnership
��L7- ❑ Firm/Co.
Business Telephone
Name of Licensed Plumber .461642
INSURANCE COVERAGE: Check one
I have a current liability insurance policy or its substantial equivalent. Yes g�- No ❑
If you have checked yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy 9--1 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:
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
I hereby certify that all of the details and information I have submitted (or entered) in the 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 Plumbing Code and Chapter 142 of the General Laws.
I c
Fee
Check # Signature of License Plumber
License Number
Date —
APPROVED (Office Use Only) Type or Plumbing License: Master
Journeyman ❑
BELOW FOR OFFICE USE ONLY
FINAL INSPECTIONS SKETCHES- PROGRESS INSPECTIONS
FEE
NO.
APPLICATION FOR PERMIT TO DO PLUMBING
NAME & TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER
PERMIT GRANTED
DATE 19
PLUMBING INSPECTOR
' 3 2 CJ J Date. .` =./..3.:. ...
OF N�oT a 1M TOWN OF NORTH ANDOVER Id
0 _ �p PERMIT FOR GAS INSTALLATION
,SSACMUSEt
This certifies that - . . . . . . . . . . . . . . .
has permission for gas installation . . . . . . . . "i
in the buildings of . ` :�. . . . . . . . . . . . . . . . . . . . . . . .
at . . !. . .>. . . f:r.':: r. /. . . 5.1 . . . . . . . .. North Andover, Mass.
Fee. ?:. . . . Lic.
,GAS INSPECTOR
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer
SIP MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO .DO GASFITTING °
(Print or Type)
, Mass. Date 19_ _Permit#
' Building Location �(9 Owner's Name
Type of Occupancy
New 14,x Renovation ❑ Replacement ❑ Plans Submitted Yes 9-40 ❑
i
r
GA-
(n W
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Z�/� W U) X 0 D cn =
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W t= O U CO I- _ U
OJW tW- a Z Z 0wPIr m. WHw w0U) o. rzwQ
u� �� ¢ z Z t- p > ww u) W Z U W W a:J 0X W rn �Z W J Q (r F— I- } to m Z O Z W 0 W _
tr i O 0 z u- 0 0 g OU > a O
SUB-BSMT.
BASEMENT
1 ST FLOOR
2ND FLOOR t
3RD FLOOR
4TH FLOOR
5TH FLOOR
6TH FLOOR
j 7TH FLOOR
8TH FLOOR
r
i Installing Company
Name
Y
)04 Check one: Certificate
Address .3 4#/r/I LC2S- S / _ Z-60-rporation
C .SZ Partnership
Business Telephone Firm/Co.
Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE:
I have a curre liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142.
Yes V No ❑
If you have checked yes, please indicate the type of coverage by checking the appropriate box.
A liability insurance policy Other type of indemnity-O Bond - ---
OWNERS INSURANCE WAIVER: 1 am aware that the licensee does not have the insurance coverage required by
Chaptw:142 of the Mass. General Laws and that my signature on this permit application_waives this requirement. _
Check one:
Si nature of Owner or Owner's A ent
Owner ❑ Agent O
I hereby certify that all of the details and information I have submitted (or entered) in above application cation 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 Plumbing Code and Chapter 142 of the General Laws.
BY Type of License
t2'Plumber
Title ❑:Gasfitter ignature of icensdd Plu e o Gas Fitter
C�Master f
City/Town ❑ Journeyman License l Number
APPROVED OFFICE U E 0NLY?
1 taLl i.vry r v A vrr ll.G uJG uNL,I
FEE
' at. NO
-APPLICATION FOR PERMIT DO GASFITTING
` OWNER: is
NAME & TYPE OF BUILDING
LOCATION OF BUILDING:
PLUMBER OR GASFITTER:
LICENSE NO:
PERMIT GRANTED
DATE: 19
GAS INSPECTOR
J
PE&t4 IT 16-7
��� O. SHIP (DATE IDOOK LOT NO. Z RECORD OF OWNERPAGE
r ZlCW41E SUB DIV. LOT NO.
PURPOSEOCATION �3 J' PURsc of wILOtNa� � ftZlG1�
OWNER'S NAM[ Cil r�� /�,, 7it1S� NO. OI !TORIES SIZE c-3000 - --
OWN[R'S ADORES!
