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HomeMy WebLinkAboutMiscellaneous - 55 CORTLAND DRIVE 4/30/2018 55 Cortland Drive Unit 32 LOPIG FILE Town ® 4 over ) 7 9No. �v _ - �aA EWICK dover, Mass., '13 COC NIC NE 4 11. � �oRq rE D PPS\ •(� BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT......./ �..7uildings ���,.�iilel.�.......... .. ..� ... • Foundation ...Co. ......... .. 1 nas permission to erect........................................ Rough on ... • to be occupied as................................ Chimney y. ftnform .r...provided that the person accepting thrs permit shal ' 0 resp ct cto t to s of the application on file in Final this office, and to the provisions of the Codes and y-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 7� Final PEWIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU=0TARTS Rough ................... ..... . ................... .................. ......... Service B LDING INSPE Final Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wail To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner .. ,.. _�,. Street No. i �eSEE REVERSE SIDE Smoke Det. J` a / -A y � CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 179(9/8/00) Date: March 28, 2007 THIS CERTIFIES THAT THE BUILDING LOCATED ON 55 Cortland Drive #32 MAY BE OCCUPIED AS Sin e.Family Dwelling IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Meeting House Commons LLC 121 Carter Field goad North Andover MA 01845 Building spwor IAORTH Town of 4 over No. ) 77 T C% - :5: % - : E - dover, Mass., cc ORATED ADRATED `r BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System NJA % C• B LDIN�I1PnECTOR THIS CERTIFIES THAT ,.�irla✓.� ..� ..... ..��� ........ . ..�... .. ......... dation has permission to erect.......................................?. Uildings on �� dos. ...� i Rough to be occupied as................................�...�/�. 4 f.I.... . ...................................� 3� C provided that the person accepting this permit shat ' e resp ct conform to t to s of the application on file in in t�"� this office, and to the provisions of the Codes and y-Laws relating to the Inspection Alteration and Construction of Buildings in the Town of North Andover. KUMBING IIISPE&TOR VIOLATION of the Zoning or Building Regulations ulations Voids this Permit. uu b ftnal)O(Z ?,,k 7/d -7S7� PERMIT EXPIRES IN,6 MONTHS ELECTRICAL INSPECTO UNLESS CONSTRUCTIO TARTS ou -�, ��j I ................. . Service .... .... . ... ................. ......... B DING INSPE nal , ? Occupancy Permit Required to Occupy Building GAS INS�j ECTOR 0 Display in a Conspicuous Place on the Premises — Do Not Remove No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner + street No. SEE REVER N S S E Smoke Det. __Jl E ID Town of North Andover NORTH Building Department 3�0���� D .`'e4,°o 27 Charles Street o North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 *��o # y <oc»<»1wK« • •� A�RArtD APP,�•ty �SSACNUS� APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS 0.y►u` -br 1 Ot. A)04k Xk1te-4' fil d LOT NUMBER 3;- SUBDIVISION M&& da.�ZUSC 4�!6W-4MS DATE REQUEST FILED Mq rr 23 , 200 DATE READY FOR INSPECTION f y" Z7 to U07 TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLET WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIV $25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE D ES NOT ME ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METER I�� 3—Z3—J�' DATE + D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION.IREQUEST DATE. SIGNATU W AUTHORIZATION �v KT- 19 T ry -• ® over own ) 790 �. o L A E dower, Mass., -1,40 CCCM.0 ME WICK GRATED BOARD OF HEALTH PERMIT T D Food.'Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT.--1111-7 ....... ..... . .... Foundation s /......... ... has permission to erect...................................... ...CookRough .. u�ldings on ... I/Ir, g • to be occupied as......................... . . Chimney provided that the person accepting this permit shat ' a resp ct conform to t to s of the application on file in Final this office, and to the provisions of the Codes and ail relating to the Inspection AReration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PE'R,;Vll 1 EXPIRES IN 6 MONTTIS Final �,,7 T �7 T ►7-�i� � ELECTRICAL INSPECTOR UNLESS LESS CO V S�1. =O � i I1Lt�5 Rough ..................... Service B WING INSP Final Occ cPanc:r Permit Required to Occi.ipy Bulling GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FIRE DEPARTMENT Street No. LSEE REVERSE SIDE Smoke Det. Date.. �.. �. .".�.. . . ,AORTN ' TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION a �s • ty SSACMUSEt This certifies that . . . . .' . . . . . . ... . . . -. . . . . . . . .. . . . . . . . . . . . has permission for gas installation.. : ' . . . . . . . . %. . . . . . . . . . in the buildings of . . . . .: . . - :.'-; :tet- '! . . . . . . . . . . . . . . . . . . . at 4:% `` .A . . . . --c.'?. : . .: . . . , North Andover, Mass. Lic. No.!t�!v�7 . ,: , . . . . . . . . .. ;.. . . . . . . . . GAS INSPECTOR4 Check# I/J i -. r k 1 . MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date /0//.7/07 NORTH ANDOVER,MASSACHUSETTS/ Building Locations � � /"0;/-I"k,01 CLPermit# Amount$ O Owner's Name G 1 � New❑ Renovation ❑ Replacement ❑ Plans Submitted ❑ cn U �a OV F x h o w r��"t >" z z H a v� aG z U C > w cW7 N z H z x w w w H w u x x z d w Q x H. �^ > m z O z w p x x o x 3 c a o °a > a a F o SU B-BASEM ENT B A S E M ENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) ��/ Ck one: Certificate Installing Company Name he Corp. 'address dk,,Pf ne&4, v ❑ Partner. 3usmess a ep one ❑ Firm/Co. Jame of Licensed Plumber or Gas Fitter gSURANCE COVERAGE Check on have a current liability Insurance,policy or it's substantial equivalent. Yes No 1:3 1 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: 1 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 ❑ 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 Code and Ch ter 142 o the General Laws. By: Sig ature of Licensed Plumber Or Gas Fitter Title ❑ Plumber l Z/.�- -7 City/Town ❑ as Fitter License Number ❑Master APPROVED(OFFICE Use ONLY) ❑ Journeyman 1 Date.................................. l tOR74, TOWN OF NORTH ANDOVER a APIWORWPERMIT FOR WIRING ` �ssHCHU /�l� Iyi:fir C/r li This certifies that ............................�...............:..........:.... ............................ has permission to perform ............................................................................... wiring in the building of........-/— ; ....G.;-6r�........................................ ......... ....... � . .. . ..n.............../.....at.S. ........... ,North Andover,Mass. Fee r.fJ........ Lic.No.t't.R.. . �:„�r�!.•�. ... ELECTRicALINSPECTok `. + Check At f� Commonwealth of Massachusetts Official Use only Permit No. 7 f✓ 7�� Department of Fire Services Occupancy and Fee Checked •3104 BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/051 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / Z?j 0-7 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street& Number) .�� <�-3�,� ( -L.q Owner or Tenant -� L6 t 6he t V LZr� ✓at Telephone No. 7Fl 6fi�—263 Owner's Address ,L TL-,A 6 &j'b O t A/p, vi Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building 9J,-5, ✓--- Utility Authorization No. 19 1 (o(o(e C-D Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service rWO Amps t. Let / -L:{c_Volts Overhead ❑ Undgrd ©,1--No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (fit J 5 G Completion of the following table may be waived by the Ins ector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle) Fans o.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ o.o mergency Lighting i rnd. rnd. Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones o Detection and No.of Switches No.of Gas Burners No. Initiating Devices 4 No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No. of Waste Disposers Heat PumNumber I Tons KW No.o -e m ontae Totals Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ un icippl ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.o No.o Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring. No.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: 1�', ^pp,'� (When required by municipal policy.) Work to Start: j I-L,? Inspections t� o be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVERA 'E: 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 Covera e in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) 1 certify,under the ams and penalties of perjuty,that the information on this application is true and complete. FIRM NAME: ✓( S6LIC. NO.: K"St o Licensee: �C,q A&L- . ,v a ti Signature LIC. NO.: 4-Z,7 (If applicable, e r "exempt"in the license number line.) Bus.Tel. No. 3 3�(2 --01� Address: c vt Svc E !1 t t �,r�H O3 Yg Alt.Tel. No.: *Security System Contractor qcense required for this work; if applicable,enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(check one)❑ owner ❑ owner's agent. Owner/Agent J:'- Signature Telephone No. PERMIT FEE: $366) d _ /?, ,0 ,7 s a Date.?.,kf��. .'. . °'.".O RT:�4, TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACHU9E� This certifies that .C. .,n/k . . . . . . . . . . . . . . . . . has permission to perform . . . . . -'. /... ... . . .... . . . . . . . . . . . . plumbing in the buildings of . .. r ?XX . . . , ; { at . . . . . . . . . . . . . . . ., North Andover, Mass. Fee. 31'.0. . .Lic. No../. ?.'. ?. .'. . . . . . . �`��. . . . . . . . -PLUMBING INSPECTOR Check # 1 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS / Date —7- Building Location c� /ti/��11A,.1 5 Owners Name `�1� �t�y /y Permit# S Amount Type of Occupancy New E]r Renovation Replacement Plans Submitted Yes No FIXTURES W. SZBBM ISS HffR / M Flint 3M FLOM 4TH FUM SIFT FIOM 6M KaR 7TH HDM gm Hfm (Print or type) Check one: Certificate Installing Company Name �`�1 / Corp. Address h Partner. Business Telephone —yd 2—/,5 0 l0 El Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the type 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 of the above three insurance Signature Owner 0 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 Plumbing Cid an apter 142 of the General Laws. 4 BY Signa o kens um Der Type of Plumbing License Title City/Town LiceL/lNum e—Fi r Master IT Journeyman APPROVED(OFFICE USE ONLY Date..: l.�f. . .. .. .. . . NORTH pf ,ao 1ti0 of TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION SACHU5Et 1 / This certifies that . 7?. t. `. . . .f.1. . .� . .`. . . . . . . . . . . . . . . . has permission for gas installation . . . !.`. �".t . �. .s:.a. Y. . . . . . . . J,- in the buildings of . .4; ,�: � ! % /... . . .+. . . . . . . . . . . . . . . . . . . . . at . . . . . .r.� :.: !. �. . . . . . . . . . . . . . .. North Andover, Mass. Fee.',,:,=. '. Lic. No. !.'. :. . . ,� ,. . . . . . /o G GAS INSPECTOR' Check# 2 ` & � j " MASSACHUSETTS UNIFORM APPLICATON FOR PERM TO DO GAS FITTING (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations L�4Y3�/l GIS, C—/ Permit# S-a"7' y �— Amount$ lco Owner's Name New 13/ Renovation ❑ Replacement ❑ Plans Submitted ❑ x o Z U0.' F Q d O ;;) O z F G zW W n z U W W G a A F Wx C7 F z F Z x W w V p W FW U W CG F" } v, oq z O z W O x a O x w 3 a v a o > a SU B -BASEMENT BASE M EN T 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH . FLOOR 5TH . FLOOR d 6 T H . F L O O R 7TH . FLOOR 8TH . FLOOR (Print or type) // Check one: Certificate Installing Company & Name='/ �tli//�/ / � ❑ Corp. Address ` ❑ Partner. G Business I a ep one d ��� ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ If you have checked Les,please ipdicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 0 Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State GasCod and Cha 2 of the General Laws. By: ignature of Licensed Plumber Or Gas Fitter