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HomeMy WebLinkAboutMiscellaneous - 53 COCHICHEWICK DRIVE 4/30/2018 51-53 Cocluchewick Drive BUILDINA it P j t y I f I 7446 NpRTIy OF of '` 6 6 6 TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION �9SSACMUSE� This certifies that . . . . !. . . . . . . . . . .! . . . . . . . . . . . . . has permission for gas installat'on . . . . . . . . . . . . . in the buildings of . �.`!�� . a.. . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . ���.! C .0""'.�� C. . . . . .. North Andover, Mass. Fee.T P.' . . Lic. No.. GAS INSPECTOR / Check# /S '1 V6 NMSSACHGSEITSLNtFORXIAPPUCATONFOR PER1tiIlTTODO GAS WUNG (Type or print) Date 111-2-110 NORTH ANDOVER,MASSACHUSETTS Building Locations 3 (f w / e- '1 Permit# Amount$ Owner's Name � � S � /j jNew❑ Renovation ❑ Replacement I Plans Submitted F zy M F 1 p7 � q o z z O F W q W q O a F+ N z H z E4 y w p0 O W z A U` U x A O0 H O SUB-BASEM ENT B A S E M ENT is 1ST. FLOOR 2ND . FLOOR 3RD. FLOOR . `14T II . FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR z 8TH . FLOOR (Print or type) Check one: Certificate Installing Company Name_ / J / S�(L° -�._ /pL �7 Corp. Address 6- {- f) k I17!1 A- � <�,� Partner.. ,,�,U i ✓t!',j d Lj--I, /� business Telephone 7 11 � 11 kirm/Co: Name of Licensed Plumber or Gas Fitter I INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes U No 0 If you have checked yes,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 hereby certify that all of the details and information I have submitted(or entered)in above—:ippi icati on are true and accurate to the'. beat of m} knowledge and that all plumbing work and install, 'ons pe•formk.d un.U1.p rr I t issued for this application will he in compliance with all pertinent provisions of[fie Nlassachu.,tt•, tat• ,as Code;�� Chapt 142 oW General Laws. By: Signature of Licen ed Plumber Or Gas Fitter Title M—Phtmbcr 3 CityiTown Gas Fitter ►cense:l umber ©-Master APPROVED('OFFICE USE ONLY) rl Journeyman ;aORT3� " a rn APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION Building Permit # 30_� 04-1 oy ADDRESS/LOCATION OF PROPERTY : 51 1 2C 41(-14 Map Parcel Lot Number SUBDIVISION DATE REQUESTED FILED/READY FOR INSPECTION CLOSING DATE ON PROPERTY: 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 PPLiCABLE CODES. k SIGNED ROUTING 0 II CONSERVATION PLANNING DPW -WATER-METER 6 METS%ks SEWER/WATER CONNECTION NOTE � I DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTA OF THE OCCUPANCY/INSPECTION REQUEST lX DPW„ �Dl J 1 _.._ Signature File: (:)C form revised 2005 i r � 'ecw� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 303 Date: Januga 12, 2007 THIS CERTIFIES THAT 1 THE BUILDING LOCATED ON 53 Cochickewick Drive MAY BE OCCUPIED AS Attached Town House ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY, Certificate Issued to: Campion Hall LLC 865 Turnpike Street NortWgdover MA 0 5 ; wilding Inspector i i 9 I II I J Town of over 44 A 19 16 o� �0 'QA COCr.IICMEWICK`� dover, Mass., �.9 OR � ATED S G 4 BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....... .... C mt,44......'r m... .................... u do �� has permission to erect... , • e W ............................. n/ P buildinWsn.. ... C 1 C l� a PSL ®z� "'to be occupied as.........T � *A* � �' * 0 k i V S *0 Ci M ht � chicon ................................................................................................................... ......... ... ey provided that the person accepting this permit shall in every respect conform to the terms of the appiication 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. t/1r•4►o V N •� S PLUMBING I&SPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. "u PERMIT EXPIRES IN 6 MONTHS N TARTS UNLESS CONSTRUCTI ELEC'T'RICAL INSPECTOR ......... .............................I*...... Service C� J� 1 . . . .. .. .................. ............ BUILDING INSPECTOR ` 401) AV Occupancy Permit Required to Ocmpy BuildingGAs INSPECTOR Conspicuous Place on the Premises — D h ���r/� Display in a Cons p o Not Remove F� No Lathing or Dry Wall To Be Done SL FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner 15'0( /- ,jt"-K/ Street No. �- /z `� "' SEE REVERSE SIDE Smoke Det. inv%L - i CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 303 Date: January 12, 2007 THIS CERTIFIES THAT THE BUILDING LOCATED ON 53 Cochickewick Drive MAY BE OCCUPIED AS Attached Town House ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Campion Hall LLC 865 Turnpike Street No Andover MA 01845 Building Inspector i j i I NORTIy ` � • Town of over No. 3 01 O _ N. _0 Nw- C�AHE6W \� dover, Mass., 7�. ORATED P �(C S G 4 BOARD OF HEALTH M T Food/Kitchen PER I T Septic System THIS CERTIFIES THAT....... ... mul......T ;y+W- � BUILDING INSPECTOR .................... u do ? A has permission to erect... '!V►t•rin Wsoi .. ` � o....................... build �.. ... 3.... ....................... to be occupied as � ......%".......... Ci..M..r►l Chimg n_e y.......................... ...... . . ................ . .......... . .......... .. . 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- ws relating to the Inspection, Alteration and Construction of �o/d Buildings in the Town of North Andover. %-"d+ V N t S PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. "u PERMIT EXPIRES IN 6 MONTHS LID' UNLESS CONSTRUCTI N TARTS ELECTRICAL INSPECTOR ......... BUILDING INSPECTOR service Occupancy Permit Required to Occupy Building GAS INSPECTOR R&ghd Display in a Conspicuous Place on the Premises — Do Not Remove No Lathan or D Wall To Be Done. � Lathing FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION B ildIn Permit # , 4- o 3 ADDRESS/LOCATION OF PROPERTY : Map Parcel Lot Number SUBDIVISION DATE REQUESTED FILED/READY FOR INSPECTION CLOSING DATE ON PROPERTY: 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 PPLICABLE CODES. , SIGNED ROUTING CONSERVATION PLANNING DPW - WATER METER 9 1 / 3/07 6 rn c l-mR5 SEWERMATER CONNECTION a NOTE DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTA OF THE OCCUPANCY/INSPECTION REQUEST DPW Signature F;le: OC form revised 2006 Date...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING S C'4US This certifies that ..... ..A& e— haspermission to perform ................. wiring in the building of ................................ .S3 L1"?0C171CA&W1 at.....................................I.............'t.....16/4 North Andover,Mass. Fee.1...Z . lq ... ...... Lic.No. ....... ...:4........... ELEcTRicAL INSPEC 7R Check ,, The Commonwealth of Massachusetts Office Use Only �. Department of Fire Services Permit No. tA�MBOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 CK# s i i g ;Mf Occupancy&Fee Checked (Rev.11/99) (leave blank) s" APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) DATE October 4,2010 City or Town of North Andover To the Inspector of Wires: By this applicationthe undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 53 Cochichewick Drive Owner or Tenant BUILDING CONTRACTOR Andover Rennovations I Owner's Address CONTRACTORS ADDRESS 110 Winn St. I Woburn,Ma 01801 I Is this permit in conjunction with a building permit Yes 0 No F� Building Permit no. Purpose of Building Residential Condo Building Utility Authorization no. Existing Service Amps Volts PHASE Overhead BUndgrd e No.of Meters Mast Service Syphone New Service 2 0 0 Amps 1201208 Volts Single PHASE Overhead Undgrd x No.of Meters One Mast Service Syphone Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Install wiring for new bonus room. Completion of the following table may be waived by the inspector of wires No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Transformers Total KVA No.of Lighting Outlets No.of Hot Tubs Generators Total KVA No.of Lighting Fixtures Swimming Pool Above In-grnd grnd No.of Emergency Lighting Battery Units No.of Receptacle Outlets No.of Oil Burners FHW FHA FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners FHW FHA No.of Detection and Initiating Devices. No.of Ranges No.of Air Conditioners Total No.of Alerting Devices. Tons Heat Pump Number Tons KW No.of Self Contained Detection/Alerting No.of Waste Disposers ..................