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Miscellaneous - 51 LYONS WAY 4/30/2018 (3)
G �� ,;. Safety Insurance Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall NORTH ANDOVER,MA 01845 NORTH ANDOVER, MA 01845 RE: Insured: TERESA ST PIERRE and DAVID'ST PIERRE Property Address: 51 LYONS WAY,NORTH ANDOVER, MA Policy Number: HMA 0085128 Claim Number: BOS00045368 Date of Loss: 9/18/2014 Company: Safety Indemnity Insurance Company Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate,please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim number. Holly Coughlin Claim Examiner 9/24/2014 Safety Insurance Company Homeowners Claims Unit P. 0. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3026 Fax: (617) 531-6684 Email: HollyCoughlin@Safetylnsurance.com Pcaption-Crl--�CWW No. Date NaRTM 1 TOWN OF NORTH ANDOVER f R i y + ; , Certificate of Occupancy $ Building/Frame Permit Fee $ sACNUs Foundation Permit Fee ./ $ Other Permit Fee 117_ TOTAL Check # 14 . 6 3Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING T T�L4.SeChO for U ICI& US 'U9I BUILDING PERMIT NUMBER DATE ISSUED: rn SIGNATURE: Building Commissioner/Inspector ouildings Date SECTION I-SITE INFORMATION O 1.l Property Address: 1.2 Assessors Map and Parcel Number: Map Number. Parcel Number \ 1.3 Zoning Information: 1.4 Property Dimensions: v 0,5 .00 Zoning District Proposed Use Lot Area(so Frontage(ft) 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Requi red Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: D Public 0 Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System i SECTION 2-PROPERTY OWNERSIiIP/AUTHORIZED AGENT m 2.1 Owner of' Record �R��►� ST P/,r�2E vel .Z ydAIS- Name(Print) Address for Service: v (P Signature Telephone l 2.2 Owner of Record: e O ! Name Print Address for Service: Z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed"Construction Supervisor: Not Applicable Srccgryim-w �4(f'on sKi opo Licensed Cor.4truction Supervisor: O License Number Address D 97k I/ 3.38 Expiration Date t nateg (--Telephone P r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name 1,;4 so Y! rn Registration Number r .sresrr w.�/ l�.r�r,�� r Address � o Z /6 Expiratin Date ` GZ) Si¢nat Telephone J r SECTION 4-WORKERS COMPENSATION(NLG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes....:.. X No.......0 SECTION 5 Descri tion of Proposed Work check all applicable) New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other 0 Specify Brief Description of Proposed Work: )Z-X 39 C/Z.OUx(d rS"L✓iM�vi/NG L SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be {3I? xCITSE`OY f Completed by pennit ap licants ?h n 1. Building (a) Building Permit Fee )46 00 Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) x (b) 4 Mechanical HVAC I 5 Fire Protection 6 Total (1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. i Signature of Owner Date } SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, eSJ,GA0�4 W rl- as Owner/Authorized Agent of subject Property Herebv declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name �/��/l S ure of er/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 3fw SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 3 (- © FORM - U - LOT RELEASE FORM 7a-zq INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT 4019 V IV -S,7—A ;;R)W,�_; PHONE (02--3392— ASSESSORS 02.-3392— ASSESSORS MAP NUMBER (96 LOT NUMBER SUBDIVISION LOT NUMBER / STREET STREET NUMBER .S I OFFICIAL USE ONLY REC ATIONS OF TOWN AGENTS DATE APPROVED CO RATION STRATOR Cr DATE CTED CONUVIENTS ` ) 4 /?)Po In.pr (SJitAt,✓,�1 . DATE APPROVED TOWN PLANNER DATE REJECTED _ COMMENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE ����,, ��.. fib• `P • ayao ea Mlimm.AdL �._...;�.. its MW -'a lop awi�.�•..-ems�,;� 'O� -ri �� _ --..s...-,.�.. .t FilmY ♦• N t4 • • '' '�1� ... ... .� .......... �.r"o.nLs..O1Pn...�f4.61'b ail!d Slr.�'aia.��4>dl.T,..}i.s�Ird�,</!.�.A II\�...�!AY,O/��/�wO.�.i Y./��.I.b•A�A�..ii rV�.rlll�Itl�\.fb!d J�i Ni R.4 �Y cam.A.fl .10�•��d�d\ ,-_ .�� y�.y,.vyr+r����r�i r'��•�'�r���.®arar w��+ vin."'[®'•ora•'mow.�vs a�w v,n��'ro�v va.••�..a.�,.•v��n.= w•v�eev,�►Fav w�v��•�.r/w yr.�r'rao'v�♦.�'w��w w'�.���v�v vw.'•+r•.�w�v We+ .a• �. .tee.o.r--.��..•-•.., a • � s PRP�e. - !�VIF30 � � VIFl3 4 ,4 000 =12 N `� 0 X121.0 T -130.00 �2 44L, Moulow ea0/ Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration 4 `�..r . w �� `-: � �,f Registration: 128048 Type: DBA i Expiration: 02/17/2003 POOLS BY STEPHEN ZAGORSKI ='ti _ `a STEPHEN ZAGORSKI ------- 244 HIGHLAND ST - � i.<� ---- --- HAMILTON, MA 01982 _ ,. — -------_—.-- Update Address and return card.Mark reason for change ✓lie Cho�r�w sea o� ac�2tcOP 6 U r�lS'ur'c3S .,u- ....:'i.' U Zklipl .�'.; :_U:. Board of Building Regulations and Standards License or registration valid for individui use only HOME IMP.ROVEMENT CONTRACTOR before the expiration date. If found return to: Registratio'n128048 Board of Building Regulations and Standards Expiration 02/]7/2003 One Ashburton Place Rm 1301 DBA; Boston,Ma.02108 Type: POOLS 13YZTEPHEN ZAGORS:KI STEPHEN ZAGORSKI 244 HIGHLAND STM� p l d ✓/Q 303{ 1 - - �y • .-♦ .... I1'•4 YWi.'O&CO' ...-.' 1-O vfaT M0U;9tACGiCiD } .. . : O 14 Q•C:—T4C IT O�fj P � •0OfWOOvw 'ra y, 20U4.cur'TNG P=)L cow*, t�O 10'WN._IwtO 01002 W� r.pci.LfvaLtRCisf . OfN.-op ooa , f 4 -17 t ,; " ,.� �•a.o CONSTRUCTCON, INCA. 5 .� ... -; d t 'G-i>r » ,.. ._ •, .fr, . ,r.n , {:yfi(.wll -15 { h'co.inutnua7 u�Luow ENo i Kt' DEEP iIJO 8_$hUxOEPiNv .