Title ❑ Plumber /2/ City/Town as Fitter License Number Master APPROVED(OFFICE USE ONLY) ❑ Journeyman Permit Number MECcheck Compliance Report Checked By/Date Massachusetts Energy Code MECcheck Software Version 3.3 Release ]b Data filename:Untitled TITLE:The Hampton at Meetinghouse Commons CITY:North Andover STATE:Massachusetts HDD:6322 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE:Other(Non-Electric Resistance) DATE:03/24/06 DATE OF PLANS: 09/01/05 PROJECT INFORMATION: Meetinghouse Commons North Andover,MA COMPANY INFORMATION: Meetinghouse Commons LLC North Andover,MA COMPLIANCE: Passes Maximum UA=296 Your Home=271 8.4%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1:Flat Ceiling or Scissor Truss 998 0.0 30.0 31 Wall 1: Wood Frame, 16"o.c. 1467 0.0 13.0 118 Window 1:Vinyl Frame,Double Pane with Low-E 198 0.340 67 Door 1:Solid 35 0.340 12 Floor 1:All-Wood Joist/Truss,Over Unconditioned Space 998 0.0 19.0 43 Furnace 1:Forced Hot Air,90 AFUE Air Conditioner 1:Electric Central Air, 10 SEER 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 Massachusetts Energy Code requirements in MECcheck Version 3.3 Release lb and to comply with the mandatory requirements listed in the MECcheck Inspection Checklist. The beating 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. e 'rQ Builder/Designer Date 4- MECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.3 Release lb DATE:03/24/06 TITLE: The Hampton at Meetinghouse Commons Bldg. Dept. Use Ceilings: [ ] I 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 continuous insulation Comments: I Above-Grade Walls: [ ] I 1. Wall ]: Wood Frame, 16"o.c.,R-13.0 continuous insulation Comments: Windows: [ ] I 1. Window 1:Vinyl Frame,Double Pane with Low-E,U-factor:0.340 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break?[ ]Yes[ ]No Comments: I Doors: [ ] 1. Door 1: Solid,U-factor: 0.340 Comments: I Floors: [ ] I 1. Floor 1:All-Wood Joist/Truss,Over Unconditioned Space,R-19.0 continuous insulation Comments: I Heating and Cooling Equipment: ( ] I 1. Furnace 1:Forced Hot Air,90 AFUE or higher Make and Model Number [ ] I 2. Air Conditioner 1:Electric Central Air, 10 SEER or higher Make and Model Number I Air Leakage: [ ] I Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] I When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cf n(0.944 L/s)air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder: ( ] I Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. I Materials Identification: [ ] I 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-factors,and heating equipment efficiency must be clearly marked on the building plans or specifications. { Duct Insulation: [ ] { Ducts shall be insulated per Table J4.4.7.1. { Duct Construction: [ ] All accessible joints,seams,and connections of supply and return ductwork located outside { conditioned space,including stud bays or joist cavities/spaces used to transport air,shall be sealed { using mastic and fibrous backing tape installed according to the manufacturer's installation { instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] { 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. { Heating and Cooling 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. { Circulating Hot Water Systems: [ ] { Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: [ ] { All heated swimming pools must have an on/off heater switch and require a cover unless over 20% { of the beating energy is from non-depletable sources. Pool pumps require a time clock. { Heating and Cooling Piping Insulation: [ ) HVAC piping conveying fluids above 120°F or chilled fluids below 55°F must be insulated to the levels in Table 2. Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temperature(F) Up to 1„ Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Rane F 2" Runouts 1"and Less 1.25"to 2" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD(Building Department Use Only) _ J�< tro�iti�n��auKa�ll of ������arf r�ael�� BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 055417 Birthdate: 0410511960 Expires:04105/2006 Tr.no: 21033 Restricted: 00 THOMAS D ZAHORUIKO 121 CARTERRELD RD N ANDOVER, MA 01845 Acting Lown-1-1-1 i a� The Commonwealth of Alassachusetts ' Department of Industrial Aecldents Of ice of Ini,estigations 600 Washington Street Boston, AIA 02111 J wwminass.govIdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/individual): Address: City/State/Zip: _ Phone #: 9 )� 4? 7~Z4i f Are you an employer?Check the appropriate box: 1.El am a employer with 4. El am a general contractor and 1 Type of project(required): employees(full and/or part-time).* have hired the sub-contractors 6. � New construction 1 am a sole proprietor or partner- listed on the attached sheet. + 2• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working forme in any capacity. workers' comp. insurance. [No workers'corninsurance 5. 9. ❑ Building addition p- ❑ We are a corporation and its required.] officers have exercised their 10-❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. C. 152,§l(4),and we have no 12.❑ Roof repairs insurance required.] 1 employees. [No workers' comp. insurance required.] 13.0Other 'Any applicant that checks box R I must also fill out the section below showing their�jorkers compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and[hen hire outside contractors must submit a new affidavit indicating such. {Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance covera rification. 1 do hereby certify under th ains and pe a/ties �f perjury that the information provided zbove is•true and correct. SioU.nature: Date: U� Phone#: — 3S Official use only. Do not write in this area,to be completed by city orfosvn official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: r AOo, _ + I r 1� 1 L _-1 11-' --J FRONT [NocT Hampton at Meetinghouse Commons, tk Andover, MA '0 1 s45 nit if-3Z Date: 09/0 1/2005etinghouse Commons LLC Nord, Andover, MA z o 0 MI.sS IZ W1 a�DAOoM 4. .p J rJ 10'a�2 O i D-&4 8 40 1Z M I9 1 1 _ tacim4 Q� �tt���Jb Liyltlt� ��`o z2-o Ck O $E�d0 -D!3 6 7 � a lvi - - \_ RAN)6 3 F OYZS'S • s A O o ,9 4 �-S C aV cR�D O' Pof tc 1A ,9 O Ln Y P� aK r-T 9x 8 t5�1 2. 2-0 s,0 44-o Nl!oZeS F 1 RST FLOUR �1-�I� 6l A SF �{3� T},e r]amR!on at Meetinghouse Commons, G f�Rt�6� �$� 5. � No4 Andover, MA O 1 845 nit #32 CR4� PCRcQ -72 S-F' Scale- 118" = 1'0" Date_ 09/01/2005 56et 2 Meetingkouse Commons LLC, No4 Andover, MA Ll Lt-o 7?_-0 01J S lT� A t.� coocRCTE 30W PST- T14 r-K ST- T14)cK 3 �tsc�oR BaL�- OR STR3k I' of 1 o 4-1 c1.��,u gF�cy"OLL Al oar D 14 O � o 4'i P.G. SLA Zo"x)O" FTC.. � K�yu��• o��1S1 N t - N 6l N]Ca r�ftaCr 'J $�.St .9 O W lo"o FovMDA�'to N7 pL.A FNort6 ton at �/jeeting},ouse Commons, _ Andover, MA 01845 nit_�.32yr = 1'on jute: 09/01/2005 Sheet 3_- TT o— 5e Commons j_j_C, �ort� Andover, MA LZ) 10 1 � a 2� 10 i t 1 AID o 1 t n xo > r N � v fiJ V 3 Tke Hampton at Mectingkouse Commons, North Andover, MA o 1 845 nit #32 • Scale: 1/8" = 1 'o" Date: o j'/o 1/2oo5 56cet 4 Mccting} ouse Commons LLC Nortk Andover, MA WINDOW & DOOR SCHEDULE Interior Doors, 2-8 X 6-8 unless specified 341/2X 82 /2 r D-1 Entry Door, Twin Sidelights 68 %2 X 83 D-2 Entry Door 381/2X 83 D-3 Slider w/transom 72 X 96 '/4 D-4 Slider 72 X 821/2 N D-5 Entry Door, Single Sidelight 53 '/2 X 83 A Double-hung single 341/4X 65 1/4 B Double-hung twin mull 68 X 65 1/4 C Double-hung triple mull 101 1/2 X 65 1/4 0 D Double-hung single 341/4X 57 1/4 E Double-hung twin mull 68 X 57 1/4 F Double-hung triple mull 101 1/2 X 57 1/4 2 1 P, Fs fl 221/4XG Double-hung single 65 1/4 H Double-hung single 341/4X 53 1/4 0 1 i Double-hung twin mull 68 X 53 1/4 , 1 L Double-hung w/transom 341/4X 79 M Glider 60 /4 X42 1/4 N Double-hung twin mull w/transom 68 X 79 2 1 � P Awning 341/4X 24 1/4 Q Awning twin mull 68 X 24 1/4 r -hung 30 1/4 X 49 1/4 S Double T Double-hung triple mull w/transom 1011/2X 