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HomeMy WebLinkAboutMiscellaneous - 594 BOXFORD STREET 4/30/2018 594 BOXFORD STREET 2101105.C-0079-0000.0 Date f v 1. K. ..... 5 HORTAI TOWN OF NORTH ANDOVE o ~ � 9 • . PERMIT FOR GA INSTA TION 0 9SSACMUSE� This certifies that . . . y . • • • • • • • • • • • • • •• • • • • • • has permission for gas installation . . . . . . . . . . . . . . . . . . . in the buildings of . . . .P-Al. . . . . . . . . . . . . . . . . . . . . . . . . . at . . • • • • • , North Andover, Mass. Fee.)�. .� . Lic. No..;k,:?. . , .D.-^�'t�--=.� . .. . . . GASINSPECT R Check# 5763 i RM APPLICATION FOR PERMIT TO DO GASFITTING MASSACHUSET'T'S UNIFORM G I (Print or TYPe) I 7 Permit # —_ Mass. Date l �`•' _ � ner s Name h�� Build-[ Location • �• ��,Q Type of Occupancy Plans Submitted: Yes❑ No S/ New ❑ Renovation ❑ Replacement N N W N y� N O O m = !- rr s O V to _ W 1N. LU ~ y -2 2 O C f- t7 O U 4 G O O O H in U1 W O C Y T N ¢ W 2 V s ¢ pu_� 1✓ U < a r W ;2 ur 2 j Y f, Y N M Z 't7 C p ry. F•• Y 4 y W_ 2 = ; p d J V O AC G Y C a H. y sus-BSUT. s0.S£MEHT e -IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Check one:. Certil-tcate lC Installing Company Name 1. p�Corporation ❑. Partnership Address r n Firm/Co. Business Telephone Name of Ucensed Plumber or Gas Fitter INSURANCE COVERAGE: Policy or its substantial equivalent�hick mePts the requirements of MGL Ch. 142. I have a current 1' bility insuranceP NO ❑ coverage by checking the appropriate box* Yes � es ease indicate the type it you have checked y_. PI Bond ❑ Other type of indemnity❑ A liability insurance policy � e required by INSURANCE WAIVE application waives this re4uirement. R S R:i am aware that the licensee PPI s not ha!e the insurance coverage r OWNE Check one: Chapter 142 of the Mass. General Laws, and that my g Owner❑ Agent❑ Signature of Owner or Owner's Agent application are true and accurate to the best of my rformed under the permilus�ed for this applicatiOnwill be in compliance�'hth all I hereby certify that all at the details and information d have submitted dor entered)i above app chusetts State Gas Code and Chapter 142 of th `General Laws' / pertinert p ovision t all of the mbMas� and installations pe / TIG of license. c,yifj 8t a of�censed umber orf rtter umbeasditter Ucense Number aster,oumeyman Gh 6(( d NL BELOW FOR OFFICE USE ONLY PROGRESS INSPECTION FINAL INSPECTION SKETCHES FEE N0. APPLICATION FOR PERMIT TO DO GASFITTING NAME d TYPE OF BUILDING LOCAT O O BUILDING .._---- PLUMBER OR OASFITTER LIC- NO. PERMIT GRANTED GATE GAS INSPECTOR . Date..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING CHUS -d This certifies that ...... ....................................................................................... has permission to perform .......�..t.......................................... wiring in the building of.......144" . ...e......................................... at.....e.il,'l..ALI .. . ........ ...........North Andover,Mass. Fees,-RS.t............. Lic.NoA..?",.-/.-9 ... ....... iLiCTRICAU NSPEC OR Check # 6883 \\ Commonwealth of Massachusetts Official Use Only Permit No. E�3 X Department of Fire Services e� Occupancy and Fee Checked l 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: V" `1 City or Town of: �) . k v\&OJ tr 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) N sT. Owner or Tenant Telephone No.)�)7) Owner's Address Sot o xur& 1% Is this permit in conjunction with a building permit? Yes Fr No ❑ (Check Appropriate Box) Purpose of Building Utili y Authorization No. Existing Service kolo Amps -9.) /�Qqb 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 maybe waived by the Inspector of Wires. No.of Recessed Luminaires 1 No.of Ceil:Susp.(Paddle)Fans No.of Total; Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above E] In- ❑ o.o Emergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones o Detection an No.of Switches No.of Gas Burners No. Initiatin Devices g Tons No.of Ranges No.of Air Cond. Total No.of Alerting Devices K No.of Waste Disposers Heat Pump Number Tons KW o.o Self-Contained Totals: ,., Detection/Alerting Devices i No.of Dishwashers Space/Area Heating KW �� Local❑ Municipal Connection ❑ Other Heating Appliances Security Systems: No.of Dryers g pp KW No.of Devices or Equivalent No.of Water Kms, No.of No.of Data Wiring: Heaters Signs Ballasts I No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecom Device�o rWiring:Equivalent No.of Devices or E uivalent OTHER: 6.� Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: D (When required by municipal policy.) Work to Start: 10-l( D b Inspections to be requested in accordance with MEC Rule 10,and upon completion. < 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 cover a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE cove ❑ OTHER ❑ (Specify:) I certify,under th_pains and penalties of perjury,that the information on this application is true and complete. FIRMNAME: (atC C.��c r•�c� ei-��-'4� LIC.NO.: R 10 a%L Licensee: 6,;," Signature ` la LIC.NO.:5'SOlj Z.T (If applicable,enter "ex pt"in license number line.) Bus.Tel.No.: Tn S1.`�''5W Address. 10 � lst— DC . ( '�^'�S�y'� Alt.Tel.No.: POT1��Q-`��1�� *Security System Contractor License required or is 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 Signature Telephone No. PERMIT FEE: $ ��, v�r� fl� `� � !�_�� �� i Locations No. Date f '40RT0, TOWN OF NORTH ANDOVER 3� a OL • i ; ; Certificate of Occupancy $ �'�J''•a°ttn Building/Frame Permit Fee $ ncMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Q 19682 Building Inspector TOWN OF NORTH ANDOVER %►O R TIS APPLICATION FOR PLAN EXAMINATION o�<<�=o ,e gtio 0 A Permit N0: - Date Received bArap Date Issued:-Lo- 2' �9SSgc►+us�t�� IMPORTANT: Applicant must complete all items on this page LOCATION Y) jTgfj0 Prin PROPERTY OWNER 6te(+J SSS Print MAP NO.: &5-C PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ne family ❑ Addition ❑Two or more family ❑ Industrial ❑Alteration No.of units: ❑ Repair,replacement ❑Assessory Bldg ❑Commercial ❑ Demolition ❑ Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED F7/N ISH 81?55Mr?J T US1ti(9 a6(5 6IA6 ; i6Ji F,i)ijg .r; 2 xZ DROP C&IU.UG tfl�tJl-w//-T 7��r`. A0, -m USS 1qs- 6,Vn/Ly Identification Please Type or Print Clearly) OWNER: Name: IAS A? 59&y Phone: Address: 5%5� &K/W 92- 42,/�i✓Akf5r, CONTRACTOR Name: OW-S 6�IAA Z"'T� S- Phone:2&-,�V-6!Z0 Address: ST an"i 402aZ/ C4-' )*J Supervisor's Construction License: Exp. Date: Home Improvement License: 13 2 q4c Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT.•$1200 PrR$1000.00 OF THE TOTAL EST/MATED COST BASED ON$125.00 PER S.F. Total Project Cost I Z��3, FEE:,$ Check No.: Receipt No.: / Z- Page lof4 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding,Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Pale 4 of 4 TYPE OF SEWERAGE DISPOSAL Tanning/Massage/Body Art ❑ Swimming Pools ❑ Public Sewer ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ ❑ Permanent Dumpster on Site Private(septic tank,etc. Electric Meter location to project NOTE: Persons contractin itt: nregistered�ccoontractors do not have access to the g an fund Signature of ge caner ��'� Signature of contract r Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED >/HEALTH ❑ ❑ COMMENTSr��� yC � �;,� � /'0 f2 FIRE DEPARTMENT -Temp Dumpster on site yes (no Fire Department signature/date COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Signature& Date Driveway Permit Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA— For department use) � Lr n �` Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMG Jan2006 0 Town o 4Andover A E over, Mass., coc CHEWICK 14 V�� '? E D BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT.....4.11.1.44 ........ BUILDING INSPECTOR ................................................................................ Foundation has permission to erect.............................. buildings on.....sle/...........4 .o.it..IS# to be occupied as.... ........ 41W..A A0.1.7.......... Rough . 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC04415N STARTS Rough %om 4 Service BUILDING"MSkiHbk Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Board of Building Regu on-isand -Stand One Ashburton Place- 0 t Boston. Massachusft 02109 Home Improvement Contractor Registration 137M �ccwd 1129/Z007 OWENS CORNING BASEMENT FINISHING -_-- - DANIEL WALSH _ ---------.---= i AJt7C. CERTIFICATE OF LIABILITY INSURANCE OP ID E DATE(MMIDDIYYYY) BAYST-1 04/10/06 PRODUCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Kaplansky Insurance Brookline HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 114 Harvard Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Brookline MA 02446 Phone:617-738-5400 Fax:617-738-8214 INSURERS AFFORDING COVERAGE NAIC9 INSURED INSURER A. Norfolk & Dedham Group 13943 INSURER B: D"gqstate Basement System LLC B/A Owens Corning Finishing INSURER C: 960 Turnpike St 02021 INSURER D: Canton 2j��,, INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTR NSRE TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD" DATE(MMIDDNY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $' 1000000 COMMERCIAL GENERAL LIABILITY PREMISES (Eaocarenoe) $100000 CLAIMS MADE 0 OCCUR MED EXP(Any one person) $ 5000 A X Business Owners R0309626 02/06/06 02/06/07 PERSONAL BADV INJURY $1000000 GENERAL AGGREGATE $ 2000000 GENS.AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $Excluded POLICY jpF"COT LOC AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS - (Par person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS LIABILITY ANY PROPRIETOR/PPRTNERIEXECl1TIVE E.L.EACH ACCIDENT $ OFFICER(MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1$ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION L, DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTY'E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES, A ¢E THE ACORD 25(2001108) 0 ACOR0 CORPORATION 1988 1'he Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass gov/dia Wort ars' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ADDlicar t InformationPlease Print Legibly Name(B A ' ess/Organization/Individual): a/S l/ til14J&&t,0V6Vr �YS� Address: 0 ' 6 _i City/Stat Zip: 6^' U r 04 Phone#:_ Are you an employer?Check the appropriate box: Type of project(required): LZ I am a employer with ?_q 4. ❑ I am a general contractor and I emplo ees(full and/or part-time). have hired the sub-contractors 6' E-1 New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet t 7• �emodeling ship ai id have no employees These sub-contractors have 8. 0 Demolition workii g for mein any capacity. workers' comp. insurance. 9. �guilding addition [No workers' comp. insurance 5. ❑ We are a corporation and its requ' .] officers have exercised their 10.Q Electrical repairs or additions 3.