HomeMy WebLinkAboutMiscellaneous - 50 BROOKVIEW DRIVE 4/30/2018 % 1 B5.A-00 3-DRIVE
210/105.A-0033-0000.0
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Commonwealth of Massachusetts
City/Town of ReCEIVEg)
System Pumping Record �� 2010
Form 4
M s MWN Or NOR AN
DEP has provided this form for use by local Boards of Heal , but the
information must be substantially the same as that provided here. a or check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System Locati :'Lefto , right front of house, left side of house, right side of house, Left
rear of house, rlg aro house, left side of building, right rear of building, under deck.
Cityrrown State Zip Code
2. System Owner:
Name
Address(if different from location)
City/Town Zip Code
Telephone Number
B. Pumping Record
1. Date of Pumping Date 2. Quanth-Pumped: Gallons
3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank
❑ Other(describe):
4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No
5. Conditiono_ f Sy ( Pti
6. System Pumped By:
Neil J. Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc.
Company
7. Locati-oamhere contents were disposed:
L.S. owell VV$steWater,
Signa ur of Hauler Date
t5form4.doc•06/03 System Pumping Record•Page 1 of 1
3036 Date./ ..�--9..
HORTh TOWN OF NORTH ANDOVER
3?py. ,e,4110
PERMIT FOR GAS INSTALLATION
� 9 P
J� ,SSACHUSEt
i
` This certifies that . . :: . .�'. . . . . . ". . . . . . .::s` . . . . .
has permission for gas installation r`t �. . . . . . . . . . . . . .N
a _
in the buildings ofi}. .��. :''�':=.�f. . . . � dov6er,
at . . . . North Mass°
CU
CU
.`. . Lic. No.... . .f . . . . . . . . . . . . . . . . . . . . . . . .. . .
GASINSPECTOR
WHITE:Applicant CANARY:Building Dept. PINK:Treasurer
MASSACHUSETTSUNIFORMAPPt a�Cp'a lOt4 FOR, PERMI TO 00 GASFITTIN' G t
(Print or Type)
NORTH ANDOVER Maass. b (Date � .�� 7
tullding LocationP13 Permit # 0
Owners game
New Renovation [J Replacement Plans Submitted
IX
to y
al
us
us 01
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t:
d Qa N h d tL O ® h /�V)
W •[ w w OF a o: w 4 \\
NW Z v W '. �f us ct O a w
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> tl t- W -f F to
= 4 Z c: O to
L7 t? t. .^_. a C'A ...s O C �+ c2 0. F- O
suer--aS?.t T.
IST FLOOR f { f I I ! f ! f !
21413 FLOOD
3RO R-oOR
4TH FLOOR f ! f I I L I I II ! I ( B p
svi FLOOR
6T'K FLOOR
-7TK FLOOR
arrl PLt1oR ! I ( I
(Print or Type.) Check one:' Certificate
Installing Company Name SnS�r2�4 ' Q Corp.
Address S>C), _ 1 - Partner.
Firm/Co.
Business Telephone:
Name of Licensed Plumber or Cas Fitter
Insurance Coveraq e: Indicate the ;ype of insurance coverage by checking the
appropriate box:
Liability insurance policy = Other type of indemnity = Bond
Insurance Waiver: I , the undersigned, have been made aware that the licensee of
this application does not have any one or the above three insurance coverages.
Signature of owner/agent of property Owner U Agent El
i hesdby ecrtiry, that all n[the deuits and Wormition I:tare tubmitted (or entered)in at:ove appricztion are true and accurate to the belt of MY
`c,140wiedbe and that sill ptumbUsg work and instadAtions pesforracd under Ptrrnst 4sced Co: this sppiication will be in compGattca with&Alpai crit
g«ovisions or the htattachusetts$tate cat Cade usd ciavter 142 of tie icnesal l.►wt_ _
_PE LICLNS'.
Plumber
TitIe Gasfitter Signature of Zicensed
City/Town: Master P1 er or Gasfitter
F' s oritY Journeyman
A PROVED (OFFICE vs ) License Number
Dat "(e.�T.
3892 1•'�
0'
,,ORT
:'4� TOWN OF NORTH ANDOVER
�? o0
PERMIT FOR PLUMBING
'7SA US
This certifies that . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . .
has permission to perform
plumbing i the buildings of
at.mac?. . . . . . . . . ., North Andover, Mass.
Fe . . . .Lic. No 3a�-. . .
" PLUMBING INSPECTOR
WHITE: A �a�aTa li'20CANARY:'�uirag 4P'P l.D PINK:Treasurer
(Type or Print)
NORTH ANDOVER ,Mass. 1-4 ` Date:
Building Location O-D V Permit I
' Owners Name
v NewRenovation Replacement [i Plans S�,bmitted
FIXTURFS '
H a o z > o
WY J P ?• U N .3C `T Q
4n U3 0
LW 413
0 93
J a _ o! 03 = X < w a� = Q a a <
a W ¢
to 76
o.
= ac w a n a =
o a
W QI 0 J in lr J t` Q
t- O > F- O a a.a a .F• z o p 93 _ w !' O u Z
3 ac -A so a n o = r- to U. a o < tt o o
SUa-"BSMT. •
BASEMENT
IST FLOOR
2ND FLOOR
3RD FLOOR
ATH FLOOR
6TH FLOOR
6TH FLOOR
7THFLOOR
eTHFLOOR
(Print or Type) Check one: Certificate
Installing Company Name Corp.
Address Partner.
Firm/Co.
Business Telephone
Name of Licensed Plumber: _
` Insurance Coverage: Indicate the type of insurance coverage by checking the
appropriate box:
Liability insurance policy [7 Other type of indemnity ❑ Bond ❑
Insurance Waiver: I , the undersigned, have been made aware- that the licensee of
this application does not have any one of the above three insurance coverages.
Signature of ownerlagent of property Owner Agents. ❑ I
I bsaby ccaify Wal all of d►o dctaila and in(oonuuon 1 I4a.c sal,o6wd lot cnmcd)in alw•-Art•licaliow sae I/rt aN pyals to tlw btu til at
•v sand that all lun�bin •oak and inslaltaUnna 1•ufn•n�cd undo Pcuuil I�tYCd (of this applipliWa�Il1�i. ■��
• kwo kdC P C basics �titVK�l�►�
fiti+i a o!dis ilaaiacbuutla Stale I'lumbioi Codc and Cluptct 142 of liw Grnval Lara.
i
By
Title Signature of Licensed Pluulber
Type of Plumbing License
u :
Cit a
Y/To np, �i
i
/kS
A DDRf1VFf1 70FFICF USE ONLY1
License Number ❑ Master ❑ Journeya"
MASSACIMSI TTS U(141FOI- NI APPLICATIOtA-FOi7'PERMIT :`E'O.00 MBI1t4G
(Type or !print)
NORTH ANDOVER ,Ma S. bate. �a /�/ ��
Building Lo V ► �`� c c �t�J 1 Permit #V t ^
w
Owners Name �1�e J tiJn a 1� P� 1�►�
iNew Renovation Replacement E( Pians Submitted
FIXTURES
co o z z Ul
LTJ r J .tP
to :Dy ct: B �- z O
tr- to-
Cr'9 «.. N PJf xtu 52
y a t9 m awl >- � F- v! x Ct 4 of � a °� tr d u.
x o a_ � tx a to '0 cc -1 z Cl � o U CC
U2 r r w o a z Y a o
1, v y 1.- o x a �- z a vJ z w r o c�
4 d XCn ca :3 4 Q O Q 1 Q i5w 4 O Q i
3 x tss a s x 1- in u v o a 3 c>_ m o
aASEMENT
IST FLOOR T77 ,
2ND FLOOR O
3Rn FLOOR
4TH FLOO
STH F1:.00n
G3TH FLOOR
7T11 FLOOR
STK FLOOR
ffiH
. (Print or Type) Check one. Certificate
Installing Company Name , , 1 ( ] Corp.
Address 1 oc� ]�a,. S–( — � Partner. ---
r
Firm/Co.
Business Telephone L<S-z,
Name of Licensed Plumber: -
Insurance Coverage: Indicate the type of insurance coverage by checking the
appropriate box:
Liability insurance policy Other type of indemnity C3ond El � -
Insurance Waiver: 1 , the undersigned, have been made aware that the licensee of
this application does not have any one of the above three insurance coverages.
Agent `--�
....
o.. . Signature of owner/agent of property Owner g
❑ t-1
[hereby certify that all of Ute delaids and information 1 have submitted(or cntcrcdt in above application arc true and dccurate to U,e best of my
• x 91 wltJ;e and that all plumbing work and installations perfnrn,cd under Permit ittucd for U,i>application will be in compliance with all pertincntpco-
wWo,li of the Mxssacitusetts state r iumbiny,Code and Cluptes 142 of the General l-ws-
2
Title . Signature of Licen ed t'Zumber
itvJ own � � of PlumWmastar
License•
APPROVED (orrICE USC OfILY)
T,icerise Number Eljourneyman
Date. ... .. ..
�pyNORTH
pa
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
O�
y
SACHUSEt<
This certifies that . .14�t .` : . . . . . �� .N . . . . . . . . . . . . . . .
has permission for gas installation . . . . . . . . . . . . . . . . . . . . . . . . . . . .
in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . .
at . . .5: !?c ` . .`. . . . . . . . . . . . . .. North Andover, Mass.
Fee. ?.? . . . . . Lic. No.. . .nZ 5. . . . . . . .C` . . . I . .
GAS INSPECTOR
Check# a <
43u" 0
X14%ACHUSETIS UNIFORM APPUCATON FOR PERWr TO DO GAS FITTING
(Type or print) Date f lJ
NORTH ANDOVER,MASSACHUSETTS
Building Locations .L'S'D �,�o� -v/�//� �/ I�/= Permit#
Amount$
Owner's Namef,,�Name -
/� �VFW =A
New Renovation Replacement Plans Submitted
v� n U
O OU F x x Cn
z a
z
z w a a
CW'JG z F Z F z W W Q W O W U
o x w 3 A a a A
,e U > a F o
SUB -BASEM ENT
B A S E M ENT
IST. FLOOR
2ND . F L O O R
3RD . FLOOR
4TH . FLOOR
5TH . FLOOR
6TH . F L O O R
7TH . FLOOR
8TH . FLOOR
(Print or type) / // n/ �y heck one: Certificate Installing Company
Name �ti��Y�� / �tf1.� C`D. S/l�r Corp. r /
Address — /1 /1I Partner.
E Z4 a ea- /Yl,4
Business Te p on T E] Firm/Co.
Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE Check onp,.-'
I have a current liability Insurance policy or it's substantial equivalent. YesIZI No�
If you have checked yes,please i icate the type coverage by checking the appropriate box.
Liability insurance policy121 Other type of indemnity 1:1 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 El Agent
I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State G Code and Chapteg 14 the General Laws.
oma..
ignature of �censed Plumber Or Gas Fitter
By.
Title Plumber
City/Town Gas Fitter I�'se INumber
Master
APPROVED(OFFICE USE ONLY) Journeyman
Commonwealth of Massachusetts
RECEIVED
City/Town of NOV 12 212
a System Pumping Record
OWN O
TF NORTH AIy
kIM bV By`eW
Form 4 HEALTH DEPARTMEW
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System Location: Left side of house, Right side of hous ft front of hous , Right front of house,
Left rear of house, Right rear of house. Left rear of building. Right rear of building.
Address b
City/Town State Zip Code
2. System Owner:
f
Name
Address(if different from location)
City(rown State Zip Code
Telephone Number
B. Pumping Record
1. Date of Pumping Date 2. Quantity Pumped: Gallons
3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank
❑ Other(describe):
4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No
5. Conditi n of System:
6. System Pumped By:
Neil Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc
Company
7. Lo - contents were disposed:
.L .D Lowell Waste Water
g to a of Haul r Date
t5form4.doc•06/03 System Pumping Record•Page 1 of 1
I `
N° > �1 5 Date......1.. ... �. ... /.. .
NORT"
�' °�t�``°;•1"° TOWN OF NORTH ANDOVER
o ' PERMIT FOR WIRING
�,SSACMUSE�
This certifies that ....... f .......F;%. ......Cv..............
has permission to perform ....... e
.4 ?......1. ....................................
vv�.:
wiring in the building of.....el...�.c,?.....F�.J.. C w
at..w.. ....I....t4 5w... J.k�r�lJ!�.v�......��.... ,
.... North Andover Maas.
Fee .-�. .�1 Lic.No../ o..... .................................. ........ ......
v ELECTRICAL INSPE
C�( X 07q/12/99 14:44
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
Office Use-Oniy
Permit No_
c W
Occupancy&Fee Checked
D � S-04
BOARD OF FIRE PREVEN-nON REGULATIONS 527 OIVlR 12:100
APPLICATION FOR FERMI TO PEPSORM ELECTRICAL WORK
An vir"to be peffotrrted in a=rdance with the Massarhuseas Eiectrwal Code 527 CMR 12:00
(Please Nnt in ink or type aQ information) t?a� re
To the Ins cior of VYires:
Town of North Andover
The undersigned appiies for a permit to perform 6*eieWcad w&,k described WOW. �y
Lbcadon(Street&Number L�f #�� '�✓/�ud l�i/12t�> 1) (�I U
Owner ar Terssnf
Owners Address E&X 53/ X)0-r�'k /4 M ,�O UQ.
/
Is this permit in corljunction with a building permit yes/E( No ❑ (Check Appropriate Box)
U
purpose of Bui �I w
'N Utirdy Authorization No-
()
ExisiSng Service Amps Vats Overhead ❑ Undgmd ❑ No.of Meters /
New Service l Amps Vans Ohead ❑ Undgmd No of Meters
-t
NurtfW df Feeders and Ampscity - --
Location and Nature of Proposed Electrical Work d IAJ d 0 A t�
— -- Total
No.Of LightOng Outlets No.of Hot fuse No.of Transformers KVA -
Above ❑ In ❑
No.of Lighting Fixtures SvArfiminq Pool grnd C grnd u Generators KVA
No.of Emergency Lighting
No.of Receptacles Outlets _ No.of Oil Burners aittery Units
' .of Switch Outlets No of Gas Burners FIRE ALA10415 No.of Zone
Total No.of Detection and
va.of Ra es -No of Air Cond Torts lnitiating.Devices
Heat Total Total
{ Of Di I No. Pumps Tons KW No.of Sounding Devices
Moi of Self Contained
No.of Dishwashers Space/Area Heating KW DetecdorvSounding Devices
-- ❑ municipal ❑ Other
No.of Dryers mee.nq Devices. KW Local Connection _
No=of No.of Low Voltage
No.of Water Heaters K1N signs Badases Wiring
No.HWM AmsyKe Tuds Na.of PAO= Total HP _
OTHER:
INSURANCE COVERAGE. Pursuant to the re-quire9wits_of sadtuseft General Laws
I have a current Liability Insurance Policy inWdudingcorfifileted Operations Coverage or its substantial equhal Y NO =
valid proof of same to the Off NO = If you have checked YES please indicate Me type of coverage u`f checking tt a appropriate box
elfi yRANeE = BOND = OTHER = (12specity) —
(Expiration Date)
FsdnuftdValue ofWorks _ ,/
Work to Start /—N inspection Data Rtesquesten _____Rough 0C� —Final
Work _
Signed under thePenattes of perjury:
FIRM NAME / tic.Na /'17 224
cv�,L, Slgnatura LIC.NO.
ucengee�L�-0 Zn
, � Buts;Tel No:61 E y b
Address "lc� ��� Inc t - An Tel.No.
OWNER'S INSURANCE WAIVER: I am awaV6 that the Licenses does not have the insurance coverage or its substantial equivalent as requlmd by Ma6sachu'-'
etts
General Laws-And that my signature on this permit application waives this Mquirerrient Owner Age nt (Pleam Check one)
l� ✓ ICJ
Telephone!Vo. Pt�trni T FEE
"- (Signature of Owner or Agent}
I
Lkcation
No. Date
i
0
�pRTM TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
CMUSE Foundation Permit Fee $
r SA
g Other Permit Fee $
pIS Sewer Connection Fee $
.5e( Water Connection Fee $ oe
TOTAL $ 03
—:
AV, ��
BCM Ag In4o to,
125181/11-4/98 10;25 1,621.00 PAI
Div./Pu lic Works
Location
No. ! Date
NORTN TOWN OF NORTH ANDOVER
40
a Certificate of Occupancy $
' Building/Frame Permit Fee $
i y
�sJwcMusEt Foundation Permit Fee $
Other Permit Fee $
"� Sewer Connection Fee $
$, Water Connection Fee $
d TOTAL $
Building Inspector
10/14/98 10:25 11621.00 PHIUDiv. Public Works
i
x '
PER311T NO. APPLICATION FOR PERMIT TO BUILD — NORTH NDOVER, MASS. PAGE 1
MAP 4-40.104 LOT NO. 3 t 41 12 RECORD OF OWNERSHIP (DATE BOOK 'PAGE
ZONE 4 s r SUB DIV. LOT NO. !?61� �o/I//>!� %��"!3 F�
LOCATION Cap,�'b/(c! 4s TR TIS PURPOSE OF BUILDING </!Z/e 14y IV ii/ �7ull�v y
OWNER'S NAM QC°00 y1'7 e4D coayTe H6 ,q es NO. OF STORIES o`2 � SIZE
OWNER'S ADDRESS BASEMENT OR SLAB / ,¢f�•iyt w
ARCHITECT'S NAME � yl OJ e-f ,. SIZE OF FLOOR TIMBERS IST ��1� 2ND a,(�}6 3RD'
BUILDER'S NAME ,P>!,t'y�C✓ iJQIU��P� SPAN /z/}
DISTANCE TO NEAREST BUILDING / DIMENSIONS OF SILLS
DISTANCE FROM STREET �� POSTS O 41 �f�yvs
DISTANCE FROM LOT LINES-SIDES �/t REAR S! GIRDERS 7 - -2X/O
AREA OF LOT I f f 6F yv FRONTAGE 2,0 O HEIGHT OF FOUNDATION �J� /O THICKNESS /0 4
IS BUILDING NEW yes SIZE OF FOOTING / �a X X0 -
IS BUILDING ADDITION A0,
MATERIAL OF CHIMNEY �7 Q►�'Q /7 lr,F e-/"ye�.
IS BUILDING ALTERATION IV49 IS BUILDING ON SOLID OR FILLED LAND C �0A
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE p S IS BUILDING CONNECTED TO TOWN WATER /;/is
BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER /✓O
IS BUILDING CONNECTED TO NATURAL GAS LINE C S'
v
INSTRUCTIONS 3 PROPERTY INFORMATION
LAND COST
SEE BOTH SIDES EST. BLDG. COST .�
PAGE 1 FILL OUT SECTIONS 1 - 3 1 I EBT. BLDG. COST PER SQ. FT.
PAGE 2 FILL OUT SECTIONS 1 - 12 t
4 •""`� EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REG'UL'ATIONS -'--"�
PLANS MUST BE FILED////AND AAPP OCVED BY BUILDING INSPEC R _
Q DATE FILED /Q / 7 r y #(20UILDINO INSP[CTOR
SIGNATURE OF OWNER OR AUTHORIZED AGENT
iOWNER TEL.R
F E E �j
PERMIT GRANTED CONTR.TEL K v Lei?'
IB
CONTR.LIC.#
H.I.C.#
T40RT
Town of over
No.
* $
dower, Mass., 10 13 191
O i LAKE
'9A_COCNICHEW IC K L�'�•
9� A�T E O APP 'L
(G BOARD OF HEALTH
PERMIT T Food/Kitchen
Septic System
THIS CERTIFIES THAT..�.�.��.V.�.�.�........0 BUILDING INSPECTORm V.N.......�. ..........�'.o..��....�.........
Foundation
has permission to erect. I. buildings on.� 0 ..�# O�. l'QO kv i fKl D r
........... Rough
to be occupied as.......5�.N. J.r.... .F�1..M1�1..I.. ......ZIS� +. C t QL..... . ../.....V N *r Chimney
provided that the person accep ng this permit shall in efrery respect conform to the terms of the application on file in
this office, and to the provisions of the Codes and By-laws relating to the Inspection, Alteration and Construction of Final
Buildings In the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. trough
PERMIT EXPIRES IN 6 MONTHS. Final
ELECTRICAL INSPECTOR
UNLESS CONSTRU I'�T AR Rough
.. ............................ ..... ... service
... . .. .. ........ .. ...
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove Rough
Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector.
Burner
Street No.
Smoke Det.
1
FORM U - IAT RELEASE FORK
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.
i
****************Applicant fills out this section*****************
APPLICANT. ,Fd1/dc U ay,v /� o"�C� Phone
LOCATION: Assessors Map Number '� �IOy� Parcel
Subdivision ��a�.0y�l0 rJS/tea T S' Lot(s)
Street /��Dp,(/o'�� //���C St. Nu-.=er �
Use Only*******************x****
RE NDATIONS OF TOWN AGENTS:
t� Date Approved 9 ,93- ' o
Cc. ser':a_ion AaMinistramcr Dame Rejected p
Date Approved C t
own Planner Date Ret ec=ed
Conr„er::__
Dame Approved
Fcou =ns ec -:?ealth Dame Re;ec mem
Date Approved
Dame Rejean__
Co=e: Zs
_c WcrL:s - sewer/warner connect-ons
- driveway pe-=.i+-
Fire
er:.itFire Derartme.n-_ G �d
Received by Building Inspector Dame
TOWN OF NORTH ANDOVER. MASSACHUSETTS
DIVISION OF PUBLIC WORKS
384' OSGOOD STREET, J184 i
GEORGE PERNA Telephone(508)685-0950-
D i RECTOF, Fax(508)688-9573
OF NOPfH 9ti
2 O
� tm
O
z e r Y
� IY
SAC U5
DRIVEWAY PERMIT
Date:
LOCATION:
BUILDER: phone:
OWNER: phone: 6e3? — 6-5�-$
The North Andover Superintendent of Highway Utilities&Operations MUST be notified of the
grade and set-back from street established in any driveway entry onto any street or way maintained by
the TOWN. Call the Highway Superintendent's Office, before finish grading and surfacing for approval
of such entry.
FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT.
Remarks: Approval:
NO 834
APPLICATION FOR WATER SERVICE CONNECTION '
North Andover, Mass. 19
Application by the undersigned is hereby made to connect with the town water main in �G`�
subject to the rules and regulations of the Division of Public Works.
The premises are known as No. Sa rockyte j Drty e. Street
or subdivision lot no. -J— 6 0/558
Owner Address
Contractor AddressA
z«
pplicant's Signature
PERMIT TO CONNECT WITH WATER MAIN
The Board of Public Works hereby grants permission to8rcx4_01 t.P� 0-L��
to make a connection with the water main at 161,00� vc e �l UG- Street
subject to the rules and regulations of the Division of Public Works.