•••••• ......•••••• Totals: Devices. No.of Dishwashers Space/Area Heating KW Local Municipal Other Connection R Connection • No.of Dryers KW Heating Appliances KW Security Systems: �} No.of Devices or Equivalent , No.of Water KW No.of Signs No.of Data Wiring: Heaters Ballast's No.of Devices or Equivalent j No.Hydro Massage Tubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equvalent OTHER: Attach additional detail if desired,or as required by the Inspector of wires. j 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 ❑x BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work $ (When required by municipal policy.) Work to start: October 4,2010 Inspection to be requested in accordance with MEC Rule 10, and upon completion. I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME Leonard Electric,Inc. LIC.NO. A10638 Licensee Signature LIC.NO. Address 154 Fletcher Street, Lowell,Ma.01854 Bus.Tel.No. (978)937-862,0 Alt.Tel.No. OWNER'S INSURANCE WAIVER: I am aware that the licensee DOES NOT HAVE the insurance coverage or its substantial equivalent as required by Massachusetts General Laws,and that my signature on this permit application waives this re uirement. / Owner ❑ Agent (please check one) Telephone No. PERMIT FEE$ 1 (Signature of Owner or Agent) \ i Date. A/Z) :� 4.� NORTH TOWN OF NORTH ANDOVJER' PERMIT FOR PLU"G a � s SSACNUS� This certifies that . . . .P/?P.'r . . . . . . . . . . . . . . . . has permission to perform . . . .. . . . . . . . . . . . . . plumbing in the buildings of . , � (. . . � f?,1e=.t. . . . . . . . . . . at . . . . .�.�. .C. �;.� .1.�. �.L.c�._ ..,. _!-. . . . . . ., North Andover, Mass. Fee. t f.3. . .Lic. No.. ��G�.� . . . . . . . .�/ „�.,� . . . . PLUMBING INSPECTOR Check At 7066 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,IMASSACHUSET'TS / �^ Date Building Location Il Cid,,tJA&WvCV Owners Name l e lti ve t, Fpv Permit# o ff Type of Occupancy ` e.. Amount 4- New Renovation Replacement P � Plans Submitted Yes No i FIXTURES E~ E~ > w r �y C Z Z 3 r z A ~� BASE"M ]Sr M" TT 2TL1 FIOC�2 � ! 3M MOOR 4I FL" + 5M FI" I fiTi�FI�Q2 � i 7IH FUM 9M HDQt I (Print or type) `heck one: Certifi Installing Company Name\�01'v1(�1 � (� 2 l ate E 2�t�Q�-L R�L�� Corp. Address c3N �Qz 0 Q� Partner. i Business e ep ne G Firm/Co. ` Marne of Licensed Plumber: "� �h/��l � ein �i2 4 Insurance Coverage: Indicate t e type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond El Insurance Waiver: I, the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent ❑ I hereby certify that;ill of the details and information 1 h• e sub or entered) in above application;are true and accurate)to the bestof f my knowledgeand that a(l plumbing work and ' stall scrformed under Permit Issued for this application will he in compliance with all putinent provisions of the.Mass chu' e Plumbinh Code and Chapter 142 of the General Laws. By: ugn, uc c ucensc um cr Title Type of Plu• bin Licc nse City Town iccense-17=77er ;Master ❑ Journeyman APPROVED(OFFICE USE ONLY Da(e— HORTM / 7 TO OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION NZ,SS HU5' This certifies that . . /" f�-. . . . . . . . . . . . . . ; . . . . . . has permission for gas installation . . P e^ fi : . . . . . in the buildings of . . -r ' f.� l!t ��.�.� �,> . . . . . . . . . . . . . at . . 5. . 