[:11 am a iomeowner doing all work right of exemption per MGL 1 I.Q Plumbing repairs or additions myself [No workers' comp. c. 152,§1(4),and we have no 12.E] Roof repairs insurat ce required.] t employees. [No workers' comp.insurance required.] 13.[] Other 'Any applicant dat checks box ill must also fill out the section below showing their workers'compertwd(m policy information' t Homeowners w o submit this affidavit indicating they an doing all work and then hire outside conttactors must subrnit a new affidavit indicating such. $Contractors that k this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp•policy information. lam an empl yer that is providing workers'compensation insurance for my employees. Below is the polky and Job site information. Insurance Company Name: 1L 6 9N Policy#or Se f-ins.Lie.#: (�t _-3/S Expiration Date; a�� Job Site Addr s: 59(1 9^ yCity/State/Z' : Attach a copy of the workers'compensation policy declaration page(showing the policnum �'--A C�r��ls` Y and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal pltiof a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the fes orm of a STOP enaWORK ORDER and a fine of up to$250. a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations f the DIA for insurance coverage verification 1 do h ce .y unde the n of perjury that dw information provided above is true and correct: S' a e: Phone#: - Ofj`Wal use only. Do not write in this area,to be completed by city or town offrciaL City or To : PermitfUcense# Issuing Ant ority(circle one): 1.Board of 4ealth 2.Building Department 3-City/rown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Peron: Phone#• 06/08/2006 15:05 FAX 1 781 659 4725 Andrew G Gordon Inc 14001 l � 5 V AR WCIP Liberty ISSUING OFFICE 354 MutUAL Workers Compensation and INFORMATION PAGE Employers Liability Policy ACCOUNT NO. SUB ACCT NO. Liberty Mutual Insurance Group/Boston 1.344359 0000 1 L113ERTY MUTUAL FIRE INSURANCE CO. POLICY NO. TD/CD SALES OFFICE CODE SALES CODE N/R IST WC2-31S-344359-016 XX X WESTON 102 REPRESENTATIVE 3000 2 YEAR ASSIGNED 2003 Item 1.Name of BAY STATE BASEMENTS LLC Insured DBA OWENS CORNING FINISHVD BASEMENT SYST FEIN 14-1885527 Address 960 TURNPIKE STREET CANTON,MA 02021 RISK ID 000182837 Status 46 LIMITED LIABILITY CO Other workplaces not shown above: SEE ITEM 4 Mo.Day Year Mu.Day Year Item 2.Policy Period:From 05-24-06 to 05-24-07 12:01 AM standard time at the address of the insured as stated herein. Item 3.Coverage A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A.The limits of our liability uxder Part Two are: Bodily Injury by Accident 500,000 each accident Bodily Injury by Disease 500,000 policy limit Bodily injury by Disease 500,000 each employee C. Other States Insurance:Part Three of the policy applies to the states,if any,listed here: SEE END WC 20 03 06A D. This policy includes these endorsements and schedules: SEE EXTENSION OF INFORMATION PAGE Item 4. Premum - The premium for this policy will be determined by our Manuals of Rules Classifications Rates and Rating Plans Alt information required below is subject to verification and change by audit. Premium Basis Rates LINE 110' munerarion Premiums Code Estimated Per$too Estimated • Classificationss1Voe Pretniumr;Total Annual of RE- Annual• SEE EXTENSION OF INFORMATION PAGE Minimum Premium. S 500 ( MA ) Total Estimated Annual Premium $ 1,050 Interim adjustment of pre"um shall be made: ANNUAL This policy,including all endorsements issued therewith,is hereby countersigned by AaMurized Re sentative Date 05-22-06 RECEIVED '-f3ppw INC L.Code Term Open. ANDRO die Payment RatinS nasis Pof.H.G. Home state Dividend RENEWAL OF: 05-22 NR MA WC2-31S-344359-015 GPO 4aso R Copyright 1967 National Council on Compensation insurance wC 0o ao 01 A BRO(ER Copy JUN 08,2006 01:31P 1 781 659 4725 page 1 CONTRACT Customer Name_�.tg� GLrf, CLSS P{7 Customer Signature— SKETCH Contract Date "i I Sf d Lo Sales Representative Signature— I, ignature_ y— ATTACHMENT Customer Phone G7$- 337. �(6(,3 Contract Price '=y i 5l 2 ] 5 8 l Q 0 IO If t2 13 tI 15 ,6 ,) Is '0 20 21 22 2] 24 25 26 22 26 29 3D ], 32 W 34 35 ]9 31 ]6 39 40 4T 12 41 64 45 46 42 46 49 W 51 52 5] s4 59 59 51 56 50 W C cvc�1� SVS 00 9 tose¢ bka l G 9 daa� t ac , a.1 ; , 4 i _. _ ,. _,. ,. .. 12 13 + d ►t�i�9 -Pr r L-.. .,I' — + �../)__(/I11r/y 14 �• t r 4fo J g'If + }�.^ 111111 I Nt PC� ^<.) 0.h .Lfs t ._ ) i l �� L , s .I�gl• s _. _:_ _+ t Clas et . +a�+ �_� 1_.! I%0 l J i _ + } j j 16 ,q �•ec�cts.�d ;rahI�yi,/s Un ''� t i 12 ; 15&i tzr�l , Cx+_�C _Pogj 'f SP`.nd/eS. - - z+ �r;M w;nao-�J �T L i + , Wis 22 E - U� � ` 1�4r0.P }, retie Poke23 24 DIP 21 28 32 ]] 35 NOTES: s 7y :5C "Each box equals one toot unless otherwise noted.This sketch is a good faith representation of the work to be done,it is understood that all dimensions "— derived from this sketch are approximate,and that all locations of outlets,light fixtures,plugs,lacks and/or switches are subject to change it necessary. CONTRACT Customer Name-13 Customer Signature_ " — SKETCH Contract Date Ct LI5 o Co /— Sales Representative Signature ATTACHMENT Customer Phone G78= 337. �( (�3 Contract Price 2 J 49 B ) e 11 10 12 ,J 1. 15 10 t) 18 19 20 31 22 25 2" M N 21 29 20 4p 01 V J3 0+ 25 M J) M J9 40 41 42 43 M "5 AB 17 18 "4 SO 51 S2 53 SA 45 S8 5) SB 50 68 I I I 4 5 1 Prn �.. I ,�-•�� 5 SA ee/ Siva t ! Tri ! N � +. 136k dda( + i' e C16SP� V ti $}GtYS ! ' New V- lr { ?.he lr, 24< * /jL� 0 ► 13 VIT F4� P r Stu I�<A .S � � + t_ t 1 � � �•/ -_ � I I - � i i -+ -� -�--+-- � -i-.-.- q�f I 4 t i jtit Nr. . - j .I S � r I I SS P 'l h `1 h S �l rl il" 1t.e•�,i ``- .f J -+ -{ ... . -. + a -- .y. - -... .i J +— Yr t I P ?� t j _4 ! d. 21 �f�M Wir\dt1� I.TU L _j 1 I j 22 _ _ } ♦ `- r��e 23 Pole tete 1 21 25 A 31 32 33 5 NOTES: 'Each box equals one foot unless otherwise noted.This sketch is a good faith representation of the work to be done, it is understood that all dimensions derived from this sketch are approximate,and that all locations of outlets,light fixtures,plugs,jacks and/or switches are subject to change if necessary. No 21 Date..... 22 NOR Th TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING .'ACHUS This certifies that ..... .................. has permission to perform ........... .......................... wiring in the building of......... e................. at.....�...7--y ..................... .North Udover,,tvfass. Fc .A•7.7 Lic.No. -�1121/99 14:35 C [, f# loq� 275.00 PAID WHITE:Applicant CANARY:Building Dept. PINK:Treasurer THEQDMMONWFALTHOFMASS affjSE7TS Office Use only DEPARTMOVTOFPUBLICS9FM Permit No. BOARDOFFMPREVEMYONREGMTIOI S527C'i4�fR12:00 Occupancy&Fees Checked APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BEPERFORMED IN ACCORDANCE W[TH THE MASSACEIUSSTS ELECTRICAL COD 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) DatS bo I Pg Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) Owner or Tenant C 0 L ,>-//4 L th L&14 is C7 U Z,QZMNr Owner's Address / LO %oA/Pl e S9 Is this permit in conjunction with a building permit: Yeso No (Check Appropriate Box) Purpose of Building JI ib L f. (J40(L y lw�L t.�,✓(� Utility Authorization No. �b1 Existing Service Amps / Volts Overhead 1:1 Underground M No.of Meters New Service J60 Amps /db ( b Volts Overhead M Underground �-- No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work A/TDf`L M),/,NG f r gy b L2 �/1/jf/LX .D6t.4 �z r.-G No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total 1. KVA No.of Lighting Fixtures Swimming Pool Above Below r7 Generators KVA groundg1:1round No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Bumers No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.ofDryers Heating Devices KW Local 171 Municipal r7 Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP .x OTHER U>StraroeCaerage Pt�suattblhetegtntartat cfMas chuseUsarWJLaws Ihaw aamel LobtilkyhstrdrtceP1chgm &lgCan#Atte �CmerdWorits wbstrdiaie4&kad YES F-1 NO It e%hruttedNeWproofofsaiminthe0ffmYES n NO IfyouImtdrdedYES,*ase edreth MrcfwYa'aWbyd=kalgthe D SURANCE [�:] BOND OTHER M (PleaseSpm&y) Fstm*dVakeotl7aiid Wait$ WakioS1at ItnpechcnD eRegttested Rao Final Sigma tmder�ie Pataltie,ofpajtay: FIRM NAME —7 'h)tP 43 DI arlL c Tel C ALioaseNa Limee—rilbA4.1 1 Sigma I eNo o��5ao n , J l3wir ssTdNa Add= V J v�1ar7 �"6 A4 wOV UAAI AltTeLNo. 272)927-692) OWNER'SNSURANCEWAIVER;IamawatetltattheLitatsexsnottheirstrarneoo�ea@eoritsstiSdrthtlegtm�aiatasrecpEt¢edlryly sem Iatvs and fiatmysigiAaecnthisptsF# kahcnVa*Nsthisttienal (Please check one) Owner M Agent17 Telephone No. PERMIT FEE$ DEC-29-98 TUE 15 : 52 - P 0 1 43 LOT 3A LOT 2A 87310 S.F. 2.00 Ac. ' 132.7' I 70.8 - 87.8' 'J�o3H rn I N/F GORTON rn . ••. OF 44S. 128.0' STEPHEN M. MEIESCIUC N0. 39048 �90FfSSiOa�p�� 1 75.00' BOXFORD STREET WE HEREBY CERTIFY THAT WE HAVE EXAMINED THE PREMISES AND THAT ALL APPARENT EASEMENTS AND ENCROACHMENTS ARE LOCATED THIS PLAN IS INTENDED FOR ZONING AS SHOWN, THE STRUCTURE SHOWN CONFORMS PURPOSES ONLY. IT WAS PREPARED TO THE ZONING LAWS OF THE MUNICIPALITY FROM EXISTING PLANS AND RECORDS WHEN CONSTRUCTED. ALSO, ACCORDING TO THE WITH THE STRUCTURES SHOWN LOCATED F•E.M.A./H.U.D. FLOOD INSURANCE RATE MAP, BY AN INSTRUMENT SURVEY. THIS PLAN COMMUNITY PANEL NO. 250098 0009 C SHOULD NOT BE USED FOR PROPERTY DATED 62/93, 1NE STRUCTURE IS NOT LOCATED LINE DETERMINATION. IN AN ESTABLISHED 100 YR. FLOOD HAZARD ZONE. CERTIFIED PLOT PLAN OT 2A BOXFORD STREET MARCHIONDA & ASSOC.,L.P. NORTH ANDOVER, MA ENGINEERING AND PLANNING CONSULTANTS PREPARED FOR 62 MONTVALE AVE. SUITE I KERRY & BRYAN HANSSEN STONEHAM, MA. 02180 39y Ot:r BOXFORD ST (617) 438-6121 NORTH ANDOVER, MASS. SCALE:1"i50' DATE: 12/23/98 FORM .- U LOT RELEASE=FORM, INSTRUCTIONS: This form_is used to venfythat all-necessary approval permits from- Boards and Departments having jurisdictiofi have been obtained:This does not felieve the applicant and or landowner from compliance with any . applicable requirements.ts. ■.■■■■■■■r■r■i'■mru■■rmrrrmrr■■r■ ■■■■ru e e 3r■■■■■r ■■ na w ` A N,�Se[l9 PHONE APPLICANT. C'_NN. . fi;; ASSESSORS MAP NUMBER C- LOT NUMBER 'z SUBDIVISION Q LOT NUMBER STREET i "Z oC STREET NUMBERImmommommemelamem J• OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS l/m ur"■■■.■�■■■■■■.■■■■■■■■r■r■r.■■■■■■■■■rrr■■■■■■■rr■■r■■■a0aaa&aaaaa■ / ;\Y ��� (/`-•"T�'S� DATE APPROVED CONSERVATIONADMINISTRATOR DATE REJECTED COMMENTS DAT -APPROVED TOWN PLANNER DATE REJECTED CONSENTS DATE APPROVED FOOD INSP TOR-HEALTH DATE REJECTED — DATE APPROVED/Q Z/6o p E C ECTOR-HEALTH 00, DATE REJECTED L P / COMMENTS _3 d-� y..7 2- �y \ze Ar— . 2 5 S �� w«4 l � . PUBLIC WORKS-SEWER%WATER CONNECTIONS DRIVEWAY PERMIT a DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMNNTEENTS RECEIVEDBY BUILDING INSPECTOR DATE owl v r LOT 2A 87310 - S . F . . :. ' 2 .. 00 ACS 132. 7 3'W TRENCHES 42• _ CON. 00 pis G F .. 29.6 r 1500 AL. S IC-TANK .F � FAV E �F� No 70. 8' . 81 �73G c 9 N 100' , pS-SVIIT amu- t ' LOCA1100 f DEC-213-98 TUE 15 : 59 P. 0 1 . . ;;day q gy� � L 0 T 3A .3kdu LOT 2A 87310 S.F. 2.00 Ac. 1 132.7' Fk� r 70.8', 03 N I N/F GORTON i NOF k4s'. 12tt.0' IUC Na 3w48 �0'cTrSS�p�pV� lgh0 SUR' 175.00' BOXFORD STREET WE HEREBY CERTIFY THAT WE HAVE EXAMINED THE PREMISES AND THAT ALL APPARENT EASEMENTS AND ENCROACHMENTS ARE LOCATED THIS PLAN IS INTENDED FOR ZONING AS SHOWN. THE STRUCTURE SHOWN CONFORMS PURPOSES ONLY. IT WAS PREPARED TO THE ZONING LAWS OF.THE MUNICIPALITY FROM EXISTING PLANS AND RECORDS WHEN CONSTRUCTED, ALSO, ACCORDING TO THE . WITH THE STRUCTURES SHOWN LOCATED F.E.M.A./H.U•D. FLOOD INSURANCE RATE MAP, BY AN INSTRUMENT SURVEY, THIS PLAN COMMUNITY 7NEL NO. 250098 0009 C SHOULD NOT BE USED FOR PROPERTY i DATED 5/2/93, IHE STRUCTURE 15 NOT LOCATED LINE DETERMINATION. IN AN ESTABLISHED 100 YR. FLOOD HAZARD ZONE. CERTIFIED PLOT PLAN LOT 2A BOXFORD STREET MARCHIONDA & ASSOC.,L.P. NORTH ANDOVER, MA ENGINEERING AND PLANNING CONSULTANTS I PREPARED FOR KERRY do BRYAN HANSSEN 62 ONA AVE. SUITE I STONENAM, MA. 02180 i -F91/ W BOXFORD ST f (61 7) 436-6121 NORTH ANDOVER, MASS. SCALE:1"•50' DATE, 12/23/98 i i N° 2246 Date.......... ....... ............... f NpRTM 1 a�°.;�``°;•,�,•"�0G TOWN OF NORTH ANDOVER PERMIT FOR WIRING SsACMUS This certifies that ...... a....,.:..� c ........................... ,. ^. ,/T�t� . .................................. has permission to perform ....... ..................*.. q�� �� wiring in the building of.... ��.'..`.`.. .......0:. t G ......�±?.d......... t " l'�v �r J �. at......J.....Ily..............................<........�........r........:.,North A/ndover,M'^ass. 4ee... 4.�...:A`�.. Lic.No.....�..�..' .............. : ...........1 .���...... ELECTRICAL INSPECTOR Ct, a -� > � 02/16/9911:49 35.00 PAID WHITE:Applicant CANARY:Building Dept. PINK:Treasurer Office Use Only = z uhE LollimIIlnlUEttlth of 4fla5Sarhustttg Permit No. 3eparttnent of Public- -�afetg Occupancy&Fee Checked - BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) 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) Date ?' 5' 9 I City or Town of IV ' ,4 Al DD If g 2 To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 7 90X,_r_01Z0 Owner or Tenant ���U n/ / , Ac Ja /�(e Owner's Address �/ El this permit in conjunction with-aa building permit: Yes E No (Check Appropriate Box) Purpose cf Building .SPS I de, Utility Authorization No. Existing Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters e New Service Amps _—I Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity f Location and Nature of Proposed Electrical Work _5�?6el No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No.of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total No. of Detection and tons Initiating Devices Heat Total Total No. of Disposals No.of Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices No.of Dryers Heating Devices KW Local [] Municipal [IOther Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs //No. of Motors Total HP OTHER: SPG INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Com�ple�d Operations Coverage or its substantial equivalent. YES a NO C I have submitted valid proof of same to the Office. YES `d NO G If you have checked YES, please indicate the type of coverage by checking the appro�iate box. INSURANCE [B BOND ❑ OTHER ❑ (Please Specify) Estimated Value of Ele ,ical W rk$ 3,40' ct d ® (Expiration Date) Work to Start _ Inspection Date Requested: Rough Final Signed under the Pen Ities of perjury: j � G FIRM NAME SU 71 U A� I✓-!ri f /%Ic l LIC. NO..B�� Licensee ROA4KV H I ✓� Signature �'- LIC. NO.—)-a -70 ,,vv �/J p d1 Bus.Tel. No.�7�—�B� G 1/71 Address _2? lV69 6 lW J S� Q 4 " Alt.Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE$ (Signature of Owner or Agent) x-6565 Date . . . . . `1 s� = 3933 NOR711 3r°;<� o� TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING M ,SSACMUSEt Qj This certifies that . .(, ?�.f9. . . . . . . . . . . . . . . . . . . . . . Q has permission to perform . . . ./ti.. . . . . . . . . . . . . . . . plumbing in the;buildings of . . .( ��.R. . . . . . . . . . . . . . . at. . .�/ , . 13.0 }C v C. . . . . . . . . North Andover, Mass. Fee. Lic. No./P :L( -. \ .�.�-._. . . .l. ,ll . . PLUMBING INSPECTOR kH' WHITE:Applicant CANARY: Building Dept. PINK:Treasurer t a MASSACHUSETTS UNIFORM APPLICATION FOR PERMI DO PLUMBING (Type or print) �O(� MASSACHUSETTS Date Building Locations Permit #- 3 9 J 3 Amount al'?J" Owner's Name New Er Renovation E] Replacement 13 Plans Submitted FIXTURES z z w F W �" a a W Q w tx w � a a o' z a E~ w w w bU01'iC j it1Z1�1:A�1 2M R-CM . 1SC FIDt3t 1 I 1 I 3M Fifm 41H HU[R SIR Flint l 6M RDM 7M Flint SIH Hj" (Print or type) Check one: Certificate Installing Company Name Galinsky Plumbing & Heating Inc. ® Corp. 1906 Address P _Rnx 1701 Havarh;I l _ MA 01831 partner, Business Telephone 978-374-1743 Firm/Co. Name of Licensed Plumber: Stephen C Galinsky Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy "X 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 El 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 Perm' Issued for this application will be in compliance with all pertinent provisions of the Massachusetts Sta4 Plumb Co d a ter 142 of the General Laws. By: bignatureOtLicenseariumver Type of Plumbing License Title 11((�44Sg�� � City/Town MA64 m e"l Master Journeyman ❑ APPROVED(OFFICE USE ONLY 3084 Date..�� `3. �.• .... NORTH TOWN OF NORTH ANDOVER e,ho PERMIT FOR GAS INSTALLATION 0 m f P ,SSACMUSEt (�.' 3— has This certifies that .. . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . permission for gas installation in the buildings oft. ^�. . •. . ... . .• M at� ��.. . . �r ... ` . . . ., North Andover, Mks. Lie. No�'�:` :O... . Ill. GAS INSPECTOR WHITE:ADDIICant CANARY:Building PINK:Treasurer r MASSACHUSETTS UNIFORM APPLICATION7n. PERMIT TO DO GASFITTING (Print or Type) Mass. t 19 9 I e City, Town Permit # 2,61� Building Owner's 1 (I at.( /Z� �r es AT: Location Name t L -1 Type of Occupancy� 0�,i1ZL New Renovation ❑ Replacement❑ Plans Submitted Yes ❑ No ❑ N lL � W N Y = to to N V v WUl tL O G7 1r G Z Z O t Ln 2 O W .4 ¢ 0 0 C W U m tII W W H d W Q Ut N c7W UA Y uj O W Q S tL 2 � W WW LU J r = W l 0 r < Q r r >. to m 2 0 2 W O y Z v c3W ZZ 4 � W < 2 6 Q O O W ¢ O W r 3 r W s L 2 u. � 3 n c7 � � x > a 3 SUB—aSMT. d mj­ -BASEMENT FF m Q IST FLOOR m 2ND FLOOR- e 3RD FLOOR 0 4TH FLOOR 5714 FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR (Print or Type) Q Check One: Certificate Installing Company Name Address A-1)\ Partnership VCS ► ' I C CI 1--)- 3 ❑ Firm/Company Business Telephone Name of Licensed Plumber or Gasfitter 2IS ��'l.A't'�41 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 compiianes with all pertinent provisions of the Massachusetts State Gras Cade and Chapter 142 of the General laws. TYPE LICENSE: By Plumber Title Gasfitter Signature of Licensed Master plumber�orrGasfitter City/Town: Journeyman `I APPROVED (OFFICE USE ONLY) License Number i � BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE No. APPLICATION FOR PERMIT TO DO GASFITTING NAME A TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED DATE ig OAS INSPECTOR 309 ', Date.. ..: ... !.`'`..... A �• a NOaTM TOWN OF NORTH ANDOVER `1 • pf4��ao ,^,�C +. of y a p� PERMIT FOR GAS INSTALLATIONS + �•o ,SSACMUSE� d' Ch This certifies that . :>l�::s. '.!. .��?�. . . . . .. . . . . ... ... has permission for gas installation .. .,!�, . � 4 . .���.<': c. .• a ti in the buildings of . ;} .. . . . • • • . • •• • •• • • ••• • • •• at . . . S. `�'. `/.. . .� .:. .3 v �. .�z.�. . . . . .. ., North Andover,Mass. Fee. Lic. No.. . 3.:'t. . is �..... . . .`.�;.,_-! GAS INSPECTOR .� WHITE:Applicant CANARY:Building Dept. PINK:Treasurer t MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING ��Type or print) lAua\ 6\da�f Date l9 MASSACHUSETTS Building Locations Permit# 3 a q Amount$ b p Owner's Name New Renovation Replacement ❑ Plans Submitted � w � u z a z c z C C C w F n G9 z F C 6. C4 y W �. 4 w C CG d F .7 w w (� i fs Gz It W " -t r9G ` F' }- m z z C z I : a w z a m It C C w = C w F i SUB-BASEiM ENT B A S E M ENT 1 1ST. FLOGR 2N D. FLOG R 3RD. FLOOR • 4TH . FLOG R 5TH . FLOOR 6T Ii . FLOOR ` 7T 11 . FLOG R RT 11 . FLOOR (Print or type) Check one: Certificate Installing Company Name Galinskv Plumbing & Heating Inc. M Corp. 1906 Address P.O.Box 1701 Haverhill, MA 01831 Partner. ------- Business Telephone 978-374-1743 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Stephen C Galinskv INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ® No[3 If you have checked Les,please indicate the type coverage by checking the appropriate box. Liability insurance policy ® Other type of indemnity ❑ Bond 0 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 Gas Code and Cha ter 142 o he eneral Laws. By. Signature of Licensed Plumber Or Gas Fitter Title ® Plumber City/Town Gas Fitter License N um er 0 Master APPROVED(OFFICE USE ONLY) ❑ Journeyman TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLINGno RE-' � BUILDING PERMIT NUMBER: p DATE ISSUED: M ic 03 SIGNATURE: Building Commissioner/Inspector of Buildings Date z SECTION 1-SITE INFORMATION O 1.1 Property Address: (' 1.2 Assessors Map and Parcel Number: � l r-11A��O✓� / ,J7 n `)��``S Map Number Parcel Number l/E1le ,/`T T r� 1.3 Zoning Information: 1.4 Property Dimensions. Zoning District Proposed Use Lot Area Frontage ft 1.6 BUILDING SETBACKS Ut Front Yard Side Yard Rear Yard R aired Provide R 'red Provided Required Provided v 1.7 Water SupplyM.G.L.C.40. 54) 1.5. Flood Zane Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System D J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No 1717 2.1 Owner of RecordQn ,,yy (� p i2ry d31ey14N �1`fwNSS� lo t -D�� �)'il2 -jr N0�2 i�f }INf)oyc — Name(Print) Address for Service �f I Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O. Z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O License Number Address D Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name Registration Number r Address _r Expiration Date z Signature Telephone G) SECTION 4-WORKERS COMPENSATION(NLG.L.C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......❑ SECTION 5 Description of Proposed Work check all hcable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: ( PIS t&4 I&I)c S i-V (I ct � v SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be 7 '' W _ r Completed b permit a licant n °� ;° x = � 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x(b) 4 Mechanical HVAC 0.0 5 Fire Protection C30 — 6 Total 1+2+3+4+5 / ,CTJ Check Ntunber SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, tAl �/ as Owner/Authorized Agent of subject property r7 Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Si ature of Owner/Agent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS ]ST2 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS DIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Location (7y No. �S� Date NORM TOWN OF NORTH ANDOVER F OS ' Certificate of Occupancy $ • i y s4CNUs Building/Frame Permit Fee $ -� Foundation Permit Fee $ 0 Other Permit Fee $ TOTAL $ Check # 166 21 / '---Building Inspec dr a+ w� TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ".,s ., „n .k`�.,,ti �k .,.',•tib. 