79 U Double-hung twin mull 68 X 49 1/4 X Round stationary 24 X 24 The dam�ton at Meetinghouse Commons, No4 Andover, MA 01 845 y `Scale: 1/8" = 1'0" Date: 09/01/2005 sheet 5 Meeting{�ouse Commons LLC, North Andover, MA Ad AZ y F� m L Ail C Q cz- -k i kv- S-1 LL S Z AIL.ZR, Z"�Zu C,�'T 05, r-I Pr-s RZQ- ?T Poll. LkN-LY N13 66 V.Or. TJ T W,Pc SLAk,%X TYPICAL DECTtClVd T�cHampton -H-a—m--p—tonat Mc-cting'60` Commons, NoA AnJovc;r, MA O1 845 U-n-L11-4-3Z 0 rl 5ca1c: variC5 U).t,: 0910112005 56ect 6 ZI, - Mcctir-196 ou5c Common-5 LLC, Nort6 AnJovcr, MA = . i �2 s ' v- 1 I 1 l IIF .r r 7 O�T ���v �1 �� E mpton at Meetinghouse Commons, 1t\ vn o cr, MA O1845 nit #3Z vv, = ro" Datc: o9/o x/2005l�ouse Commons LLC, No4 Ar,Jover, MA o r i3 ,v Flm- >t C� ? io'a12� o D M $ f M rt� O -o )1- 0 72-0 1 1 1 LiV1tJL-s 0 7 3 X \; RAXL - 3 g oYL� M up 03 O l 4 19 ?- GAR 6 taR 6E �-5 PoRc 1; .9 -D f 0 s 2. 2-00 r-b moi'{-O N old r C,L P RST 'Pl.AW �'L h SF '��" �'�' FNort� mpton at Meet;ngkouse Commons, Andover, MA o 845 n;t #32 XRo� PoRck} s `Z2 S-F. t/8" = vo" Date- 09/0l/zoo5 jheet 2 ,� �'�' house Commons LLC, Nortk Andover, MA TOTl}L 'C-L X C-WK !cl 18 S5- ONS 1ST uf SI0Po-,L Colockt-rE 3000 PST- 0 i0" �4T• UN svrE GK OR 51'R�P ' � I of l CD j ? s�a�p-p�o1iJ6 o ;-1 �Gt.F��l 8+4 G1ZF�LL Al 3 �» I�R� �R�►i�J t*1 O iCzyu��?' o4.�1f1 � o - N - , X11 R 61 Tl�Coa�P�aC3-��J $�•S£ .9 O to Y F O U�J D�t� to N PL A r.J F mpton at Meetinghouse Commons, _ ndover, MA O 1 845 nit #.32 1/8" = i'0" Date: 09/O i/2005 sheet 3 ouse ommons orth AnOver-, MA cz)7->+10 j Z �� 1 2x 10 �i'TI Al I tN fill' ' xo IlL x p � ISLE U > r v V 3 S 11 G The Hampton at Mectinghouse Commons, S�GO�J.D D. ..�w. y.w-��,. t 1RST D L-C.� -�•-....� North Andover, MA o 1 845 nit #32 jcale: 1/8" = 1'o" Date: 0910112005 5} cct 4 Mcetingbouse Commons LLC, North Andover, MA WINDOW & DOOR SCHEDULE Interior Doors, 2-8 X 6-8 unless specified 34 /2X82 /2 r- D-1 Entry Door, Twin Sidelights 68 %2 X 83 D-2 Entry Door 381/2 X 83 D-3 Slider w/transom 72 X 96 '/4 9 D-4 Slider 72 X 82 '/2 ' D-5 Entry Door, Single Sidelight 531/2X 83 N A Double-hung single 341/4X 65 '/4 B Double-hung twin mull 68 X 65 '/ C Double-hung triple mull 101112, X 65 '/4 a D Double-hung single 341/4X 57 1/4 M Z x G E Double-hung twin mull 68 X 57.1/4 F Double-hung triple mull 101 ;/2 X 57 '/4 2 12- R 6 ° 221/4X 65 '/4 G Double-hung single H Double-hung single 341/4X 53 '/4 0 I Double-hung twin mull 68 X 53 '/4 L Double-hung w/transom 34 '/4X 79 M Glider 601/4X 42 '/4 N Double-hung twin mull w/transom 68 X 79 2 n P Awning 341/4X 24 '/4 Q Awning twin mull 68 X 24 '/4 r S Double-hung 301/4X 49 /4 T Double-hung triple mull w/transom 101 '/2 X 79 U Double-hung twin mull 68 X 49 '/4 ROOT- F R'kN+'E X Round stationary 24 X 24 F mpton at Meetinghouse Commons, AndoverMA01845 nit # vis" = t'o" Date: 09/0i/2005 Sheet 5 houseCommons ort} Andover, MA C LLC, N id 0 K CIE!1-1-.q LA o A�. j Ll 3R i�61vC �Llcl; 6x ?T 0 0 8 1 4-11�-- Y:10 P – F SL L-ZA-Lly AB 66 V.PSr. —TTifiPc '&Lkvt pl\-�lt TYPtr-AL SCCTtc)� 7 F k D F- pa�,.cv-, T6c at Meetinghouse Commons, Unit #,JZ FNorA Andover, MA o 18+5 I)at,- 09/01/2005 56cct 6 15cale: varies MMcctin� over, MA ecting6ou5c Commons LLC) Nort6 Ar,8 ILI 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 M �l . 4\67)S LLC. PHONE ?6-- 87-Z6k5 LOCATION: Assessor's Map Number. /Q�C PARCEL 3 f SUBDIVISION l" t� �aC /nn��/rt�f LOT (S) � STREET Cd rt(cj JDnV1Q) ST. NUMBER * **********OFFICIAL USE ONLY ATI F TO NTS: COtAERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS _ .N /A TOWN PLANNER • DATE APPROVED DATE REJECTED COMMENTS G� • t-(O B 1V FOOD/IN ECTOR-HEALTH DATE APPROVED N DATE REJECTED SEPTIC [ SPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS Is ii WE PUBLIC WORKS - SEWERIWATER CONNECTIONS 07 ,,'DRIVEWAY PERMIT f FIRE DEPARTMENTy�2 Qd �.aV e ��, kb1.4-41.bk(1-'If liwfLle/S (�,+��Q�iV6-6 RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm