Loading...
HomeMy WebLinkAboutMiscellaneous - 74 SHERWOOD DRIVE 4/30/2018I LwJ O = Cc o CDD nCD O p 0 rL 3 m Z 0 _� U) O� O rt rD- C T .. O O CL m CD W n 0 (p 0 0 = C � C CD 2 U) CD co H CL '� Q OO �00 AM �DCD CD -0 Q� CD co OZ O rt 3. 0 = = CD CL U) >0 O to O CD — 0 CDU) ID CL CD CD �-0 U) 0 � {r ) 0cNt R AA R ��►: a C CD CD - C C CD 3 CD y S DCD C o � � o CL . co Ln 3 - c rD T 3, O n� C T 0 O O T o 3 O .Z7O S O O EL) C rD � O r m w S N �C S Q C S -6 rn;a n CD y O CDo N Dl .G .. O Q O � Ln < + O T. _ S O CL H m C W i� CL�• r- W v O V vC D N a Q� W = c a O 3 i CD ui H _ � CCD O CD � W O _ CD m m O y. cn 0 N '-S� O Z 2 Z CD 0n O 0ow Cl) CD a O CD O = Cc o CDD nCD O p 0 rL 3 m Z 0 _� U) O� O rt rD- C T .. O O CL m CD W n 0 (p 0 0 = C � C CD 2 U) CD co H CL '� Q OO �00 AM �DCD CD -0 Q� CD co OZ O rt 3. 0 = = CD CL U) >0 O to O CD — 0 CDU) ID CL CD CD �-0 U) 0 � {r ) 0cNt R AA R ��►: a C CD CD - C C CD 3 CD y S DCD C o � � o CL . co Ln 3 - c rD T 3, O n� C T 0 O O T o 3 O .Z7O S O O EL) A� rD O O r m w S N �C S Q C S -6 rn;a M O y m r � N Dl .G .. O Q O Ln < + O T. _ S O T m H m C W i� C G 0m W v z zX D N a � W O 3 i ui H _ � M m m -Zi O o m m m y cn 0 0 '-S� --1 Z 2 bCl 0ow Cl) Z G7 y m O O = Cc o CDD nCD O p 0 rL 3 m Z 0 _� U) O� O rt rD- C T .. O O CL m CD W n 0 (p 0 0 = C � C CD 2 U) CD co H CL '� Q OO �00 AM �DCD CD -0 Q� CD co OZ O rt 3. 0 = = CD CL U) >0 O to O CD — 0 CDU) ID CL CD CD �-0 U) 0 � {r ) 0cNt R AA R ��►: a C CD CD - C C CD 3 CD y S DCD C o � � o CL . co Ln 3 - c rD T 3, O n� C T 0 O O T o 3 O .Z7O S O O EL) A� rD O O x Km (D z m S w S N �C S Q C S -6 O M O m r � N Dl .G .. O Q O Ln < + O T. _ S O T m H m C W i� C G W v z z D N O 3 i H H _ � M m m -Zi O "_ m m m y 700 0 '-S� 0 2 A� O • i � Commonwealth of Massachusetts City/Town of System Pumping Record NORTH ANDO . Eli 11 2012 Form 4 ©VVI �r gil t<.�rt +.ttZ R 'h 1. 'ti'p i•S 9tiIXf .. DEP has provided this form for use by Ibcal Boards of Health. Other forms may be ised,.but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority within 14 days from the pumping date in accordance with 310 CMR 15.351, A. Facility Information Important: When filling out 1. System Location: forms on the _. .... _- - - 79, z/ computer, use - only the tab key Address to move yourG _._....._ _ IV Az Zip Code cursor - do not &iylTown State use the return key. 2 System Owner: / Name ---- -- ----- - _Ad___ dress (if different from location) Stale Zip Code City�i"own �J p Telephone Number _- B. Pumping Record 1. Date of Pumping 2. Quantity Pumped: Gallons ate 3. 3. Type of system: ❑ Cesspool(s) [� Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other (describe) 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. System Pumped By: Name Vehicle License Number Company 7. Location where contents were disposed: Signature of Hauler Ciate Signature of Receiving Facility Date 15form4.doc• 03106 System Pumping Record - Page 1 of 1 Date ..... `..�.. .. . TOWN OF NORTH ANDOVER PERMIT FOR WIRING . 4P77.. �-CThis certifies that ........ ................. . has permission to perform ... /�?. wiring in the building ... , N S�.l�i E'(� ........ ...... ..... orth Andover, Mass. Je .r ... Lic. No. 0174 .. ....... ELECTRICAL INSPECTOR Check#, 1.1184 _ 2012 Massachusetts Electrical Code Amendments 527 CMR 1.2.00 § Rule S: In accordance -with the provisions of M.G.L. c. 143,'§, 3L, the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wiresappointed pursuant to M. G.L c. 166, § 32, an electrical permit shall he issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L, Permits shall_be limited as to the time of ongoing construction.actinity, and maybe_deemed_by-the dnspector_of_Wires rabandoned_and.invalidaf_he..—. or she has determined that the authorized work has not commeAed of-iiaa not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on thq permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 23 8 of the Acts of 2012. The purpose of this act is to promote job;growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certairrpermits •and licenses concerning the use or development of real property. With limited exceptions, the Act automatically dxtends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qual-ifying period beginning on August 15, 2008 -and extending through August 15, 2012. )Rule S—Permit/Date Closed:f ❑ Permit Extension A et — Permit/Date Closed: *** Note: Reapply for new perm A Commonwealth of Massachusetts Department of Fire Services a BOARD OF FIRE PREVENTION REGULATIONS g (Please add zip codes & electrician's cell contract # & bld permit # if applicable.) Official Use Only Permit No. 1 ) 184 Occupancy and Fee Checked ,ev.1/07] (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 ININK OR TYPE ALL INFOR1lfATION) Date: /D City or Town of. C O (-++2-, A ►3 cio,3er To the Inspector of Wires: By this application the unde s' d r igne gz Yes notice of his or her mtentio tt perform the electrical work described below. Location (Street & Number C.f Owner or Tenant Cj e 2n Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building Utility Existing Service Amps / Volts Overhead ❑ New Service Amps / Volts Overhead ❑ uMVer of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 1A (Check Appropriate Box) uthorization No. Undgrd ❑ No. of Meters _ Undgrd ❑ No. of Meters Conspletion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires 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 ❑ In- ❑ o. o rnergency ig ng rnd. rnd. Baiter Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiatin Devices No. of Ranges No. of Air Cond. Tonsl No. of Alerting Devices No. of Waste Disposers neat rump I Number . ............................................... Tons I Totals: No. of Dishwashers Space/Area Heating I<W No. of Dryers Heating Appliances KW No. of Water KW Heaters KW No. of No. of Ballasts o. Hydromassage Bathtubs OTHER: 35a o. of Motors Total HP Data Wiring: No. of Devices or Telecommunication No. of Devices or ❑ Other Attach additional detail if desired., or as required by the Inspector of Wires. Estimated Value of Electrical Work: 9 0-3 (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE OVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER X (Specify:), Self Insured Icertify, under thepains andpenalties ofperjury, that the info.,rnzation on this application is true and complete. FIRNAME: ADT LLC DBA ADT Secu M[ rity / LIC. NO.: C-172 Licensee: Thomas J. Lee Stiignature ,' .,iib LIC. NO.: C-172 (If applicably.. enter "exempt" in the 1' ease number line.)t Bus. Tel. No.: �Q ()3 `> c� SY%7� Address: . ' C.. i r�' f r �� l\� fy 1 C9,O�,c Alt. Tel. No.:� . *Security System Contractor License required for this work; if applicable enter the license number here: 001779 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) El owner ❑ o� h Own r's agent. Signature Owner/Agent _� Telephone o. [PERMIT FEE. $ LTH OF MAVkSS'CHUSETTS 666MONWE ELECTRICIANS A:REGISTERED SYSTEM CONTRACTO ISSUES THE ABOVE LICENSE 0: :ADT .LLC. DBA A. EIT SECURITY. LEE 41'D` UNIVERSITY -AVE WESTwbbD MA 02,090-2 3 1 - liz c 07/51/13 2019.341 -4 Fold, Then Delach Along All Pedorations ' ,No 2684 NORTH 0 0 Date.. is// TOWN OF NORTH ANDOVER PERMIT FOR WIRING V? 3 This certifies that .... 7q. MP S ........t. `•O R..�,v ........ 0, ...................................... has permission to perform . ......................................... Iring in the building of ... ........................................................ ,7 c-'- 'Eknd�ov�ertLss at..... . ...... ...... eKh Lic. No. F�e ..... ..... I* N*S" -PE r b R Check# Z WHITE: Applicant CANARY: Building Dept. PINK: Treasurer �\ TBEC0 : 0AWE4LTH0FMA. "C11USET1S Office Use only DEPARTAIFJVTOFPUBLICSAFM Permit No. p BOARD OF MEPREVEMONREGULAT10AS527CMR 12* $P Occupancy &Fees Checked APPUCATTONFOR PATO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat ` 000 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 Owner's Address Is this permit in conjunction with a building permit: Yes M No M Purpose of Building Existing Service Amps / Volts Overhead New Service Amps / Volts Overhead (Check Appropriate Box) Utility Authorization No. Underground No. of Meters Underground No. of Meters �— Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work � � /JiY/J,4i ��liadna /lgmlo No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total dZ 1KVA ANo. of Lighting Fixtures Swimming Pool Above Below Generators KVA and ground ,No. of Receptacle Outlets i No. of Oil Burners No. of Emergency Lighting Battery Units o. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local r7 Municipal Other No. of Dryers Heating Devices KW Connections a No. of Water Heaters KW No. of No. of Signs Bailasis No. Oydro Massage Tubs No. of Motors Total HP i OTHR LmsanoeCaaage PtitsuatttiDthetegtutana>is�Ga�aalLam IhaNeawnutLmbtlityhstm=Pcbcym&dmgCm#* cuArwcrilsakgm>ualewi%, ait YES NO IhaNesubm&dvandptoofofsametotheOffm YES 1_J No F-1 IfjwhaeduiWYES,plememdc*t cNxofw bydmkirgthe 1NSURANU [ff BOND M MHER ftweSPaffy) Work toSatt o 3 a hWecfiwDa&Re*xstod Signed taxie ,& ties afperjtay. FIRM NAME FZ40fFA no EViatim Date Is, Mxkd VaiueofE6cfixal Work $ ^^Rough .S Faial Li=WNa Bus¢m Td Na Acle /ll,11-0 (/ /�,G'll ,B�i /�%/� ' 4/%-S Al Tel. Na OWNER'S INSURANCEWAIVER,Iammmethatthetioansedomnot theitstranoeco►�ageairss tacgrale la>taste t�dby selcsGataalLaws and ditmysign kmonthispennit this t rteM (Please check one) Owner M Agent_ j Telephone No. PERMIT FEE , (/ .2 C' G l� Date..l ......... No 4644 TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING This certifies that � ��. �G "• • • • • • .J• has permission to perform ... t .... . plumbing in the buildings of ........' ................... . l% at. iG...... .'r....... . , �orth Andover, Mass. .�.. ! ...S.. r� Fee./J<.'.. Lic. No.. Z.Y.? 2. ....... L-J�t ea? ..... LUMBING INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOI2sYERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS it�j --7 , ( `'�4 I '\ Date v �� Building Location Ly 2y`V� Owners Name ,11 f`1 1 G I V Permit # O-1 15�y Amount Type of Occupancy New ® Renovation Replacement Plans Submitted Yes No (Print or type) �� Installing Company Name Address4 �� e Seh k^1 Rnsinecs Telenhone (_ 11 , L4 7 — Check one: Fi Corp. E] Partner ® Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy E-1 Other type of indemnity ❑ Bond Certificate Insurance Waiver. I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner F� Agent M I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachu State Plumbing C and Chapter 142 of the General Laws. By:igna 51171censwer Type of Plumbing License Title V N um e 11 0 City/Town icensems— Master ® Journeyman APPROVED (OFFICE USE ONLY i G (Print or type) �� Installing Company Name Address4 �� e Seh k^1 Rnsinecs Telenhone (_ 11 , L4 7 — Check one: Fi Corp. E] Partner ® Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy E-1 Other type of indemnity ❑ Bond Certificate Insurance Waiver. I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner F� Agent M I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachu State Plumbing C and Chapter 142 of the General Laws. By:igna 51171censwer Type of Plumbing License Title V N um e 11 0 City/Town icensems— Master ® Journeyman APPROVED (OFFICE USE ONLY 3405 Date .. //f -..? . 5 :. r. a .. . N0RT1y , TOWN OF NORTH ANDOVER pya .ao ,etipL p PERMIT FOR GAS INSTALLATION This certifies that %�.7. Z/1<^ .... i'. / zz ��:! .... has permission for gas installation ... . ey.'. :-:'� ........ in the buildings of ... . v ! . !.�� ......................... . at ....!. .... .. ........ , North Andover, Mass. Fee.).),. " .. Lic. No.,?.�... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MAP PARCEL MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS or print) NORTH ANDOVER, MASSACHUSETTS Building Locations }/ l \CJI( IV -- /t A 0V erg Owner's Name New 21 Renovation ❑ Replacement ❑ Permit # r]J Amount $�— �1r'l Id%jO Plans Submitted ❑ (Print or type) - rA. OQY Name oT Address Business Telephone (q 11 `i `([ j b % S Name of Licensed Plumber or Gas Fitter N�►U)N Y L'�1� k one: Certificate Installing Company Corp. ❑ Partner. ® Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No[:] If you have checked M, please indicate the type coverage by checking the appropriate box. Liability insurance policy 10 Other type of indemnity ❑ , Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner —1 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 Cade and Chapter 142, of the General Laws. . own VED (OFFICE USE ONLY) Signature of Licensed Plumberibr Gas litter Plumber - y % 0 ❑ Gas Fitter License Number ❑ Master EDJourneyman Location '�'L/ - - "� A ---r -- ✓'�'� No. Date N^,. TOWN OF NORTH ANDOVER Certificate of Occupancy $ *A •'<�' Buildin /Frame Permit Fee $ 'T CHuse Building /Frame Permit Fee $ Other Permit Fee $ TOTAL $ �� Check # 14234 � j' Building I64pector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING .5,. A This Section for Official Use Onl �s � � � ��, � � � �f� M4 bre ..�'im-'A'i� L.: ' BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Buildin Commissioner or of Buildings Date , 1.1 css:1.2 Assessors Map and Parcel Number: y � _ e—e' W D Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zonin District Proposed Use Lot Area Fronta' e ft 1.6 BUH DING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide R ed Provided ReqWred Provided 1.7 Water Supply M.G.L.C.40. § 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal On Site Disposal System 0 2.1 Owner of Record /,—**N C!-- e, X� 0 —..- Nam Address for•Service: �i'e-TPrnint) S' afore Telephone 2.2 Authorized Agent Name Print Address for Service: Signature Telephone t ;a� ,. _ 3.1 Licensed Construction Supe rvi c Not Applicable ❑ - q p r i 5 Address License Number d 'sor. _ �Lic�enctionS Exbiration Date lure Telephone 3.2 Register }lo'�7'(q' C r��n�ictyorp Not Applicable 074 - Company Nam Registration Number C� Addre `,, � fiif ,�� �,✓� � �� Eacpirationt( lo..:2,o7/Si a re - elephone :=w7.L• SrilQls i .3'��f�E1W iOMPl�27: 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 Yea .......❑ No ....... ❑ sEcort s >R©vl Ax. �t+ crc°actc�rl ��s �ulr�rr�►ts r� 'T �t 1� c > .. � ►s ►A > 5.1 Registered Architect: l Name: Address Signature Telephone 1StCi+ect tfUfrdHF7F! _ I Area of Responsibility Registration Number Expiration Date I I I Name: Address: Signature Total I Not applicable ❑ Registration Number 1 - Expiration Date Name: Address - Signature Telephone f Area of Responsibility -- .r Registration Numbers' e Expiration Date Name Address Signature Telephone iq ' Area of Responsibility ` ' t Registration Number Expiration Date, Name Address Signature Telephone Not Applicable ❑ Company Name: Responsible in Charge of Construction I 6 '; 51��'!`�. i�Y�1�.fi'��►N �>R'`PR�:J!P!+>+I��? k.��Ykall,atsPl�eaVie� `'"'*,. b New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: A-0 i A-2 A-5 BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height ft Rt Independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, Owner of the subject property t/ W Hereby authorize -YC LZ My behalf, in all ifiatters relative two work authorized by this building permit application gna of Owner Date act on USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A4 ❑ A-2 A-5 ❑ A-3 ❑ ❑ IA 1 B ❑ ❑ B Business ❑ 2A 2B 2C ❑ ❑ ❑ C Educational ❑ F Factory ❑ F-1 0 F-2 ❑ H High Hazard ❑ 3A 3B ❑ ❑ IInstitutional ❑ I-1 ❑ 1-2 0 I-3 ❑ M Mercantile ❑ 4 ❑ R residential R-1 ❑ R-2 0 R-3 ❑ 5A0 �B�/' ❑ S Storage ❑ S-1 0 S-2 ❑ U Utility M Mixed Use S Special Use ❑ ❑ 0 Specify: Specify: Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND OR CHANGE IN USE Existing Use Group: Existing Hazard Index 780 CMR 34: Proposed Use Group: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height ft Rt Independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, Owner of the subject property t/ W Hereby authorize -YC LZ My behalf, in all ifiatters relative two work authorized by this building permit application gna of Owner Date act on A �blz�,a � 4 S 3 �.'.� �. Z , yrp/2?Q� qg � z Y@i •Y.usSY�'?�i�Yo_vRx9wS±L .tlmstauti "' ' ci P.Y�i. �{ . I, as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury Print Name Signature of Owner/Agent Date Item Estimated Cost (Dollars) to be Completed by t. permit applicant f 1: Building D (a) Building Permit Fee Multiplier 2 Electrical LL (b) Estimated Total Cost of Construction from (6) 3 Plumbing h Building Permit fee (a) x (b) 4 Mechanical (HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) 69 ®o Check Number f .a? iy„ fi i �.q, 7 -N`✓e } 'C .'. jj'z ,�!`.. y. { P•. i; {t yy4S t"Y74' #'t i".,r..ii.... y F,k E'&W,r€+ ' s{ W z :."? ,yy'' SPE ^r3h,\y3, { f:3 �{, S� �'V t e n 4 1,, + 3 h:. `n` f 4' 'Y f ti $' x 5 'Ai §� �s ,,ttr �pvti Nl`% U. 1 lI�T "% xP+ # Y t.4' Vf 1s.A]ASyi10- Y'v r� 4 :^': i 7R\ h P,,.�' ! r "A �+•-'N 3,N `4 i <�5�" S 1 fa / fi. Ei•,.. V �{^ rrt .'E �!.✓X P �Y., }'F��/ `5..f .��`tl:.}lZ ,•a )} �y� iY'S* a�f NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS IST 2ND 3RD SPAN �-- DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 3 WM- t 0'q _l'�q•: w�S� 3 �5��^�"T i A►µ�U.�� m l�cc�e �- �l3 a.'�' 11 FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used'tb verify that all -necessary approval / permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. an ffinumm on son Eno at APPLICANT e - b b,A HONE % (D ASSESSORS MAP NUMBER �V 5 OT NUMBER SUBDIVISIONS LOT NUMBER STREET `� l 'P R (/t/� m - ��/ J/�l REST NUMBER OFFICIAL USE ONLY RECON tMENDATIONS OF TOWN AGENTS �� DATE APPROVED 9 1CO RVATIONADMNISTRATOR DATE REJECTED COMMENT'S TOWNPLANNER CONDAENTS FOOD INSPECTOR HEALTH ,r� SEPTIC INSPECTOR - HEALTH n COW ENTS S!�;Qf G �e�)io mss _ 7;� 741/ a �� PUBLIC WORKS — SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REQ --r � �61ZMMM DATE APPROVED DATE REJECTED CONRV ENTS RECEIVED BY BUILDING INSPECTOR DATE J '�• G G LIC #054201 4� Roo RE6 #ZO569, fe4 h7;- (761)246-2328 11 HAWrHoP.NE STREET, WAKEFIELD, MA 01860 FAX(761)246-2328 e) C) The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit am a homeowner performing all work myself. rJ-a -a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Comoanv name: Address City: Phone #: Insurance Co. Policv # Company name: Address City: Phone # Insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of thyv tement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under a gejhs a penalties of rjury that the information provided above is We and correct. Signature v%/ Date 1,PP Print name C Phone Official use only do not write in this area to be completed by city or town official' ❑Check if immediate response is required Building Dept Contact FORM WORKMAN'S COMPENSATION A. r ❑ ' Building Dept ❑ Licensing Board ❑ Selectman's Office ❑ Health Department ❑ Other A Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 DEBRIS DISPOSAL FORM ¢ NORT}i ' O O CO[MI[ W wK M ACHU`�' In accordance with the provisions of MGL c 40 s 54, and.a condition of Building permit# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, sl 50a:. The debris will be disposed of in /at: /-- 4 6 '�- -yam acility location Signature of Appli Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. ✓4f 4mitt[ m^,/d 4 1t--Lf(634 fiGPi�i3 OARD OF BUILDING REGULATIONS N SUPERVISOR i 1 License:- CONSTRUCTION pq 4 , Number: CS' ;} 054201 ;e Birthdate: 11/19/1952 Expires: 11/19/2001 Tr. no: 9869 (, b - Restricted To: 00 EDWARD G CHAPUT ( 11 HAWTHORNE ST WAKEFIELD, MA 01880 ministratorai Ad . � UQUE It(PR4i+iUE�T CONTRACTOR Registration: 1�Q56� • - �` Expiration: 6/191Q� -type: UBS , CI�RPUT CONSTRUCTION , Edgard eDapat ; ADMINISTRATOR NAKE#"IELD HA Oi8$0 . Cl) m C m Cl) 0 m _v, _ rM ' _ CO) Cl) CD a Z CA CD O 'v CL n� CZ ? CO) � O � C CD CDCL cr O CD CD O CSD C CD y CL v y co CD � v CA O Z O O S! a O CCD 0 C CD _C $ m _ O -• H O Q N n,o <m "o CO) —1 O a 9 0 m n CD y"a,� m 3 Z •� �� H O 6) m CD =r 0) = CO) CD O m N p > > N m -j n .O•�. O O O N, C09 CD to ncc 0 , , g: VJ m CC o CD C= 1 to s ® N G ` Q C� W— c CL1 O f N C- m i04v E� m lo . �„ y � N � o :• p� yup �mm: �, C.) t O o O mo� zN . O m CD � C) CD .ate O� n , C7 o_: o m 70:: o 9 K, ro 4 - w rD M 7� x °� o O rA r x °� W y 5. o o�v a- Ci7 r � w o G ►� r O x °� n 0 aGa a- o C 0 d b cp . � o p O x y 0 No 2111 6.1 Date. ......................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that ......................................................................................... has permission to perform wiring in the building of... .. ............................ . ..... 1 25 at ..... 75 . ...................... .............. ............................. , North Andover, Mass. Fee..................... Lic. ............. I ................................................ ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 4 Ocpanmmt of Public Safety f OOARO OF FIRE PREVENTION REGUTATIONS� S27 CMR 1200 3/90 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK', All Work to be performed in accordance With the Masaaehusetu Eleetr{eal Coda. S27 CMR 12:00 (PLEASE PRINT IN INR OR TYPE ALL INFORMATION) Date City or Town o° Al. 14AIDO V E a To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street 6 Number) 7q D O-rer or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes a No ❑ (Check Appropriate Box) Purpose of Building_ 5 -c-ten -ha I Utility Authorization NO. Existing Ser -ice Amps / Volts Overhead 'L❑ Undgrd ❑ No. of Meters New Service Amp / Volts Overhead ❑ `Undgrd ❑ No. of Meters Number of Feeders and Ampaeity Location and Nature of Proposed Electrical Work 13V rol /a.,— /Zi /A r M No. of Lightizfg Outlets No. of Hot Tubs No. of Iransformers Total KVA No. of Lighting Fixtures g 8 Above In- Swimming Pool grnd. ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices g No. of Self Contained Detection/Sounding Devices Local(] Municipal ❑Other Connection No. of Ranges Iotal No. of Air Cond. tons No. of Disposals No. of Heats Total Total Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No, of fro. or Signs Ballasts Low Voltage Wiring No. Hydro massage Iubs No. of Motors Total HP INSURANCE COVERAGE: ' Pursuant to the requirements of Massachusetts General Laws I have a current Ltabilit Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES (E'" NO I have submitted valid proof of same to this. office. YES Q --f No p If you have checked YES; please indicate the type of coverage by checking the appropriate box. INSURA14CE 'BOND ❑ arL7ti ❑ (Please Specify) Estimated Value of Electrical Work S 9-75-,00 Work to Start / % 8 — ) O40*�nspection Date Requested: Signed under the penalties of perjury: FIRM NAME SV 121 v m,, xpiration ate Rough Final LIC.. NO. Licensee 14e-6 /-)-R r-nt' /J. � ✓ / //✓Aj6- Signature �O %1.Qi_1 oa/ ; .i/yc�t LIC. No. 2 � Y � !] Address e?_7 M1 Wien .57- 1-4W2E1VC , 174 Bus. Iel. No.97l3- Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or is sub- stantial equivalent as required by Massachusetts GeneralwsLa ,and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. Signature of Owner or Agent PERMIT FEE S No 2078 _, Date../ 71,Q7 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ......TO..............��.. .. r.. �.y..... ..................................... has permission to perform ..................................................................... wiring in the building of .... C b < <� e , ............................... at7........................................................y // f ? .. ,North Ando .er, Mas' ..... ............ !� Icr- 3�s".�J�%D� �� 71 / �j�ELECTRICAL INSPECTOR G�/��� WHITE: Applicant CANARY: Building Dept. PINK: Treasurer "`VVV THEC0A�%I0�TH0F'Mf�,SSACHUSL'�TS� Office Use only DEPARTAIEIVTOFPUBUCSAFLn Permit No. BOARDOFFMPREVE1MONREGULAHOASSrC W?12-W _^ Occupancy & Fees Checked APPUCATTONFOR PERMITTO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 /�/q �/� � t (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date O� Town of North Andover - To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street 6 Owner or Tenant Owner's Address / f) v -i r � `I- I ,/ -- g - Is this permit in conjunction with a building perm: Yes No (Check Appropriate Box) Purpose of Building�S / � 6 c � "f--11 / L -y- ;� /N L L /aG w Utility Authorization No. /, 6=6� Existing Service Amps` / Volts Overhead Underground No. of Meters New Service Ob Amps"d�Volts Overhead Underground No. of Meters T_ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of 4hting Fixtures Swimming Pool Above Below Generators KVA groundg1:3round No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Snitch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No, of Sounding Devices No. of Dishwashers Spice Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW ® Connections _ No. of Water Heaters KW No. of No. of Signs Bailasis No, Hydro Massage Tubs No. of Motors Total HP OTHER '•t ]r>✓uanceG Ptastx�ttttothettjgtmarta�of'Nl�ad�set�C>�alLaws Iha,,eaome tLikkka==Pd yutduLktgCarode Co►aEWcrtssksunbale4nvdat YES ® NO Raresthnttedvdsdpmof'ofsWXloftO(iW- YEs M NO r If}ouhaedxdwdYFS,pimeirtd*thetMmcft bydxckmg& 0 BOND 0 O1HR r7 WcdciDSw hgtecdmD&Regtrested Sigred unckrTie Rndb es ofpajtuy: n FIRMNAME Fi, ee R'S r ftme) FstQtaledVahjeofE6trical Wodc $ Raigh Fugal LioaseN . Lioel>SeNo � �i �v / q ` Business TcL Na _ Ad. - I IAl��v-D (iL�BU�°/� AIL TeLNa 77 7„ 7775 OWNER'S INSURANCEWANFR;lamav&et rL&Liamqedxinstuarneer arils alqi%ata>tasmgLmWbyMm dasettsG=rAI mvs and Oat my Witmcnibis pm* wphca6w vans dris rawaaTKM (Please check one) Owner Agent ®�� Telephone No. PERMIT FEE to 1889 I TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that —r�.�........tq :'.'. ............................... ..' ............................ has permission to perform .... .......................................... wiring in the building. of .............................................. .. ...................... at ... . ............. . North Andover, Mass. – Fee- S,1A ............ Lic. Noli .......... ........... ............... ELECTRICAL INSPECTOR WHITE: Applicant CANARY;, Building Dept. PINK: Treasurer THECOMMONW 4LTH0F1114SSA0ffJS= DEPARTMENT OFPUBLICSAFETY BOARD OFFLREPREYEHONREGULA7TOASS27CMR12.-00 Office Use only Permit No. Occupancy & Fees Checked APPUCATIONFOR PERMITTO PERFORIVIEL,ECTRICAL WO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSsTS ELECTRICAL CODE, S27 CMR 12:00 /99 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat 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) L- y <A�: / 14w)� y�- `%L/ Owner or Tenant ^ (b} -"> ;.d --I- V e // " f V 1i-10 Owner's Address .�....�.,L� � , TVI'y471 of Is this permit in conjunction with a building permit: Yes &D No a (Check Appropriate Box) Purpose of Building Existing Service Ampsi� / Volts New Service f (jam,. Amps fIA-Volts 1 Number of Feeders and Ampacity Utility Authorization No. Overhead Q Underground Q No. of Meters Overhead M Underground No. of Meters _ i _ Lobation and Nature of Proposed Electrical Work--� w 5 Onko ,aj- gt i 1,C1 No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool . Above Below Generators KVA ground ground No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of He Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local F --JJ Municipal Other No. of Dryers Heating Devices KW 4 Connections No' of Water Heaters KW No. of No. of Signs Bailasis No" Hydro Massage Tubs No. of Motors Total HP 0TEEIR • .�_.._ W41 N1111M, :• w:• . �... •• •• :• i - • fir .9.'� • • ' • :• :. 'A r i a:r..�- .- •' .• - . • ::•v ! . d11.•1 +-•U .97 0 •at- s � :• ��, i c►:•i � far • :o :,ter,• ` � :� i < ol BeskmTdNa -no L— "l !> U'9�/fyl�d✓ Ak.TdNa OWNUVSDSURANCEWANER,IxnmacethttheLiomwdomw lheinst=oew*=Wo akswiwia*mdatasteglmwbyMm �td�mysgr�taernthis pemrit tianwatws ilns tec�mst�. (Please check one) Owner ® Agent Telephone No. PERMIT FEE _ d7 J� Date. :G ...... f� HORTM TOWN OF NORTH ANDOVER pF 4t,,o ,e'y0 3? PERMIT FOR GAS INSTALLATION This certifies that . r4<—? .� /.-.1....Z- .".f has permission for gas installation`....... . in the buildings of .... /-'f ��-U�z :' ..... . at .. y .`�' .4 �: ..........1. , North Andover, Mass. Fee.. .�..Lic. No. .t . !.<.r.! . .......i. � ......... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer b ✓IASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO or print)a" li0 �I (;' & as kr-r i MASSACHUSETTS I Building Locations _7 -�v� ax-I/l— Permit # 3 J^y Amount $ Owner's Name � � New Renovation ❑ Replacement❑ Plans Submitted (Print or type) Check one: Certificate Installing Company Name,_ Galinskv Plumbing & Heating Inc. XX Corp. 1906 P.O.Box 1701 Haverhill, MA 01831 Address ❑Partner. Business Telephone 978-374-1743 ® Firm/Co. Name of Licensed Plumber or Gas Fitter Stephen C Galinskv - INSURANCE COVERAGE Check one: 1 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 ❑ 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 intbimation t have suomrttea (or enterea) In aoove appncauvn 41C UUU a61.. ••-- bgst of my knowledge and that ail plumbing work and installations performed under Permit Iss for this application will be in compliance with all pertinent provisions of the Massachusetts State Ga*-o�e an�pter"t eneral Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature dVI ® Plumber ❑ Gas Fitter © Master ❑ Journeyman u w � � Z z c. w Z CC a m O a5 >Et w P z O z O vFi w . x w z .^, C V SUB-BASEM ENT BASEMENT i I 1ST. FLOOR 2ND. FLOOR / 3RD. FLOOR 1 4TH. FLOOR STH. FLOOR 6T 11. FLOOR 7T 11. FLOOR RT 11. FLOOR (Print or type) Check one: Certificate Installing Company Name,_ Galinskv Plumbing & Heating Inc. XX Corp. 1906 P.O.Box 1701 Haverhill, MA 01831 Address ❑Partner. Business Telephone 978-374-1743 ® Firm/Co. Name of Licensed Plumber or Gas Fitter Stephen C Galinskv - INSURANCE COVERAGE Check one: 1 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 ❑ 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 intbimation t have suomrttea (or enterea) In aoove appncauvn 41C UUU a61.. ••-- bgst of my knowledge and that ail plumbing work and installations performed under Permit Iss for this application will be in compliance with all pertinent provisions of the Massachusetts State Ga*-o�e an�pter"t eneral Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Plumber Or Gas (cense Number Signature dVI ® Plumber ❑ Gas Fitter © Master ❑ Journeyman Plumber Or Gas (cense Number N° 4.265 Of ,NORTp ° s s ,SSACMUSE� This certifies that .. ~.;.7. has permission to perform Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ........... 1 ............................... plumbing in the buildings of.�.�..�. . r?—........ . North Andover, Mass. Fee Lic. No... ....... .. ���. c ��............ PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer L r� MASSACHUSETTS UNIFORM APPLICATION 7DWZ TO DO PLUMBING 'ype or print}d�7� MASSAC SETTS e. duildingLocations —7Z S � ��.o �0 �� w� Fermit # 4,e Z Amount 2� Owner's Name New Renovation ❑ Replacement [3 Plans Submitted (Print or type) Check one: Certificate Installing Company Name Galinskv Plumbing & Heating Corp. 19nh Address P . O .Box 1701 ® ppm., HAVArhi 1 1 MA ni R41 Business Telephone 978-374-174-3 ® Firm/Co. Name of Licensed Plumber: Stephen C. G a l i n s k y Insurane CQyeraee: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ® Other type of indemnity Bond insurance Waiver I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance gn Owner 0 Agent ri I hereby certify that all of the details and information I have submitted (or entered) in above ap licatio true and accurate to the best of my knowledge and that all plumbing work and installations erform der P ued this application will be in compliance with all pertinent provisions of the Massachusetts S P g Code C p of the C3eneral Laws• 13y: Type of Plumbing License Title 13L,,,gg,__�� City/Town Li ZM'i Der � Master 13 Journeyman 11 APPROVM (oFna usE ONLY r CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number Date THIS CERTIFIES THAT THE BUILDING LOCATED ON. MAYBE OCCUPIED AS S j a:q )e / i m, & 10r -S 1d e&r � IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. o ,ORT" CERTIFICATE ISSUED TO J � e., w o dd De u k t,- L ADDRESS °SACHUSt� - Building Inspector Cl) m C m Cf) 0 m y co Cl) Z CD ar Cid C; o � C0 -p O CD o p CL Q CD o CA 'O CD O W d 0 .p c 0 c CA E C7 CD 0 rF CD CDa CA. CD CA 0 O CCD O G CD W V J 2 a\ cn C O c��o 0 CL m y m m C7 v, m a c M= LA -n ir c. 5 m -4 o m y O y o m ® �m CD Oc w y. m o Com. CD ® co, ,om; CD H = :.%. i ��i W CA CL am c V CL C c CD: y ca c m m =-9 CD:bf oC.) =rCD (� _ 1 3 CA o CDRAW ?. m V: � H CD o �: o C' � m . d m : C2 Co CA n� c o o=' ro c z r0. ;•J e y 0 0 c J t`� �I Location d � �'r�?� No. Date �` ` / M�RTh TOWN OF NORTH ANDOVER .�?O� •t`•o !+,SOL h - p Certificate of Occupancy $ -� ©• Building/Frame. Permit Fee $ sJACHUStt Foundation Permit Fee $ Other Permit Fee $ Pfi9 c ` Sewer Connection Fee $ --------- g'4p Water Connection Fee $ /!,51 r , TOTAL / $` a a� Buildi Ins a tar 19ta/W 1!4247 1.91', -00 Div. P blit Works S X CD C Y m i > ) rr 7 7 N T. h > W. W z N w nm L m 6. N � m Q �C 9 > of i v m m S X G y n M CD C N > W. W z m m G y n M �;4,,ti �ag 0� 3y Y 19, o Y 33 4tvx4s FORM U - VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all' necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section*************�**** 10-e.(/�y ir,�,� Phone 0 z 'v�� � • APPLICANT: 2 ✓ a �+ f0 LOCATION: Assessor's Map Number Zo LCAC Parcel Subdivision ,LJL— Lots)' Streethe�'Cc/DoU�- �� 1 �� St. Number 171/ ************************Official Use Only************************ Z AT&Admini 0 WNApiq Date Approvedion trator Date Rejected ,,� Comments Food Ins ctor-Health ]� - l •c Inspector -Health Comments 5,50_5 Date Approved: Date Rejected Date Approved Date Rejected Date Approved Date Rejected g Public Works - sewer/water connections W 3 - drivewayermit Fire Department Received by Building Inspector Date G Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of Applicant on Building Permit (below) Address of Property for Permit (below) Map and Parcel: Purpose of Application (check below) Phiopne Number of Applicant: Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management Bylaw. I also. understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the Building Permit. Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building Department and is only officially accepted when the Building Permit iq issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application fora building permit for the enlargement, restoration, or reconstruction of a dwelling in existence as of the effective date of this by-law, provided that no additional residential unit is created. The lot(s) were/was created. prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning y aw. This application is for dwelling units for low and/or moderate income families or individuals, where all of the conditions of 8.7.6.care met and/or represents Dwelling units for senior residents, where occupancy of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this Section "senior' shall mean persons over the age of 55. This application is a part of a development project which voluntarily agreed to a minimum 40% permanent reduction in density (buildable lots), below the density, (buildable lots), permitted under zoning and feasible given the environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently designated as open space and/or farmland. The land to be preserved shall be protected from development by an Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism approved by the Planning Board that will ensure its protection: . This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready :for building permits,(i.e. all other permits from all other boards and commissions have been received and the project is in compliance with those permits), and the Development Schedule does not accommodate issuing a building permit in that Year, one building permit will be issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Applicant must supply approved forth U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination' that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the.information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate information, or the checking off of an above item which does not comply, whether done to my knowledge or not, is grounds for refusal by the Building Department to issue a Building Permit. ignature o wner or Authorized Agent who signed the Attached Building Permit Date This form must be attached to the Building Permit'upon application for such permit COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR Builder/Designer 131 an J .4. Date MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # ; MAScheck Software Version 2.0 ; Checked by/Date ; CITY: Lawrence STATE: Massachusetts HDD: 6235 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 9-1-1999 DATE OF PLANS: 9/1/99 TITLE: PROJECT INFORMATION: LOT - 5 SHERWOOD DRIVE NORTH ANDOVER, MA 01845 COMPANY INFORMATION: WILLIAM BARRETT HOMES 1049 TURNPIKE ST NORTH ANDOVER, MA 01845 COMPLIANCE: PASSES Required UA = 637 Your Home = 622 Area or Insul Sheath Glazing/Door Perimeter R -Value R -Value U -Value UA -------------------------------------------------------------------- CEILINGS 1781 38 0 0.0 53 WALLS: Wood Frame, 16" O.C. 3342 15.0 3.0 223 GLAZING: Windows or Doors 568 0.350 199 DOORS 40 0.350 14 FLOORS: Over Unconditioned Space 1935 19.0 92 BSMT: 8.0' ht/7.0' bg/0.0' insul. ------------------------------------------------------------------------------- 186 0.0 41 COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR Builder/Designer 131 an J .4. Date vim,`47, � I � �� 14� {►Z � /�� ,ROAAOAllOL 100,/ 001, ol ow de lo i N \1 � 1 fib r' �:� \ \ t• \ / I ON \ \\ b 4411 \I i I�` D r--_ - - I------, q grV1 F �\ rJ • � .�Q1 I� 1t I I � t��� i �• U _J—L O to r,� (b y( nlal Z CjW c�Q R NO Cb Co 1. o �4r ► I ` ECJ '` fir.-.. I / i J� a I I • o Cp 1 t tt t I I �` �ti� ` I i I /It 0 Ul� Ulm o 5 °-,z �° o "? ° :r .o (D :r o N aM m 0 m roc3-;d C y• -a ' m 0 m :3 fD CD 0-0 C MM -1 m _ M m -• Q x D a fD Q En n a� -* CA m Ln m 3 CL ` c ' .« o Cu o' 3 0 c lho ,�,► E ° a 0, 3 .< lk CL M x .. c oaj N C N � N .+ m E` Z a o 3 0 4 CD C °- mn a b ff r7' o a d ~ N ^ •ALO/1 0 � yz o y � z 0 9 Q.. COO 0 c m C m m 0 m FA -v, CO2 C") n Z y CD O 'O CL r �� C. y cl CD o p CD Q d CD CD O CD C CD rA CD CZ O CO) O I tC CD CO2 O 'o Z CD n C3 O o CD O Ic CD Cl) C/) VqJ L--1 z0 cn C O O Z O CD 0 co O c CD ca o: O N C 0 CL N 5 N m _. N O Q N = a0 m -0 C/! m 0m C7 m -CD nn N _ .-► � 0-► m NIn =r CL m O m CO) O W o�mLm a CD AL O N n V' _ CD �� = ao !� o CD CD m N O m CL CO)CD Co CL N C G CO CD H N CD m CD O O W O :� o CD ... : m sa � m n 3 u �o CD Im 03 mac: CO) = :cm� 06 cn 7oc- ' rn aGO) y w o °° ' 3 o Gn p " w o "� O :p � �' Go o � d coo I -j O o A. O "> z Q • a W � �AA 05C�f� �'�" azo �crnrl �; 5VIwo0n 12p\W L01' ' S I / 811 _- 1 .011 r,A : PM -PSP: OF FINS HOMF-5 sru`nu; FpONf" LFVAION C1mNMPy; VISIONS; G 4 - 1 el -.0 4 i \ T r PRO ECf Mr: 5CA X; DAtE: 51 Ef: W L - � o �M � �� �--� ��pwoon apiv� Lor -� �ET TIiL�; t�i1UJN (3Y: VISIONS: G� o G-� I3�.I L-Pr-il, Or- FINN- HOMF-5 M\ ff\ I,�VAVON 4f - A r� f1 I i I I I I I I I I II I i II • II I I I I II II II I I II IL-__-- � -I I I I I II II I I P f I I I I I I I I I I CSC I I • Z II I I I I I I I I I I I I II II I I II I I ii I I I. I. I I II I I I i I I ,I I I II LJ r PRO ECf Mr: 5CA X; DAtE: 51 Ef: W L - � o �M � �� �--� ��pwoon apiv� Lor -� �ET TIiL�; t�i1UJN (3Y: VISIONS: G� o G-� I3�.I L-Pr-il, Or- FINN- HOMF-5 M\ ff\ I,�VAVON 4f - A I I 4 1 II I I II LS r1 LJ pro.�cr,m�: ':1/61 c�: nn�; o�� ��� �����-I��vvoon nr?Iv� Lof - I/ 81,�I,,ollf V/ QUI L PFI; OF. F I I \IF- HO b 6F- 5 of fnt; mvm 6Y; VISIONS: 51MEI.�VA111N5 1',6,N, � y b 8'-0" 1 5'-0" 1 20'-0" O b 90 N b N 5'-9" 1. 4'-9" I. 5'-0" 1. 4 1-91l 10'-6[1 1 1"VI X19. o crrlV: 51'1 �PIWO0V IXIV� of - I / 811 I _�i i PAZ j l err. E3U L PF- P- OF F I NF- HOMr-- 5 sr �rrnl , FOUNPAWN FLAN I wN 6r. f' CAA wsloNs: G • � t 3V -of l 41-0" 1 a���� y.-p�� � 4'-0" 1 16'-0" I� o C N - f3'-f01/a" I 5/ A" :N J'-3" 13'- 1 y' -a, 1, 3'-3" o� ----------- w 7s l � n N ------------ 1151-11, ---------- 13'-1" I. 6'-2 73 -75 q W $� 0.0 6S\P Y ® p p y� {� FRo fcT Ime: 5 a : PAS; sNEET; V V IL -IIS- � ®`" A A IV f� 5H rwoop Prly� Lff SNEI T 111LE; mvm IN, I�VISIONS: I �J �� d FIt?5MOO pI.AN f,cm, I i J?t _ I � I N 2' " " 5' 0" 10' -0" p b � I � mvg o" Vim q O WASi DKV x b `J--�-----------J I I = N PuOD N Pu 61 a b N ' I 1 b1 o y I v - N ---------- —( I �zl 6 - J I --------- ----- --- 21- -9" 21'-9. 26' Ou I u� S W A- 4- a �� cc -- J � ®. • 1 c�6 IN CQ ' N FROYCi Inn; SCAB: 12M 5fEt: W 5HI Plwo0n nrIV� 1.01" - 5 I / 8 s 1 X011 g ,, C)q 13ULPF-IP,, OF FI NF- HOMES .r,,5�CONn FLOO; PLAN �,��Y: 1',G,N, WVh10N5; 1 13U'Jt�GING -CC i 7� B�JI?GING � � ALL MEMDEES� 2X1015" OC, Z S1 5TM MLI ]W,F �117GING FL1,151 MI M P REAM � 6RIpGING C'�17u'ING G��GI"1G Z Q) AU, MEMOM AT Q 2 X 10 15" O,C, c = -CC FLU51 PIMP P BEAM FLU5H FIMAMEt7 6EI AM m- b fill III I Z � W1176ING D�It7GING (�I?GING W 10— � � AM � �� �"-B" I'<ZO,fCT TM.E:SCALE: SN��WOOn nI;IV� Loo - 5 I / 811, I -0 DAi�: SET: --77 %afTwI FIK51' & S�CONb �rJ�MING rI.M15 MAIN 6v; 1��G,N, MA51m: � L3UIIL-VF-C? OF FINF- HOOb I�S /�` o 0 � // // 5 W L- � � AM PWIl>;cf ME.- 5H�Plwoon Pkl vV Lo' - 5 5W:11811--1 1-011 /811.11,011 PM: 0/�I 9�9 5 ef. f7IZAWN 6Y; WV15lA5: 93�I�I�P�i: OF I%IN� H0�11�5 ��Tnn,�` FPAMING i'I.ANS 1�,G,N, / o 4 *7 r 0 ".. r -r" - 10" 1 143 its- OUB OWN 7o c^ � F N v scuj 511 . I 1 -011 L3UL-t2r--P, OF FINS HO F -S ` vmVY;f.6,H, ffvI51ON5: �UII.�ING 5�C111N5 � y, -o, 8'-41/ 2" �crnp � O ACV, Z N X y o. Q _ r4 z � O O � O y �NWN X ZN�� X\� N'4ZX�Cci _ 1 O N35 �� n 143 its- OUB OWN 7o c^ � F N v scuj 511 . I 1 -011 L3UL-t2r--P, OF FINS HO F -S ` vmVY;f.6,H, ffvI51ON5: �UII.�ING 5�C111N5 � 0�ZQ�� �crnp � O ACV, Z N X y o. 143 its- OUB OWN 7o c^ � F N v scuj 511 . I 1 -011 L3UL-t2r--P, OF FINS HO F -S ` vmVY;f.6,H, ffvI51ON5: �UII.�ING 5�C111N5 � 0 -4Ul < Ul m p c 3 . 5 n m m m Z � 0 O O •* 0 nl p• (D D'7'I O C -0 M N (D (D 0 2 o c 3 C)- N. pe 3 CD 0 A 0 H 7 N 0 0-0 (D O O = M a ��'coo D c d T3CD 50 CL A Ln nj o o c c m 0 N o �. c� E � o c n. = c Q (D 3 m S. U1 N _ Ql N 0 =) N '0 a a0 0 •' M ('% a CL ::r 3 04 .� v SC mn CD .. CL0 r, t� " S o CD 0. o con SHERWOOD DRIVE 115 f 52' 32' w LOT 12 w LOT 1J H- T.O.F. EL.=140.4' 46 f FOUNDATION LOCATION PLAN CLIENT: MESSINA CONSTRUCTION THIS CERTIFICATION IS MADE AND LIMITED TO THE A80VE CLIENT. LOCATION: LOT 12 SHERWOOD DR. NORTH ANDOVER, MA 13' LOT 11 I CERTIFY THAT THE PRIMARY STRUCTURE SHOWN CONFORMS TO THE HORIZONTAL SETBACK REQUIREMENTS OF THE LOCAL APPLICABLE ZONING BY-LAWS IN EFFECT WHEN CONSTRUCTED. (THIS CERTIFICATION DOES NOT CONSIDER ANY OTHER RESTRICTIONS SUCH AS COVENANTS WETLANDS,EASEM£NTS, ORDERS OF CONDlTIONS,ETC.) THIS DRAWING SHALL NOT BE USED BY TF1£ CLIENT FOR ANY PURPOSE OTHER THAN THAT OUTLNED ABOVE,EXCEPT WITH THE WRITTEN PERMISSION OF CHRIS77ANSEN & SERGI INC. FURTHERMORE THIS DRAWING IS THE COPYRIGHTED PROPERTY OF CHRISTIANSEN & SERGI INC. AND ANY UNAUTHORIZED USE 1S PROH/BITED.CHRlSTTANSEN A! SERGI TAKE NSlBIUTY FOR THE UNAUTHORIZED USE OF THIS D IIY Qp ? j1t4FOR- MATION CONTAINED HEREON.! , Ply MICHAEL J. u� SCALE: 1" = 60' DATE: 3/21/2000 CHRI S TIA NSEN, SERGI PROF° �R,.o ERS RSI r: 4. 160 SUMMER ST. HAVERHILL.M4. 01830 TEL. 978-373-0310 ©2000 BY CHRIS"ANSEN & SERGI INC. DRAWING NO. 00010002 TOWN OF NORTH ANDOVER APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS/LOCATION OF PROPERTY : % 1f S A ee Leo d A Oriy e— DATE REQUESTED FILED/READY FOR INSPECTION6 CLOSING DATE ON PROPERTY: (s> FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND PERMIT SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY DOLLARD $20..00) WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL: APPLICABLE CODES. SIGNED�l ROUTING CONSERVATION ' PLANNING DPW - WATER METER Cl-2 NOTE: DPW MUST INDICATE THAT WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST DPW ig nature