-e'MfuOEOM LOt.IGtTUDINAL SKTIOtJ 'TL12U CET-Q �' , •• • Lam":; ba �„„�,.: �-r; ;� j O -,::,. ! '7<►t�.clu. ': ,, 1e w�wslu mor nc"ANIrJ Sw�va¢qu.I �' ' ►LLO1NG0 6 MIr,YIuyM .. 14L .. '9•A•i _ — r A"yS,.: .: cc sov"waii s r '1 \ SF }� -i x, SECTION AT 4-d BMAx-r. .. .. u. MAMMAL uNolsruaeco '"•, t i 'n.Tcou.'cqa _ � i soles #•rwsw ea..awr ':*: .. H � , dbm (-WaTi2-� 0x0 JdNT . w AT MAW eb wT '%r-TION MAIN r�carKsa �n+l+snlortor I ..� . �� •�� ( •11PiCa1_ �'----�1 ►NSnLWNMGNT 9�.,� T ,-h 5.. Sy a r t? • cgwx ASC To T•INtT •. �• Y- I s¢ff:l.le oe'eaawelve 4. �.1 s 90RT4) _ •. �. 8 . - ►.• ooaoNlT � •• Y i a, :.. - Ji To arcay � GI .i 'u1cwE 7 31' t��cealxctnwd 1 - •'L+ Fj� 1 14'—�:, ►Iwoww uiw-� i! _ Y c` 1 I nt=QWNT D A7FL�•.'.IICETAIL KIMMI-2 DEW UNL . +' 9 P*f Oks.a.TA oawb6 Sw.aa iyyis• x. '' fl! _ . ... z IJ? + cuN.,a•wa tx w�.Tb��L �� T L1'ST :. .. .. --. p• ;i% �w•J„S, i ..,. wfT SRT•i+tILC MITN •n ,, ,. �:.: � "' ,�.�,.� N..rw:�cwucv ' .. :. -. 4•�j�+:�TiJl�a, ,„ . ' .... ..Gf.WEI::.. . ."_'. ,, •� } . . r 7.. .� .� MQb GC?1S7 X. MAWD I C - NORTH Town oover No. Co- �A COCHIC � dower, Mass., $ o? 102404) / DRATE D P'P�,`�� S u G H ` BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System .,t BUILDING INSPECTOR THIS CERTIFIES THAT.......... v.l... ...........�f.�....p�. ..�.�.�� ..................................................... Foundation has permission to erect..... buildings on ...... ....... .. . . Rough .V .............w .. Y... . t0 be occupied as N 6P UNd Sw 1 COM!ti� p00 /� h!d�^ ' /41?c� Chimney ................................... ....................... .. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 149613,1 //q., — PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough +r A I Ntd l n_? 10 , PERMIT EXPIRES IN 6 MONTHS Final s r-*b A�K ��o�- hc+ L i N �=S UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough .... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE No 36 Date.....6f/. � fHCR M1 TOWN OF NORTH ANDOVER t PERMIT FOR WIRING SACHUSE� This certifies that ......., C!..... /.fir 1./ (.. ................................... has permission to perform .. ...t9.... ' / ..!............................................ wiring in the building of.... ............................................... .6 L (� `,/ ...... ,,North And ver s. Fee .`��:��.. Lic.No,17'llt?� .......... ..7/..�...... LECTRICAL IfVSPEC'C�OR Check # �U , WHITE: Applicant CANARY: Building Dept. PINK:Treasurer DEPARTME7VT0FPUBL1CS4FM Permit No. BOAROOFFIREPREYEMONREGUL4TIOASS270912.0 IP Occupancy&Fees Checked I I APPUCATTONFOR PERMIT TO PWORMaE=CU WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTs ELECTRICAL CODE,527 CMR 12:00 j (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat i 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) Owner or Tenant PY ple> oe Owner's Address Is this permit in conjunction with a building permit: Yes[allo (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead Underground M No.of Meters New Service Amps Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work /-//7 li'1 q 17 j No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units �yNo.of Switch Outlets s No.of Gas Bumers No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons 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 No.of Dryers Heating Devices KW Local Municipala Othrr Connections No.of Water Heaters KW No.of No.of signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP a •OTHER i Irrsu-atreCo�aa�Aasuantbtheregtma►�dfIvla�ad�Ga�aiLaws Iha�eaaiQatLi�tTdyLtoePblicyirchdatgCanpl�e Co►eagea� taquivalent YES NO Iha%eslrbmftdvatidp ucfbfsatrekrthe061oe YES aNO If}wha%edoiWYES,Ple wmdc*theWcfaotsagebydiedmtglhe INK ANCE BOND MIER � (I'Iea9eSpedfy) VCi/��� �UU� ExpMm Dtaile F dVahtedE6cfixalWads$ WodctoShalt 1rgxxhmD* / FW FIRMFIRM NAME utx$r�iel?a>allisofpajtsy b .il LC�r�C /1 /yU. ��rf 6617 >l4�m ��`� L mseNa Li /�� ,(f/� (` oaw D J4),01e/ J/�/1h ire Lk=No //i BusirmsTd.Na V/ �i030 >,a AIL TCL Na OWNM'S,MJRANCEWAIVER,I.amawatethatdrIJb dmnot einsuraowmr."sub�e asm*medbyM GaealLam mddAn y rnflrispeaiitwain sthism mana>t. (Please check one) Owner Agent ❑ ^. Telephone No. PERMIT FEE r N2 2366 Date.... NORTp 0 TOWN OF NORTH ANDOVER 0 0. PERMIT FOR WIRING U US This certifies that ... .................. .......................................................... has permission to perform :E. . ........ ......... ................................................ wiring in the building of.... at.41........ ................................. .North Andover,Mass. Fee..4�.,,?....... Lic.No.7Se ..... ........................ ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer TIM COMMOA7W,4L7710FM4&V.4 WSE77S Office Use only j Z D PART111EW0FPUBL1CSA= Permit No. a BOAMOFFMPREVEMONREGM770AS527CM1200 Occupancy&Fees Checked M 5APPLICATTONFORPE MT TOPERFORMELECTRICAL WO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE IV. SACHUSSTS ELECTRICAL CODE,527 CMR 12:00 z � (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. PARCEL Location(Street&Number) 0 Owner or Tenant 77O Owner's Address Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building iF-b, Utility Authorization No. 003,337 Existing Service Amps/ Volts Overhead Underground a No.of Meters New Service ddb Amps d-y© Volts Overhead Underground �` No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work AI LW PDfYI No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground and No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burnm