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HomeMy WebLinkAboutMiscellaneous - 78 PALOMINO DRIVE 4/30/2018This certifies that -7-:4 .. ..t..`.... .s :... �. 1! .``rn.?s�. i has permission forgas inystallation in thebuildingsof......................... . . ,North Andover, Mass. Fee. —)A`-�v . Lic. No. .... ................... .. . 10 GASINSPECTOR Check # 6 alp `-alp 0 ii € 632 Date ...... m/ TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION .1 This certifies that ..... 6� .......... /* has permission for gas installati .. .... .............. in the buildin&s of ....... Z7 ..................... ........ . .......................................................... at.7k .... kb./*6*�*.'�� e ........ ... ).ia, North Andover, Mass. ' Fee ... 9 Lic. No. 160'5 4? GAS INSPECTOR Check# 56? MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY I North Andover MA DATE 1 1212/2015 PERMIT # JOBSITE ADDRESS 78 Palamino Dr OWNER'S NAME I Geraldez GOWNER ADDRESS TEIf 978-3974411 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL[] EDUCATIONAL ❑ RESIDENTIAL Q PRINT CLEARLY NEW: ❑ RENOVATION: ❑ REPLACEMENT: 0 PLANS SUBMITTED: YES ❑ NOE] APPLIANCES 1 FLOORS- BSM 1 2 C 3 1 4 5 6 7 8 9 10 11 12 13 14 BOILER _ __ _ -- - ----- - - --- BOOSTER i CONVERSION BURNER _M COOK STOVE _ DIRECT VENT HEATER DRYER !T� FIREPLACE FRYOLATOR FURNACE GENERATOR S� GRILLE F INFRARED HEATER LABORATORY COCKS �T MAKEUP AIR UNIT OVEN POOL HEATER ROOM 1 SPACE HEATER — F—'I�"--'�--ter- ROOF TOP UNIT TEST UNIT HEATER VENTED ROOM HEATER WATER HEATER HER �- COVERAGE 1 have a current liability insurance policy or Its substantial equivalent _� p y which meets the requirements of MGL. Ch. 142 YES Q NO ❑ I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY []:] OTHER TYPE INDEMNITY ❑ BOND ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of mykn wledge and that all plumbing work and installations performed under the permit issued for this applicatcompion Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME Gregory K Maffei Sr LICENSE #z4;:49 MP 0 MGF ❑ JP ❑ JGF 0 LPGI © CORPORATION ❑# PARTNERSHIP 0# LLC Q# 3451 C COMPANY NAME: Maffei Plumbing and HVAC LLC ADDRESS 1383 Main Street CITY I Rowley STATE MA ZIP 01969 TEL 978-312-6268 FAX I- CELLI 978417-9264 EMAIL gmaffei@maffeiservices.com w F °z F U W a d � a z❑ � w O O w F a z LU W W Aw z 19 Q W ow. y+ w p; W w w y W O d � ss. a � v x CL F, a - CL a < x w f- u. F zz z 0 F U W a d C7 x z I .COMMONWEALTH OF MASSACHUSETTS The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Street, Suite 100 Boston, MA. 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): PLUM -9144 1-6kZAk- C( - Address: rS4"—_ 3J"It— City/State/Zip: Are you an employer? Check the appropriate box: Phone #: ? Irl' 5/3 Z / l 2-8 1. M-ra_m a employer with Z� employees (full and/or part-time).* 2.0 I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3.0 I am a homeowner doing all work myself. [No workers' comp. insurance required.] t 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5. ❑ I am a general contractor and I have hired the sub -contractors listed on the attached sheet. e sub -contractors have employees and have workers' comp. insurance.t 6.FJ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, §1(4), and we have no, employees. [No workers' comp. insurance required.] Type of project (required): 7. 0 New construction 8. El Remodeling 9. ❑ Demolition 10 ❑ Building addition 11.0 Electrical repairs or additions 12. M-161umbing repairs or additions 13.0 Roof repairs 14.0 Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees,' they must provide their workers' comp. policy number. lam an employer that is piovidhig workers' compensation insurance for my employees.' Below is the policy and job site information. Insurance Company Name: % 6f�77cq�-i Policy # or Self -ins. Lie. #: 7 6 LJ %� (� %o tr/pxt �� Expiration Date: `O Job Site Address: —& & 404/ e City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify qpdg the pains and penaltiesqf p�rf�at the information provided above is true and correct. Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # 2— Issuing Issuing Authority (circle one): i 1. Board of Health 2. Building Department 3. CitylTown Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Information and Instructions ►. Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill- out the workers' compensation affidavit Completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and -phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents foi• confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should'enter their ' self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia A MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK i 1 CITY 0_ 60er _ MA DATE PERMIT # JOBSITE ADDRESS I '7 �g_ ►n M i (1 n_ OWNER'S NAME Z _ GOWNER _ ADDRESS 97 Q r TEO' �?- 4721 FAX —^ TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ® RESIDENTIAL PRINT CLEARLY NEW: [3 RENOVATION: D REPLACEMENT: ® PLANS SUBMITTED: YES Q NO Q APPLIANCES 1 FLOORS-- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER I T__ I I I 1 BOOSTER CONVERSION BURNER COOK STOVE r q& _ _ . DIRECT VENT HEA ER (F7J DRYER FIREPLACE r _I �I _ _ [-_ I _ _.