Boa d f ublic Works
By
Inspected by
Date
See back for rules and regulations
• RULES AND REGULATIONS GOVERNING THE INSTALLATION OF WATER SERVICES
1. No persons shall tap or in any way tamper with water mains which are part of the distribution system of the Town
of North Andover without a valid permit from the Division.of Public Works.
2. All water services shall be installed a minimum of five feet below the finish grade.
3. No water services shall be backfilled without inspection by a representative of the D.P.W.—Telephone 687-7964.
4. Service connections shall be 1" type k copper tubing.
5. All fittings shall be brass flange type Mueller or equal
H 15202 Corporations
H 15212 Curb stops
H 15402 Three part unions
H 8185 stop and waste valves
6. Curb boxes shall be installed at the property line and shall be of the Erie Type with 4�/2 foot rod and brass plug
type cover.
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: 8-13-1998
DATE OF PLANS: 10/5/1998
TITLE: 28x55 Colonial
PROJECT INFORMATION:
Lot 1
50 Brookview Dr
N. Andover Mass.
COMPANY INFORMATION:
Brookview Country Homes
COMPLIANCE: PASSES
Required UA = 59'0
Your Home = 514
Area or Insul Sheath Glazing/Door
Perimeter R-Value R-Value U-Value UA
-------------------------------------------------------------------------------
CEILINGS 1404 30 .0 0 . 0 49
WALLS: Wood Frame, 16" O.C. 2720 11. 0 3 .0 209
GLAZING: Windows or Doors 420 0 . 350 147
DOORS 21 0 . 350 7
FLOORS: Over Unconditioned Space 1404 19 . 0 67
FLOORS: Over Outside Air 10 19 .0 0
BSMT: 8 . 0 ' ht/7 . 0 ' bg/0. 0 ' insul. 160 0 . 0 35
HVAC EFFICIENCY: Furnace, 90 . 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.
Builder/Designer Date
i
MAScheck INSPECTION CHECKLIST
Massachusetts Energy Code
MAScheck Software Version 2 . 0
28x55 Colonial
DATE: 8-13-1998
Bldg.
Dept.
Use
CEILINGS:
[ ] 1 . R-30
Comments/Location
WALLS:
[ ] 1. Wood Frame, 16" O.C. , R-11 + 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
[ ] 2 . Over Outside Air, R-19
Comments/Location
BASEMENT WALLS:
[ ] 1 . 8 . 0 ' ht/7 . 0 ' bg/0 .0 ' insul. , R-0
Comments/Location
HVAC EQUIPMENT EFFICIENCY:
[ ] 1. Furnace, 90 . 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:
[ ] 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.
DUCT INSULATION:
[ ] Ducts in unconditioned spaces must be insulated to R-5 .
Ducts outside the building must be insulated to R-8 . 0 .
DUCT CONSTRUCTION:
[ ] 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 125% of the design load as specified
in sections 780CMR 1310 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)-------------------------
✓�ie �a�xmto�zruealC� o�,��rrJJ?C�ClJCIIJ '
DEPARTMENT Of PUBLIC SAFETY
CONSTRUCTION SUPERVISOR LICENSE
f , Humber Expires: Birthdate:
j CS, i'.,,OB5693'`01/13/2000 01/13/1954
Restr'lcW Toc 00
I
DAVID A''KINDRED
30 MILLPOND POB% 531 1
N ANDOVER, MA 01845
"156635
Restricted To: 00
1 00 - 35,060 cf enclosed space
(MGL C.112 S.66L)
i lA - Masonry.only
1G - 1 G 1 Family Homes
� i Failure to possess a current edition of the
Massachusetts State Building Code !
is cause for revocation of this license.
