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BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
Office Use Only
12
Permit No.I
WV
Occupancy & Fee Checked -S f
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00
(Please Print in ink or type all information)
Town of North Andover
The undersigned applies for a permit to perform
/tth/,eelectrical work described below.
Location (Street & Number 5(o, `� 6 /,,-1 �—z .SZ
Owner or
Owners
IV; //.
Date - (b - 9 &'
To the Inspector of Wires:
Is this permit in conjunction with a building permit Yes [Y No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Voits Overhead ❑ Undgmd ❑ No. of Meters
New Service Amps Voits Overhead ❑ Undgmd ❑ No. of Meters
Number of Feeders and Arrtpacity
Location and Nature of Proposed Electrical Work Se G U r J40 Al a r ,01"
OTHER: SP C v r ! `t /T ( el ✓ e
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General laws /
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES % NO =
have submitted plid proof of same to the Office YES Y NO = If you have checked YES please indicate the type of coverage by checking the appropriate box
INSURANCE 19 BOND = OTHER = (Please Specify)
q (Expiration Date)
Estimated Value of Electrical Wo S ` o o ' U e)
Work to Start .5-'7 �7 Inspection Date Resquested Rough Final
—
Signed underthe PenIdes of pedu '
FIRM NAME S J) r l U A r- �} f %} A. -M LIC. NO. 8 V
Lirnnsaa fav I)•P r -I- D Sy LL I v 4 nl Signature
LIC. NO. °2c;2 V7 O
/tlJufLlln _D �i Bus. Tel No. / 78— toCJ�-6f%%
Address027 /+' �� � W . 124, 4 Alt Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licens6s 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 requirement. Owner Agent (Please Check one)
Telephone No. PERMIT FEE S --
(Signature of Owner or Agent)
Total
No. of Light8ng Outlets
No. of Hot fuse
No. of Transformers KVA
Above ❑
In ❑
No. of Lighting Fixtures
Swimminq Pool gmd ❑
gmd ❑
Generators KVA
No. of Emergency lighting
No. of Receptacles Outlets
No. of Oil Burners
Battery Units
No. of Switch Outlets
No of Gas Bumers
FIRE ALARMS No. of Zone
No. of Detection and
Total
No. of Ranges
No of Air Cond
Tons
Initiating Devices
Heat Total Total
No. of Diposal
No. Pumps
Tons
KW
No. of Sounding Devices
No./ of Self Contained
No. of Dishwashers
Space/Area Heating
KW
DetectionlSounding Devices
❑ Municipal ❑ Other
No. of Dryers
Heatinq Devices
KW
Local Connection
No. of
No. of
Low Voltage
No. of Water Heaters KW
Signs
Bailases
Wiring
No. Hydro Massage Tuds
No. of Motors
Total HP
OTHER: SP C v r ! `t /T ( el ✓ e
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General laws /
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES % NO =
have submitted plid proof of same to the Office YES Y NO = If you have checked YES please indicate the type of coverage by checking the appropriate box
INSURANCE 19 BOND = OTHER = (Please Specify)
q (Expiration Date)
Estimated Value of Electrical Wo S ` o o ' U e)
Work to Start .5-'7 �7 Inspection Date Resquested Rough Final
—
Signed underthe PenIdes of pedu '
FIRM NAME S J) r l U A r- �} f %} A. -M LIC. NO. 8 V
Lirnnsaa fav I)•P r -I- D Sy LL I v 4 nl Signature
LIC. NO. °2c;2 V7 O
/tlJufLlln _D �i Bus. Tel No. / 78— toCJ�-6f%%
Address027 /+' �� � W . 124, 4 Alt Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licens6s 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 requirement. Owner Agent (Please Check one)
Telephone No. PERMIT FEE S --
(Signature of Owner or Agent)
NMI 4- ! Date..�.... 'F.... �............
�o� TOWN OF NORTH ANDOVER
I've—
p PERMIT FOR WIRING
This certifies that ............ ...`....:............:......................................::'.. .
has permission to perform •. ..`' .: - ,
wiring in the building of ........... �........... J .................... ........................
at .,.....................:.....................' /���.......................... , North Andover, Mass.