__�_ ^I FRYOLATOR l I FURNACE I GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS(T�-- MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER GOOF TOP UNIT TEST [++I 1 _ _ I _r i _ _I J _i. _ I 1 _1 JNIT HEATER L_—� _ I UNVENTED ROOM HEATER WATER HEATER — I l I — I I- - L_ I .. OTHER lT _ f — f INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES -1 NO[] -_f IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY d OTHER TYPE INDEMNITY BOND (L] OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Iifassachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ® AGENT �I SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in comp lance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. _�� PLUMBER-GASFITTER NAME LICENSE # 16,29-_1 SIGNATURE MP 0 MGF JP—I JGF D LPG] � CORPORATION Ej# _ u PARTNERSHIP ©# -- LLC # COMPANY NAME: _... _ _ __ _ r_S_._...--.---.___.------.___. _._____---I ADDRESS _0 r- CITY _ w _ _ _ _I STATE ZIP 0% _- �/ �_ TEL 7 -_-lcZ 3 jj�� FAX --_ . CELL% IL -— bt W� W °z 0 H U W a w r � o z O NFJ W � � ~ W OF a Z LU a :c F- ►� Cl) W W� a W O LU > w � w o a a a � U J F,, a a Q to): Cd xw I--LL. H O z z o H � U W a c�7 a w The Commonwealth of Massachusetts Department of IndustriqlAccidints Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLyibly Name (Business/Organization/Individual): zzwcf c LD/S C Address: � oxg [ c� City/State/Zip:L(tinm c -e 04 0/ X W Phone #: Are u an employer? Check the appropriate box: 1. 0 I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. t ship and'have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.E] Roof repairs 13. ❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. I Homeowners who submit this affidavit indicating they aie doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. lam an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. Policy # or Self -ins. Lic. #: Job Site Expiration Date: City/State/Zip:, Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cgtl'fy'under the pates and penalties of perjury that the information provided above is true and correct. Phone #: Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - - Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced -acceptable evidence of compliance with the insurance coverage required" Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)" A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA, 02111 Tei, # 617-7274900 ext 406 or 1-8777MASSA.FE Revised 5-26-05 Fax## 617-727-7749 _WWW.rnass,goV/dia I ainliau IS � / \:� � »,2».'A ri . J4. tA uj W. U3 z w w Co. A-1 cn W :.CI Lu' r4 I 0 0 22 3 Date.... ........ ... ....... ... ... TOWN OF NORTH ANDOVER PERMIT FOR WIRING Z 0&/0/ -: ......... Z -- This certifies that ......... /� .................................... ........ has permission to perform & ...5.Q. 4n e4.&........ . 2P—.16 ................. wiring in the building of ............... (�. 4....�2 ....................... . 7 9 619 0 ........................ 9N at ...... ...................... Prth Andover, Mass. Fee -Q L i c. No. ................. -- AISPECTVC.5� Check # 1% Commonwealth of Massachusetts Official Use only Department of Fire Services Permit No. l Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts ElectricaWCod(ME ), 527 CMR12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 14City or Town of: NORTH ANDOVER To the Infres: By this application the undersigned gives noti % of hiss or her intention to perform the electrical work described below. Location (Street & Number) Owner or Tenant ter/ - Telephone No. Owner's Address 00 *7 02 Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building `Utility Authorization No. Existing Service mps l ;DC7/ 1/QVolts Overhead ❑ UndgrdA No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: �o �/(,� 0,�� � / a— 11021fi l y.S sT P/LI Completion of the following table may be waived by the Insnector 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- E] rnd. rnd. No. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number Tons J.KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers HeatingAppliances KW PP Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring.. No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical W41-0-0-0— (When required by municipal policy.) Work to Start: 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 coverage is in force, and has exhibited proof of same to the permit issuingaffice. CHECK ONE: INSURANCE D( BOND El OTHER ❑ (Specify:) I cert, under the ns anti pen hies of perjury, that the informal tis a icatio s true and complete. FIRM NAME: Al 4,0LZ0,'-P LIC. NO.: Licensee: Signatu - LIC. NO.: iD (If applicable en r "ex t" in the lig nse npimber ling.) Bus. Tel. No.: Address: a C - ©Alt. Tel. No.: *Per M.G.Llc. 147, s. 57-61, security work requires Department of Public Safety "S" Lice se: Lic. No. 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 Owner/Agent PERMIT FEE. $ Signature Telephone No. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 UT. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): RQ i na )9 Iz C2 I F—IC47fi Je- a Address: T_�_ City/State/Zip: �f4 ,h7 i p/ Phone #: �� — LS 7 �j Are ou an employer? Check he appropriate box: 1 am a employer with 4. ❑ I am a general contractor and I employees (full and/or pa - tme).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. F1 Electrical repairs or additions 11. F1 Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box # 1 must also fill out the section below showing their workers' compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. -lam an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: S Expiration Date: Job Site Address: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). ► Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance co e ve vkfication. I do hereby certify of perjury that the information provided above is true and correct. use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone ATTACHMENT 2 Certificate of Completion for Simplified Process Interconnections Installation Information: ❑ Check if owner -installed Customer or Company Name (print): $/�v L- G-ERIrLVEZ, Contact Person, if Company: MailingAddress: Ply [_o W IVO 17 (Z . City: /JJRT �{ r �w1f State: Zip Code: Telephone (Daytime): 9 _K-3 q 7 `L-41 (Evening): Facsimile Number: E -Mail Address:_ K Vp, (D)-ACAzt.✓1r_ Address of Facility (if different from above): City: State: Zip Code: Electrical Contractor's Name (if appropriate): L/CVo I CLFCI- r L Mailing Address:E 5 City: it &AI State: /' ` Zip Code: t% Telephone (Daytime): _q - `�Lt (Evening): Facsimile Number: E -Mail Address: License number: Date of approval to install Facility granted by the Company: ��J (s— 3, aQ Application ID number: i �1 ��— Inspection: The system has been installed and inspected in compliance with the local Building/Electrical Code of (City/County) Si d Lo 1 Electrical irm Inspector, or attach signed electrical inspection): Name (printed): Date: 8—/7—// As a condition of interconnection you are required to send/fax a copy of this form along with a copy of the signed electrical permit to (insert Company's name below): Name: Company: National Grid Mail 1: Attn: Distributed Generation (Alex Kuriakose) Mail 2: 201 Jones Rd City, State ZIP: Waltham, MA 02451-1613 Fax No.: 791-907-1647 email: distributecl.generationci u� s_ngrid.com complies with M.D.T.E. 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Z WI D eV � - 1 � D��m mn� O n m��-tCm -o 0 0 CD O Op g0: Cl) a D o o��m-iDoy wO ZQrO v C m Zrz < ;u Z • 0 mmcmZ z �c 0 rn j m 0 D �mCn z W o m Ommm ' O O m G)XzXm C D < D ..< -i D 0 m 0 1 Tt O N r> < ; m ;um m o m�zs �0 : g pC oC p 1 q mo m� m O I ; m0 -a v n �Dm Cl) m �Cl) pro < g m w O << p�C� m o m C m O cn v z < cn < ' c -r. r Cj � � — o 0 o O Wi=n �'m K< go m z r = m �C m � �zz �oc O D z z< (D Dom �O D _I m m U m ° O Z m�� z m r u m>n u u 0 m Y' Q G) O O O o o < o A O f�t s A Location No.y Date TOWN OF NORTH ANDOVER . s Certificate of Occupancy $ sACNUS <� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL Check # /� J �i 5 �4 6 2 Building Inspector e TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING s41 BUILDING PERMIT NUMBER:a a DATE ISSUED: / I Ip� SIGNATURE: Aky Building Commissioner/I for f Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: ,,/) %8 �d�0ivli n a �r 1.2 Assessors Map and Parcel Number: .30 a C D Map Nunirer Parcel Number 1.3 Zoning Information: D �'S.�n�'J'o✓t Zoning District Proposed Use 1.4 Pstons: //37 Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 WaterSupply M.GJ..C.40. 54) 1.5. F1 Zone Information: Public Private 0 Zone Outside Flood Zone 1.8 Sewerage Disposal System: Municipal On Site Disposal System ❑ SECT O 2 - PROPERTY OWNERSHWAUTHORIZED AGENT 2.1 Owner of Recoo�rd Name (Print) Address for Service: < _-,: ;1 � 9Z �`— 7117 tgnature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone 1 n a C n C n J r SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6) I &/Z? 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 all applicable) New Construction 0 Existing Building ❑ Repair(s) ❑ Alt.erations(s) ❑ Addition 0 Accessory Bldg. ❑ Demolition ❑ er ❑ Specify J'r— Brief Description of Proposed Work: SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant USE ONLY 1. Building A000 (a) Building Permit Fee Multiplier 2 Electrical b (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) o�:.➢ "� 4 Mechanical HVAC 0 5 Fire Protection p 6 Total 1+2+3+4+5) r000 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUII.DING PERMIT 1, ! dnQ ��� �' �j��'7►'f as Owner/Authorized Agent of subject property Hereby authorize �� / to act on My behalf, in all matters relative 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 Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB RD SIZE OF FLOOR TITVMERS iST2m 3 SPAN DIMENSIONS OF SILLS DIMENSIONS 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 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 APPLICAN'�p7� rq� % /tea A /jam PHONE7S " p / 8 /% LOCATION: Assessor's Map Number—If- PARCELOJ ocle 1675-1, SUBDIVISION_ / Dr PS � N.L/ �//l f LOT (S) STREET ST. NUM13ER2 *****************************************OFFICIAL USE ONLY*********************************** COMMENTS TOWN PLANNER COMMENTS FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMM TOR AGENTS: DATE APPROVED r� DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTO Revised 9\97 jm ATE Town of North Andover Building Department 27 Charles Street North Andover, MA. 01845 D. Robert Nicetta Building Commissioner (978) 688-9545 (978) 688-9542 Fax Please print,2 DATE / /3/% Q ,`- JOB LOCATION / Number "HOMEOWNER 117ee Name PRESENT MAILING ADDRESS City Town HOMEOWNER LICENSE EXEMPTION yw,i� e W r Street Address ,15 Home Phone -7a—p/ —10t Work Phone Zip • The current exemption for "homeowners" was extended to include owner -occupied: dwellings of two units or less and to allow such homeowners to engage an individual for hire who does. not possess a license, provided that the owner acts as supervisor. (State Building Code Section 108.3:5.1) .DEFINITION OF HOMEWOWNER- Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures ac- cessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned "homeowner" certifies that he/she understands the Town of No. Andover • Building Department minimum inspection procedures and requirements and that helshe will comply with said procedures and requirements. HOMEOWNER'S SIGNA APPROVAL OF BUILDING OFFICIAL North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. The debris will be disposed of in: /Uc� 5;- 11 Grim (Location of Facility) J Signature of Permit Applicant 3 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 10+00ar70es xw— ItaVDatee 71 _ 10+ 00 (� pp— ` \ \ Buyers(s) \ I' Par /! ate W les n z. a0ate \� uthorized 1 ,.�;;t,:y nttr?.• l \ J • RAIS �RlM � � —/ R=117.0 N, .--- ,� 1= 153.0 1 16' —R81 R{ 90T-143.5 r7 },'++�T.w ++w:n._,�.�,p�..�._ -- w�..�w�..�rtw• •._w...w ��✓_T ,.rt 1 . n! .. 20' WIDE DRAINAGE °'� ----� —_ - - - F'VL.TE HOME CORPORATION RESERVES THE RIGffr 1?MAKE FIELD C;IANGES TO THIS PLOT PLAN r IN OROCR TO ACHIEVE PROPOER SITE DRAINAGE. MEET SETBACK REQUIREMENTS, AVOID LEDGE OR ACCMAYBE(MADE W 711OUTATF THE CONSTRUCTION C(T NSULTATION WITH OF THE HOME IN TTHE BUYER IN OST ORDER 'TOIIEXPEDITEhTHE COESE NSTRUCTIONMOFTTHE HOME. 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W N x V z c_ L0 4 5' 1' >g z O y r i ~ y � Z � � � I D r I Z. gd 1� g M g - '"•°s �S poITT oom sc grab z�m �� H Xm yA A13O D� Z Z A OO J '• y�ma :$g Ism m sig yQ� "j ~C O �¢ Z. gd w� m � x -0y1 H � mR s r m E� N��ygz O m PH n s� mrno + 1 m mr:_iA1 00 �v_m 2y n1 22 H y — r— 2v y z oa� ydD T ADD JOIST UNDER WALL Cm� sO O - a pyszgz m mRl Tmj� yy(� 2 = EVIC (2)13/4 x 117/8' PRODUCT 'n4 Z O N xm§ Oo T z N m o n o" 2 CD -- O oK Z n 0 m,4z0 D �55m ME -18 oy*mm K --NO HOLES HOLE, L ES: 14"LPI.36 3'•10° 4_U. 5, 5'J' TD r UHECAN BE CUT ANTWHERE IN THE W®_ SQUARE B RECTANGULAR ryOLEg 5 'o $ OUND HOLES DOO NOT NEED HOLES MUST BE CEN71=qEp AT MID -HEIGHT OF WEB. PRODUCT LONGEST HOED DIMENSION Z THAN - FROM JOIST FIgNGE.E AT MID-HEIG'T%TMUST NOT BE CLOSER Z' UT HOLES CAREFULLY. DO NOT OVERWi. DO NOT IXli FLANGES. 'i 7/B'LPI-28 4'-1' 4'-8" 54•• HE LENGTH OFUNCUT WEB BET WEE,-, L DO.N TBErFL GES. 10E THE _ 3 6'S°" 6'$ 8'2' 9° 9• 10• 7/8•LPI30� N/A NIA 0 5 RI LENGTH OF THE LONGEST ADJACEN7 HOLE DUST BE N. 11-7I8'LPI�6 6-2'5'�° S -0' 9'3' 10'•8• NIA Wq HOLE CHART AND IM IPORTANTIN07 S�TI�RECONIAENDATIONS•FOR FULL 14°LPI-30 2'-1• 8'•9' 8'-8' 7D'.6" 12'-1• N/A WA SCNL 1P=1'-0' 18 ° 1' 7 5 q 5 ° 3-0' 3'-6" 4'•10• 5'-B' S' -T' 112' SCJ1L• 3 =1'_9• p T 14"LPI368'-2' 6'-H' Tom• 6CAIE 1 =1'-0' r 4' S ° 1. 9'-3" 12'_9• m z A ARCH TECL• 9ANp W. f>'RIFFIINS21 z s` I GOO Y TNA' INE-27 NESE DCDINENIS W]rE PI3PAffD lq DIE£ SCAIE 1 1 = Y4 I AN A W,I IICENSEO APPRMO BY ME, AND THAT JJHSDICBONS DCQ3fD ARCH&Ci UMBER 71E Upg OG 1HE FOI1.DfiNC BAR R IN G T O N — DELAWARE 8189 PROTOTYPE _ �7 8 NEWJERO 7745_R MASSAci RN�EISLANO 23s` PULTE MID—ATLANTI NLlY JERSEY Al 13967 N1RME 6718E 9857 u".L.rewM,r S CAROLINA 944,7 N. CAROLINA 6362 LPI FLOOR FRAMING PEIU15nYANIA RA -OI 165B 2100 RESTON PARKWAY, SUITE 643 4; RESTON, VIRGINIA 2209 1' it �_;II 3� m yyyF p fi[rmma 0 ? [-0i�pry ZA 1 m mr:_iA1 00 �v_m 2y n1 22 — r— 2v y z oa� ydD T ADD JOIST UNDER WALL M a pyszgz m < A z = y "S�To D �NSzjA O mmA, y 3 Z n I ADD JOIST UNDER WgLL yz �1 rw, A Amy wTySO zK_AO Km 7r ion A ry — mm Lo ''N^ cn 1 -- i ;r 40 � A�}'I O O /r S� r7r sm� ( I c �mz I I Oa mm ..� c a yo r I 9T G)Fy m I Op D z m0 O Z >A I 2,1 m y n Aj p z„ Igyp f m r D z z I =g O0 I / �iT 1ym 4 y�y m y.a (2)13/4 x 117/8' PRODUCT 'n4 Z O N xm§ Oo T z N m o n o" 2 CD -- O oK Z n 0 m,4z0 D �55m ME -18 oy*mm K --NO HOLES HOLE, L ES: 14"LPI.36 3'•10° 4_U. 5, 5'J' TD r UHECAN BE CUT ANTWHERE IN THE W®_ SQUARE B RECTANGULAR ryOLEg 5 'o $ OUND HOLES DOO NOT NEED HOLES MUST BE CEN71=qEp AT MID -HEIGHT OF WEB. PRODUCT LONGEST HOED DIMENSION Z THAN - FROM JOIST FIgNGE.E AT MID-HEIG'T%TMUST NOT BE CLOSER Z' UT HOLES CAREFULLY. DO NOT OVERWi. DO NOT IXli FLANGES. 'i 7/B'LPI-28 4'-1' 4'-8" 54•• HE LENGTH OFUNCUT WEB BET WEE,-, L DO.N TBErFL GES. 10E THE _ 3 6'S°" 6'$ 8'2' 9° 9• 10• 7/8•LPI30� N/A NIA 0 5 RI LENGTH OF THE LONGEST ADJACEN7 HOLE DUST BE N. 11-7I8'LPI�6 6-2'5'�° S -0' 9'3' 10'•8• NIA Wq HOLE CHART AND IM IPORTANTIN07 S�TI�RECONIAENDATIONS•FOR FULL 14°LPI-30 2'-1• 8'•9' 8'-8' 7D'.6" 12'-1• N/A WA SCNL 1P=1'-0' 18 ° 1' 7 5 q 5 ° 3-0' 3'-6" 4'•10• 5'-B' S' -T' 112' SCJ1L• 3 =1'_9• p T 14"LPI368'-2' 6'-H' Tom• 6CAIE 1 =1'-0' r 4' S ° 1. 9'-3" 12'_9• m z A ARCH TECL• 9ANp W. f>'RIFFIINS21 z s` I GOO Y TNA' INE-27 NESE DCDINENIS W]rE PI3PAffD lq DIE£ SCAIE 1 1 = Y4 I AN A W,I IICENSEO APPRMO BY ME, AND THAT JJHSDICBONS DCQ3fD ARCH&Ci UMBER 71E Upg OG 1HE FOI1.DfiNC BAR R IN G T O N — DELAWARE 8189 PROTOTYPE _ �7 8 NEWJERO 7745_R MASSAci RN�EISLANO 23s` PULTE MID—ATLANTI NLlY JERSEY Al 13967 N1RME 6718E 9857 u".L.rewM,r S CAROLINA 944,7 N. CAROLINA 6362 LPI FLOOR FRAMING PEIU15nYANIA RA -OI 165B 2100 RESTON PARKWAY, SUITE 643 4; RESTON, VIRGINIA 2209 1' it �_;II (2)13/4 x 117/8' PRODUCT 'n4 Z O N xm§ Oo T z N m o n o" 2 CD -- O oK Z n 0 m,4z0 D �55m ME -18 oy*mm K --NO HOLES HOLE, L ES: 14"LPI.36 3'•10° 4_U. 5, 5'J' TD r UHECAN BE CUT ANTWHERE IN THE W®_ SQUARE B RECTANGULAR ryOLEg 5 'o $ OUND HOLES DOO NOT NEED HOLES MUST BE CEN71=qEp AT MID -HEIGHT OF WEB. PRODUCT LONGEST HOED DIMENSION Z THAN - FROM JOIST FIgNGE.E AT MID-HEIG'T%TMUST NOT BE CLOSER Z' UT HOLES CAREFULLY. DO NOT OVERWi. DO NOT IXli FLANGES. 'i 7/B'LPI-28 4'-1' 4'-8" 54•• HE LENGTH OFUNCUT WEB BET WEE,-, L DO.N TBErFL GES. 10E THE _ 3 6'S°" 6'$ 8'2' 9° 9• 10• 7/8•LPI30� N/A NIA 0 5 RI LENGTH OF THE LONGEST ADJACEN7 HOLE DUST BE N. 11-7I8'LPI�6 6-2'5'�° S -0' 9'3' 10'•8• NIA Wq HOLE CHART AND IM IPORTANTIN07 S�TI�RECONIAENDATIONS•FOR FULL 14°LPI-30 2'-1• 8'•9' 8'-8' 7D'.6" 12'-1• N/A WA SCNL 1P=1'-0' 18 ° 1' 7 5 q 5 ° 3-0' 3'-6" 4'•10• 5'-B' S' -T' 112' SCJ1L• 3 =1'_9• p T 14"LPI368'-2' 6'-H' Tom• 6CAIE 1 =1'-0' r 4' S ° 1. 9'-3" 12'_9• m z A ARCH TECL• 9ANp W. f>'RIFFIINS21 z s` I GOO Y TNA' INE-27 NESE DCDINENIS W]rE PI3PAffD lq DIE£ SCAIE 1 1 = Y4 I AN A W,I IICENSEO APPRMO BY ME, AND THAT JJHSDICBONS DCQ3fD ARCH&Ci UMBER 71E Upg OG 1HE FOI1.DfiNC BAR R IN G T O N — DELAWARE 8189 PROTOTYPE _ �7 8 NEWJERO 7745_R MASSAci RN�EISLANO 23s` PULTE MID—ATLANTI NLlY JERSEY Al 13967 N1RME 6718E 9857 u".L.rewM,r S CAROLINA 944,7 N. CAROLINA 6362 LPI FLOOR FRAMING PEIU15nYANIA RA -OI 165B 2100 RESTON PARKWAY, SUITE 643 4; RESTON, VIRGINIA 2209 1 Aut6CAD File: H:\FILES\ARC\Share\Singles\1999pLAK6\B05TaYpLANS\BARRINGTDN\BARRINGTWJ-LP12R.dwg Platted at: Fri Mar 24 1G: 39: 21 2000 1 Elm $mm s m �pr ob fmm0 m 6� D �i �3 Dann I.1 8 g W T pti Z ANN� o�5pC0 yD O 2� as .ZI m o p IT 0 � m c mP �O 5A m m �pr Z a fmm0 m 6� D �i ❑ a Tn 1�3 m� r � S r r � C—: L gym- _O Aa pp -� Im as ,q d mA m n �m O T ti Z L� 9 na m v no 3 �x �o �a �m -min !H M m. =y 08 c mP �O 5A vO O p m v y/2yN(. O�n r Dpm WT- fmm0 m 6� D �i m m,� e� C—: L gym- _O Aa pp -� ui a ym as ,q d mA c ROUND HOLES v o �o go 6m to y mn m� co p<m ZC Dm�m.yy= ~mCOA ,q d mA m I10 . mm A O IA ♦ / C p Z w m mmn .J D € o y� m Smm mt�g o<ICC� O m -min !H �g of m. =y 0 f 7 pr <I p SGVL I t = 1'4 2_ m Y m -F p"L PULTE MID—ATLANTI A gg MA v 2100 RESTo PARIC`VAY, SUITE 4; m� o�'li8$ TTI Q '6o mv, II.nn��m 0 pZO�m TZ O-- �p0 10 mV A<0 GIC N �2 y £� zm 2 N �m IN ;co �mm .n eO pZ �v A—n �r 80 m0 N X n C !' Z V Z m r m D ''Z^ ( J M W N _*z a 1 n a= >t N r = VJ= ROUND HOLES PRODUCT HOLE DIAMETER mn D Z 1'_t• 1•_ . 11.7/8'LPI-3- 1'-0" $ N/A WA Dm�m.yy= ~mCOA 7'-17• 7-17" 3'•10' 4.1 p• 5�. 9 7'-3` N/A WA 2 • 14'LPI30 2'- 4'-0' -10 3'-5' D m AT A O IA ♦ / A mD w Li NIA NIA 11'7/8`LPI-38 g'-2" T-0• 7_ 74'LPI�O 2'-1•' 11• • 9$• 1d� 12'6. WA WA 3'-8' 2Ny0 A _ y 8'-3• 1r•0• 1z-9' O 0 f 7 D O �D SGVL I t = 1'4 PTLE Z m -F p"L PULTE MID—ATLANTI _ LPI FLOOR FRAMING 2100 RESTo PARIC`VAY, SUITE 4; 10 :3 D ? r m owe rr z W z Om N O PN 2 �1; StNL t f= Y� IO 0 f Y 7 SIAL F _ a :10BT-FY ECTDAVID N CRJF} M 1HA7 MESE GOOIYfNiS HERE PREPAREDOR APPRDYEp AY Y[ AN) 1HAT EIILY UQ115E0 LICENSED A40 IT URRER TryE LAWS a THE F.1 ERYCRN1$: y�y _ 3 DELAWARE 8189 RHODE ISLAND 2354 `V g HARYLAND 7746-R MASSACHUSSETTS s857 NEW •ERSEY AI - 13967 VIRGINIA 6718 S. CAROLINA 04417 N CAROLINA 6362 PENNSYLVANIA RA -0151668 i DIS TANCE I � ROUND HOLES PRODUCT HOLE DIAMETER 11-7/8•LPI-26 1'S'. 2'-3° 3'-1" 3'-11• 4'-9• $'_ 8-g` N/A WA 11.718'LPI.30 MIN. 21(LENGTH 1'_t• 1•_ . 11.7/8'LPI-3- 1'-0" $ N/A WA OFIARGER HOLE 7'-17• 7-17" 3'•10' 4.1 p• 5�. 9 7'-3` N/A WA 2 • 14'LPI30 2'- 4'-0' -10 3'-5' D rvorE3: 7 4'LP136 3'-10• 4' q'_9• $ -8• 4-4" 6' T 1• ,_2• $,$" 8' 1' $ +. A'HOLE CAN BE CUT SQUAREMDRECTANGULAR SQUARE 8 RECTANGULAR HOLES ESMJSiBECENTEREDATMIDFEIGHTOFWES 3. ROUND MOLES DO NOT NEED TO BE AT M THAN 7/Y FROM JOIST FLANGE. ID-IIEIGHi, BUT MUST NOT BE CLOSER PRODUCT LONGEST HOLE DIMENSION 3• 4` $` B' 7• g= 4. CUT HOLES CAREFULLY. DO NOTOVERCUT. DO NOTCUifIANGES S. THE LENGTH OF UNCUT WEB BETWEEFIHOLES MUST SEATLEAST TYACE THE LENGTH OF THE LONGEST g. 11-7/8'LPI.26 4'-1° 4'-6° $'_3' S'-70' 6'- 70• 11-718'LP430 4' $ 6'-Z• 9''S" N/A WA -0' $��• 5'-11• g•-9" g-0" 9-3` 10'-6• ADJACENT HOLE DIMENSION. 