'r`i� 1V _. _ < 5° b;, BUILDING PERMIT NUMBER. 8�/ DATE ISSUED: s 3 SIGNATURE: l Building Commissioner/Inspector of Buildings Date Z SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: O ax Fo.e.D 9'e'r /aS� o0 I���T� ��0✓��, O/�r`� Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zonin Distrid Proposed Use Lot Areas Fronta ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide 'red Provided Re red Provided v 1.7 Water Supply M.G.L.C.40.§54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 J SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENTHistoric District:Yes NO m 2./J1�Owner of Record n h—la2y d l2yWN `T)ArdSSF–tj SH 3011-orzb &—jaaT ��0k "100✓f1- � Name(Print) Address for Service: Siptititreff Telephone ( -1 2.2 Owner of Record: W Name Print Address for Service: O Z Signature Telephone M SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licepsed Construction Supervisor: O License Number on Address Expiration Date = Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number M Address r Expiration Date z^ Signature Telephone Y SECTION 4-WORKERS COMPENSATION(M.G.L.C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......0 SECTION 5 Description of Proposed Work check alt applicable) New Construction ❑ Existing Building 0 Repair(s) 0 Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other 0 Specify Brief Description of Proposed Work: MStzct laXt(P S{0/ yrag V- got SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OF)Fl<CIAL USE"'ONLY Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x(b) 4 Mechanical HVAC 5 Fire Protection 6 Total- 1+2+3+4+5 J`j Y%2 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, 13 t2" ,as Owner/Authorized Agent of subject property I Herebv authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Q t Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1 as Owner/Authorized Agent of subject property Herebv declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name F Signature of Owner/A ent Date {• .. i NO.OF STORIES SIZE BASEMENT OR SLAB RD SIZE OF FLOOR TEVMERS 1 2 3 SPAN DIWNSIONS OF SILLS DIMENSIONS OF POSTS DEMENSIONS OF GIRDERS IiEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE • 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 APPLICANPHONE LOCATION: Assessor's Map Number iT PARCEL-4L71— SUBDIVISION ARCELDD 7SUBDIVISION LL LOT(S) STREETlf7p,2u� ST�eef ST.NUMBER _�j ************ ******** *** ***OFFICIAL USE ONLY************************ * )REAC14EN�DATJQNS O Q N AGENTS: ONSERVATION ADMI ISTRAT DATE APPROVED 3 DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTHDATE APPROVED DATE REJECTED /ISiEPTIC INSPECTOR-HEALTH DATE APPROVED �O DATE REJECTED COMMENTS PUBLIC .WORKS-SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm DEG-29-95 TUE 1 5 : SS j P A. 77 90)04p�R / LOT 3A LOT 2A 87310 S.F. 2.00 Ac, 1 132.7' j I r- 0) I � Yz 87.8 �J�o3ti N/F N GORTON i MELELEHSCICIUC N0. 39048 90FfS$�Oa p�� A( la 2?11 q%SUR��'y4 ' Y 175.00' BOXFORD STREET WE HEREBY CERTIFY THAT WE HAVE EXAMINED THE PREMISES AND THAT ALL APPARENT EASEMENTS AND ENCROACHMENTS ARE LOCATED THIS PLAN IS INTENDED FOR ZONING i AS SHOWN. THE STRUCTURE SHOWN CONFORMS PURPOSES ONLY. IT WAS PREPARED TO THE ZONING LAWS OF THE MUNICIPALITY FROM EXISTING PLANS AND RECORDS WHEN CONSTRUCTED, ALSO, ACCORDING TO THE . WITH THE STRUCTURES SHOWN LOCATED F.E.M.A./H.U.D. FLOOD INSURANCE RATE MAP, SY AN INSTRUMENT SURVEY. THIS PLAN j COMMUNITY PjkNEL NO. 250098 0009 C SHOULD NOT BE USED FOR PROPERTY DATED 6/2/33, IHE STRUCTURE IS NOT LOCATED LINE DETERMINATION. j IN AN ESTABLISHED 100 YR. FLOOD HAZARD ZONE. CERTIFIED PLOT PLAN LOT 2A BOXFORD STREET MARCHIONDA & ASSOC.,L.P. NORTH ANDOVER, MA ENGINEERING AND PLANNING CONSULTANTS PREPARED FOR KERRY & BRYAN HANSSEN 62STONEHAM. AVE,02180 .a'�I6l' W BOXFORD ST (617) 438-6121 NORTH ANDOVER, MASS, SCALE:1"=50' DATE: 12/23/98 NORTH Town of E Andover No. Z 8 '0700 Q dover, Mass., T COCMis IC W C�� �ADRATED C, BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.....,�1 epi!Y 9�-....%-� A. ?......... a N S 5 r n� .....�..�',,.... .. .............................................................................. Foundation has permission to erect.10../ z�.?. ... ........... buildings on ........ ....................... .. . Rough ............... ...... ,l� . . s��� �a .5�7'tW I.N.......r. .a.r......... ..A.. .�C ......... Chimney to be occupied as................ ..........rl- ..................................... provided that the person accepting this permit shall in every respect conform to th 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. `©S e/ -'77 14_ c3 Q PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR � Rough ........................................................................................ Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. PERI tIT NO _�� APPLICATION FOR PERAT TO It �NORTH ANDOVER, MASS. PAGE 1 VAP+43., ��s/1I LOT NO. RECORD OF OWNERSHIP iDATE BOOK 'PAGE ZONE SUB DIV. LOT NO. I i LOCATION /1 - . S PURPOSE OF BUILDING OWNER'S NAME koie _ /Lr., �J _ ,5��/ NO. OF STORIES SIZE OWNER'S ADDRESS 6,6Z- boy�d - nH?Y,5-r-f" BASEMENT OR SLAB ARCHITECT'S NAME CrIZoJvtA-L. pO S- SIZE OF FLOOR TIMBERS IST � 2ND � /� 3RD[ �I 6 BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING Ic°" DIMENSIONS OF SILLS DISTANCE FROM STREET /3-5-/ J " POSTS f/✓/ DISTANCE FROM LOT LINES-SIDES•�1� GL REAR l,JGIRDERS AREA OF LOT , 7,3©� , ffJJ FRONTAGE �!•7.!S HEIGHT OF FOUNDATION C'� J - THICKNESS IS BUILDING NEW" Y L05 / SIZE OF FOOTING /T '9^L X IS BUILDING ADDITION Y MATERIAL OF CHIMNEY yyle l/=JsJ/ 1_ IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND Jv� WILL BUILDING CONFORM TO REQUIREMENTS OF CODE ,QS IS BUILDING CONNECTED TO TOWN WATER J BOARD OF APPEALS ACTION. IF ANY !I/D w//J _ IS BUILDING CONNECTED TO TOWN SEWER AI'6) IS BUILDING CONNECTED TO NATURAL GAS LINE e.� INSTRUCTIONS 3 PROPERTY INFORMATION ��e; r SEE BOTH SIDES (� , LAND COS V EST. BLD COST PAGE 1 FILL OUT SECTIONS 1 - 3 1IG/ � ES LDG. COST PER SQ. FT. 1 PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG.COST PER ROOM� � 1 �grJ'yI� SEPTIC PERMIT NO. x ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED Ilay L UILDINQ INSPECTOR V SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE © OWNERTEL.# PERMIT GRANTED CONTR.TEL.# 6 r ` Jc 19 CONTR.LIC.# y✓ �Z% H.I.C.# r > y. .BUILDING RECORD I OCCUPANCY 12 SINGLE FAMILY I I STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY _ OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTSRAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH ' 1 CONCRETE CONCRETE BL"K. PINE _ BRICK OR STONE HARDW D PIERS PLASTER _tel T-1—Y11—ALL UNFIN. X. 3 BASEMENT AREA FULL Y FIN. B'M'T' AREA 'L 11, '/, FIN. ATTIC AREA NO BMT FIRE PLACES , HEAD ROOM } MODERN KITCHEN 4 WAILS 19 FLOORS iJ I I CLAPBOARDS X B 1 2 9 ' DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING 7ARD111'0 Jt _ f ASBESTOS SIDING COMMGN �_ r VERT. SIDING ASPH.TILE 1 STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS.8 FLOOR _ BRICK ON FRAME CONC.OR CINDER BLK. STONE ON MASONRY WIRING ' V STONE ON FRAME SUPERIOR IJ POOR ADEQUATE 1 NONE 5 ROOF 10 PLUMBING GABLE HIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY _ h WOOD SHINGES KITCHEN SINK _ 1` SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 1 17 ' 6 FRAMING I 11 HEATING WOOD JOIST l' PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 6 COLS. '" STEAM STEEL BMS. &COLS. HOT W T OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H"T"G UNIT HEATERS 7 NO, OF ROOMS GAS OIL B'M'T god — ELECTRIC 1st _17-dl 1 NO HEATING Location No. J' Date :3 NoRTM TOWN OF NORTH ANDOVER � .. , 0 o p Certificate of Occupancy $ ' Building/Frame Permit Fee $ Foundation Permit Fee $ ssACHUSE -- Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ �^" Building Inspector Div. Public Works Location ��� � (�, (a`I Z'a No. Date t-� M MORTh TOWN OF NORTH ANDOVER 3? .. OL ML mm& n Certificate of°Occupancy $ �� ` i • + ; . Building/Frame Permit Fee $ cMusEt�' Foundation Permit Fee $ ' l Other Permit Fee Tr $ R— �tpGt Sewer Connection Fee $ Water-Connection Fee $ • ll1at�te- TOTAL $ ' Bui ding�txispector + A 12513 ` Div. udlic orks PERJ[IT NO. APPLICATION FOR PERIAIT TO NUILD - NORTH ANDOVER, MASS. PAGE 1 h*AP K46?' LOT NO. 2 RECORD OF OWNERSHIP (DATE BOOK iPAGE - ZONE I SUB DIV. LOT NO. ,rI LOCATION l r , ; -" PURPOSE OF BUILDING - OWNER'S NAME / J 5 j NO. OF STORIES SIZES OWNER'S ADDRESS �- V BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS 1ST 2ND < 3RD BUILDER'S NAME •, x_71_. SPAN j DISTANCE TO NEAREST BUILDING /j�J DIMENSIONS OF SILLS DISTANCE FROM STREET ! ; / POSTS DISTANCE FROM LOT LINES—SIDES k �: REAR lam! "' "' GIRDERS G`J„•/ AREA OF LOT - - FRONTAGE , HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW ` _ SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE f J IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY / t/Jr IS BUILDING CONNECTED TO TOWN SEWER ` IS BUILDING CONNECTED TO NATURAL GAS LINE '••r" :) INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST • SEE BOTH SIDES r EST. BLDG. COST ) PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG.COST PER ROOMf' SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED BUILDING IN@PECTOR SIGNATURE OF OWNER OR AUTHORIZED AGENT F E E OWNER TELJ r / PERMIT GRANTED CONTR.TEL.k 19 CONTR.LIC.# H.I.C.# BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY Y` S"OR1ES THIS SECTION MUSTSHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY T' OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE B 1 2 13 CONCRETE BL'K, PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY UNFIN. 3 BASEMENT 11 AREA FULL FIN. B M AREA 1/ '/r '/ FIN. ATTIC AREA _ _✓7 NO B M'T FIRE PLACES L HEAD ROOM MODERN KITCHEN 4 WALLS ( 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDIV D _ ASBESTOS SIDING COMMON VERT. SIDING ASPH.TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS.& FLOOR I_ BRICK ON FRAME CONC.OR CINDER BLK. ` M STONE ON MASONRY WIRING V� STONE ON FRAME SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 71 10 PLUMBING GABLE LxHIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) ��� —71 FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER = ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO )3 8 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE P/ FORCED HOT AIR FURN. / 75 TIMBER BMS. &COLS. STEAM STEEL BMS. &COLS. HOT W'T'R OR VAPOR WOOD RAFTERS ` AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd ELECTRIC 1s<t 13rd I NO HEATING FORM U 6• LOT 'RELEASE FORM •INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and^apartments having jurisdiction have been obtained. This does not relieve the applicant andlor landowner from compliance with any applicable or requirements, APPLICANT FILLS OUT THIS SECTION APPLICANT �/ w k�� HAS5�,✓ PHONE 1,;'9 LOCATION: Assessors Map Number_ /05 PARCEL SUBDIVISION // LOT(S) STREET ' ST. NUMBER�� *******OFFICIAL USE ONLY JNO TITNOWN AGENTS: CONSERVATIO OR DATE APPROVED " DATE REJ TED ' COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED o? DATE REJECTED i COMMENTS PUBLIC WORKS-SEWERMATER CONNECTIONS (tely 5;Iq I DRIVEWAY PERMIT FIRE DEPARTMENT — Z r'8 RECEIVED BY BUILDING INSPECTOR — DATE 03/113/98 19:27 FAX 508 6889556 : i NORTH ANDOVER zou1 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 an Building Permit(below) Addres3 of Property for Permit(below) P ,*lJ 14,V60N Map and Parcel Yofq Z.Purpose of Application(check below)• Phan Number of A tic t Single Family __.Twa Family 1- yzZ-- I the undersigned applicant far the above property attest that the attached building permit for which this form is completed deet comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management 8ytaw. I also understand providing this form does not absolve me or any party to this per slow the requifemen(8 of obtaining other permits required pnor to the issuance of the Budding Permit; Further I understand that rn inteMre[ation of rho EXEMPTION status is subject to review by the Building Department and is only o(flcially accepted when the Building Permit s4 issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the worts as applied for on the above lot, in the building permit application and associated attachments.Complies with one or more of the sections following as indicated by a check mark. This is an application far a building permit for the enlargement.restoration,or reconstruction of a dwelling in exnslence as of the eftecrive 0310 of this by-law,provided that no additional residential unit 11 C►fited. PThe ratty)wertdwas Created prior to May 5,1996 are rxQmpt from the provisions Of this Section 8.7 of the Zoning' aw. Tim application is for dwelling units tar low andior moderate intame families or individuals,where all of the Eondihans of 8,7.6.c•ero mot andior represents Dwelling units for zenior rosrdtnla.where occupancy of the units is rostriclud to senior persons through a property a:emoted and recorded deed restriction running with the land. for purWI=of this-94000-senwr•shall mean perUn3 over the age of 53. This application is a part of a dsveWemsnt prosect which vasumarily agreed to a minimum 40%pem+artent. rruucdon in density.ibuildable lots)Me-below the density,(buildable lots),permitted under toning and feasible given the envrmnmenpl Conditions of the tract,with the surplus land equal to at toast ten buildabls acres and permanently Zdalgnated as open space and/or farmland.The land to oe preserved shall be protected from development by an incwIttiral preservation Restriction,Conservation Restriction,dedication to the Town.Or other similar mechanism approved by the Planning Board that will ensure its pmleetion. This applicatlan represents a tract of land ext:ting and not nerd by a Developer in common ownership with an Want parcel an the etfectrve date or this Sec ton 8.7$hall(teeiYQ i ane-lune exemption from the Planned Growth Rate and Oevslopmont Scheduling provisions for the pun7gse of constructing anis single faimrry dwelling unit on the This appllcattan represents a lot which is ready for building permlts,(i.e.all Other pQrnits from all other boar05 and commissions have been received and the project is In compliance with those permits),aria the Oevelapment 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 buildirtg pemruts. Applicant must Supply approved form U win this EXEMP'nQN. Please provide any and all information that would assist the Building Department in making 3.letermination' that your application is allowed one or more of the above EXEMPTIONS. ©y 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 re" sal by the Building Oepartment to issue a Builaingg Permit. 4mi ,gna ore at caner ur Authorized Age nt mora srgnea t e Anacliad 8wldrny Permit at This form must ba attacMad to the Building Oermit upon application for sucn permit. i � t MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2 . 0 'Pj 'y C�'J j ' Checked by/Date 7 CITY: Lawrence STATE: Massachusetts HDD: 6235 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 11-13-1998 DATE OF PLANS: TITLE: Plan #1265 PROJECT INFORMATION: 28 x 38 Colonial 2, 338 sq. ft . COMPANY INFORMATION: William Barrett Homes 1049 Turnpike Street North Andover, MA 01845 (978) 682-2320 COMPLIANCE: PASSES Required UA = 498 Your Home = 496 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 1195 38 . 0 0 . 0 36 WALLS: Wood Frame, 16" O.C. 2522 15 . 0 0 . 0 194 GLAZING: Windows or Doors 380 0 . 500 190 DOORS 52 0 .350 18 FLOORS : Over Unconditioned Space 1208 19 . 0 57 •FLOORS : Over Outside Air 18 19 . 0 1 HVAC EFFICIENCY: Furnace, 85 . 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 �� y MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2 . 0 Plan #1265 DATE: 11-13-1998 Bldg. Dept. Use CEILINGS: [ l 1 . R-38 Comments/Location WALLS: [ ] 1. Wood Frame, 16" O.C. , R-15 Comments/Location WINDOWS AND GLASS DOORS : [ ) 1. U-value: 0 .50 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 [ ] 2 . Over Outside Air, R-19 Comments/Location HVAC EQUIPMENT EFFICIENCY: [ ] 1 . Furnace, 85 . 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 determined. 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: [ l 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 . ----NOTES TO FIELD (Building Department Use Only) ------------------------- 1 n VZO .Y % W. Yi f' 1 + O� L \ B7 3 07 5 F i co i '3'4 ltr•, � ai.. 1,1Mi� OF�� z �t. CoN 40) ' ! 1.45.'•� �Ai � �.J. 1 f „ -00 i pt1G q PVi �. TP) �:F COQ f.'jt 60 71 - .. �56' ?r `c 9.i J kF _ Cl^ - `. fps ` I ORT Tomm of _t over No. MTO dover, Mass., / 19 / .- COCHICN WICK 'Y'�• p Pavy C S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System ` BUILDING INSPECTOR THIS CERTIFIES THAT.. .. . ......*..,�I`Id ..........., A�Vv ........................ .............. Foundation has permission to erect. �.. buildin son..... ........ .... .....5 Rough ................ ................ &Uil!o r� sty// .t0 be OCCUpied 8S.... � Chimney provided that the person athis 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 y VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MOS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI ST T e u 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 Final No Lathing or Dry Wall To Be Done FIRE NT Until Inspected and Approved by the Building Inspector.' D �T"I Burner I . Street No. Smoke Det. • 28 x 38 Co I on i a =1 i p �� !-� ��► - ��`� /i Via. ��-=— ■■■ ■■■ _ __ E ■■■ ■■■ _- ■■■ ■■■ . — ■� - ,'■�; � =_ iii = - - - - -- - --- - ,- ■■■ ■■■ ■ ` ■:I _ ■■■ ■■■ — — I� ISI `�I — \ 0 1 Farm-ers Porch — -Open Foyer — 2 Car Garage tots* 4 Bedrooms — 2 1/2 Baths 2,338 sq. f t. A e FA o"i Al-7/P 4,Tj / ` 5 • ��� 11 11 IRIII ��111�pA; @1-K'iie: AY�IVIII�� ei'I'IEe u ee X11 ■ II ILII I._ now_ _ IM !MEN ENE III _ ... _ _Somme ■■■ 0 - -I..■ ■■■ OEMOMNI- -L.■ ...:-. - mom: mom mall mmm: 21■0 . ... p mom son _fam ..■ ■■■■■■ ■■■WIS ... ... mom ■■■ ■■■ ■ ■■■ son - — _I — I FE-1-0-11=_ \ ■■. 11 .. �_ ■. N .■■ ... = a. GENER-A . L NOTES : loth Edition Massachusetts 5uilding Code Notes and details apply as necessary to the house design . BUILDING CODE NOTES safety Glazing= I. All notes and details contained within these drawings are to be used Application of Other Laws t 3603 . 20 ,4 ,2 ] Specific hazardous locations: the following shall as they would apply to the house being constructed. r r be considered specific hazardous locations For the:purposes or glazing. [ 3601 , 1 , i ] Application of other lawn Nothing herein contained shall �, Glazing In an individual fixed or arable anal,other than (n 2. When plans are used In conjunction with builders specifications and be deemed to null IFS any provisions of the zoning bylaws or ordinance of g p p p p an munic allt in the Commonwealth of Massachusetts Insofar as those those locations described in 180 CMR 360320,42 items 5,and 6,, any discrepancy occurs, the specifications will supersede the drawings, y �' y provisions deal exclusively with those powers of regulating zoning which meets all of the Following conditions:: 3, All substitutions are the respons(bllity of the Builder, granted by the provisions of M . G ,L . c . 40A and 41, A. Exposed area of an Individual pane greater than nine square Feet(084 mm 2). 4. All dimensions are to be Field verified by the Contractor and any Minimum Standards 13, Exposed bottom edge less than 18 Inches (460 mm) adjustments made accordingly. above the floor. C 3601 ,2 . 13 Minimum standards= The purpose of 180 CMR 36 Is to 5. All work shall be completed in compliance with all applicable provide minimum standards for the protection of life, limb, health,property, Curbs for Skylights Budding,Plumbing,Electrioal codes. Any other local,state and/or envlronment and for the saFety and welfare of the consumer,general public, federal codes that may appI to this project shall be considered and the owners and occupants of residential buildings C 3603 .20 ,5 ,5 ] Curbs for Skylights= All unit skylights Installed as part of the construction documents. regulated by 18 CMR 36, In a roof with a pitch flatter than three units Vertical In 12 units (o. All waste materials and debris shall be removed and disposed horizontal 125% slope)shall be mounted on'a curb extending at least four Inches (102 mm) above the plane of the roof. of properly. -Scope 1. Numbers set within [] reference that section of the 6th Edition of t 3601 , 2 .2 ] Scope:180 CMR 1, In its entirety,shall serve as the Drainage the Massachusetts State BuildingCode, administrative requirements of 180 CMR 36, t 3604 . I .3 7 Drainage-Surface drainage shad b'e diverted to a B. these drawings were.prepared per guidelines set forth 1n the storm sewer conveyance or other point of.collection or away from the , Mass.State Building-Code Section [ 36 ] for 14 2 famlly dwellings, " Foundation system to avoid creating a hazard:i=(niched grades shallbe arranged to direct surface water away from all foundation walls.The finished grade shall slope a minimum of 1/2" per foot for a distance of at least six feet from the face of all foundation walls. .