Fee..........:......... Lic. No:..'..Y, .i:� ............................................................
ELECTRICAL INSPECTOR
45/48/98 14:09 35.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
2 •N 2614 Date ......
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that .... ..........................................................................
has permission to perform ....... ..............
.............
wiring in the building of .............................................
at...........
........ �—,-]North Andover, Mass.
Fee,,;?1
........ Lic. No . ................ .............. ...........................
ELECTRICAL INSPECTOR
Check # �1
7
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
r
lrt
Commonwealth of Massachusetts Official Use Only
L? ` Department of Fire Services Permit No. c��o
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Ch eked
[Rev. 11/991 (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 TYP LL INFORMATION) Date: -.1 /-06
City or Town of:v To the I17spector of Wires:
By this application the undersigned gives notice of his or her intention to perforin the electrical work described below.
Location (Street &
Owner or Tenant
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Sen -ice Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
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 Total
Transformers KVA
No. of Lighting Outlets
No. of Hot Tubs
Generators KVA
1\0. of Lighting Fixtures
SwAbove imminb Pool arnd. ❑ In-
arnd. ❑
oo Emergency tbinb
.
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
Initiating Devices
No. of Ranges
a
No. of Air Cond. Total
Tons
No. of Alertina Devices
b
No. of Waste Disposers
Heat Pum
Number
- ` `
Tons
`� "
KW
..'.................-
No. of Self -Contained
Totals:
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local Municipal ❑ Other
ction
No. of Dryers
Heating Appliances KW
rity ystems:
--No.7ttTwes or Equivalent ;;,(a
No. of Water KW
No. of No. of
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, w• as required by the Inspector of Wires.
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 ❑ BOND ❑ OTHER ❑ (Specify:)
(Expiration Date)
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: 210-Qlm Inspections 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: ADT Security Services 111 Morse Street, Nomvootl, MA 02062 LIC. NO.: 1533C
Licensee: John S. Bassett Sibnaturc LIC. NO.: 1533C
(If applicable, enter "exempt"in the license nronberline•) Bus. Tel. No.: -7$L-278-1169
Address: Alt. Tel. No. 603 594 5928 RESI ONLZ'
JRANCE WAIVER: I am aware that the LicYnsee does not have the liability insurance coverage normally
By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent.
Telephone No. I PERMIT FEE: $ 3,; M
OWNER'S INS
required by law.
Owner/Agent
Signature —
Date.....................
,&ORTM TOWN OF NORTH ANDOVER
pb`.to ,s,4,
PERMIT FOR GAS INSTALLATION
This certifies that .........................
f�
has permission for gas installation ......:.:.....:. � ........
in the buildings of ....: ..............................
at .....u..'!..0 .r .. ... . • • • • • • • •, North Andover, Mass.
Fee...... 28 ....... 2%00pAY'G.....................
AS INSPECTOR
WHITE Applicant CANARY: Building Dept. PINK: Treasurer
a�;I-d&s4�d#
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
Office Use Only
Permit No_
_Z�K�L
Occupancy & Fee Checkecr>W `_•
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts
(Please Print in ink or type all information)
Town of North Andover
Electrical Code 527 CPR
2f00
Date 7 �U
To the Insp or of Wires:
The undersigned applies for a permit to perform the electrical work described /b'elow.
Location (Street & Number L O`% ed
l� / 1 rl,)JI. kt , J b
Owner or Tenant ( 61-01V. i'TL 114 y L e7 o`f r-/ "-> 6-0 r
Owners Address 16 tf f -L-A NAl 1e T u T
Is this permit in conjunction with a building permit` Yes-- No ❑ (Check Appropriate Box)
Purpose of Building S)l N 6 L I- 1— f" f 1-1 6 �Le—ter. r, Utility Authorization No.p-
. ll o � ' /02 f
Existing Service Amps Voits Overhead ❑ Undgmd ❑ No. of Meters
New Service d (iO Amps f JA Voits 6 - Overhead ❑ Undgmd (®— No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical
_ AA -T --CZ— iIJ I R, N16 FO)2 A 14JAJ J/ /VGc1-
CAM /`y 0 U✓tet
OTHER: -
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO =
have submitted valid proof of same to the Office Y89O,-' NO = If you have checked YES please indicate the type of coverage by checking the appropriate box
INSURANCE -<_BOND = OTHER = (Please Specify)
(Expiration Date)
Estimated Value of Electrical Work$
Work to Start Inspection Date Resquested Rough Final
Signed underthe Penalties of perjury:
FIRM NAME / nA/1 A -T ns r rz L LIC. NO. �y
Ltct♦nrsee rtG c� J P ✓ � f�Sign.. !UI� LIC. NO.
�1- " i1 /91v� Bus. Tel No.
w 0
Address L" t• - G U Alt Tel. No. 2,a`"/ q -q4 - � 7 '� 7
OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coven or its substantial equivalent as required by Ma achusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one)
Telephone No. PERMIT F
(Signature of Owner or Agent)
Total
No. of LightOng Outlets
No. of Hot fuse
No. of Transformers KVA
Above ❑
In ❑
No. of Lighting Fixtures
Swimminq Pool gmd ❑
gmd ❑
Generators KVA
No. of Emergency Lighting
No. of Receptacles Outlets
No. of Oil Bunters
Battery Units
No. of Switch Outlets
No of Gas Bunters
FIRE ALARMS No. of Zone
No. of Detection and
Total
No. of Ranges
No of Air Cand
Tons
Initiating Devices
Heat Total Total
No. of Di sal
No. Pumas
Tons
KW
No. of Sounding Devices
No.l of Self Contained
No. of Dishwashers
Soace/Area Heating
KW
DetectionlSounding Devices
❑ Municipal ❑ Other
No. of Dryers
Heating Devices
KW
Local Connection
No. of
No. of
Low Voltage
No. of Water Heaters KW
Signs
Bailases
Wiring
No. Hydra Massage Tuds
No. of Motors
Total HP
OTHER: -
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO =
have submitted valid proof of same to the Office Y89O,-' NO = If you have checked YES please indicate the type of coverage by checking the appropriate box
INSURANCE -<_BOND = OTHER = (Please Specify)
(Expiration Date)
Estimated Value of Electrical Work$
Work to Start Inspection Date Resquested Rough Final
Signed underthe Penalties of perjury:
FIRM NAME / nA/1 A -T ns r rz L LIC. NO. �y
Ltct♦nrsee rtG c� J P ✓ � f�Sign.. !UI� LIC. NO.
�1- " i1 /91v� Bus. Tel No.
w 0
Address L" t• - G U Alt Tel. No. 2,a`"/ q -q4 - � 7 '� 7
OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coven or its substantial equivalent as required by Ma achusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one)
Telephone No. PERMIT F
(Signature of Owner or Agent)
0
-544 WF"W
Date .....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
0"
'tee
.... ...................
This certifies that ......... LoVIA ... ..... ....... .......
0
has permission to perform ....... '-k ge <)
....... ....... , ................. v .............
. ................
wiring in the building of ........ Cn. I x:�.
at ....... 5 .. ............
.N........................ . Nop�.Indover, Mass.
Fee ,.,�-IQ-AO Lic. No.;2.�./ ............................ ..............................
ELECTRICAL INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING
or print)
1vVKrH ANDOVER, MASSACHUSETTS
Date -5--// 191
Building Locations V L 5T S Permit # *q CZ/op-
Amount $
Owner's Name 1 (3 4,-,r fcK—(
New � Renovation 11Replacement E -]Plans Submitted ❑
(Print or type) J /� n 1 , Check one: Certificate Installing Company
Name j a VA- ►jam. r' � �} ) Irl C < Corp.
Address "� ` � ❑ Partner.
(�-.Cit: �t_E� i � \ V✓ v� r: I �- � �
Business Telephone ❑ 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 LM No❑
If you have checked yes, please indicate the type coverage by checking the appropriate box.
Liability insurance policy a 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
Wass. 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 anti accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts Sta)e Ga? Code and Cher 1)1pfthe General Laws.
By:
Title
City/Town
APPROVED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Er Plumber % 0.3 YY
❑ Gas Fitter License Number
er
Master
❑ Journeyman
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2ND. FLOOR
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4TH. FLOOR
5TH. FLOOR
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(Print or type) J /� n 1 , Check one: Certificate Installing Company
Name j a VA- ►jam. r' � �} ) Irl C < Corp.
Address "� ` � ❑ Partner.
(�-.Cit: �t_E� i � \ V✓ v� r: I �- � �
Business Telephone ❑ 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 LM No❑
If you have checked yes, please indicate the type coverage by checking the appropriate box.
Liability insurance policy a 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
Wass. 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 anti accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts Sta)e Ga? Code and Cher 1)1pfthe General Laws.
By:
Title
City/Town
APPROVED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Er Plumber % 0.3 YY
❑ Gas Fitter License Number
er
Master
❑ Journeyman
Location 0
Date 51-3olq7T
TOWN OF NORTH ANDOVER j
3? •' 1 •` O0L O
9 Certificate of Occupancy $
x ; ; Building/Frame Permit Fee $
Foundation Permit Fee $
s�CHUS
0&,er Permit Fee $ �=-
'' Sewer Connection Fee $ -�
7d j Water Connection Fee $
TOTAL $
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FORM U - VERIFICATION 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 local or state law,
regulations or requirements.
****************Applicant fills out /this section*****************
APPLICANT:�iUCC��i5��,�C�J LZ G Phone
LOCATION: Assessor's Map Number Parcel
Subdivision/:s
K -/1 ��7rr �/ • Lot (s) %S
Street�iZ%��i _S %� �,9`G`/I St . Number
************************Of icial
RECOMMENDATI0 0 WN GENTS:
Conservation Administrator
Comments
lanner
Comments
Food Inspector-HHe-alth
Septic Inspector -Health
Comments
Use only************************
Date Approved
Date Rejected
Date Approved
Date. Rejected
Date Approved
Date Rejected
Date Approved
Date Rejected
7 9
Public Works - sewer/water connections �-��� __2 rf,o %j 7
- driveway permit c,J 5f 26a) /2 7
Fire Department
A,;;���14-c X04,
Received by Builaing
Inspector/ Date
03/13/98 19:27 FAX 508 6889556 NORTH ANDOVER
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.
MNamepplicant on Building Permit (below) Address of Property for Permit (below)
Map and Parcel Te jy Purpose of Application (check below)Phone m�eropilcant Single Family Two Family
Z—e23Ze
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 iik issued.
Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for an the
above lot, in the building permit application and associated attachments, complte3 with one or more of the
following sections as indicated try a check mark.
Thr is an application for a building permit for the enlargement. restoration, or rennstructon of a dwelling in
ZV,114,WThe
nce as of the effective date of this by-law. provided that no additional residential unit is created.
ex
lots) werelwas created pilar to May e, 1996 are exempt from the provisions of this Section 8.7 of the Zoning
.
This application is for dwelling units for low and/or moderate Income families or individuals, where all of the
conditions of 8,7,6.c•tam met and/or represerds Dwelling units for Senior residents. where occupancy of the units it,
restricted to senior persons through a property executed and recorded deed restriction running with the land. For
purposes of the Section 'senior" shall mean per3403 aver the age Of 55.
This application is a part of a development project which voluntarily agreed to a minimum 40% permanent
Mau an in density. (buildable lots). below the density. (buildable lots), permitted under coning 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 sOaCe and/or farmland. The land to be preserved shall be protected from development by ar,
Agricultural preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism
approved by the Planning Board that will ensure its prosection.
This application represenq a tract of land existing and not neid ay a Developer in common ownership with an
adjacent parcel on the effective date of this SecUon a.t shall receive a one-time exemption tram the Planned Growth
Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the
panel.
This application represents a lot which is ready for building permits.(i.e. all other permits tram all other boards and
commisslans have been received and the praiect 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
Oevelooment until such time as the Development Schedule accommodates issuing building permits. Applicant must
supply approved form U with this UEMPTIQN.
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.
Sy signing below I attest to the accuracy of the information provided and that the attached building permit is
a yawed 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.
ignature of Qwneror Authorized Agent w a signed the Attached Building Penna ate
This form must be attached to the Building l;ernit upon applicadan for such permit
0001
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MAScheck COMPLIANCE REPORT
Massachusetts Energy Code
MAScheck Software Version 2.0
CITY: Lawrence
STATE: Massachusetts
HDD: 6235
CONSTRUCTION TYPE: 1
HEATING SYSTEM TYPE:
DATE: 3-13-1998
or 2 family, detached
Other (Non -Electric Resistance)
DATE OF PLANS:
TITLE: 5-6 C-c%inc� LC 1S'f t'CiiY►'1 �Oa /0
COMPLIANCE: PASSES
Required UA = 792
Your Home = 782
Permit #
Checked by/Date
Area or Insul Sneath Glazing/Door
Perimeter R -Value R -Value U -Value UA
CEILINGS
1946
38.0 3.0
54
WALLS: Wood Frame, 16" O.C.
3600
15.0 3.0
241
WALLS: Wood Frame, 16" O.C.
198
19.0 3.0
11
GLAZING: Windows or Doors
702
0.500
351
FLOORS: Over Unconditioned
Space
1927
19.0
92
BSMT: 4.0' ht/0.0' bg/4.0'
insul.
68
10.0
6
BSMT: 8.0' ht/7.0' bg/0.0'
insul.
120
0.0
27
HVAC EFFICIENCY: Furnace,
86.0 AFUE
COMPLIANCE STATEMENT: The proposed building design represented in these
documents is consistent with the building plans, specifications, and other
calculations submitted with the permit application. The proposed building
has been designed to meet the requirements of the Massachusetts Energy Code.
The heating load for this building, and the cooling load if appropriate
has been determined using the applicable Standard Design Conditions found
in the Code. The HVAC equipment selected to heat or cool the building
shall be no greater than 125% of the design load as specified in
sections 780CMR 1310 And J4.4.
Builder/Designer,
4
Ar
Date 3 J33 9
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CERTIFICATE OF USE & OCCUPANCY
Town of North Andover f
Building Pemneumn.,d� o.t.
THIS CERTIFIES THAT
THE BUILDING LOCATED O ��
MAY BE OCCUPIED A
N ACCORDANCE
WITH THE PROVISIONS OFIE MASSACHUSETTS STAT7BILDING CODE AND
SUCH OTHER REGULATIONS AS MAY APPLY.
N011Th CERTIFICATE
o CATE ISSUED TO 10
ADDRESSSACHUS
Building Inspector
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3733 /
�'.;�•° :'�o TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
-tom
This certifies that71
X.. /?°l.1 ............ .
has permission to perform /V ...............
plumbing in the buildings of ..../?'/!/�.Y. ................
at.. /I ................ North Andover, Mass.
Feeal�O..... Lic. No. /. �, .� ............................. .
PLUMBING INSPECTOR
48/10/98 49:28 2% 00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION F PERMIT TO DO PLUMBING
.ype or print)
NORTH,
>3unding Luca
LCHUSETTS
V1NW kcc.�-
`h
Date --j
11" (
Permit # 2 3
Amount ZJ 6 ✓
Owner's Name
New Renovation ri Replacement ❑ Plans Submitted
FIXTURES
(Print or type) heck one: Certificate
Installing Company Name 3 -torp. r9._�
Address - 3 �' c -7o) Partner.
Business Telephone g 7 - TW -11 Z y3 Firm/Co.
Name of Licensed Plumber:
Insurance Coveraee: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity ❑ Bond ❑
Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner 11 Agent M
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 Massachus!�f State Pig Code nd C °apter 142 of the General Laws.
Type of Plumbing License
40 YF
icen uumner Master r]/ Journeyman
`!ED (OFFICE USE ONLY
MA I
NMI
(Print or type) heck one: Certificate
Installing Company Name 3 -torp. r9._�
Address - 3 �' c -7o) Partner.
Business Telephone g 7 - TW -11 Z y3 Firm/Co.
Name of Licensed Plumber:
Insurance Coveraee: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity ❑ Bond ❑
Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner 11 Agent M
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 Massachus!�f State Pig Code nd C °apter 142 of the General Laws.
Type of Plumbing License
40 YF
icen uumner Master r]/ Journeyman
`!ED (OFFICE USE ONLY