No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons 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 _ No.of Dryers Heating Devices KW Local Municipal Other Conncctions No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER• -- d husuzro Qmzage.Plast>arttotbeiegi�oflvlassadm9&C=walIaws IlAacuii=Liabhyhlsta=PdxyurhrlagCanplcte CmuaWcrits alNx,',lmt YES NO IhawWxn03dtandpocf,ofsame1otbeOfce YES F87/rNO IfyuuhaNedmia�dYFS,pi=mdc*tbe Fcfcowagt,bydaedrgthe MSTAl,TCE [Z BOND CIIIIER F1 03mwSpa*) Es1im&dVakEdUxbcalWuk$ Wo k o Sm, a bTect mD&-Re4rsh2d Rage b✓/L(- Final Sigoed,mdcffie%ahimofpetjuay: G 1G�7Z LioatseNo 7 7 � FIRMNAIvIE Licerr�ee ��Ub9�v C /)61 n0,,J Sim LioenseNo 7 7 Q 'J �j Bun mssTe1Nb M3 - A� 1"•� . �QX d175— S L N)l �67 ! AltTd.Na d3i-os6q OWNE12SINSURANCEWAIVE;;Iamawatethattbr,lm sedoesmthawdrinaaame crit3ahtrideqrAutasmgmedbyMa%ahls&Cvrj=lLaws aod4�rrrysigtmhaem4�ispearrit. waiwsthis taqmanat. (Please check one) Owner Agent Telephone No. PERMIT FEE$ Signature o weer or Agent Date._' .`l�: �G N° 4436 of, 4C „oR'N TOWN OF NORTH ANDOVER ��•° ,•1 l" PERMIT FOR PLUMBING ,SSACHUS� This certifies that �/ f�.� . . .LI.�.Y.r� . . . /�0�.�. . . . . . has permission to perform . . . c. . . . . . . . . . . . . . . . . plumbing in the buildings of . . f'.S !'�i. . . . . . �.`� . . . . . . . . at . . � ./. . . . . f%u!-:1. 5-. .t 19.`l . . . . . . . . ,CNorth Andover, Mass. FeOr � Lic. No./ . . . . . . . �. . . . . . . . . eLUMBINIG INSP CTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer 2 MASSACHUSETTS UNIFORM APPLICATION FOR E 0 DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS ELI 7 �� /, `•, Date Building Location GY Owners Name Permit# � Amount �G�- � Type of Occupancy _ New Renovation 0 Replacement 0 Plans Submitted Yes No FIXTURES W G' w a a r„W) Z W E- W Er k� d Cn d x W x d W A aCn s x E~ > a a rA � d -< a x a H x a o a a E~ WOd x m SLRaM .j m1v m M FIDQt aru MM 3M FLOOR 4M RaR 5M HJOCIR 6M RKM Mi RaR 8M HIM (Print or type) Check one: Certificate Installing Company Name �r�Lc e /"�"� Corp. Address �' Gr � SPartner. Business Telephone _ Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy H Other type of indemnity El Bond Insurance Waiver. L the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I have 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 Sta lumbingha dr 142 of the General Laws. By: igna or Licensed. um er Type of Plumbing License Title City/Town icense Numoer Master Journeyman ❑ APPROVED(OFFICE USE ONLY Date.,- - /? - c . t / ... .... . . ....... NORTH TOWN OF NORTH ANDOVER pf���io ,s,ti0 3? O ° PERMIT FOR GAS INSTALLATION ,. ' m 9 ti ,SSACIN ! I This certifies that . . . . . . . . . . . . . . . . . . . . has permission for gas installation . .A P. in the buildings of . . .�/<'� i.// .*. . . . . . . . . . . . . . . . . . . . . . . . at . . .-�. :� . . . !l� F. . �./. . . . . ., North_Andover, Mass. Fee. . 2�-. Lic. No.. 0 2?.1 . . . . . .. . ?!1 .. . . GAS INSPECTOR V WHITE:Applicant CANARY:Building Dept. PINK:Treasurer x 113:. 1 > Y MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DOG FITTING Type or print) ate J 7 19 e5V - NORTH ANDOVER, MASSACHUSETTS Building Locations �° permit 3 ! -z Amount S �J f c,4- Owner's Name a New Renovation ❑ Replacement ❑ Plans Submitted ❑ �ak1 :G n i :n Cn C z In — _r In z :.1 — In — C v m n n z W d Jn �! ? f ;t ? Z =r z c� j :� n z C — CCn 7 SUB-BA5E ,M ENT ` y BASE .M ENT IST. FLUOR 2ND. FLOUR 3RD . FLOUR 1T 11 . FLOOR ST If FLOUR 6T 11 . FLUOR 7T If FLUOR 3T II - FLOGR (Print or type) P Check one: Certificate Installing Company Name (� 7 ❑ Corp. Address ❑ Partner. us Telephone �'p f'� l0� ?j ® BsinesFirm/Co. Name of Licensed Plumber or Gas Fitter a INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ "-,=l If you have checked ves•please 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 I hereby certify that all of the details and information I have submitted(or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued For this application will be in compliance with all pertinent provisions of the Massachusetts State Gas C90 and Chapter 12 ofthe General Laws. j Bv: Signature of Licensed Plumber Or Gas Fitter Tide F7 Plumber 11Q7 /7 00- CitviTown ❑ Gas Fitter lcense (Numoer � I�l;�ster APPROVED(oFrICF 115E om.Y) ❑ Journeyman it Town of North Andovero� r10RT4 q �eo Building Department M6, o 27 Charles Street 0 North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 a <o[wl[w.wKM 4�g4Tto aPP,((5 9SSACNUS� APPLICATION FOR CERTIFICATE OF OCCUPANCY/ INSPECTION ADDRESS10 LOT NUMBER SUBDIVISION 4V DATE REQUEST FILED DATE READY FOR INSPECTION r0 c o 3100 FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OFT�WENTY-FIVE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTUIRE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE -ICTAL USE ONLY ROUTING CONSERVATION DATE w( L 11 PLANNING DATE , D.P.W. —WATER METER Oji DATE !g GYM D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE APWAGTHORIZATION Mesiti Dev Grou Fax:978-5578160 Jul 17 2000 1354 P.01 TOWN OF NORTH ANDOVER DIVISION OF PUBLIC WORKS 384 OSGOOD STREET NORTH ANDOVER,MASSACHUSETTS 01845 J William Hmurciak o�+�^�. Telephone(978)685-095Q Director Far(978)688-9573 `* y July 14, 2000 Mr.Kenneth,Grandstaf� President Mesiti Development Group 231 Sutton St. Suite 2 F North Andover,Ma. 01845 Re: Conditional Operation of the Campbell Forest Sewer Pumping Station. Dear Mr. Grandstaf i The Division of Public Works has inspected the sewer collection system and sewer pumping station,and appurtances on Campbell Road related to the construction of the Campbell Forest and Lyons Way subdivisions. We hereby grant conditional approval for use of the system and pumping station subject to the foIIowing: 1. Completion of items 1 through 15 as listed on the July 10, 2000 letter to Mr Dennis Bedrosian from Maurice Harpin of Mesio Development Group, a copy of which is attached. The work will be completed within 45 days of acknowledgement of the receipt of this letter. 2. Satisfactory completion of an as-built plan for the Campbell Road sewerage system 3. Submittal for our review and approval a copy of the preventive maintenance contract for the pumping station. 4. A performance guarantee shall be provided in the amount of$25,000.00 to insure the proper maintenance and operation of the pumping station. 5. The Division of Public Works will be allowed access to the Pumping Station and will be allowed to reconstruct,repair,replace,add to, service,inspect and operate the pumping station and related equipment.and facilities in the event ___ that_ that Mesiti Development or its agents fail to adequately.perform maintenance of the pumping station. Mesiti Dev Group Fax:978-5578160 Jul 17 2000 1354 P.02 6. Mesiti development shall reimburse the Town upon demand for the reasonable costs of emergency repairs to the Pumping Station. 7. Mesiti Development Group and its successors or assigns shall indemnify, defend,and save harmless the Town of North Andover and its Division of Public Works and their respective employees, officials and agents against all suits, claims,judgments or liability of every name and nature arising at any time out of or in consequence of the acts of the"Town"or its agents, employees and officials in the performance of the access purposes covered by this grant of conditional use or the failure of the developer and its successors or assigns to comply with the terms and conditions of this grant. Very T ours, - Lt;� L J.William Hmurc' .E. Director of Public Works The undersigned acknowledge the receipt of and agrees to the terms and conditions of the above 7�e of ndirional use. up K ethGr d silent Date: CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number /� Date THIS/CERTIFIES THAT THE BUILDING LOCATED ON 1(04 '7 #t P a� yG/Us w MAY BE OCCUPIED AS.. AMI /w� �Ilti IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. y' /coIn MS] a �a ,C3.4�hS� 02�/v// v��e2 CERTIFICATE ISSUED TO 0 ADDRESS """S� Building Inspector e NORTH F r� Town o _ RAndover 0 • o dover, Mass., 3457 40 0 O COC MICMEWICK ' ORATED `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System �� W.4BUILDING INSPECTOR THIS CERTIFIES THAT....... ... ......... Y............. ... ..L.................. .................................... Foundation�/f/�. has permission to erect.........I............................ buildings on lol I.. 6*A �...... .. . . . ,�.................. Rough /©jz << __to be occupied as.......�-OP4000o..e?.�6....8� . ?-��6r.m-$to .� ...v!d �tl'.....�....... �• Chimney provided that the person accepting this permit shall in every respec the terms of the application on file in Final �� this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. ,O PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough <.., PERMIT EXPIRES IN 6 MONTHS ELEC ICAL INSPECTOR UNLESS CONSTRUCTION ST: oug �, .:................. ce BUILDING INSPECTOR �J F' Occupancy Permit Required t0 Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove n 1 �?�73N No Lathing or Dry Wall To Be Done FIREI&PARTmENT Until Inspected and Approved by the Building Inspector. Burner Street No. / r 3 lav SEE REVERSE SIDE Smoke Det. - Location No. l Date `s7. TOWN OF NORTH ANDOVER �0 f s Certificate of Occupancy $ Building/Frame Permit Fee $ C" Foundation Permit Fee $ e,/ Other Permit Fee $ TOTAL $ Check # i Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. 66-Al, / DATE ISSUED. (D '�C` ic SIGNATURE: //8 AW Lq-, Building Commissidner/Ins=tor of Buildings Date z SECTION 1-SITE INFORMATION IO 1.1 Property Address: 1.2 Assessors Map and Parcel Number: L yon s w a.y S12b�lr V/J 05�1 �D # Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: /209- S jn 5/e yti� V- 9S- s /0 ' Zoning District Proposede Lot Areas Frontage R 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 30 1 �3 3 v 33 b° v: a 1.7 Water S;pply M.G.L.C.40. 54) 1.5. blood Zone Information: 1.8 Sewerage Disposal System: Public Private ❑ Zone Outside Flood Zone 0 Municipal On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record Name(Pri l Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Z. r m Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: C 's 0 6 y .,?3 X O X/'/V License NumberMn Address l 'S .7o() ic Expiration Date e Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name M Registration Number r Address z Expiration Date /1 Signature Telephone k SECTION 4-WORKERS COMPENSATION(M.G.L.C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes....... No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction Existing Building ❑ Repair(s) ❑_]_Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: x! SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to he OFFICIAL USE ONLY Completed b ermit applicant 1. Building (a) Building Permit Fee / Multiplier (_ 2 Electrical (b) Estimated Total Cost of l �� Construction (� 3 Plumbing Building Permit fee(8)X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION 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 permit application. Signature of Owner Date SECTION 7b OIWNER/AUTHORIZED AGENT DECLARATION 1, as 9�r/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 p Print Name Signature of Owner/Ag Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE r - " • FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT PHONE �'s 7-s 4 v ASSESSORS MAP NUMBER l U G f3 LOT NUMBER SUBDIVISION YP21 S W LOT NUMBER '7 STREET Z- S f-vi STREET NUMBER 6-1 OFFICIAL USE ONLY RE ORATIONS OF TOWN AGENTS . .-a.....■.r.... ...................!!■t..............t... .. ....tet .t DATE APPROVED 1,01 / l V CO SERVATION ADMINISTRATOR DATE REJECTED COMMENTS I DATE APPROVED TO R DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED , COMMENTS V _ (0k)(c, PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE -b 9 LOT 2 1 45,290 1 .04 Ac. V) --- _='( -&42'1 B" T=19,4 8' x R=175,00 59.99 '1 r�- .20 sbj 32.0 T- 13.92' r11 5.00 �1 �- 36.0, _ ^ .- LXiSTAG ' Un �,. LOT f�uNi7ATION 7 44,895 8.F. 1 .03 Ac. .� _.. • SWOH (FND.) - , - � --- `-- - ' 834"08'02"E 111.$1 ' 536'02`52 E 77.11 N/F HAROLD PARKER STATE FOREST G' 4A 3EN M. 19C�A1 c� �n NORTH ToVM Of over p y h T �O LA o over, Mass., l.Z • y—o 0 COCHICHE w ICK V ADRATED P -`y S H E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......... .y.�.!V 5........... /4 y . . .......... ............ ...... . ... .............................................................. � � Foundation has permission to erect... ..f�7i..�WV....... buildings on ." 4A...6 /.....4-Y.O.A0.6_...M.y Rough to be occupied as.....10 P F. A10111W..; ......Q�a.r....� � �.W.R.M .1 A..................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 1"J40446 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST Rough ........... . .. ...*........................................................E.............OR... Service 1 BUILDING INSPCT Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner i Street No. SEE REVERSE SIDE _ Smoke Det. Location "\o jIVAS No. '� Date /6l%/ NORTol TOWN OF NORTH ANDOVER a Certificate of Occupancy $ S U Et<' Building/Frame Permit Fee $ �Ss+cMus n, Foundation Permit Fee $ �U U Other Permit Fee $ _ TOTAL $ U. �- Check # 0"/ Q Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING d4' C19� BUILDING PERMIT NUMBER: DATE ISSUED. / ®0 ic SIGNATURE: Build i Commi Afflner/In for of Buildings Date Z SECTION i-SITE INFORMATION O 1.1 Property Address: )) 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed l e Lot Area sf) Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re 'red Provided 1' 3/ A 3C> ' 3S" 30 1.7 Water Supply M.G.L.C.40.§54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public Private ❑ Zone Outside Flood Zone ❑ Municipal On Site Disposal System ❑ SEC ION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT----T M 2.1 Owner of Record Name(Print)(Print��/ _ Address for Service Signature Telephone 2.2 Owner of Record: 0 Name Print Address for Service: Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable 0 Licensed Construction Supervisor: Q j/ t< 71� � t �� %� _/ E'f— License Numbermn Address �°�' 7—$ .3c a Expiration Date Signature Telephone r 5'76U 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name M Registration Number r Address r z Expiration Date ^ Signature Telephone Y/ SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. -Signed affidavit Attached Yes.......X No.......❑ SECTION 5 Descri tion of Proposed Work check all a bitable New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: c V n J-2 r-ol SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee a 30 0 Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x (b) 4 Mechanical HVAC 5 Fire Protection 5 Total (1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION fO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWN NE�ER/AUTHORIZED AGENT DECLARATION I, '457l e� //2g/GS ez as QmerxfAuthorized 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 Print Name Si ature of Owner/A ent Date-lei ME NMI, l '� r NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF OF FLOOR TIMBERS is c3 23KD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS /0 HEIGHT OF FOUNDATION '7'/D " THICKNESS /, " SIZE OF FOOTING ' `, X p t' MATERIAL OF CHIMNEY eoe) ) IS BUILDING ON SOLID OR FILLED LAND z IS BUILDING CONNECTED TO NATURAL GAS LINE z�� FORM U - LOT RELEASE 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 or requirements. * *********************APPLICANT FILLS OUT THIS SECTION******:�**,*******"`* 67,,'*-S 7-S-76,0 APPLICANT 6rp-j Al2% LLC PHONE 6 7-S oti LOCATION: Assessors flap Number /deo 8 PARCEL 1 S SUBDIVISION 7 LOT (S) '7 STREETi»1S r-r✓a __ ST. NUMBER J` USE RE ONIMENDATIONS OF TOWN AGENTS: ��Gv gotE— ,/J� 5I F1 CONSERVATION ADMINISTRATOR DATE APPROVED I� DATE REJECTED COMMENTS �Sf Cil �rlL. 6, ��' �dn �.-S/ �La •• TOW PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS -SEWERfWATER CONNECTIONS (- Z-7-6o DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 im T 1 �1! The .Commonwealth of Massachusetts W j Department of Industrial Accidents J Office of Investigations Boston, Mass. 02111 Tc` Workers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # F7 I am a homeowner performing all work myself. F7I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Comoanv name: L&� �- Address o2�f SGfBn 5vif� 02:� City' ,®4 Phone# 0 Insurance Co ���,���� eq Policv# u✓ r��/��/�/S/-� Com anv name: Address City: Phone#* Insurance Co. Pc1icv# 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 31,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine cf($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. f do hereby certify under the pa' s and pena ies of perjury that the information provided above is true and correct. Signature Date l Z dG1 Print name " O �3S�P�// Phone* Official use only do not write in this area to be completed by city or town afficial' City or Town Permit/Ucensina ❑ Building Dept ❑Check if immediate response is required ❑ licensing Board ❑ Selectman's Office Contact person: Phone ❑ Health Department ❑ Other -':� I; ✓�z -�ar�vnzareweaCC�i a�✓�/lai�tae�tedeCG1 � '. 7 ., ' DEPARTMENT OF PUBLIC SAFETY ►: ,¢ CONSTRUCTION SUPERVISOR LICENSE " --� Number: Expires: Birthdate: CS 069234 0510912000 0510911954 Restricted Ta: 00 ALAN G RUSSELL 400 MAIN $T GROVELANO, MA 01834 I i MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 I I I I I Checked by/Date I I I CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 2-28-2000 DATE OF PLANS: February 2000 TITLE: Lot 7 The Boxborough PROJECT INFORMATION: Lyons Way Subdivision North Andover, Ma. COMPANY INFORMATION: Lyons Way, LLC / Mesiti Dev. Corp. 231 Sutton Street Suite 2F North Andover, Ma. 01845 COMPLIANCE: PASSES Required UA = 556 Your Home = 548 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 1534 30.0 0.0 54 WALLS: Wood Frame, 16" O.C. 2268 11.0 0.0 202 GLAZING: Windows or Doors 484 0.350 169 DOORS 96 0.490 47 FLOORS: Over Unconditioned Space 1582 19.0 0.0 75 HVAC EQUIPMENT: Furnace, 92.0 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the a e Standard Design Conditions found in the Code. The HVAC equipment selecte to heat or cool the building shall be no greater th;d/4.4 of th des' n load as specified in Sections 780CMR 1310 Builder/Designer s I Date CIZ /v0 MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 Lot 7 The Boxborough DATE: 2-28-2000 Bldg. l Dept. 1 Use I I I CEILINGS: [ ] I 1. R-30 1 Comments/Location I I WALLS: [ ] I 1. Wood Frame, 16" O.C., R-11 I Comments/Location I I WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.35 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location I I DOORS: [ l I 1. U-value: 0.49 I Comments/Location I I FLOORS: [ ] I 1. Over Unconditioned Space, R-19 I Comments/Location I I HVAC EQUIPMENT: [ ] I 1. Furnace, 92.0 AFUE or higher I Make and Model Number I I AIR LEAKAGE: [ l I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: [ ] I Required on the warm-in-winter side of all non-vented framed I ceilings, walls, and floors. I I MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can i be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R-values, glazing U-values, and heating i equipment efficiency must be clearly marked on the building plans I or specifications. I I DUCT INSULATION: [ ] I Ducts shall be insulated per Table J4.4.7.1. I I DUCT CONSTRUCTION: [ ] I All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. I I TEMPERATURE CONTROLS: [ ] I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: [ l IRated output capacity of the heating/cooling heating/coolingsystem is I not greater than 125% of the design load as specified i in Sections 780CMR 1310 and J4.4. I ( ) I SWIMMING POOLS: I All heated swimming pools must have an on/off heater switch and I require a cover unless over 200 of the heating energy is from I non-depletable sources. Pool pumps require a time clock. [ ) I HVAC PIPING INSULATION: I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in.) : I PIPE SIZES (in.) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 I Low temperature 120-200 0.5 1.0 1.0 1.5 I Steam condensate any 1.0 1.0 1.5 2.0 1 COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 I [ ] I CIRCULATING HOT WATER SYSTEMS: I Insulate circulating hot water pipes to the following levels (in.) : I PIPE SIZES (in.) NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS I HEATED WATER TEMP (F) : RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+" I 170-180 0.5 I 1.0 1.5 2.0 I 140-160 0.5 I 0.5 1.0 1.5 BUILDING DEPARTMENT DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 S 54,a condition of Building Permit Number Is that the debris resulting form this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150A The debris will be disposed of in: Kr�sps� Location of Facility Si d e oypermit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector t _ v . 7. r 1 i e Town of North Andover Planning Board f i "I This form represents the schedule for allowing the following lots to be considered as eligible for building permits under the Town of North Andover Growth Management by-law Section 8.7 of the Zoning by-law. Pursuant to 8.7 .5 this Development Schedule must be filed in the Registry of Deeds and be referenced on the deed of each of the lots below and be fled with the Planning Board prior to the issuance of any building permit or permit for construction. Name and Address of Applicant for Lots: Name of Development: MPG Reql� eopr Il 01a BOSTON p'l T'ew bury, M6 01874 Map and Parcel of Original Lot: IV4 P 16(a a Lot 79. Date of Application for Lots Division: L. Lots Covered by this Schedule: Ldfi'S —'7 L oNs The Planning Board by their signature below, or a signature of a duly authorized representative, do hereby establish for the above named development the following Development Schedule for the purpose of Section 8.7 of the Growth management By-Law. The applicant, their assignees, successors and or sutsequent property owners shall conform to the following schedule that limits the eligibility of the following lots for building permits. This form must be filed in the Registry of Deeds by the property owner or representative and be referenced on each deed for each of the following lots. Such deed reference for the deed of each lot shall at a minimum reference the book and page in which this Development Schedule is filed and contain the language : " This lot is subject to a Development Schedule pursuant to the Town of North Andover Zoning By-Law all owners, representatives, and future purchasers should avail themselves of said restriction by reviewing the approved Development Schedule as filed in Book and Page The fact that a lot is eligible for a building permit is subject to the limitation of the number of building permits per year pursuant to section 8.7.2.d of the Zoning By-Law." The Planning Board hereby schedule the lot(s) for the above development as follows: Year Eligible Number of . Building Office Use Building Office Use Lots Eligible Date: Lot Eligibility Notes Utilized S 5 'Tukv q9m a in m z o =r 60 O� m pyo 5L a s Signature of Plannin and ' o ded Representative Date Signature f Property Owner or uthorized Representative Date n . . I FORM J LOT RELEASE The undersigned, being a majority of the Planning Board of the Town of North Andover, Massachusetts, hereby certify that: a . The requirements for the construction of ways and municipal services called for the Performance Bond or Surety and dated �P 19 gam_ and/or by the Covenant dated 19 and recorded in District Deeds , Book S 3 9 Page by or registered in Land Registry District as Document No. and noted on Certificate of Title No . in Registration Book Page has been completed/partially completed, � to the satisfaction of the Planning Board to adequately serve the enumerated lots shown on Plan entitled " pioNPjqd LYONS UJ4 _f flh,a yer MA Section (s) Sheets Plan dated _T - -L� ► - � ay , 19 q�_ recorded by the Esse Na 't, Vi-S+r ' Registry of Deeds, Plan Book or registered in said Land Registry District, Plan Book Plan /3`fSot and said lots are hereby released from the restriction as to sale and building specified thereon. Lots designated on said Plan as follows : (Lot Number (s) and street(s) ) s b. (To be attested by a Registered Land Surveyor) I hereby certify that lot number (s) / �' 1-YONS WAY on Street (s) do conform to layout as shown on Definitive Plan entitled LYDps Wr4 y NoNdaver MA Section sheet (s) 1-/y -.' 17- 5 *Reired Land Survevo �aq OF 44.4,9 s� O o� STEPHEN M. G- j MELESCIUC N No. 39049 P � ��, �9dFES�;iOa�Q r 1 of 2 ,y ►� D SURv��.B C'. The Town of North Andover, a municipal corporation situated in the County of Essex, Commonwealth of Massachusetts, acting by duly organized Planning Board, holder of a Performance Bond or Suretydated d Covenant 19 and/or dated 19 from of the City/Town of County, Massachusetts recorded with the District Deeds, Book age or registered in Land Registry District as Document No. and noted on Certificate of Title No. Registration Book, in satisfaction of ges the terms thereofg and hereby releases dits right, title and interest in the lots designated on said plan an follows: P EXECUTED as a sealed instrument this day of lg Majority of the a',Itl"47 Planning Board of the Town of North Andover COMMONWEALTH OF MASSACHUSETTS �Sse�c ss �yPnl�er ZI, 19 GL�L Then personally appearedo�, o„ , membersof the Planning Board of Town —of North the above Massachusetts and acknowledged the foregoing instrument to be the free act and deed of said Planning Board, before me. Notary Public I"1 C��.f fin My Commission Expires 2 of 2 wr4e 45,290 S.F. 1,04 Ac, W441 I �� raMiN 1 My ,r MH r N �+•"" '� 0� a r c54 LOT 44, 9.5 F. 1.03 Ac. PAU rA J NAL PROPOSED SITE PLAN LOT 7 LYONS WAY MARCHIQNDA & ASS0C.,L,P, NORTH ANDOVER, MA ENGINEERING AND PLANNING CONSULTANTS PREPARED FOR MfSIT1 DEVELOPMENT GROUP 62 MONTVALE AVE, SUITE I STONEHAM, MA, 02180 31 SUTTON STREET - SUITE 2F (781) 438-6121 'r NORTH ANDOVER, MAS5ACH4SETTS 01845 SCALE; 1"640' DATE; 1/24/00 NO 941. Y4 °APPLICATION FOR WATER SERVICE CONNECTION iocjir• North And over,'Mass.'y�• 2 Application by the undersigned is hereby made to connect with the Town`water main"in' Street, subject to the rules and regulations of the Division of Public Works. C� The premises are known as No. Street or subdivisi n lot n . Owner Address Contractor Address App icant's Signa ure I V)�� PERMIT TO CONNECT WITH WATER MAIN The Board of Public Works hereby grants permission to /"`G'�j ,�/` ✓ Com/ to make a connection with the water main at Street subject to the rules and regulations of the Division of Public Works. Board of Rublic Works By zz;4 9, Inspected by Date See back for rules and regulations �ee A Jel, `G�rG�� io��� 14 4 i APPLICATION FOR SEWER SERVICE CONNECTION Z 7 72� North Andover, Mass.. Application by the undersigned is hereby made to connect with the town sewer main in m Street, subject to the rules and regulations of the Division of Public Works. The premises are known as No. CC��G Street or subdivision lot no. f� Owner Address U ' Contractor Address Applicant's Signature PERMIT TO CONNECT WITH SEWER MAIN The Division of Public Works hereby grants permission to to make a connection with the sewer main at Street subject to the rules and regulations of the Division of Public Works.. Division of Public Work Y Inspected by Date See back for rules and regulations TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET 01845 Telephone(508)685-0950 Fax(508)688-9573 TAORTN 9 O t,QED 6T ti O ,n 9 9 QOATF0 9SSACHUSE� DRIVEWAY PERMIT Date: 2C 00 LOCATION: BUILDER: phone: OWNER: ��=��1i �Z) v phone: X 87 S � � D 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: TOWN OF NORTH ANDOVER DIVISION OF PUBLIC WORKS 384 OSGOOD STREET NORTH ANDOVER,MASSACHUSETTS 01845 J. William Hmurciak,Director Timothy J. Willett Telephone(978) 685-0950 Staff Engineer Fax(978) 688-9573 Additional conditions for lots 4 and 7, Lyons Way January 26,2000 This Division agrees to sign the Form U, and issue water and sewer permits, for lots 4 and 7 in the Lyons Way Subdivision subject to the following conditions. We agree to sign the Form U for these lots so that the construction of these two homes can begin at this time. The conditions are as follows. 1. No sewer service shall be installed into either residence until all off site sewer facilities are declared"active"by this Division. These off site sewer facilities include sewer lines and a pump station on Campbell Road, as well as sewer lines and two pump stations on Turnpike Street. At this time, the construction of these items has not been completed. a 2. No water service shall be installed into either residence until all off site sewer facilities are approved by this office. Any violation of the above conditions will void both water and sewer connection permits. No refunds will be granted. Z �'_ ase�f i >/ao Mesiti DevlopnVeniPrinted Name Date i Division of Pu i orks Printed Nam Date CC:Bill Hmurciak Jim Rand Mike McGuire Heidi Griffin 4e 45,290 S.F. Xv�eS 444 124 PH P r'''•• 31,`°• 1 N 7c0 : 0• _ 2 O1 31 CV if. OT 44, 95 F. 1.03 Ac. A.a PAT! u A CH °'DA y a.8 )+ NAL / 00 PROPOSED SITE PLAN LOT 7 LYONS WAY MARCHIONDA & ASS0C.,L,P, NORTH ANDOVER, MA ENGINEERING AND PLANNING CONSULTANTS PREPARED FOR 52 MONTVALE AVE, SUITE I MFSIT1 DEVELOPMENT GROUP STONEHAM, MA, 02180 31 SUTTON STREET -• SUITE 2F (781) 438-6121 r p yA NORTH ANDOVM, MASSACHUSETTS 01845 SCALE; 1"640' DATE 1/24/00 r ( RTF-1 - r own o Andover 0 No. _ - •/fui To ndover, Mass., ~- LAKE O C OC HICHEWICK AERATED IT . FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT ..... .. .d ........... !: .......... .. .... ................................................. . y has permission to excavate and pour foun ation at ....,./Q. ...?...... 0-5/ ,,, for the purpose of......1....��KI/.`��.....��. ...8.p ...................... ...���r...��y1.�ir .. r�'t A' The person accepting this permit must return to the office of the Building Inspector a certified plot plan show of building thereon before Foundation will be inspected. re) IID ` D P t S VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. BLDG. PERMIT FEE 41 4 D LESS FDA FEE ... ... ... . .... ..... ... ... ... .................................... DUE FRAME PERMIT $ 13UILDING INSPECTOR c1ORTFI Town of 4Andover 0 0 No. ►- 70 L A dower, Mass. ,- '3 S/0 COCHICHEWICK ORATED p �C:p S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System 4 BUILDING INSPECTOR THIS CERTIFIES THAT....................y. .....v....... y.... Vis............ ............. ........... ..... ...... ....................................... Foundation WA has permission to erect............./........ building on ..k04...�... ...4V. . itis..... Y Rough oe"% e?�l� Atr t0 be occupied aS. .. �.��' V +r" w� • Chimney provided that the person accepting gis. permit shall in every respect conform to the terms of the application 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 M I Na M PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR ss UNLESS CONSTRUCTI S Rough 1 ............ .... .. .... .. .................... ........ .................................... Service ` BUILDING INSPECTOR Final Ocatpancy 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 BLDG. PER ty IT FEE � � � Street No. SEE REVERSE SIDE LESS FDA FEE Smoke Det. DUE FRAME PERMIT $ Location No. / G Date MaR,M TOWN OF NORTH ANDOVER Certificate of Occupancy $ sA�N�s c�' Building/Frame Permit Fee $ Aye`/ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 7/,-1;-- 1 3795 Gam. j' Building Insyector MAR - 1 3 - 0 0 MON 16 .- 05 P _ 01 LOT 2 00 45,290 S.F. 1 1.04 Ac. V) x'42.'18" -• '� � T=19,48' R=175,00' -j 00 7.0.42--.1 _� ,� VM � . 1. 4 3.2 0 c- ' �/ .•, 8 `6 L 2 7.72' *` 1 32.Q' .�' L�=12'42 '18„ 4 T=13.92' 5.00' M1 E:XISTING in '�'� �•„ FOUNDATION LOT 7 tp ` �,... 44,895 S.F. 1.03 Ac. SWOH 34'54'36"E 174.92' S34"08'02"E 111.61' S36'02'52E 77.11' . Y' N/F HAROLD PARKER STATE FOREST 4k OF 41A,9,9 STEPHEN M. ELE y 0. 3 o � V WE HEREBY CERTIFY THAT WE HAVE EXAMINED THF PREMISES AND THAT ALL APPARENT EASEME N iS AND f NCROACHMFNTS ARE LOCATED THIS,PLAN IS INTENDED FOR .ZONINO AS SHOWN, THF STRUCTURF: SHOWN CONFORMS PURPOSES ONLY. IT WAS PREPARED TO THE ZONING LAWS OF THE MUNICIPALITY FROM EXISTING PLANS AND RECORDS WHEN CONSTRUCTED. ALSO, ACCORDING TO THE WITH THE STRUCTURES SHOWN LOCATED F.E.M.A./H.U.D. FLOOD INSURANCE RATE MAP, BY AN INSTRUMENT SURVEY, THIS PLAN COMMUNITY PANEL NO. 250098 009C SHOULD NOT BE USED FOR PROPERTY DATED 6/7/93 , I11E STRUCTURE IS NOT LOCATED LINE DETCRMINATION, IN AN ESTABLISHED 100 YR,F'LOOD HAZARD ZONE, CERTIFIED FOUNDATION PLAN LOT 7 LYONS WAY MARCHIONDA & ASSOC.,L.P. NORTH ANDOVER, MA E:NCINE:ERINC AND PLANNING CONSULTANTS PREPARED FOR MESI'rI DEVELOPMENT GROUP 61 ON AVE. SUITE I STONEHAMAM, MA. 02180 231 SUTTON STREET, SUITE 2F (781) 438-6121 NORTH ANDOVER, MASSACHUSETTS 01845 SCALE: 1"==40' DATE: 3/14/00