BASEMENT OR SLAB
ARCNIT[CTS NAM[ /z / I SIZE OF FLOOR TINGE" IST / !NO
o'
BUILOER-S NAME '0`o/ 4 !FAN •i�
DISTANCE TO NEAREST BUILDING /�O T DIMENSIONS OF SILLCLS►
�_
DISTANCE FROM STREET 7,/.i �` _ I POSH or
DISTANCE FROM LOT LINES
�—SIDES 7 v)./ REAR /cT► - GIRDERS
ARCA OF LOT FRONTAG[�JoVo NEIGNT OF FOUNDATION TNICKN[fS
tS BUILDING.NEW f StZ[ FOOTING i
IS BUILDING ADDITION MATERIAkOF CNIMN[r
If BUILDING ALTERATION to BUILDIHM SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE Ii BUILDING [CTED TO TOWN WATER eG!
BpARD OF APPEALS ACTION. IF ANY ( If BUILDING CON *tTED TO TOWN SEWER �
If BUILDING CONNECTED TO NATURAL GAS Lam? No
! PROPERTY INFORMATION
h INSTRUCTIONS
LAND COST
SEE BOTH SIDES EST. BLDG' COST
EBT. BLOC. COST PER So.vFT. 1 U
PAGE I FILL OUT SECTIONS i - !
- EST. BLOC. COST PSR ROOM
PAG[ It FILL OUT SECTIONS I - I!
SEPTIC PERMIT NO.
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED my
ATTACHED GARAGES MUST CONFORM TO STATE FIR[ REGULATIONS i
GLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED *UILDbft INSPECTOR
s1G or N owluo GENT
\ OWNER
sae»n 4WARITM
CONTRA TEL.k- ` 'x, 2-3
0
7o:
.• CONTR&Uc.
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FORM u - IAT RELEASE FORM
INSTROCTIONS: This form
approvals used to verify that all necessary
/permits from Boards and Departments Navin
have been obtained. This does not relieve the applicant g jurisdiction
landowner from compliance with an and/or
regulations or requirements. y applicable local or state law,
****************Applicant fills out this section*****************
APPLICANT: P �2;t�?Phone � �
LOCATION: Assessor's Ma 16j
Map Numbe Parcel
Subdivision /0.0,Vfo
Lots)
Street O
St. Number I�
Use only***********************
*
DATION 0 TOWN AGENTS:
7ation Administrator Date Approved
Comments
Date Refected
'p r
own Planner Date Approved t� -
Date Rejected
Comments
Food Insp ctor-Health Date Approved
Date Rejected
P c spector-Health Date Approved
Date Refected
Comments
Public Works - sewer/water connections
- driveway permit Li ¢ 2�
Fir pe r
P tme nt
p
Received by Butlin
g Inspector
Date
Y
Growth Management Bylaw Exemption Statement
Town of North Andover Building Department
This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the
Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information
as requested below.
Name of Applicant on Building Permit(below) Address of Property for Permit(below)
Map and l6arcel : Purpose of Application (check below)
P ` e�t� l cant: ,(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 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.
TKis is an application for a building permit for the enlargement, restoration,or reconstruction of a dwelling in
exist,`ce as of the effective date of this by-law,provided that no additional residential unit is created.
The lot(s)were/was created prior to May 6, 1996 are exempt from the provisions of this 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.c are 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
purposes of this Section"senior"shall mean persons over the age of 55.
This application is a part of a development project which voluntarily agreed to a minimum 40%permanent
reduction in density,(buildable lots), below the density,(buildable lots),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 and/or farmland.The land to be preserved shall be protected from development by an
Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism
approved by the Planning Board that will ensure its protection.
This application represents a tract of land existing and not held by a Developer in common ownership with an
adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth
Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the
parcel.
This application represents a lot which is ready for 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
Development until such time as the Development Schedule accommodates issuing building 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 I 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 not, is grounds for refusal by the Building Department to issue a Building Permit.
Signature of Owner or Authorized Agent who signed the Attached Building Permit Date
This form must be attached to the Building Permit upon application for such permit.
� 4
` t
MAScheck COMPLIANCE REPORT
Massachusetts Energy Code Permit # ~
MAScheck Software Version 2 .0
Checked by/Date
CITY: Lawrence
STATE: Massachusetts
HDD: 6235
CONSTRUCTION TYPE: 1 or 2 family, detached
HEATING SYSTEM TYPE: Other (Non-Electric Resistance)
DATE: 4-24-1998
DATE OF PLANS : 4/15/98
TITLE: New Home Lot 1 Long Pasture Estates
COMPANY INFORMATION:
Crowley Construction Corp
PA E
COMPLIANCE: PASSES
Required UA = 883
Your Home = 701
Area or Insul Sheath Glazing/Door
Perimeter R-Value R-Value U-Value UA
-------------------------------------------------------------------------------
CEILINGS 2323 38 .0 0 .0 70
WALLS : Wood Frame, 1611 O.C. 4163 13 .0 3 .0 297
GLAZING: Windows or Doors 556 0 .350 195
DOORS 80 0 .350 28
FLOORS: Over Unconditioned Space 2327 19 .0 111
HVAC EFFICIENCY: Furnace, 89 .0 AFUE
------------------------------------------------------------------------------
COMPLIANCE STATEMENT: The proposed building design represented in these
documents is consistent with the building plans, specifications, and other x'
calculations submitted with the permit application. The proposed building
has been designed to meet the requirements of the Massachusetts Energy Code.
The heating load for this building, and the cooling load if appropriate
has been determined using the applicable Standard Design Conditions found
in the Code. The HVAC equipment selected to heat or cool the building
shall be no greater than 125 of the design load as specified in
sections 780CMR 1310 and J4 .4 .
Builder/Designer Date
Nom, check INSPECTION CHECKLIST
Massachusetts Energy Code
MAScheck Software Version 2 .0 T
New Home Lot 1 Long Pasture Estates
DATE: 4-24-1998
Bldg.
Dept .
Use
CEILINGS :
[ ] 1 . R-38
Comments/Location
WALLS:
[ ] 1. Wood Frame, 16" O.C. , R-13 + R-3
Comments/Location
WINDOWS AND GLASS DOORS :
[ ] 1 . U-value: 0.35
For windows without labeled U-values, describe features:
# Panes Frame Type Thermal Break? [ ] Yes [ ] No
Comments/Location
DOORS :
[ ] 1 . U-value: 0.35
Comments/Location
FLOORS :
[ ) 1. Over Unconditioned Space, R-19
Comments/Location
HVAC EQUIPMENT EFFICIENCY:
[ ) 1 . Furnace, 89 .0 AFUE or higher
Make and Model Number
THERMOSTATS:
[ ] Adjustable thermostats required for each HVAC system.
AIR LEAKAGE:
[ ] Joints, penetrations, and all other such openings in the building
envelope that are sources of air leakage must be sealed. Recessed
lights must be type IC rated and installed with no penetrations
or installed inside an appropriate air-tight assembly with a 0 .5"
clearance from combustible materials and 3" clearance from insulation.
VAPOR RETARDER:
[ l Required on the warm-in-winter side of all non-vented framed
ceilings, walls, and floors .
MATERIALS IDENTIFICATION:
[ ) Materials and equipment must be identified so that compliance can
be determined. Manufacturer manuals for all installed heating
and cooling equipment and service water heating equipment must be
provided. Insulation R-values, glazing U-values, and heating
equipment efficiency must be clearly marked on the building plans
or specifications .
T\ 10'r TTT0TTT.N1rTn7,T.
I ,] Ducts in unconditioned spaces must be insulated to R-5 . 4
Ducts outside the building must be insulated to R-8 .0 .
DUCT CONSTRUCTION:
I ] All ducts must be sealed with mastic and fibrous backing tape.
Pressure-sensitive tape may be used for fibrous ducts . The HVAC
system must provide a means for balancing air and water systems .
TEMPERATURE CONTROLS:
[ ] Thermostats are required for each separate HVAC system. A manual
or automatic means to partially restrict or shut off the heating
and/or cooling input to each zone or floor shall be provided.
HVAC EQUIPMENT SIZING:
[ ] Rated output capacity of the heating/cooling system is
not greater than 1250 of the design load as specified
in sections 780CMR 1810 and J4 .4 .
MISC REQUIREMENTS:
[ ] Refer to 780 CMR, Appendix J for requirements relating to swimming
pools, HVAC piping conveying fluids above 120 F or chilled fluids
below 55 F, and circulating hot water systems .
----NOTES TO FIELD (Building Department Use Only) -------------------------
NORTTjy
y Y
® of - over
* i dover, Mass., 1998
�O'9v
Co- ICN WICK `iLAKEY , -
Oq-4 E
S E BOARD OF HEALTH
PEnMIT T Food/Kitchen
Septic System
. pp / BUILDING INSPECTOR
.. �THIS CERTIFIES THAT.................................5,#40X. . .. .................. 1 ...
....�.....A
.
. .
c � Foundation
has permission to erect.....................t................. buildings on ........4..85 ......... �. .................. Rough
to be occupied as ,� �.Z. .(... .. ...............;............... Chimney
provided that the person accepting this permit shall in every respect conform to the terms of thex0cation on file in Final
this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of
Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. _ Rough
Final
PERMIT EXPIRES-IN 6 M0NT iS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION ST TS 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
Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT
Burner
Street No.
Smoke Det.
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.. _. -. ., - w».........�........-..d....4e+.». ....,.e+•.-.�...........-.-._..- .�.a....-^ ...-. .r—Tom.'^"'.�"+"!`_`^.?`
1