4. . . . ., North Andover, Mass. Fee. . . . Lic. No.. -- GAS INSPECTOR Check# 5686 IVIASSACWSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FIT7/// (Type or print) NORTH ANDOVER MASSACHUSETTS M Date V�! Building Locations [r✓� � ,� I Permit# mount$ ly w Owner's Name � � I New❑ Renovation , Replacement ❑ Plans Submitted a U x4 x H a F a Z x a xk� o C :U a a W W F+ A t.., eZ d zzl C P_Z4 E" Y cn z. O, W J a H a UU c�4 q a F O SUB -BASEM ENT BASEM ENT 1 1ST. FLOOR 4 2ND . FLOOR 1 3RD . FLOOR i 4T 1-1 . FLOOR �1 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR ELI (Print or type ri— Check one: Certificate Installing Company Name 1 AU) QA A(r, Corp' .� Address lA J �l Z.4 Partner. Business a ep one Firm/Co. Name of Licensed Plumber or Gas Fitter �re11 � INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No� If you have checked Les,pl s ndica13 te the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 13 Bond .13 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 Owner13 Agent i hereby certify that all of the details and information I have submit (or entered)in above application are true and accurate to the fff best of my knowledge and that all plumbing work and installati s pert r 'c under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts tate o and Chapter 142 of the General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title Plumber 19� iCityiTown � Gas Fitter License IN umber Master APPROVED(OFFICE USE ONLY) Journeyman l 1� Location No. 3o v Date 16 w MOR, TOWN OF NORTH ANDOVER �O Certificate of Occupancy $ Building/Frame Permit Fee $ Q Foundation Permit Fee $ r Other Permit Fee $ TOTAL $ Check #3 0 Y S� 1 87u3 Building Inspect/ U �� � - G DEYARTM�NT RECEIVED -o B�'DIN 7� TOWN pF dip ANDp�R SIEOR_ SOF, OR DEM01ii IT 11, ( MANGET OE UFAM11,Y DW ELLIUNG NOVATE, z TION TOCONSTAUCT ItEYA ATDAN Ao Or pff�icial Use 4n1 N LJILDING DEPT Z AFLCAf0 PLl fiction DA'L'E ISSUED: )O 2—p b 0 ,F4rx PETER. 303 BtJII�DING Date � Ssioner/I or of Buildin SIGNA1 Buildi � n and Parcel Number 14 ..,.. 1 N 1. Addr 1 P e: umber i III 1 .! p, /� � N 0 /` DO 1.4 ProP� ¢nsians. M Fra►►a 8 1.3 'on Z'Minglr►fo ' o ✓t� �" Arm Loc /i� R Yazd osedUse A _ 7,ortin (ft) G SETBACKS S Side Yazd R . Front Yard R � t.s sewed s do Dista Sys ° Rred ons 1.5. �e���zoneIda ° M» � NL(3d-C.40. 54) zone i__ Pobiic pnva� ° ° 2.11 C+wn . er of Recon � !I , 1 0 J Address for Service: d R 1 n filo�o P4 —+ Name(Print) Telephone ' z I" Signature �Agent �� D j 2.2 Ai p dares fo ce-, o V e R1 0 • E -• Name Pnn 1 Telephone i i Sig iture Not ApPh le 0 1 O " ction SuPervisor se Numb lop 3.1 Licensed COn Liven IF I Address striiction Licensed Not ApphcaWc ° Tel � '�O m 1� Signa a ImProi'ement Contractor Rsration N r 3.2 Regi //�� 50 ,£,.,-4 �m�iy Name Address Tekph� Signature i I V�— aqua _Mv�n3' to olj to TOWN 4 NOTit"rH ANDOVER BUILDING DEPARTMENT RECEIVED APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISIMMY I`�'�1'�(�5 OTHER THAN A ONE OR TWO FAMILY DWELLING ��YY��//ii ii ITM5 (J Section for Official Use Onl ,z, ,Y, BUILDING PERMIT NUMBER: DATE ISSUED: l® 0 b�UILDIN'G DEPT. I -a J + Z SIGNATURE: or I O Buildin Commissioner/I or of Buildings Date 1.1 Property Address: 1.2 Assessors Map and Parcel Number: f Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: — v ZoningDistrict Proposed Use Lot Area Frontageft , M 1.6 BUILDING SETBACKS(ft) P,S PF, APAD L164 Front Yazd Side Yard Rear Yard ' O Required Provide ReWired Provided Required Provided e P JR�1.7 Water Supply M.GI.C.40. 34) 1.3. Flood Zone Information: 1.8 Sewerage Disposal System Public ❑ Private 0 Zone Outside Flood Zone 0 muakw On Site Deposal System ❑ 2.1 Owner of Record - �'�G N1 GAIL ��JJIIJI�(r �oJn1A9r'�a� �SS�� QS(,�00 Sri 0 Name(Print) Address for Service No RTIC c� (Z J I`� ot d y(�5 m Signature Telephone X 2.2 Authorized Agent ro(?nito/r(5 ter- n Name Prin Address for Service:+N DO J &,fir M O1{U,� O Signiture Telephone Z m 90 3.1 Licensed Construction Supervisor Not Applicable ❑ A) rrlf 0 Address License Number O mn Licensed struction Supervisor. p10 /3 7 0 �� Elf n T Signa Telephone 0 .� 3.2 Registered a Improvement Contractor Not Applicable ❑ 0 / I C reA Ak 5 St7 'na/VS1r co 10)G. Registration` N��3 O m c Company Name Q Q �^ g Address b 1 0^N r I K C sY /VD ,J��4�"f 9 Q � ti — z . .G) Signature Telephone Workers Compensation Insurance affidavit must be completed and submitted with this application. Failuie to provide this affidavit will result in the denial of the issuance of the buildin rmit. Signed affidavit 5ECTIOAI. S P)tt�FrSI Af :" CiSTUCTIt3N SRVICS F+E3K li> $1 AND STRUMS.SIIC"IE'Tb 5.1 Registered Architect: . 00- 0, SRAM A kL Name: ' Address 70 "3 �- Signature Telephone 9W Gff4 PJ Name: Y, Area of Responsibility Met- L AJR AM Registration Number Address: r'r. 3 7R1- Y .61,9 1 Expiration Date Signature To I Not applicable 0 Name: 34 M,�� ry sl -- Address AJ 19 W z AJ ENIS6 6 !' 4 -Registration Number el 4+. `61� Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Y30I Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date JN �. Company arae: Not Applicable :1'0 Responsible in Charge of Construction r , r New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: aL UNI T C$Q!R\IA CS E S<TA k L D i I USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ IA ❑ A4 ❑ A-5 ❑ IB ❑ B Business ❑ 2A ❑ C Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ I histitutional ❑ I-1 ❑ I-2 ❑ I-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R residential K R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floors , Total Area s Total Height ft Independent Structural Engineering Structural Peer Review Rapred Yes ❑ No ❑ SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property Hereby authorize to act on My behalf,in all matters relative two work authorized by this building permit application Signature of Owner Date a � I, 4tj S� as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury Print Name z o¢- Signature of v nt L Date . 0$X,,ti' Item Estimated Cost(Dollars)to be Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction from 6) C.7� 1 IJ f 3 Plumbing Building Permit fee (a)x(b) 4 Mechanical(HVAC) V ly 5 Fire Protection 6 Total (1+2+3+4+5) 01 qS d Check Number a ts`>1r 2. Y�.:, .r41�;: S{�Jt.�+?c1f�,i �,6RX � � .iZ;l�'£n a �^',r, J 9s�.t ->n ,�.f,�� r�.?,�zr.E.z �.�M✓"!3'x���'�s ;. rk� ��y,• '-Ei'�' .'a,t a-:`a" ,i w'.,�:� a 3Sr`�..,t':^, '�y} {wn .•d:i z M�:� �c r�� W V 1},�� }t ,« �r1, t !ci 4 �' s��� �,` r _{��;,� �9�t h Re r. rt} t t � .� Yt v+ ��. �1£l`:ri5��..,,....�x, �'wt 'h�tytj�UjJi§F ..�...� �' J��,:..�ro �{"�i{.<t;' e" , :r.'"!°.�'��,6G ',�"T '���: i��✓�.t r.��r 7' t:t.,x � r:r lty-c x,y'r,. 4t 1'7..,:a ?� r1:-.� ST4 A>sf�x�`+? ��" �`,:�'.,:..X_,y�r� s�+ `'�F��',«�lJ ,4�1',i2rlµt��{�,f,Yl?�'�.y�,;,�k...y't iu_��,' -.Y t .s �'�: iy:?'�N W��a��,:Y,a�t ��nJ y'� 'ir�b,�,,r, -'� 1t',.z°(v�l.` ;�}•`�,�tr�i�•l, 'i';Jt;�:'t xr:..�t�.q'. NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3 RD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS DIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE a e � "�rt ter>i�y+, e .� �i•;��'cty ref ,«^��'..? X � .fps'' 1+��' �fzii'- `� 3?;r'tR ,.7'.x..4 a• _�'e ... ` � 5^i• :k Tx A.x CAPRI fou* 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*********************** APPLICANT �0 A , PHONE LOCATION: Assessors Map Number PARCEL/(� ! SUBDIVISION LOT(S) STREET��10 C.�11 G KE t�tJi G4C ORI ) c ST. NUMBER= OFFICIAL USE ONL REC MENDATIONS OFWN AGENTS: CONSERVATION ADMINIST OR DATE APPROVED a' l 1 DATE REJECTED COMMENTS - I TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH . DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS �? UBLIC WORKS -SEWERNVATER CONNECTIONS/DRIVEWAY PERMIT FIRE DEPARTMENT -r4 ,Y10-A RECEIVED BY BUILDING INSPECTOR DATE_ Revised 9197 Jm , L X i I , North Andover Building Department ,. Tel: 978-688-9545 I DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) i Sign ure of Permit Applicant 0¢ Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 1 I • I t 1 I 1 r ! I 1 a I I 1 The Commonwealth of Massachusetts I > Department of Industrial Accidents Ofte of Invesdfgadons • Boston, Mass. 02111 Workers'Compensation Insurance Afi'idsvit Name Please Print i Name: Locatkon: City Phone # I am a homeowner performing all work myself. F-1 I am a sole proprietor and have no one working in any capacity 1 LAJ T I am an employer providing workers'compensation for my employees working on this job. COMM VA- S&O AJ - Address Address e � ciM A)p M A 0164:`Pham q2i W . Insurance r. palit 0 -7 S7 6,!r 0 Company name: Address City Phone�k Co. Policy! Faikwe to seem coverage re required under Section 25A or MOL 152 can lead to the imposition of crinwnal penalties d,a flne up to$1,500.00 andlorOne yews'Imprtsorxneat_ae.retell.aa_dxN.penaKJwJnbeh mdASTOPII.O ORDR.and.a.flmd.(SIQD.0v��daYepMnd.ms 1 understand that a copy d this statement may be forwarded to the ORioe d Inveadgadons d the DIA far coverage veriflcedon. I db hereby cw*under the pains and penalBes o/perjury that fhe Tnrbrmatlon ` provided above Is true acrd caned. Signature Data �4 - � Print nameJ o 4"3 Ptbone# 07 Official use only do not write in this area to be completed by city or town offidM' Cfty or Town P si na []Check I Immediste response Is required ❑ Bufidng Dept~ ❑ Licensing Board Contact person: ❑ Selectman's Office Phone ❑ Health Department ❑ Other NORTI4� OANM Of 4Andover No. .3 03 , LA o dover, Mass., COCMICMEWICK ADRATED O`P�,��� , S � a BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System ., THIS CERTIFIES THAT ...... .. N� �� N .� BUILDING INSPECTOR f� ............ ................... ....................................................... .................. 40undation has permission to erect.. �'� lr r buildin Vson .� C�I C 1& .. . .... .... 6L" �., •A,.% , �P w 1 V s "1�o Ci r�� ugh tobe occupied as............ ............................................................................................................................... Vk... 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-Lpws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. % A& 0 49)4� V N s PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTI N TARTS ELECTRICAL INSPECTOR Rough ......... ............................. .. Service ... . . . ......................................... BUILDING INSPECTOR Final Occupancy Permit Required to Ocatpy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. - SEE REVERSE SIDE smoke Det. v4ORTH Town of Andet0 - - No.3� — � SbD n •? n D o LA E o dover, Mass. COCMICMEWICK 1 ADRATED P ,�5 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System T!I N' 11' RIWAD"14 BUILDING INSPECTOR THISCERTIFIES THAT....... ......... .. . .......... 4............. ........... .......M�...... ..... ...�...... .................. undation � A` has permission to erect... 'l1Nlr r, buildin s on ...� 5' C�1 i C e W K c �►......... �. • K . .... ........ .. .. to be occupied as............ ... �, �" '� s Ci M�t � ��i 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- ws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. A&4+0 V N PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTI N TARTS ELECTRICAL INSPECTOR 46, Rough .......... .............................�.. ... Service .. . .. . ............... ........................ BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. ' I 1 4 l r �1 Location ` No. �O 3 Date Cop� MpRTM TOWN OF NORTH ANDOVER O � 9 ` } Certificate of Occupancy i s ts�uwsE Building/Frame Idin /Frame Permit Fee $ � 4 v. 1"] Foundation Permit Fee $ Other Per ., mit Fee $ TOTAL c Check #3-0 18703 Building Inspect I , OFFICE OF BUILDING INSPECTOR �3 TOWN OF NORTH ANDOVER +' '•' CONSTRUCTION CONTROL fc use' PROJECT NUMBER.- PROJECT UMBER:PROJECT TITLE: "1`4�t 5 tD C dC9 S �a! CAM 10 4L�L PROJECT LOCATION: (f'0 CI+I C14G WIC i'(:� NAME OF BUILDING: C A-1e A�A G j o usr NATURE OF PROJECT: Xn W,ti/ 4,0 y C IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, I, &a 19e,—:t A _ ,��� �1L� REGISTRATION NO. BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH;HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT D ARCHITECTURAL STRUCTURAL MECHANICAL FIRE PROTECTION ELECTRICAL . � � OTHER(SPECIFY) i I FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B I EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. . Review, for conformance to the design concept,shop drawings,samples and other submittals which are submitted by the contractor in accordance with the requirements of the constriction documents. 2. Review and approval of the quality-control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become, generally familiar with6the progress and quality of the work and to determine, in general, if the Work is being performed in a.manner consistent with the construction documents PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, 1 SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR QGGYPANCY. I SUB RIBED AND SWOR IGNATUR M TO BEFORE ME THIS�DAY OF Q � j I SONIA M. GRIECO Notary Public ,NOTARY PURL C MY COMMISSION JeCommonwealth of Massachu Commission Expires Mar 3,20=06 I i vt i HEARTHSTONE LAND ENGINEERING REAL ESTATE R E A L T Y C O R P O R A T I O N DEVELOPMENT CONSULTATION MARKETING December 20, 2004 Mr. D.Robert Nicetta North Andover Building Commissioner 400 Osgood Street North Andover,MA 01845 Re: The Residences at Campion Hall Dear Mr. Nicetta, At the December 14th Zoning Board meeting,we submitted our proposed plans for the stairways and stairway&mezzanine level railings for our project at Campion Hall.We recognize that our historic stairways, while extremely well built and solid structurally,were constructed prior to modern building codes, and thus may not be in compliance with those standards.We also understand that with an historic renovation, the local Building Inspector has certain latitude in terms of what can be approved. Our biggest concern is the `back'staircase;a beautifully constructed spiral, this staircase runs from the basement level to the 3rd floor. It's as solid as the day it was built, and serves as the required second egress stairway for the upper floors.We realize that it does not meet today's building code standards because of its winders,but feel it is an integral part of the Mansion's architecture and that it would truly be unfortunate if it were to be removed. Regarding the railings, our goal is to maintain the historic look of the original Mansion by reconstructing the vandalized sections of the main staircase and newel posts, and raising the railings on both staircases to code height by mounting an additional railing over the existing railings. Similarly, the existing railing around the mezzanine will also be raised to comply with the building code,as shown on our submission. We have reached the point in our architectural design schedule where we need your input before proceeding any further. We hereby request your comments, suggestions,and recommendations, as well as your approval to preserve the existing stairways in their current configurations. We would be happy to arrange a site visit for you with our architect, to view the stairways in question.We believe that our proposal meets most of the requirements of the building code,provides the required safety nieasuies, and satisfies the Board's desire to preserve the historic nature of the Mansion. Please feel free to contact us with any questions or concerns,or if you would like to schedule a visit to the Mansion.We can be reached at (978) 475-5400. Sincerely, f,4.:c /\f /71 Eric K. McCarthy E DECEIVED 0 V Z. cc: Ms. Ellen P. McIntyre, Chair DEC 2 2 2004 North Andover Zoning Board of Appeals c Mr. Rob Bramhall BUILDING DEPT. 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