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HomeMy WebLinkAboutMiscellaneous - 55 PHEASANT BROOK ROAD 4/30/2018 (2) G i i 1 i 9 0 U 5 Date. 6. . ., . .�. . 4, TOWN OF NORTH ANDOVER ° p PERMIT FOR PLUMBING ;,SSACNUS� i This certifies that . . �C' `r�: . 2 . �.� .01t^. . . .`.•. `:.. . . . . . ' L ' has permission to perform . . .ze. C.k, t': . . . . plumbing in the buildings of . . .Sv.t c .kV ^-t. . . . . . . . . . . . . . . . . . at . North Andover, p Fee CC�.(�. .Lic. No..k.1.4? "7. - sA PLUMBING INSPECTOR Check # � MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO DO PLUMBING CITYITOWN... _ P.1� _.......... ....... w ... :. A APPLICATION DATE. ,r I.14"'I�.w„r. JOB ADDRESS I DI L.QI623 PLANS SUBMITTED: YES❑ N0 OCCUPANCY TYPE: COMMERCIAL❑ RESIDENTIAL 1' P NEW[] ALTERATION[] REPLACEMENT REMOVAUDEMOLITION❑ So ,,)) �t r PLUMBING: PIPING—FIXTURES-FIXED APPLIANCES—APPURTENANCES 7 ENTER TOTAL AMOUNT FOR EACH SELECTION LIMITED TO FIVE 5 NUMERALS ALTERNATIVE TECHNOLOGY DISPOSER SINK: MOP SERVICE ASPIRATOR DRINKING FOUNTAIN STERILIZER DRAIN: AREAD FLOORD EJECTOR ❑ STORAGE TANK BACKWATER VALVES EMBALMING I I AUTOPSY URINAL BAPTISM:FONT SACRARIUMF-1- FOOD CHEST MISTING SYSTEM VACUUM DRAINAGE SYSTEM BAR SINK GLASS WASHER WATER CLOSET BATHTUB WHIRLPOOL I ICE MAKERS_WATER HEATER:ALL TYPES / BIDET INTERCEPTOR:ALL INTERIOR WATER PIPING: — CROSS CONNECTION DEVICE KITCHEN SINK r OTHER NOT LISTED 7 DEDICATED: ACID WASTE SYSTEM LAUNDRY CONNECTION DEDICATED: GASIOIUSAND SYSTEM LAVATORY DEDICATED: GREASE SYSTEM PIPE RELINING WORK ONLY DEDICATED:RECLAIMED WATER ROOF DRAIN DENTAL FIXTURE I EQUIPMENT SINK: 1.2.3 BAY PREP. DISHWASHER SINK:CLINIC FLUSH RIM PLUMBING INSTALLER—FIRM-COMPANY INFORMATION CHECK ONE ONLY g Mv Corporation Business#�sc NAME.F Stark&Cronk Plumbing Inc ADDRESS 308 Main Street -- i Groveland ❑Partnership Business#�— CITY: J STATE MA ZIP 01834 978-372-6981 374 0837 re starkcronk.com LLC Business#�1 TEL: . -. �„�, .��,�.,.,�. FAX � EMAIL 9@ m 1 NAME OF LICENSED PLUMBER: J� CUC�1 Q , ❑DBA Unincorporated INSURANCE COVERAGE I have a current liability insurance policy or,its substantial equivalent,which meets the requirements of MGL.Ch.142 YES E] NO If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY OWNER❑ AGENT i Signature of Owner or Owner's Agent OWNER'S NAME i �,,.,. »»,,,. �. .. .._ _ .. TEL. u �- »,. FAX. I hereby certify that all of the details and information I have submitted(or entered)regarding this permit ation is true and accurate to the best of my knowledge.I certify that all plumbing work and installations performed under the permit ssued will be in compliance with all pertinent provisions of the Massachusetts Uniform State Plumbing Code,and Chapter 142 Phgle r (OFFICE USE ONLY) TYPE OF LICENSE: Permit# ❑Plumber Signature-; sed Plumber Inspector ✓❑Master 11027 License Number::.,» _._. Fee: ❑Journeyman ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES 7704 Date. ..Q '. `L... .. NORTH o? �` TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION SACH 5E� This certifies that . .. .. . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation SKY- in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . at ..,�? . �� .�� Sc�. r l �uc�!�� . . . ., North Andover, Msty Fee A w . Lic. No..W�i-7. . . . . . ; . . .. . t GAS INSPECTOR Check# 5 $ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO DO GAS FITTING CITY/TOWN:iOr�h�, trX. .... . ... . _v, . STATE:MA APPLICATION DATE. JOB ADDRESS . ..( . GOCCUPANCY TYPE: COMMERCIAL r7 RESIDENTIAL PLANS SUBMITTED: YES❑ NO NEW[] ALTERATION[] REPLACEMENT REMOVAUDEMOLITION❑ Lj I;Y" I- NATURAL& LIQUEFIED PETROLEUM GAS: PIPING-EQUIPMENT—APPLIANCES—SYSTEMS Z 9p, ENTER TOTAL AMOUNT FOR EACH SELECTION LIMITED TO FIVE 5 NUMERALS AIR ROTATION UNIT FURNACE: ALL TYPES TEMP HEATING EQUIPMENT BOILER:ALL TYPES GAS PIPING THERMAL OXIDIZER BOOSTER GENERATOR STATIONARY ENGINE TURBINE BROILER ILLUMINATING APPLIANCE UNIT HEATER BURNER: ALL TYPES INCINERATOR WATER HEATER: ALL TYPES CO-GENERATION UNIT INDUSTRIAL AIR HANDLER EQUIPMENT OVER 12,500MBH COFFEE ROASTER INFRARED HEATER I-OTHER NOT LISTEDI COOK APPLIANCE HOUSEHOLD KILN 1 GLORY HOLE I CRUCIBLE COOK APPLIANCE COMMERCIAL LABORATORY COCKS a DECORATIVE APPLIANCE MAKEUP AIR UNIT DIRECT VENT APPLIANCE MECHANICAL EXHAUST EQUIPMENT DRYER: ALL TYPES OVEN: ALL TYPES FIREPLACE:VENTED I UNVENTED POOL HEATER FRYOLATOR' ROOF TOP UNIT FUEL CELL F= ROOM HEATER—VENTEDNENTLESS CHECK ONE ONLY PLUMBING/GAS FITTING FIRM INFORMATION wv Corporation Business# 2assc Stark&Cronk Plumbin Inc NAME 9' : ADDRESS .,308 Main Street .. p❑Partnershi Business# ----- "r CITY Groveland STATE MA 01834 „'ZIP 'LLC Business# ------- r�, TEL: 978-372-6981 FAX 374 0837 "„ EMAIL 9reg@111111­starkcronk greg@starkcronk.com 1 Unincorporated NAME OF LICENSED PLUMBER I GAS FITTER: J(, 8-.a'4/Ct— INSURANCE COVERAGE I have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES ✓❑ NO If you have checked Yes •please indicate the type of coverage by checking the appropriate box below. A 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 Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY OWNER❑ AGENT Signature of Owner or Owner's Agent OWNER'S NAME: —. -, J TEL: FAX' I hereby certify that all of the details and information I have submitted(or entered)regarding this permit applic ion is t ue and accurate to the best of my knowledge.I certify that all plumbing work and installations performed under the permit issu , ill be' compliance with all pertinent provisions of the Massachusetts Uniform State Plumbing Code,and Chapter 142 of the Gen I a (OFFICE USE ONLY) Type of License: Permit# ❑Plumber ❑Gasfitter Inspector ❑✓ Master Journeyman gnature of Licensed Plumber 1 Gas Fitter ❑ Y .........�.._._.__.._...�..____...._ _........ [:]Undiluted LP Installer License Number: 11027 Fee: ❑Limited LP Installer ROUGH GAS INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number °O Date e2/cRO/ O D THIS CERTIFIES THAT/ THE BUILDING LOCATED ON ���oc>c> P 13ho o 111 - MAY BE OCCUPIED AS st,�9l� �/ /,ii,el��9 IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. 02,5-tall viv%e/1 f-1,v,sh,—j CERTIFICATE ISSUED TO0,4.9da44 ADDRESS b D S= CNUs� Building Inspector 4 T40RT Town of Cl _ over O L IT No. - -- EXCAVATION AND FOUNDATION C3roi oLw w 040 , R'�sl�'y Tip us THIS CERT IES THAT 4 has permission to excavate and pour foundation at L0+ + for the purpose of .1. 1)WC1ko The person accepting this permit must return to the office of to Buildin Tn ector w?Pt� t plan showing location of building thereon before further construction may resume. NORq PERMIT EXPIRES IN 6 MONTHS love o UNLESS CONSTRUCTION STARTS o m •� o? 9' ~ Date 0 -% .- LAKE 9Z_COCNICNEMICK �i,9soq�EP .�y Building Inspector SgCHUs� NORT#q 0q" ® oAndover No. O' " �`y Z o �` dower, Mass., 0 o o o Y O l �n COC NIC HE WICK � ADRATED S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System r�i a(wA �a #Y -T— �, BUILDING INSPECTOR THIS CERTIFIES THAT..... . ,,,,,,,,,,,,/�V.S.. y........ ....... """""' Foundation X/f/�'� i4 As'3 A root C(?- has permission to ent..��!V.I.,l.�............ buildings on�.d.�u..................................�� �N......... ...... Rough/� 00, to be occupied as....... ifN�M'V t I ,iI �� IIM� A0000 % i p_ provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final r/ - ��pe this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of / `C9"""_ Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. ough 40 10 13 PERMIT EXPIRES IN 6 MONTHS ELEC'TIVC INSPECTOR P �? O UNLESS CONSTRUCTION iD ST TS �/„/ `��� ..,,�I.� .. . a ou yS ... BUILDING INSPECTOR in Occupancy Permit Required to Occupy Building GAS INSPECTOR � i r✓ Display in a Conspicuous Place on the Premises — Do Not Remove Rough No Lathing or Dry Wall To Be Done f Until Inspected and Approved by the Building Inspector. Burner FIR PARTMENT gSmoke SEE REVERSE SIDE �/J,G /� �, , r, c a th of Mtssttr tis DEPARTMENT OF PUBLIC SAFETY--DIVISION OF FIRE PREVENTION 1010 COMMONW[ALTH Avamuz. 9osTam N. Andover 2-29-2000 i y or own ate of issue) CERTIFICATE OF COMPLIANCE _ CHAPTER I481 S CTION 26F, M. G . L. This Certified that the property located at 55 Pheasant Brook has been equipped with approved smoke detectors and was found to be in compliance with Chapter 148 Section 26F, Massachusetts General Law. /; Znapection/Testinq completed ons 2-25-2000 �: _ Znspec Fee Paid: 25. 00 �/G �sr•�/ -r Head of Fire. Department Notice: This certificate expires sixty (60) days after date .of issue. (Seller's Copy) I S , µORTH Of t�ao , 6 O c� ACOC At •v 7?AoA,�o pPP' .(J �SSacHus�� APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION F ADDRESSILOCATION 0 PROPERTY : r©o oe DATE REQUESTED FILED/READY FOR INSPECTION CLOSING DATE ON PROPERTY: = 2 62 - D D FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK'AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNED _ I ROUTING i � a( 9-4(9-661 CONSERVATION v_ r I PLANNING I DPW - WATER METER NOTE DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST DPW ! 1 §egnjadure File: OC farm revised 618/98 _ ' FFR l 4 2000 - � �S 2J , BUILD; IL� ��6r ¢1�fENTi �,on 71 1 t. z CR. - Date 1 on TOWN OF NORTH ANDOVER n Certificate of Occupancy $ � Building/Frame Permit Fee $ 6 +' ' /" �b'•^°''<�' Foundation Permit Fee $ SS�C14USE i ' Other Permit Fee $ ►- Sewer Connection Fee $ En — $ !lJl� gds water Connection Fee $ { TOTAL $ Bu•din spec or . 12527o2/16/99 12:061,356. Div. Pubfip, orks 00 PAID { i VEA MIT NO. —APPLICATION FOR PERMi'1"I•O ANI)O U'R, MA 4" -- AI\1'N(1- / D� n 1 W.N1) n r',+ 2. NF'a'Hii f)I�rttNt 1111111' - --- DA IT - BOOK 7/)1.1. SIM DIA'. I OI`N NO."�� �, F 0 4 Q������ IM AII()N SS Ph& 4�/� tf G g I�IIItltrirlY l; iL�l��ili)INt "Op fic, �AG 'A ir . 1)WA:R'S NAI,IIi No , OF SI(NtILS n 5171. g fr L� r a-l�l�E [.G�-t�/�O t e[ 1 uWNF:R'S ADI)It1:S1 � � .. BASEMENT OR SI All � G GrYt �/ AR(1111EUI'S NA),IE 0. SI&''OF FI()OR 11KII0 Rs 151 ! Z 175 37----_-- HIM DER'S NAME lhe r, ceD SPAN L )" DIS IANCFTONEAREST HUII DINGG �, DIMENSI(N4SOF SILT S �2% (Q / DIS IANC-E FROM STREET 2 O /. DMILNSI(NJS Of 11 IS I S A I DIS I ANCE FROM LOT LINES-SIDES REAR ,L DIMENSIONS OF GIRDERS ,^ AlIFJItIFIUF / f- rR(N NAGE ! IIEIGIIr( FtxlNl)nll(7N IV THICKNESS IsBIIILDIN(iNEW e SIZEOFI-O(YIING X IS HI)ILDIFRi ADDITION MATERIAL OF CI IININEY O f&-a Y dN e IS BI)ILDING ALTERATI(NJ IS BUILDING ON SOLID OR Fit LED LAND /l WIII-BUILDINGCONFORMTORECx)IREMENI-S OF CODE @ IS BIIII.DINGC(7NNEClED101OWN WA'IER •3 e 130.4RDOF APPEAIS ACTION, IF ANY IS BIIILDINGC(N4NECIED 1OlOWN SISWLR I IS BUII.DING CONNECT EO TO NAII)RAI.GAS I INE G INSFtilcii )NS 3. PROI'E12'11' INFORATAIION I.ANDCOST 0 G ES 1. BI IXi.CC1dT �O PAGE I FII.I.C>lrrSECTIONS 1-3 EST. BI IXi.Cc75T ILRS)1. Fi. 6 ES r. BI Ot i. CUS I IIll.R ROOM (� ELECTRIC KIEFERS MUST BE ON Ott FSIDE OF BIM DING SEPI IC PERNII F NO. ArlACI IED GARAGES MUSTC(NJFORM rOSrATE FIRE REGIILATI(NJS �. APPROVED BY: Q CQL,�- PLANS MUST BE FII.ED ANO APPROVED BY.N1ILDING INSPECTOR C BUILDING INSI'EC I OR DA IS I'll 1:1) {/ ��./1 OWNERS II:III •� 4.� "r' I F CtNJIR.IEI.N ,7 7_J J,J � ' f I J !1 RRR TF1 [� , 'OFrI \. CR.I.I('ll J QSIGNAIIIRFOI'OWNF.RI AI fI1NN217}:D A(YNT _ ELI. 5 J �� --�� n).('.q --•- -- ""- 1'ERI,IIT GRAN 11:1) 19 g` s. OSI / 000 INS 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 /�w� Pte-/�� r a� PHONEIJ'-.r,21 - 7 S/.3 �1 LOCATION: Assessor's Map:Number /06AO Le,?1/0 PARCEL SUBDIVISION�jGo )cQ r g e!i LOT (S) 3 if STREET j4lh est s'Grt .efi©o ST. NUMBERS ** **********OFFICIAL USE ONLY******************* RECO M E ATI S F TOWN AGENTS: 10 ig CONSERVATION AD INI$TRATOR DATE APPROVED DATE-REJECTED COMMENTS f TOWN PLANNER DATE APPROVED I �- P�� DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED Of SEP I P OR-HEALTH DATE APPROVED 7` DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONSW I DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of Applicant on Building Permit(below) Address of Property for Permit(below) /i e r •f co w - liar 'e J,0 2"13 SS 1J�i e S'a.�f Or 0 0k.hof Map and Parcel :!p G 8 Purpose of Application (check below) mb7r�A jcant: - ✓Single Family _Two Family PM I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the Building Permit. Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building Department and is only officially accepted when the Building Permit iq issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This' an application for a building permit for the enlargement,restoration,or reconstruction of a dwelling in existen as of the effective date of this by-law, provided that no additional residential unit is created. The lot(s)were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning t Bylaw. This application is for dwelling units for low and/or moderate income families or individuals,where all of the ` conditions of 8.7.6.care met and/or represents Dwelling units for senior residents,where occupancy of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this Section"senior"shall mean persons over the age of 55. This application is a part of a development project which voluntarily agreed to a minimum 40%permanent reduction in density,(buildable lots), below the density, (buildable lots),permitted under zoning and feasible given the environmental conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently designated as open space and/or farmland.The land to be preserved shall be protected from development by an Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism approved by the Planning Board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for building permits,(i.e.all other permits from all other boards and commissions have been received and the project is in compliance with those permits),and the Development Schedule does not accommodate issuing a building permit in that Year,one building permit will be issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination* that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate information, or the checking off of an above item which does not comply,whether done to my knowledge or not, is grounds for refusal by the Building Department to issue a Building Permit. ign or Uwner or prized Agen o signed the Attached Building Permit Date This form must be attached to the Building Permit upon application for such permit - "µ �ae �r,a�z'i�aoruaeal/� a n1r DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION UP C ONS ERUISOR LICENSE NuAber. 1. Expires: Birthdate CS 068988 10/14/2000 10/14/1958 Restricted To: 00 r ALBERT C COUILLARD a 85 CASABLANCA CT HAVERHILL, MA 01832 MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MA$check Software Version 2 . 0 Checked by/Date CITY: Haverhill STATE: Massachusetts HDD: 6027 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 1-18-1999 DATE OF PLANS: 1/18/99 TITLE: LOT 23A PHEASANT BROOK ROAD, NORTH ANDOVER PROJECT INFORMATION: EVERGREEN ESTATES r COMPANY INFORMATION: BROADWAY REALTY TRUST COMPLIANCE: PASSES Required UA = 553 Your Home = 415 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 3600 38 . 0 0 .0 108 WALLS: Wood Frame, 16" O.C. 2679 15 . 0 3 . 0 179 GLAZING: Windows or Doors 46 0.350 16 DOORS 5 0 .350 2 FLOORS: Over Unconditioned Space 1743 19 . 0 83 BSMT: 8 . 0 ' ht/4 . 0 ' bg/4 . 0 ' insul. 174 10 . 0 27 HVAC EFFICIENCY: Furnace, 80 . 0 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 1250 of the design load as specified in sections 780CMR 1310 and J4 .4 . Builder Designer �- Date MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2 . 0 LOT 23A PHEASANT BROOK ROAD, NORTH ANDOVER DATE: 1-18-1999 Bldg. Dept. Use CEILINGS: [ ] 1 . R-38 Comments/Location WALLS: [ ] 1 . Wood Frame, 16" O.C. , R-15 + R-3 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0 .35 For windows without labeled U-values, describe features : # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: [ ] ` 1. U-value: 0 .35 Comments/Location FLOORS: [ ] 1 . Over Unconditioned Space, R-19 Comments/Location BASEMENT WALLS: [ ] 1. 8 . 0 ' ht/4 . 0 ' bg/4 . 0 ' insul . , R-10 Comments/Location HVAC EQUIPMENT EFFICIENCY: [ ] 1. Furnace, 80 . 0 AFUE or higher Make and Model Number THERMOSTATS: [ ] Adjustable thermostats required for each HVAC system. AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air-tight assembly with a 0 .5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be deter Manufacturer manuals for all installed heating and cooling-:equipment and service water heating equipment must be provided. Insulation R-values, glazing U-values, and heating equipment efficiency must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] Ducts in unconditioned spaces must be insulated to R-5 . • Ducts outside the building must be insulated to R-8 . 0 . DUCT CONSTRUCTION: [ ] All ducts must be sealed with mastic and fibrous backing tape. Pressure-sensitive tape may be used for fibrous ducts . The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict Or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] Rated output capacity of the heating/cooling system is not greater than 1250 of the design load as specified in sections 780CMR 1310 and J4 .4 . MISC REQUIREMENTS: [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems . w ----NOTES TO FIELD (Building Department Use Only) ------------------------- TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 GEORGE PERNA Telephone(508)685-0950 DIRECTOR Ottt Fax(508)688-9573 t � NORTIy`EO ib qH� OL O ...-. - F A ♦ i � p41TF0^PP+V�y 9SSACHUSEt DRIVEWAY PERMIT Date: LOCATION: �S l . �� K41- �ioo ,� ��� l�7 23y� BUILDER: phone: OWNER: lry f2 Phone: 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: N° 855 -'' APPLICATION FOR WATER SERVICE CONNECTION- North Andover, Mass. 9 .- Application by the undersigned is hereby made to connect with the town water main in 'ce ' Gw �ec� S — subject to the rules and regulations of the Division of Public W rks. f t The premises are known as No. �� G7�G1�cLC ��� r� Street - or subdivision lot no. Owner Address Contractor Address A an ignatur v M e / PERMIT TO CONNECT WITH WATER MAIN The Board of Public Works hereby grants permission to to make a connection with the water main at ' G Street subject to the rules and regulations of.the Division of Public Works. rd o Public Works By Inspected by Date See back for rules and regulations I NORT ` ALn Town ofj tover NO• EXCAVATION AND FOUNDATION C3roa o�.w � Res��y Trus THIS CERTIFIES THAT has permission to excavate and pour foundation at Loi- A 3 A for the purpose ofa.L :DWILkD The person accepting this permit must return to the office of tl—ie'Buildin Tn ector w?tP* t plan showing location of building thereon before further construction may resume. F NoRPERMIT EXPIRES IN 6 MONTHS Q gtio UNLESS CONSTRUCTION. STARTS o; * _ Date 4,1 9�-CCH `V•' Oq r Building Inspector �SS'4CHUS�,�C • OR- Town RT 0 of over o m * i — oZ C;L 194 * : . over, Mass., LAKE � '9A_COC HICHEWICK i�'�• '9 019'q T ED PP`y J S E BOARD OF HEALTH Food/Kitchen PERMIT T Septic System THIS CERTIFIES THATr o o cl.w A izeal"4...... 5. . V 4 ` k R B UILD ING INSPECTOR ..... .. .................... ............. ....................... Foundation �as.,� ohas permission to erect.............. ....................... buildings on .k� a3 . Rough to be occupied as..... 1.b. .1' ....... .M!!1 A.�.. ......�w a.f.��y.. ....a....���!1 l....apj.�.w. ....NQ.t Chimney provided that the person accepting this permit sha in every respect conrm to the terms of the application o 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 pgoe PERMIT EXPIRES IN 6 MO THS Final ELECTRICAL INSPECTOR UNLESS CONSTRU ,N S e . Rough .................. ..... .. ... ......... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough P Y P Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. Smoke Det. Location � - No. �� Date - r� r�, NORT1y TOWN OF NORTH ANDOVER ►' 9 ` Certificate of Occupancy $ s�cHusEt� Building/Frame Permit Fee $ ` I Foundation Permit Fee $ Other Permit Fee $ TOTAL $ i Check # 13562 Building Inspecto c PER11WIT NO. ©l APPLICATION FOR PERMIT TO BUILD********NORTII ANDOVIJR, MA DLLPNO. `O LOTNO. b 2. RECORDOFOWNERSUIP DATE BOOK PAGE 'LONE SII I)DIV. LOT NO. n DQ�wG J 7— LOCATION LOCATION PURPOSE OF BUILDING K g e S T jf sG N/M Cl'l OWNER'S NAME Y, a v✓ ( / dea NO.OF STORIES SIZE OWNER'S ADDRESS , Q BASENIENTORSLAO �s Ch[p�/J�— ARCIIITECT'SNAME �+ oC SIZE OF FLOORTIAIOER$- O?C OF 2 31a— BUILDER'S SPAN DISTANCE TONEARESFBUILDING D�f DIMENSIONSOFSILLS DISTANCE FROM STREET 3G L�� DIMENSIONS OF POSTS UISTANCEFILOM LOT LINES-SLUES S'ZREAR 0�f' DIMENSIONSOFGIRDERS AREA OF LOT L,v FRONTAGE !i Ob IIEIGIITOFFOUNDATION y THICKNESS D IS BUILDING NEW C C /S SIZE OF FOOTING 2 �ii�! a IS BUILDING ADDITION N MATERIAL OFCUMINEY IS BUILDING ALTERATIONu IS BUILDING ON Sol 11)Oil FILLED LAND l C$' /Y WILL IIUILDING CONFORM TO REQUIREMENTS OF CODE CS IS BUILDING CONNECTS TO TOO'N WATER G BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER y p 1 IS BUILDING CONNECTED TO NATURAL GAS LINE INSTUCTIONS 3. PIIOI'EIITY INFOIWATION LAND COST EST.BLDG.COST '7 O D'v PAGE 1 FILL OUT SECTIONS 1-3 EST.BLDG.COST PERS .FT. rj EST.BLDG.COST PER ROOM 0"P t, ELECTRIC DIETERS MUST DE ON OUTSIDE OF BUILDING SEPTIC PERMIF NO. ATTACH Ell GARAGES MUSTCONFORM TO STAII-k FIRE REGULATIONS 4. APPROVED BY: n PLANS MUST BE FILED AND APPROVED DY BUILDING INSPECTOR BUILDING INSPECTOR DATE FILEDOIYNERSTELH CONTR.TELH 5 � CONTR.LICH e SIGNATURE OF-OIYNER OR AUTHORIZED1 AGENT FEE PERMfFGRANTEII / l 0 �D ENT Revised 5/5/99 Jl1igRTM ✓1ze �anvma�zcuealll o�;.'�avaa�/za�rP,l1a � ' DEPARTMENT OF PUBLIC SAFETY . CONSTRUCTION SUPERVISOR LICENSE.' Kul abers Expires: :Bi(thdate CS 068988 . 10/14/2000 10/14/1958-. 's Restuicted`To: 00 ALBERT C COUILLARO. i .xlM� 85 CASABLANCA CT w HAVERHILL, MA 01832 Wr The Commonwealth of Massachusetts Y Department of Industrial-Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit (Name r �" , 1 ,,Q Please Print Name: ;qhe',& yy��11l? Location: Phone a /I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity CI am an employer providing workers' compensation for my employees working on this job. Comoanv name: Address Citi• Phone Y: Insurance Co Policv m t . Comoanv name: Address City. Phone»' Insurance Co. Folic•✓T Failure to secure ccverage as recuirec under Sac:ion 25A or MGL 152 can lead to the imposition of cnmir.al penalties or a tine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the f.crm or a STCP'r/CRK ORCER and a fine cf(5100.00) a day against me. I understand that a copy of'his statement may be fcrvarded to the Office cf Investigations cf the CIA for ccverage verification. I do hereby cortin/under the pains and penalties of perjury that the information provided above is.`rue and correct. Sianature �.,/L�,g/ Date Print name--_� er ca,61,'d,6r'n,o{ _F Official use only do not carte in this area to be comcleted by ciiy cr tcwn cmaaf City or Town Permit/Uccensirc Building Dept ❑Check Yimmediate response is required ❑ Licensing Board CI Se!ectman's Office Contac;person: Phone Health Department Other s -- 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**"�'****y`***'"*�"�*''*"y` APPLICANT /)�- C4�._ PHONE g >4 ' 3 2r " 2 /1 LOCATION: Assessor's Map Number .1Q6 13 PARCEL/_ SUBDIVISION 74 r LOT (S) Z 3 4 STREET ST. NUMBER�� OFFICIAL USE ONLY RECOMMENDA T IONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED ,,,,„� DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEA DATE APPROVED DATE REJECTED SEP GIN EtTOR-HEALTH DATE APPROVED �b DATE REJECTED COMMENTS �v PUBLIC WORKS -SEWERIWATER CONNECTIONS DRIVEWAY PERMIT e FIRE DEPARTMENT RECEIVED BY BUILDING iNSPECTOR DATE Revised 9l97 im BUILDING DEPARTMENT DEBRIS DISPOSAL FORM In accordance with the provisions of MGL.c 40 S 54,a condition of Building Permit Number J 2 Is that the debris resulting form this work shall be disposed of in a property licensed solid waste disposal facility as defined by MGL c 11, S 150A The debris will be disposed of in: Location of Faci 'ty Signatur .oe�f Permit Applicant ey Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector w 7. r I T---'�' b I t't?RMI"I' NO. APPLICATION FOR I'll ItN11'1' TO 131)1 **NORT1.1 ANDOVER, MA 2. Itt( OI(UOt'owNiItsilir 1):111' BOOK I'M;V II)hI. SIIR 111\'. I NI). 1 IO( %II(IN 1-1IRI't1SF:41:111111DING O\\•NI:R'SNAML N1).tX SIu1tIES SIZF. -- — - -- U\t'NER S ADI>RI:SS UASIiAIENI'Oft S1 AU AM I III UCI'S NAME SIM OF I VOOR ITMUERS fit III DUR'S NAME SPAN T— DISTANCE IONLAIII:SI BUILDING h11.11=NS1(NIS(X SILLS DIS I ANCE I R(X I S I111:1:1 DIMLNSI(NUS(X'MIS I S DIS IANCEFROM I. rrLINES-SIDES REAR DIMI;NSNNJS01 GIRDFRS ARUA01:1.0r Ilt(NJIAGE IILIGIII tX PO(INDATI(NJ TIIICF;NI:$S IS BIIILDING NEW 5111,OF 11)UI ING X -- s °. - -- IS UUII_DIN(i Al_TERATI(N! IS 13UIIDI NG ON SOLI 1)(N2 FIt I ED LAND \t 11 1.131111-DIN(;CIN�FORM TO RliQ(IIRFMFN'FS OF CIA)E IS Ili III DING C(N)NEC I LD 10 10tVN WATFR Is ma I.DIIJG C(X)NLCI LD It)NA I URAL GAS I.It IL INS IIK'IIONs 3. 111OUE11IVINFO RNIA+ION LANDCI>51' ESI ULIXi.COSF rma: I rll I-(xlrsECll(vs 1-3 ES 1. UIJXi.06 VLRSo .F1. ------ ES 1. -----ES1.UI IXi.C(IS I PERMXX.1 L'I ECFRI('Llli I LRs A111S1'UE(NJ(X rrSIDE(N UUII.DING SLIT IC PLR0,11 I NO. AI'IACI{ED(iARA(iESNII)SIC(NJrOVNITOSrAIEFIRURL'(itII.ADONS a. API'ItOI'EDU1': PLANS MUSS IIF ILII ED AND Alll'ROVI:1)I3Y U1111.1)ING IN$1'1'.CI(Xt IMILDING INSPEC IY){t DAIL I It I:I) t)WNuts to H C(MR.ILI N CINJIR.IIt-H SI(GNA 1111W(N 1)N'I4I:I(1 Xt Atli I 1 X2111:1)A(71 NI iI 1 b VI It II I'4 MAN I 1 1) - 19 e • NORT#y Town of ®ver (n .......... No. ®' /' o === o dover, Mass., O / O� v COCH CMEw CK S ADRATED P' '`� ' E BOARD OF HEALTH l Food/Kitchen I Septic System R M IT D BUILDING INSPECTOR THIS CERTIFIES THAT..... r�, GI .y wA !a �� �V S� . .........R 14........... Foundation has permission to wKt ATOP M.�............ buildings on id.?34... ..Ad.t�$!I�.......&Wt Rough to be occupied as.......JI.A41f ft?M4.*...../N..+5.#M$ IS I..'1........#0 RP �............... 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough #) " 6 13 PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR P .? �/ O UNLESS CONSTRUCTION,SITJ400f Rough � c ' ...........00000007. .............. . ....... ....... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on ' T the Premises — Do Not Remove Final No Lathing or Dry Wall 1 o BeDDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. x (603) 382-6166 119 NEWTON ROAD (ROUTE 108) 6bj PLAISTOW, N.H. 03865 April 28, 1999 Mr. Al Couillard C/o Broadway Realty Trust 1204 Broadway Haverhill MA 01832 RE: 55 PHEASANT BROOK DR, NO.ANDOVER MA. FOUNDATION i, Dear Mr. Couillard: Please be advised that I have inspected the foundation located at the above-mentioned site. I have also interviewed Mr. George Henderson,the site excavator and yourself,the site developer. From my site inspection I did not observe any cracks in the foundation wall nor did I observe any areas of distress resulting from the bearing material below the footings. From my conversation with Mr.Henderson,I was informed that 3/4 inch normal size stone was used as a bearing base between the footing and the subsurface ledge. According to Mr.Henderson,the depth of stone ranged from one inch to eighteen inches. When a concrete foundation is placed over ledge,and sliding is not a concern,compacted gravel is usually placed over the ledge so as to achieve a level and sound surface to support the foundation system. If stone is used,at depths greater than 12 inches,in lieu of compacted gravel it is necessary that the excavating contractor fully compact the stone so as to restrict the possibility of the stone shifting into the adjacent backfill and undermining the footing. From my conversation with Mr.Henderson it appears that care was taken during the placement of the stone and the backfilling phase. If some minor shifting was to take place,and the footing was slightly underminded,the foundation system has the ability to span over minor cavities. According to you, longitudinal reinforcing was placed in the footing which would allow the footing to resist tensile forces for spans over small cavities. Since our review is limited to the completed product,we can only rely on information from the builders and our observation of the finished product,and as indicated above no adverse effects were evident. CIVIL &STRUCTUAL DESIGN SITE DEVELOPMENT &PLANNING • CONSTRUCTION MANAGEMENT • TRAFFIC IMPACT STUDIES SEPTIC SYSTEM DESIGN 9 SITE ASSESSMENTS i . From our review it appears that the foundation system will not experience distress resulting from the fact that stone in lieu of gravel was used. However,if cracks or other concerns develop in the future,remedial work will re required. 4naVery truly yours, Very J.Pica P.E. RJ PICA ENGINEERING CO.,INC. H 4 Q Ronald Z`' ica � rn j �rs/ONAL V \ I