} S 10,0- AAA111111h 111111h till . _ - ChimnecS Clearances Above 13ullding Masonry Chimney Construction= Chimney Termination: . Chimneys to be constructed using information,tables, charts and [ 3610 , 2 . 5 I Termination; Ghimneys shall extend at least two details shown In 180 CMR 3610 - CHIMNEYS,FIREPLACES AND SOLID feet (610 mm) higher than any portion of the building within ten feet FUEL-FIRED APPLIANCES, (3048 mm),but shall not be less than three Feet (S14 mm) above the point where the chimney passes through the roof. v FLOOR .-PLAN STANDARDa 5ullding�th Edition Massachusetts Code Means or Egress MAXIMUM ALLOWA5LE SPANS POR HEADER Garage / douse Separate I 3603 . 10 . 1 Means of egress'. Egress from all dwelling units shall beI 3603 .5 . 11 Opening Protection Openings from a private garage by means of two exit doors,remote as possible From each other and SUPPORTING WOOD FRAME WALL5 directly into a room used for sleeping purposes shall not be permitted. Headers In Other openings between the garage and dwelling shall be equipped leading directly to grade.Such doors shall be provided at the normal level of entry/exit. In addition,all other floors within a dwelling unit Size Supporting One Story Two Stories Walls not with either solid wood doors not less than 13/4 Inch (45 mm) In thickness shall have at least one means by which a continuous and unobstructed path of Roof Above Above supporting or 20-minute fire-rated doors.Self closing devices and ire resistive to the exit doors,by means of stafrways,corridors, hallways or combinations Header Only floors or roofs rated door Frames are not required.All doors openings between the thereof, is provided. 2 - 2 X 4 41 garage and the dwelling shall be provided with a raised sill with Exception= In split level and raised ranch style layouts,the two a minimum height of four inches. separate exit doors required by 150 CMR 3603 , 10 . 1 are permitted 2 - 2 X 6 6� 41 to be located-on different levels. 2 - 2 X 8 8' 61' 10' Minimum Glazing Area, Exit Doors 2 - 2 X 10 -10' S� 6' 12' C 3603 6 .4 .21 Minimum glazing area: Every room or space intended r for human occupancy shall have an exterior glazing area of not less than C 3603 . It . I 1 Exit doors The minimum nominal width of at least one 2 - 2X 12 12' 10 8' 16 Bqe of the floor area 1/2 of the required area of glazing shall be openable. :j".5j of the exit doors required_by 180 CMR 3603.10.1 shall be 36 inches - I TABJ-1= 3606 .2 .6 1 and the minimum nominal height shall be six feet eight inches.All other ?mss; exit doors and doors leading to or From enclosed stairways,shall not 1. Nominal four-Inch thick single headers may be substituted for Smoke Detectors- be etectorsbe less than 32-inches in nominal width nor six feet eight inches double members, [ 3603 . I6 , to 1 Required smoke detector/heat detector locations in nominal height. 2. Spans are based on No.2 Grade Lumber with ter-Foot tributary Smoke detectors shall be installed in the following locations. I. In the immediate vi Exception Floor and roof loads. cinity of bedrooms., ¢ I. Exlsting buildings= New and replacement doors are permitted 2. In all bedrooms. to be six Feet six inches in nominal height. Access to Crawl Space r; 3. In each story or a dwelling unit, including basements and cellars, [ 3603 .9 . I ] Access to crawl spaces;Access shall be provided but not including crawl spaces and uninhabitable attics: r Interior Doors to crawl spaces by an opening not less than IS inches (457 mm) C 3603 . 11 .21 Interior Doors=All doors providing access to habitable by 24 Inches (610 mm). 4. In residential units of 1200 square Feet or more,automatic fire rooms shall have a minimum nominal width of 30 Inches and a minimum detectors, in the form of smoke detectors shall be provided nominal height of six Feet six Inches. Access to Attie For each I�DO square feet of area or part thereof. Exception- 5,Fixed temperature heat detectors shall be installed in accordance p C 3603 .9 .2 ] Access to atilcs An opening not less than 22 inches p I. Doors providing access to bathrooms are permitted with the requirements or 180 CMR 3603.16.4. j p g p by 30 Inches (559 mm by 162 mm)with ready access thereto shall be q to be 28 inches in nominal width. provided to any attic area having a clear height over 36' Inches (162 mm), 2. Existing Butldings: Doors providing access to bathrooms are. Where doors or other openings are installed in the drartstopping, Photo Electric Smoke Detectors permitted to be 24 In normal width. such doors shall be self-closing and be of approved materials as [ 3603 , 16 , it 1 Photo electric smoke detector requhements! specified In this section, and the construction shall be tightly fitted Any smoke detector located within 20 feet of a kitchen or within 20 Feet Minimum Slee in . Room Window Opening around all pipes,ducts or other assemblies plercing the draFtstopping, of a bathroom containing a tub or shower shall be a photo electric type p g smoke detector but shall satisfy the compatibility-requirements [ 3603 . 10 . 4 . 13 Minimum size: All emergency escape windows from Ventilation required: of 180 CMR 3603 . 11 .2. sleeping rooms shall have a net clear opening of 33 square feet, be 20 inches by 24 inches I 3603 .6 . 2 ]Ventilation required= Every room or space intended for The minimum net clear opening shall In either direction, human occupancy shall be provided with natural or mechanical ventilation. Legend: O - Smoke Detector Exception: Exception Every bathroom and tollet room shall be equipped with a Windows In sleeping rooms of existing dwellings which do not mechanical exhaust fan and associated ductwork with the fan exhausting, • conform to the requirements of 180 CMR 310.2,1 may be as a minimum, at 50 arm If operated intermittently or 20 cfm iF continuously replaced without conforming to 180 CMR 310.2.1 provided operated. Such bathroom exhaust shall vent directly to the outside that the replacemsnt windows do not slgnificantiy reduce the and no exhaust vent termination to attics or other interior portions existing opening size. of the building are allowed. i '011 21211 3828b a 14'4 a 21011 .11011 2,0 11 12'S n 6'131411 21'10'/4 41011 31211 312" 410" 111011 4'10" 1S30'10" 1'10" 6'O" SLIDING N I 1 1 I I - n FAMILY BREAKPAOT KTCHN a Ac"c*jW lmpx& o O 1 o �yay I LV I _ CfJ O t I 218n 1 316n 3'6n 113,411 0 - GARAGE FINISH 0 All wood constructed walls and_ ceiling to have 5/8" type IX' fire if 0rated Wallboard installed N j7 tp c� O N 1D. — 20 minute fire door (m1m)- 51011 IP cv O m tr CL06E nFLUO u p 4'0' BLfDING O n 13'10'/4" 12'13/4" 11'10'44" O o LIVING FO'rER DINING GARAGE 31�u 61011 6'0n 5110'/411 610n 3'13/4n 3'011 = O p % i i 16'0" x TO" Overhead door 1011 11011 121011 111911 61311 111011 11,0„ 14'011 30'0" 1 .2y PIRST PLOOR P 1265 — 3 3/I6I r� 38'0" 13�Si�2�� - '12'11/2" 11 8 3'6n b'Sn 3'6L2" 6'3314' - 6'33/4', z✓'lOn S�IDu 3'4" 314" O N U4ON_ N p acv V cv Ln � _ M BATIK BED 02 SED #3 O N o � M 2,6, cA 2'4� 2'.10" M mss. WALK-IN M F. 214, GL05 T CL " LGL i = n O { GL. GL CI' co 4.— 216" 214" in _4 O To 441/; 26 510 36 41 n I M i - I O M BED OOM 01 cz BEDROOM #4 CP o I _ -1,011 Toll 31Ell 11 _ t 3'5" 3'S" 14'0" 2'1' 6'10" 3'2'� 6'10 21111 SECOND rLOOR FLAN 3/16" = 1'O" 1265 - 4 P'Oundation Standards - ( th Ed,- Mass, B 1da, Code - 2x Bottom Plate 2x Band Joni General: DampproofIng: a Q o C 3604 .3.13 General=All permanent supporta of bulldIngs and C 3604 .6 .13 Corr-rate and maeonry foundation damprooring= Insulation 4 ' " ' structures longer than 120 square feet in area or ten Feet in height Except where required to be waterproofing by-00 CMR 3604.6.2, 2x Floor Joist P A o 0 4 ehall extend to min*um of four feet(I.2 n)below flnlehad grade except Foundation walls encloskrg habitable or storage space shall be damp- I - 2x6 P.T. when erected on solid or othenulse protected From frost. -prooFed.From the top of the Footing to the Finished grade.Maeorry walls I - 2X6 K.D.Bill l shall be dampproofed by applying not less than 3/8 Inch(6.5 mm)portlanc# �" Stll �4nehorage= cement pargig to the exterior of the wall.The parghg shall be covered _ w/Sill Sealer mIn. r 3604 .3.la 3 S.The 6111 plate or floor-system shall be anchored with a bitumhous coating,three pounds per square yard (Ib3 kg/m2)of Anchor Bolt or to the Foundation with 1/2-Inch-diameter bolts placed six feet on canter aerylb modified cement,l/B-inch(3.2 mm)coat of surface-bondtg mortar Mudsill Anchor Straps and not more than 12 Inches from corners or other approved anchom, complying with ASTM C 881 or any material permitted For waterproofing. �� Bolts shall extend a mInbum of 15 Inches into masorry or eight inches h 150 CMR 3604b2 Concrete walls shall be dampproored by applying Concrete Foundation 4 Slab Ste down 3/g" = 1'O" Into concrete.Other approved anchors shall be installed in accordance any one of the above listed dampproofing riaterlals or any one of the S ill 3/8' ■ ISO" with manufacturer spec kation&,Sill plates shall be protected waterproof Ing materials listed in 180 CMR 3604.62 to the exterior of against decay where required by 180 CMR 3603.22.6. ( optional , the wall. Girder Ends= 2x 13ottom Plate 4'-O" 4'-0" oudentionn center andorogmore thanA2 'hcheso three on�ere.Mude�tll A hae cro 13603.22.4.4 ]Cstdar ands The ends of wood gpndaro entering U��, 2x Fire Blocking _S Q shall-be installed in accordance with manufacture specifications, (13mm)exterior spacemonmj n tconcrete std walla shall unless provided with a ralinch o n (13 mm)air space on top,sides and arid,unless approved netureily insulation Opening Protection' durable or preservative-treated wood Is used. ' 2x Floor Joist C 3603.5.1] Opening Protactbn=Openings fron a private garage Basement Ventilation: ' Center Beam directly into a room used for sleeping purposes shall not be permuted, r 3603.6.8,2.13 Exceptlorr• Basements and cellars not used as Other openings between the garage and dwell shall be equipped with 1.x11 Column Ca Plate either slid ood doom not Is"than 13/4 Inch((45 mm) in tin n " habitable,occuplable space shall be provided with a minimum of fasten to Center Beam 8" or 10' or 20-minute fro-rated doors,Self closing devices and fire resistive four sliding type,or awning type basement windows for ever rated door frame are not required.All door openings between the 1500 square feet of floor area,or multiples thereof,and shall Lally Column garage and the dwelling shall be provided with a raised sill with a mininum be located,as near as practical,to provide cross ventilation. step l=ooting 3/4n iO„ height of Four Inches. Center Beam i = Fire Separation: C 3603.5,27 Fire Separation;The garage shall be separated from ' 3'�u 1'-0' the residence and Its attic area by means or minimum 5/0 inch 06 mm) _ e (max.) type X gypsum board applied to the garage side.Wherever the attic �i�1'iter Csfder GOIU>�1f11 bbdGN”- e area b continuous between the garage and the dwelling a Firastop of TRU86 r < a 4'_ y�4 'ra ° 4 _ 5/8 inches 06 mm)type X gypsum board with a minimum of one coat a va �i .