` CERTIFICATE OF USE & OCCUPANCY
Town of North Andover
Building Permit Number yy / — 7 S Date
THIS CERTIFIES THAT
THE BUILDING LOCATED ON X of '4-1 C#250) 931)0 o kul e- w Z)12jo t,
MAY BE OCCUPIED AS V l� �'�- � �IV a cSTa��u�c,�2 IN ACCORDANCE
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND
SUCH OTHER REGULATIONS AS MAY APPLY.
:, CERTIFICATE ISSUED TO
. y0
ADDRESS )414 OO"k
Building Inspector
� r10RT
Town of
over
O
No.
* z dover, Mass., 10113 -1918
A 9A_c0tH1CHE_w1cx �`�•
'7 O
q'4 T E D
(G BOARD OF HEALTH
Food/Kitchen
Septic Syste ��
PERMIT T
O
THIS CERTIFIES THATV ' ........C.. V N+ Y
O C LDING INSPECTOR
. .....
Foundationhas permission permission to erect.............I......................... buildings on 1q+...!....� `QO Kv l*KI �• Rough �� �(�-�-•--
to be occupied as.......�?�.N . ..�. ..... !Za
J. *w�. ''.!�?.<<.....a.....;! #O#J'....1�.N.�1!f r% Chimney �
provided that the person accep�ng this permit in e4ery respect conform to the terms of the application on file in Final
this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of �d
Buildings in the Town of North Andover. PLU/M`BIN INSPE OR
VIOLATION of the Zoning or Building Regulations Voids this Permit. 161
PERMIT EXPIRES IN 6 MONTHS,,
ELEcTqkZ7X SPE
UNLESS CONSTRUC N AR
otr
l ( //
...... .... .. .... ............................ ..... ..............
............LU�....
BUILDING INSPECTOR
Occupancy Permit Required to Occupy Building GAS IN E OR
o
Display in a Conspicuous Place on the Premises — Do Not Remove
No Lathing or Dry Wall To Be Done FIRE ARTMENT
Until Inspected and Approved by the Building Inspector.
Burner
Street No.
Smoke Det. 'l
NORTH �. V o o(tLo
e
1� a OL
O
r
' ....'-._. TOWN OF NORTH ANDOVER � l
SSAC,HUS f
APPLICATION FOR
CERTIFICATE OF OCCUPANCYIINSPE T10I`J
ADDRESS/LOCATION OF PROPERTY : S_b s��"�
DATE REQUESTED FILED/READY FOR INSPECTION y y 1 -12
CLOSING DATE ON PROPERTY:
—T
FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED
ALL WORK AND PERMIT SIGN-OFFS MUST BE COMPLETED WITHIN THIS
TIME FRAME.
A RE-INSPECTIO FEE OF TWENTY DOLL4RD $20.00) WILL BE
CHARGED IF T U-C,T/URE DOES NONEET ALL APPLICABLE CODES.
SIGNED
ROUTING
CONSERVATION
Imo.��` `,� •
PLANNING
DPW - WATER METER
NOTE:
DPW MUST INDICATE THAT WATER METER HAS BEEN INSTALLED
PRIOR TO SUBMITTAL C NCY/JNSPE"TION REQUEST
DP
Si lure
,AORTH _c
3�O t `tO L4
04 W)
TOWN
TOWN OF NORTH ANDOVER
SSALHUSS
APPLICATION FOR CERTIFICATE OF OCCUPANCYIINSPiECTION
ADDRESS/LOCATION OF PROPERTY :—
DATE REQUESTED FILED/READY FOR INSPECTION
CLOSING DATE ON PROPERTY:
FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED
ALL WORK AND PERMIT SIGN-OFFS MUST BE COMPLETED WITHIN THIS
TIME FRAME.
A RE-INSPECTION FEE OF TWENTY DOLLARD $20.00) WILL BE
CHARGED I=T . OES NOT ET ALL APPLICABLE CODES.
SIGNED
ROUTING
CONSERVATION
PLANNING
DPW - WATER METER
NOTE:
DPW MUST INDICATE THAT WATER METER HAS BEEN INSTALLED
PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST
DPW
Signature
'/