•r a p compound and tape shall be used to Form a barrier to separate the TRUee IL Concrete _ e g3o P6� !garage and dwelling. TRU" - 1 f=oundation30, Sim son Mudsill a door Surface= 3°PO so Pep Kew ' a An "MA6" '- C 3603.5.3 3 Floor Surface:Garage and carport floor surfaces 40 PeF p� Pap y ay shall be constructed of concrete or other approved norcombustble IIJ - See note "Sill Anchorage" E 3604 . 3 , la ] material.Slab on grade construction shall be In accordance with the we e . provbbns of 160 CMR 36055.The minimum floor thickness shall be One Story two StOr� Three Story Concrete l=ooting _e Mudsil I anchor 3 1/2 Inches.The area of floor used for parking of automobiles or other vshiolse shall be sloped to Facilitate drainage toward the nain vehicle C Spacing Plan N,T.S, entry/exit doorway, COLUMN SPACINGS UNDER GIRDERS Walkout pdn 3/8r. : hOu &'-011 Basements, Cellars and Crawl Spaces= E Table 3405-6 ] - [3603.6.8..2]Basements,cellam and crawl spaces All basements, Girder alta (max,) (max.) which are not used as habitable,occupiable space,and crawl spaces, 3 - 2 x 12 UJ - 24 W - 26 111 - 25 W - 32 ' other than crawl spaces used as an undarrloor planum,shall ba ventilated F0 = 1000 Basement 4 e— -- . 4' _ by openings In exterior Foundation walls,by openable windows or by approved A 4 e a a n 4 O mechanical means.Openings or openable windows shall be located as near ore spy 10'_3" s�-10" - 9�-6" S�-II" o window r as practical.to provide cross ventilation.The openings shall be covered _ IL A with corrosion resistant mesh not less than 1/4 Inch(6 mm)nor more than Two Story '1-8 1'-4 " Concrete e Anchors bolts or _ _- 1/2 Inch(13 nm)In arry direction,or other approved screening which Foundation _ App d Equivalent provides for equivalent ventilation except then when openable windows aro ,�o,y used for baeemenrt or cellar ventllatbn,standard window screens nay be used as the corrosion reeietant mesh. Keyway e Sas note 'Sill Anchorage" E 3604 . 3 , la ] Column.sizes - 4" x 4" or 3 VZ' diameter steel Sleepers and S1119: FootIng Size 2'-6' x 2'-6" x I'-3'd ` Anchor Bolt C 3603.22.4.3] Slospem and&ills on a concrete or mason slab From: Table E 3605 . 2 .3 ,3b ] Concrete l=ooting - e which is in direct contact with earth shall be of approved naturally Spacing Plan N,T.S. durable or preservattva-treated wood is used. Concrete pdn 3/S' = ! Yi0 re,Wo 35,011 613i/21BIN I a3l� z`• 1121126'O" 4'10" . Precast concrete bulkhead Attach per mfr, requirements f=inal size 4 location to be determined by builder 30 ---- ------------------------- �--- -------- ------ ---- --- -----�- �► ; o t FOUNDATION 1 , 8" or 10" Concrete Wall / 8'0" Pour ' h ► 10" deep x 20" wide continuous footing i ; c° _ DampprooF exterior surface ►' ' cz : •► 14" Concrete 51ab '' =-_-----------4--------=------------ - ------------ --=--- , ( _ --- `--�- Al--6 x (o--Co/6 welded wire fabric =---------- ----- ------------------------------- L---' placed at mid-depth of the slab. -; 1 '' GARAGE FINISH ' ► ' I 3'6" 6'O" 6'0" 6'O" OT/2' All wood constructed walls and t 'r — — ; '' ceilin to have 8/8" t e 'X' fire CPrated Wallboard Installed , ► 1 2 x 12 Center Beam (typ,) r'-_-------- • ' -r 1 3 1/2" Dia.Lalig Columns i ; o ►. ; With 2'6" sq. x ]IOU dp. footing . ° L w/2 - 05 rebar each way bottom ' i 9- i '► ' `~ N . . ; •► i --�- ; ►' ; 6'3/2" 2u 1 1 1 . 1 1 1 _ � 1 ''• 1 � Q 1 1 '► ' 6'10" O U 1 '► i O ' O 1 ►, ; 1 1 t 1 BEA1'1 POCKET 1 ►' ----------- -----------------�------------------- 1 1 ►. 1 ' i6" Wx6" Dpx5" H i •► --- - •' i O t ' Shim beam with steel •. - - 1 Bottom of frost wall footing: "• ' _ °' -� ; L" 4'0" below grade (min) shims or hard brick 1 1. ------ ---------------------------------� ►. _ / 1 O ; (3 Req'd) ; 1 D Dia. Concrete Pier --- ---------------------------'-- v ; -----------------------i ►• -14 - #5 vertical rebars - ----------------------------------------------- a _____ / ' Bottom 4'0" Below grade ' I (2 req'd) I 12'0" ' 1119" ' 6,3i1 2,811 16,81, 2181 ICE 14,0„ 30,01, X11 Zy FO1. NDATION PLAN r _ � 3/16" = I'O" F RA1"I I NCS STANDARDS (oth Edition Massachusetts 15u11c11n!@ Code Joist Under Bearing Qartttion Ftestopping: Notes-- E 3605 .2 .3 .21 Joists under bearing partitions:Joists under parallel [ 3606 .2 . 13 Firestopping Firestopping shall be provided to cut off all I, All structural materials shall be vold of any defects that may bearing partitions shall be doubled or a beam or adequate size to concealed draft openings lboth vertical and horizontal)and to form an diminish their capacity to function in an adequate manner. support the load shall be provided.Double Joists which are separated effective fire barrier between stories,and between a top story and-the roof Structural Engineering or any other professional services that to permit the Installation of piping or vents shall be provided with solid space.Firestopping shall be provided In wood-Frame construction In the may be required shalll be provided bg others, blocking spaced not more than four feet (1219 mm)on center. following locations 2. Use built-up 2 x 4 posts under all beams (4 minimum). ' 1. In concealed spaces of stud walls and partitions, Including Furred spaces, 3. Double up floor Joist under bearing partltion walls above. gC�jnQ: at the ceiling and Floor level. 13605 ,2 .4 1 Bearing: The ends of all Joists, beams or girders 2.At all interconnections between concealed vertical and horizontal spaces SPRUCE PINE - FIR No.2 shall have not less than I V2 Inches(38 mm) or bearing on wood or such as occur at soffits,drop cellings,cove ceilings,etc„ Modulus of Elasticity "Ell = 1,400;000 metal and not less than three inches (16 mm)on masonry except where 3. In concealed spaces between star stringers supported on sone-Inch-by-four-inch (25 mm By 102 mm) ribbon strip p an - at the to d bottom of the run. Fb: 2 x 4 - 1 ,5 1 0 2 x 1 0 1 , 1 CS , and nailed-to the adjacent stud or shall be supported by the use 4. At openings around vents,pipes, ducts,chimneys and fireplaces at telling 2 x 6 - 1 ,310 2 x 12 - 1 0J5 of approved Joist hangers. and floor level,with noncombustible materials. 2 x 8 - 1 2 10 [TABLE 3605 . 2 .3 . Id 1 Overly - Deflections: MAXIMUM ALLOWABLE SPANS FOR [ 3605 .2.r�l 1 Floor systems Joists that are framed from opposite [ 3603 . 1 . 6 7 Deflections-The allowable deflections of any structural JOISTS/RAFTERS side and extend over a bearin s ort shall be tied together b member under the live load or snow load listed in l80 CMR 3603 . 1 .3 , lapping the ends or each joist minimum of three inches (16 mm), oywith 3603 , I , 14 and 3603.1.5 shall not exceed the values in Table 3603.1.6. Joist a wood or metal splice plate,or shall be secured by overlapping the Floor size 2x & 2 X 8 2 X �O 2 X 12 Floor sheathingq at least three inches (76 mm)beyond the and of each Gleam Span' Floor Joist,or by other approved methods. [ 3602 . O 1 General, Building Definitions 12" oz. 10 -11/2 13-41/2 11-1 11220 -41/2 For simple,continuous and cantilevered bending members,the span shall F 1r'St Lateral Restraint• be taken as the distance from Face to face of supports,plus 1/2 the 16" oz, 13-11/2 12-1 1/2 15 -11/2 n-5 In - required bearing length at each and. [ 3605 ,2 .5 1 Lateral restraint at supports;Jo lets shall be supported 12" O.C. II-I V2 14 -9 1/2 10 -10 1/2 22-41/2 laterally at the ends bg full-depth solid blocking not less than two inch Framing to Concrete second (51 mm)nominal thickness: or by attachment to a header,band or rim Joist, [3603 .22 .4 .21 Framing:All wood framing members including wood or to an adjoining stud: or shall be otherwise provided with lateral g 9 g 16 D G. 10-11/2 13-41/2 16 -51/2 IS- 51/2 J ng p sheathing,which rest on exterior Foundation walls and are Tess than eight support to prevent rotation,Such lateral support is not required over inches (203 mm)from exposed earth shall be of approved naturally t2' O.C. 1i-1 I/2 14 .9 1/2 18- to VZ 22-4 1/2 intermediate supports such as center girders or bearing walls. durable or preservative-treated wood. Attie BrlG.1 For bearing walls which are offset From each Future Rooms 16" O.C. 10 -1112 13-41/2 16 -8 1/2 19 -9 1/2 Bridging: other above and below a Floor. Wall below [ 3605 .2 .5 . 1 1 Bridging: Joists having a depth-to-thickness ration Double Wall above A tt IG 12' O.C. 12-9 1/2 16- 10 i/2 21-11/2 --- exceeding 61 based on nominal dimensions shall be supported lateraliy by solid blocking,diagonal bridging (wood or metal),or a continuous Shaedr _ _ _ No future rms Vol' O.G. 11-1 I/2 15-41/2 19-11n --- one-inch-by-three-inch (25 mm by 16 mm) strip set perpendicularly across p the bottom of Joists and approprlately nailed. Bridging shall be Installed ,Qtt IG 12OZ. 16 -1 1/2 21 -31/2 21-31n — at intervals not exceeding eight feet (2438 mm). Capes 3/12 or less 16" OL. 14--1112 19- 4 1/2 24 -8 I/Z ----- Exception: Cantilevered Joists shall be laterally braced _ at points of support ' 12 O 12 - 1 15 -3 18 -5 21 -5 Roof " .C. Cutting and Notching= over attic 16" oz, 10 -5 13 .3 16 -2 15-13 3605 .2 .6 1 Cuttin and Notching; It shall be unlawful to notch _ 9 9 2 x 8 V-4" (max) cut or,pierce wood beams,Joists,rafters or studs In excess or the 2 x ID 2'-D" (max) joist Floor Fl . 12" O.G. 11 - 0 13. 11 11-5 20 -6 � �DOf limitations specified In 180 CMR 3605.2.6,unless proven safe by J , structural analysis or suitably reinforced to transmit all calculated loads. Cathedral 16' D.C. 5_6 12-1 15 -4 11-5 Double shear Lap Splice I i I li `4 i I 2 x 8 P'Ta 0 16' O.C. _ 1 _ISI_Li 1 _LL L LL -i-.1_L- --- - -__ II All members are 2 x 10 6 16" O.C.WXO) I o I _..FIRST FLOOR FRAMING 0 1 Flush Framed Beam II l li � II � n I I 6 I 2X6916° O.C. All membere are 2 x 10 6 16" O.C.Q1NDJ FLOOR F MIN '1265 - 6 F -1771 Flush Framed Dean L LEO I � 1 Flush Framed Seam` l_ All members are 2 x 8 6 I6" O.C.WX.0) ATTIC FLOOD' FRA SIN -_ __iL too i i -2x10 I � 1L-3--—2x Lower Roof Franbg 2 x a ID I6' oL. I �9 00, or _ a I - 9 It i� I, C �3 �I � el I Ridge,Hip i valley Rafters are 2 x 12All members are 2 x 10 6 16' O.G.(UN.0) /,, ROOF Fes' AMIN6 PLAN- 125 - 1 Val - 1,01 Continuous Baffled COLONIA] AFCTION STANDAR Ridge vent Roof Rafter /—jRidge Board Maintain V min, clear, (o h Edition Massachusetts 5 Code I x 8 Collar Ties ` g ,� 0 4 o O.C. %r Roof Rafters Fascia Board Gelling Jole Overhangqing soffit with ven4Tng Roof and Attic ventilation Ridge i5oard Standard Soffit 3/8' • i'O' C 3603 . 6 ,8 , I , 11 ventilating area-The minimum required net free ventilating area for such roof spaces shall be 1/150 of the area of the space ventilated,except that the minimum required area shall be reduced to 1/300, Continuous Baffled provided than a vapor retarder having a permeants not exceeding one pers� Is Ridge Yent Roof Rafter installed on the warm side of the ceiling:or at least 50% and not more than Ridge Beam 80%,of the required ventilating area Is provided bg ventilator(, located in �� the upper portion of the-space to be ventilated at least three feet (514 mm) Maintain 1 min. clear. Z x S u� 16" D.G. -above save or cornice vents,with the balance or the required ventilation i provided by save or cornice vents. Roof Rafters Fascia Board --- --- Wood Framing to Concrete= Soffit with venting _ _ r t 3603 . 22 ,4 , 2 ]Framing= All wood framing members, including wood _ _ _ _ - sheathing,which rest on exterior foundation walls and are less than eight r Inches (203 mm) from exposed earth shall be of approved naturally durable or Ridge beam 3/8" = i'O" -1 Vaulted/Cathedral Soffit 3/8" = i'O' preservatNe-treated wood. . . MinimumCeiling Leight:. 2x Bottom Plate 13603 . S . I-] Minimum ceiling height- Habitable rooms, except kitchens, Zx Bottom Plate 2x Band Joist shall have a telling height of not less than seven Feet three inches (2286 mm) Floor Sheathing Floor Sheathing for at least 50% of the Ir required ar,as. Not more than 50% of the required area may have a sloped telling less.than seven rest three Inches (2286 mm) 2x Floor Jobt . 2x Floor Joist in height with no portion of the required areas less than five feet (1524 mm) ' tling,the preserbed ceiling height Is 2 - 2x Top Plate required For at least 50% of the area thereof,but In no case shall the height 2 - 2x Top Plate In height. IF any room has a furred ca or the Furred telling be less than seven feet (2134 mm), Exceptions- 1, Beams and girders spaced no6ese than four Feet (1219 mm) on center ma� project not more than six Inches_(153 mm)below the required telling height. Interior Intermediate 3/8" ■ i'O". Exterior -Interni. FIr. 3/8" = 1'O" 2,All other rooms including kitchens,bathrooms and.hallways shall have a 2x Bottom Plate minimum calling height of seven Feet (2134 mm)measured to the lowest projection from the telling, 2 - 2x Band JoistFlashing 3. Habitable basements shall have a minimum clear height of seven feet zero Floor Sheathing Inches,except that beams,girders and other obstructions spaced not less Decking 2x Floor Joist than Pour feet on center may project not more than SIX Inches below the r required ceiling helghL 2x Deck Framing (FT,) Z - 2x Top Plate G ,0 Joist Hanger r Concrete Foundation 2 x 6 and B caring Ext. Interni. � Parallel 3/8" • rO" peck/Stair Conn. . 3/S° = ISO' Continuous Raffled Ridge Vent 4 0281001 10, �O, S / 14- 4 2 x 12 Ridge Board 1 x 8 Collar Ties aQ 4'0" OL. located in the upper third of the height, of the roof,measured from the sill plate to the ridge. ' :z 12 io� Roofing Composite Roofing n 15 Ib.Bullding Paper , 1/2" Plywood 2 x 10 6 16" O.C. v v Attic __ r r�_ Attic 1 - -- - - -- Ceitin Fascia Board 2 x 8 a0Wa' OZ. Insulation Soffit m Vapor Barrier with venting 1/2' Wallboard, CID Floor 3/4" T E G Plywood Second _ Second U 2 X 10 aD W6' O-C, io' _ _ -- lo" —Wall Vinyl siding At Barrier Fire Blocking 1/161 O.S.B. 2 x 4 6 16" OZ. m o m Insulation Cz O � P I Vapor barrier No m VZ Wallboard Floor 'r 3/4" T E G Plywood 2xioeIrv' oz, Sill Firet 1`Irst Insulation — - i - 2XbPT, i - 2x6KD. buboContinuous 5111 Gasket - -- - _ -- 1=re Blocking Mudeill anchors 6 3'b" O.C. (max) �3 - 2 x 12 Center Beam Foundation nc „ �.3,000OO b onealel}8'0" Pour 3 i/2 Dia.tally Columns 10" dp x 20" w, contin,fVg• rz `A - Dampproof exterior surface Basement Basement 4" Concrete Slab Main Pouse S e V4 IN It 1 - - FARM.ER5 PORCH SECTION � w 5 � � Sheathing 2x ( ae 1( O.C. 3 - 2xBBeam Porch post f . " „ Decking 2- x B aQ 1(" O.C. (P,T,) 2 -,2 x S Band Joist — 4x ( post a a a - D dia, conc. pier — o • G - - a a D i GG221001 Continuous Baffled Ridge Vent ..k 2 x 10 Ridge Board I x 8 Collar Ties 0 4b" O.C. 12 10 ROOFING Composite Roofing 15 Ib.Building Paper 1/2" COX Plywood t 2x8616' O.C. /'L r _ - 2 x 4 vertical aQ 4'0" D.G. 3 - 2 x 8 Strong-Back CEILING Fascia Board 2 x 8 9 16" O.C. Soffit with venting n - WALL Sid Ing At Barrier 2 x 4 aQ 16" O.C. Sill 4" Concrete Slab 1 - 2x6PT., I -2x6KD, Continuous Sill Gasket Mudeltl anchors 9 3'b" O.C.(max.) - e FOUNDATION 10" Concrete Wall 10" dp.x 20' w, cont. ft'g. pampproof exterior surface Gar .;action 1/4" = PO" s 265 _ Stslrw"ay Ulidth � TWO- C 3603,13.1 ]Width=Stairways shall not be lose than 36 Inches (914 mm) In clear width at all points abovs the permitted handrail het3ht and below the required headroom height.The minimum width at and below the FgAM ING SECTION DETAIL handrail height shall not be less than 32 inches(813 mm)where a handrail is } Metalled on one side and 28 Inches(111 mm)where handratls are provided � m � on both sides. (Oth Edition Mao, 51deC. ode;LaLn Treads and Risers [3603.13,2]Treads and risers The maximum riser height shall be 8 1/4 reQ, Ca a, } inches(210 mn)and the minimum tread depth shall be rite inches(229 mn) Ca @ The riser height shall be measured vertically between leading edges of the adjacent treads.The treed depth shall be measured horizontally between the 2x Header 2x oor joist 2 - 2x Header angle planes of the Foremost projection of adjacent treads and at a r►�ht angle to the treads leading edge.The walking surface of treads and I kegs : ' � = I �,,�'- I of a eta"shall be sloped no steeper than one unit vertical In 40 units inhorizontal U% slope),The greatest rber height within any Flight of stats W, r '�� 2 x 12 Stringers shall not exceed the smallest by more than 3/8 inch 03 nm)and any two , I success"risers shall rot deviate by pore than 3/16-inch In height.The 2 x 4 Fire Blocking greatest tread depth within any Flight or stats shall not exceed the � '4 r r placed parallel with stringers emalleet by more than 3/6 inch(9.5 mm)and any two successive treads shall Zt cc n r- t I ,' ' r- co -r- � ,,, _ (optional ? not deviate depth by more then 3/16-inch. r Nosing Prof fie : I 2 x 4 Studs beyond) C 3603.13.2.13 Hostig prof lie--A nosing shall not extend Wore than L-A 1 I/2" beyond the:Face or the riser below. 2x Header 2x Floor 'oist 2x Header - Headroom-: Center Beam I 3603 .13.3 7 Headroom=The minimum headroom in all parte of the m r- I p stairway shall not be lees than six Feet six inches(2032 mm)neasured 2 x 12 Stria ors vertically From the sloped pians adjoining the tread noting or From the floor ■ ■ 9 surface of the landing or platform. ZE 13603.a,3 1,4ccaee to crawl spaces Starway headroom clearances shall be t accordance with the provisions of'00 CCtR 3603139. r — R I - E I Firestopping : C 3606 .2 .13 Fttisetopping:Fireetopping shall be provided to cut ofF all- concealed draft openings(both vertical and horizontal)and to form an i efFective fire barrier between storks,and between a top story and the roof space,Fteetopptg shall be provided in wood-frame construction In the - fOIIOWing IOcailoris .e , 12 T a0 9" = 9�0" 3, in concealed spaces between etat stringers et the top and bottom 0 � of the run. cA p � `p - X Nandraild= Gua r d r a i l Det a i l s C 3603.14,2 .13 Guardrail details:Porches,balconbe,decks,or C 3603 . 14 , 1 . 1 ] Handrails; Nandralls having minimum and raised Floor eurrecee located more than 30 inches(162 ram)above the maximum heights of 30 inches and 35 inches M2 mm and 965 mm ), Floor or grade below shall have guardrails not less than 36 inches respectively,measured vertically.from the nosing of the treads, (914 mm)M height.open sides of stats with a total rise of more than E shall be provided on at least one side of stairways of three or more 30 Inches (162 mm)above the Floor or grade below shall have guardrail, E Q3 9K min (mum risers. Sprat staeways shall;have the rec{uirred handrail located whit shall also serve as,handrails,not lees than 34 Inches(564 mm) X m on the outside radius. All.required handrails shall be continuous t height measured vertically from the Hoeing of the treads. E t read the full length of the stairs, l=nds shall be returned or shall terminate in newel posts or safety terminals. Nandralls adjacent to Csu a r d r a i 1 open -Ing Limitations - a wall shall have a space of not less than 11/2 inches (38 mm) C 3603.14,2 .2 i Exc.]Guardrail opening limitations;Required J cobetween the wall and the handrail. guardrails on open side of star ways,balconies,porches,desks and raised Exceptions'. Floor areas,shall have hiermadlate rade,balusters or ornamental I. Nandralls shall be permitted to be interrupted by a newel closures which prevent the passage of an object five inches(102 mm) post at a turn. or more in diameter_ 2, The use of a volute,turnout or atarting casing shall be allowed Exception:Triangular spaces formed by the riser,tread and bottom rah over the lowest tread, of a guard at the open bide of a etatway may be of size to prevent the passage of a sphere sic inches (153 mm)In diameter. - ram► CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number a O - ,�S Date cR '7 q 9 THIS CERTIFIES THATCv n THE BUILDING LOCATED ON () 7 -7 23O X pop C� s MAY BE OCCUPIED AS —SIV,? If- Fam►J�J p? (Sfax/ �6C IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. 04,MORT1CERTIFICATE ISSUED TO lee-2R4 • O? r • O' ,r ADDRESS a •ti��J+•...'��• e �L�iLU `""' Building Inspector SOF? Town of _ dover �r 0 No. 18* - ri dover, Mass., 4 19 0 �j 'AA_COCHICHEWICK v��` J BOARD OF HEALTH C: IT Food/Kitchen Septic S y stem.PERM �--' BUILDING INSPECTOR THIS CERTIFIES THAT...,1.r r '.t.....�.... I`10!t�........... ......IQ/V�.v.�........................ ............... p 0 3. V �� Foundatron has permission to erect..............1........................ buildin s on .....3.....�(.. ........ ....., ....!.. ................ Ro�,g�,//�. �� fL t0 be occupied as.....6t N ..!�.......l.-.R .�.�y a......5..�' �....... 4. .1.�!� Chimney P 6 ..... .. . .......... ........ .. ... y provided that the person acce Ing this permit shall in every respect conform to the terms of the application on file in Final A� this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of ✓rl� Buildings in the Town of North Andover. PL BIN I/NSPFRTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. �� ° y` S 9 l� PERMIT EXPIRES IN 6 MON S ELECTRIC4ANSPEC10I UNLESS CONSTRUCT ST ZT Roug ... .... ... .. .. ... .. .............. - � BUILDING f FirFir a � V Occupancy Permit Required to Ocaipy Building GAS IN§PECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough s� No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIR DEPARTMENT Burner Street No. Smoke Det. 6Ge' `/� tAORTH ED 16 �+ A: 6 `� _ O O _ LAKE -- _ \0 * . COCMICKEWICK ORATED App\ �SSgC HUSE�'� APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS/LOCATION OF PROPERTY: _ �q q i DATE REQUEST FILED/READY FOR INSPECTION: CLOSING DATE ON PROPERTY: y 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 CL)DFS. SIGNED: �n I L9 T4 co S