8, REFERTOLARTANNDLINGANDINSTALLATION RECOMMENDATIONS•FOR FULL HOLE CHART ANDIMPOR7M'T NOTE S. NIA NIA 11'7/8`LPI-38 g'-2" T-0• 7_ 74'LPI�O 2'-1•' 11• • 9$• 1d� 12'6. WA WA 3'-8' 13'-0" 4'•10• 5'$" g . T." 9'-0' 11'•2' 14•LPI-36 a' -W 4'-8" $'-2" 6'-2• VV -11-T-8• A 8'-3• 1r•0• 1z-9' 1' 0 f 7 SGVL I t = 1'4 PTLE BARRINGTON— PROTOTYPE p"L PULTE MID—ATLANTI _ LPI FLOOR FRAMING 2100 RESTo PARIC`VAY, SUITE 4; RESTON, VIRGINIA 2209 A3 OCAD File: H:\FI1ES\ARC\Share\Singles\1999 PLANS\80STON PLANS\BARRINGTON\PBA2LS06.DNG Plotted at: Tue Dec 21 13:35:25 1999 rl L' /Z-'� C l I no r) -x1� X OX SN m'1^ d -- 0 A o NA Z-0 brN r.. ❑L CY❑ �T TI ( /1 V J ❑It7�7 x p� -n C4 rl0 �1 mz W W y o rl <x m I I m r O • N ~ m Am f� rr-, _ C N ❑C7 N X � ru II i 0 r i o no, z< j £ ZX ❑o y Q I r I ❑o --� N DX mV m N m m o 71 ly Z A< a m f— OD IrrrrlI L \ R7 _ .' I'I N A Ci !\ r > eW m ra - �a12,. ❑ H L9 rn C ❑ = N N '0 �X Z LI -0 ZZx ru 017 Z3 ��i41 no Z LIT V-• � m i N y ❑ c z V) Z cl R ---i zTN m LN Nm d -- 0 x X m T ❑L CY❑ N C3 m r < i7 y np r N ~ Ui II i 0 r n -- x X m m --� N DX m In Lw D m �-1 Fri 71 rLY A< Z n a Inc) A Ci :;... z m ra m b �1----------- Z tv C m m i m N X Co R ---i £ N z mr UI J N N X - H D N C30 nc p ru I NN nm X m N x ❑ -n Zero I 'ilri ed > vii o X I ZN K N m rr I It 6 ❑ b V lA I '1❑ c� ❑ -�-------------1 tix .. ......... . .. ....... X A 01 on -CX m m rnl n 1'" N� m A zo rp m c m dam AZ r CYN rx £ \ rz ❑- m AN ru x RM m m ` -I N aW N'o AA C x zZ lal ❑ =Z Dz Z ❑ C Iru iID N 4, Gl N Q N a a m VI ❑ N N V 0 W _ ffl Z) fYC m❑ Z� A a O _._...__._... ryC C1m r❑ Zr m• ❑ V 1717 £N r,ro r, o m a v mN Om ,-pX OD V N m ACY- 1' 6 AmN yr X A ji Z❑m 3>4m 030 GZZ r r A ❑ Z 1 ❑NA I 'mm c p y x r, .... .. :...... .... mN r r Z m 2rD r mx Cl ar E£� D r r 0-40 r < A r'ml K rn ❑ m I I n -- m N DX m In Lw D na m m rrl--I yC) N �-1 Fri 71 rLY A< Z £m Inc) A Ci :;... D m ra m b �1----------- m i R ---i £ N z mr Z J aX D ❑ yX i ru I i I > A ❑ e I mN mx ; �7 m rr I It 6 m £y D i r I A c� -�-------------1 tix .. ......... . .. ....... X 01 on -CX m m rnl A zo rp c m £N a X r £ \ rz ............................ ru x RM m m ` aW N'o AA C lal ❑ =Z Dz Z ❑ C Iru N Gl N a m VI ❑ N yl A V 0 W _ Z) � x A a O _._...__._... ❑ 4 m a v mN Om V z Z O A r r A ❑ .... .. :...... .... mN r r mx E£� D r r 0 / ^ V J) m a o £A mo tdc c❑m CZY e £ m x x m to I\ A m m W N •- < i> y _ Z DZ� PULT v; m° I Q < THE BARRI�IGT�N II h E HEIME N,E h ,r— to In 176 EAST MAIN ST, SUIT m WESTBOROUGH, MA ni�;R,—, AutoCAD File\FILES\ARC\Share\Gin9les\1999jILANSIB0510N PLANS\SAPBINGTBN\PBA2LS07.DNG Plotted at: Tue Dec 21 13:35:31 1999 Iy f r_STD. 12' @ BRICK OPTION V � m m Jig! p O Z m OD W IJo K I ID W Q, _ 1 N� N I J a co �I❑ X h, r ^ m r vl A mZ ClL F9 A L r H z � NX ❑ o ❑ II OX L A < ❑ 0 DAn ti y of, Z D a I • I y V mu 11C N rN Z3 Cl ON DC p. m" Lly rN' Zim mr o\ yZ — m X m m -IA m O m N r � C t= . X ❑ p L m.+ (y r rD 1l ❑ AN � r N K� y r L r y V J I CON Am \X X C p N -ly AN Co m v EA nA N A A bd r r .Z m ❑ ❑ mZj z o a a M Ll m 0y I —1 m a: to c r N 0 mo itI L, MZ F)0 Z3 N mo m c) -u p X :0❑ t= mel tl NZ A❑ Z N Z C C Ll Z Q W L p N d ❑ A 6L0 N ❑OD y r V1 THE BARRINGT�N II n,,-r F176 TEHOME NIE AST MAIN ST, SL1tT Location�g No. Date 4 TOWN OF NORTH ANDOVER Certificate of Occupancy $ 5-C). Building/Frame Permit Fee $ Z S36 Foundation Permit Fee $ /©0' Other Permit Fee $ TOTAL $ / noon 91 3 Check #/ 2flO 9 % ' f 7 ✓ Building Inspector WWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ,Un.U1F.U33G�lftI BUILDING PERMIT NUMBER: j� DATE ISSUED: SIGNATURE: Building_Commissioner/Ins c r of 13uildings Date SECTION 1- SITE INFORMATION L© 1.1 Property 1.2 Assessors Map and Parcel Number: /Address: n�-tomJ /y0 0P.1k, ^ SJYL>eS'� V✓ •Q ".� r_Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: f 1z N %� ��� ZoningDistrix Proposed Me Lot Areasf) Frontage 11) 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 2s— /.15"-3 p 1.7 water Supply M.G.L.C.40. § 54 I.S. Flood Zane Information: Public Fly Private 0 Zone Outside Flood Zone Qom' 1.8 Sewerage Disposal System: Municipal 4— On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record _Pct lke OM O 0-47 N./= xS- 7 '1'crpipi rk°co- fel�,v Name (Print) Address for Service: <0 S- - A 797 000 Z '0'ZSV , 017 7ZSignature �.T!fone� 2.2 Ownerof Record: DA VI ��- 1 wro 4 _ Name Print Address for Service: Signature Tele hone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ VITC) Licensed Construction Supervisor: CS 77,376 3/ 6 X22 1 S�lh f_S ��� N�I�4hCh�S!- cyL License Number Address , Sdff' -32� Signature Telephone Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Sisnature Telephone M z O 9 0 M 0 z M O r M r r z 0 � •moi SECTION 4 - WORKERS COMPENSATION (1�LG.L C 152 s 2t�r�� 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 buildingpermit. Signed atlidavit Attached Yes ....... No ....... ❑ SECTIONS Descn tion of Proosed Work check all applicable New Construction FY Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition 0 Other 0 Specify Brief Description of Proposed Work: OOd /- 1�AJA`-_ .St `Noj�� /0-0 d T SECTION 6 - ESTIMATED CONSTRUCTION COSTS tem Estimated Cost (Dollar) to be Completed by pennit applicant " OFFICIAL USE ONLY 1. Building 117070, coMultiplier (a) Building Permit Fee 2 Electrical U�/ � g�, � � (b) Estimated Total Cost of Construction 3 Plumbing 000 , o C Building Permit fee (a) X (b) 4 Mechanical (HVAC) or Zoo , 00 5 Fire Protection $ % S`i oD 6 Total (1+2+3+4+5) „3 t 070, e, w Check Ntunber SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf. in all matters relative to work authorized by this build' permit application. Signature of Owner Date SECTION 7t�b�OWNER//AUTHORIZED AGENT DECLARATION 1,111/1 G%l Sfl !S 0 j'I ,as Own _ onzed A 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 Prit acne Sio.nature of Ox�iie oen Date NO. OF STORIES SIZE ,),1 32,<3k- /-An 7><2o Zo,r (� BASEMENT OR SLAB��,�., }� SIZE GF FLOOR ITIVMERS 1 // � L P� 2ND 11-79- 3RD SPAN 6 `_ � DINIENSIONS OF SILLS DIMENSIONS OF POSTS X ,/ Dily _NSIONS OF GIRDERS -3 — _71r, V HEIGHT OF FOUNDATION —/0THICKNESS SIZE OF FOOTING 70ir X '0i/ NIATERIAL OF CH WINEY ©— C to _aAr 11 c t. IS BUILDING ON SOLID OR FILLED LAND So , IS BUILDING CONNECTED TO NATURAL GAS LINE 3ti F0RM U - LOT RELEASE F0RM I`ISTUCTIONS: This form is used to veru/ 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. _"***AFPLICA,uT FILLS OUT THIS SECTICN** APPLICANT R)Jfi A/001,,S OE A,XZ PHONE SOS- 3U4 fro,►' LCCATION: Asses_crs INlap (Number /087 C� P.4RCE7_ %07 SUEDIVISICN I=oAe3f- to -0 fc_,5 At0S LOT (s) i STREET Pik J0PiiV 0 Iat`✓'-e.._ S T . NUMEE:R71W 0Fr=1ClAL USE ONLY` t "'Ir -k<, RC — OF TOWN AGENTS: od CO cRVA ON A MINISTRATOR DATE APPROVED DAT REJECTED COMMENTS /_t ) Y� ( 1 TOWN/PLANN COMMENTS FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMMENTS FUELIC WORKS - SI D FIFE DEPARTMENT DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED REC`iVED EY EUILGING iNSPECTCR 4evise,4 -',g_ �M DATE oI JUN --21-2001 01:07 PM f•1AF?CHION DA&ASSOC IATaS 731 433 9654 P,01 10+00 IN IN y� AliI's 1 1 RA'S r I^153.0 1 -- � � � ,�. ,_:. - ,,..mac--.-. ------•. v. V `• I —R91 R1 80T-143. —O'cl 7. _ T. el 20'1N I Q E DR AI � AGE ~ �-;�� - �-. _- _- � � mom PVLTE HOME CORPORATION RESERVES THE RlGhT'FiFMAKE FIELD CHANCES TO THIS PLOT PLAN IN ORDER TO ACHIEVE PROPOER SITE DRAINAGE. MEET SETBACK REQUIREMENTS. AVOID LEDGE OR ACCOMMODATE THE CONSTRUCTION OF THE HOME IN THE MOST OPTIMUM WAY- THESE FIELD ADJUSTMENTS MAY BE MADE WITFIOUT CONSULTATION WITH THE 6U)TR IN ORDER TO EXPEDITE THE CONSTRUCTION OF THE HOME. PROPOSED SITE PLAN LOT 9 FOREST VIEW ESTATES MARCHIONDA & ASSOC-L.P. NORTH ANDOVER, MA ENCINEERINO AND PLANNING CONSULTANTS PREPARED FOR PULTE HOME CORP. OF NEW ENGLAND 02 MONTVAME AVE. SUITE I STONEHAM, MA. 0280 257 TURNPIKE ROAD - SUITE 200 (617) 436-6121 SOUTHBOROUGH. MASSACHUSETTS 01772 SCALE: 1"=20' DATE: 6/21/01 ✓die %anz�n�ruea/C� o��� ; %��aw�u,�� BOARD OF BUILDING REGULATIONS a. License: CONSTRUCTION SUPERVISOR Number: CS 077396 Birthdate: 03/02/1962 Expires: 03/02/2004 Tr. no: 77396 Restricted To: 00 DAVID M STILSON _ 222 SEAMES DR«p MANCHESTER, NH 03103 Administrator B UILD ENG D EP ARTNt�1 IT DEBRIS DISPOSAL FORM To accardaucc with the fn -w ons of tifGL c 40 S 54, a condition of Building Is that the debts r°SWCwcr form this work shad be dgused of in a ' �� Number L. damned by NIGL c 11, S 1:OA �° �� Ucenscd solid waste dis as d f-acility as Inc dcbris will be distosed of in: Location of Facility Si ,,,r- 6T -Permit A-pplic-mt C) l . Date NOTE: Demoiiaon cei]it from the Town of North Andover must be obtained for this projer; through the Ofnce of the Duildin� I.nstor r Growth Management Ey12w Exemption Statement Town of North Andover Building Department 71is form shall be used to assist the Building Oepartment in their determination of exemotjons under sec'en 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicGnt shall provide ail gf t`e nec�ssar/ inr.6 of the as requested 'below. Name cf Applicant on cuilding Permit (below) Address of Property icr Permit 'I �f►� gyres 9� � ��- Pr'4Id1,-h,'r ® n, ll`� �ivlap and Parcel ; �- Purpos2 of� plication (check below) Ph ne Numbe of A__pp��ant ✓single Family Two Family I the undersigned applicant for the above property attest that the attached building permit ,cr which this form is c ;mpleted does comply with the EXEMPTION section 8.7.6 of the North Andcver Growth Management Bylaw, I also understand providing this form does not absolve me or any pam/ to this permit from the requirements of obtaining other permits required prior to the issuance of the wilding Permit. Further I understand that my interpretation of the EXEMPTION status is subject, to revie%v'y the Building Deva ent and is only officially accepted when the Building Permit iq issued. Based on section 9.7,6 of the North Andover Growth Bylaw the above lot and the wort 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 dheck mark. This is an application for a building permit for the enlargement, restoration, or reconstruc;'cn of a dwelling in exrstencn as of the erfiectve date of this by-law, provided that no additional residential unit is created. aw. The lot(s) were/was created prior to May 6, 1996 are exempt from the provisions of this Sec len 9.7 of the Toning Byl T hit acojlritlon is for dwelling units for low and/or moderate income families or individuals, where all of the ccnoitions of 8.7.6.care met and/or represents Dwelling units for senior residents, where occupancy of the units is restnc ed to' senior persons through a properly executed and recorded deed restriction running with the land. Fer pumoses of this Section "senior' shall meanpersons over the age of 55. li !/ This applicatlon is a part of a development project which voluntarily agreed to a minimum 10% permanent reduc'Jon in density, (buildable jots), below the density, (buildable jots), 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 soap and/or farmland. The land to be preserved shall be protected from deve!ooment by an Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism approved by the Planning eoard that will ensure its protection. acjThis aoplicatlon represents a trail of land existing and not held by a (Developer in common cwnershio with an ac,nt parcel an the effective date of this Section 8.7 shall receive a one-time exemption from t parc--l. he Planned Growth Pate and Cevelopment Scheduling provisions for the purpose o(construc ing one single family dwelling unit on the 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 acczmmodate issuing a building permit in that Year, one building permit will be issued per Year per (Development until such time as the Oevelooment Schedule accommodates issuing building permRs. Applicant must supply approved form U with this E<EMPTION. 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 be!ow I attest to the accuracy of the information provided and that the attached building permit is allowed an E<ENIPTION 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 kr,owl?d _ not, is grou�s for refusal Wy the Wlding Oepartment to issue a Building Permit. Sigrature of owner or nzad en no sign d he Attached Building Permit pa e��S ^9/ This form must er arta e Building Permit upon application for such permit IT I Ur,/ x.11 U1_1l t-dX 'i(01--J-D t5lbt! JUI'I 1 ti 1000 12:�J r. 1'_) The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations , Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Pdnt �Jr Location City Phone aam a homeowner performing all work myself. al am a sole proprietor and have no one working in any capacity VI am an employer providing wor} em' compensation for my employees wor'King on this job. Company name: 6' 7-6- ev2,o, Address g_5-2 Building Dept M Licensing Board City: sou Selectman's Office r-1 Phone#- Svc 79,7CSG>C),�ZxS-/ In Comoany name: Address aVCycs /11v # 5'Cf e -y 3 City Phone #- 0 Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition d criminal penalties of a fine up to 51,5C4.00 and/or one yam' 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 cf this statement m6y be forwarded to the Office of In of the 01A fer coverage verification, I do herby ceytify under the pains and penaiVes of perjury that the irrlormafion provided above it hue and correct. Signature Print name Offical use only do not write in this area to be completed by city or town offidaf ❑Check if immediate rnspcnse Ls required Building Dept Contac, person: )PAY WOPKMAN'S COMPEHSAT70N x - Date Phone # C] Building Dept M Licensing Board E) Selectman's Office r-1 Health Department 11 Other M -1— -- JUN.29.2001 10;17AM e I PULTE HOME CORPORATION OF NE MASchedk COMPLIANCES REPORT Massachusetts Energy Code MA,Schegk Software Version 2.01 CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, D tached HEATING SYSTEM TYPE: Other (Non-Ele tris Resistance) DATE; 6-29-2001 I ITLE: Lot 9 )Barrington Rlevation # PROJECT INFORMATION: � Forest View North Andover, MA, COMPANY INFORMATION; Pulte Home Corporation of New England NO. 094 Permit # ' i 1 Checked by/Date NOTES: Customer ordered elevation #1 , a Palladian feature window, and 2 skylights. COMPLIANCE: PASSES Required UA = 584 Your Home = 544 Area or Cavity Cont. Glazing/Door Perimeter R -Value R -Value U -Value UA --------------------- CEILINGS ------------------------- 2001 - 60 WALLS: Wood Frame, 16° O.C. 2957 53.0 0.0 243 GLAZING, Windows or floors 430330 142 GLAZING; skylights i6 0.400 6 DOORS 39 0.280 11 DOORS 21 0.190 4 FLOORS; Over Unconditioned Space 246 3p 0.0 8 FLOORS: Over Unconditioned Space 1585 21,0 0.0 69 HVAC EQUIPMENT: Furnace, 81.0 AFUE COMPLIANCE STATEMENT: The- - Proposed building design described -here -is- - ------ consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 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 greaterZC.- des' n load as specified in Sections 780CMR 131 Builder/Designer 42 Date l�� 0 v 1;11t- 1,6* P. e/19 JUN.29.2001 10:18AM PULTE HOME CORPORATION OF NE 1 MAScheck INSPECTION CHECKLIST �aisachusetta Energy Code MAScheek Software Version 2.01 Lot 9 Barrington Elevation #1 DATE: 6-29-2001 Bldg•I Dept.( Use I f9 I NO.094 P.9i19 CEILINGS; Comments/IoCatjottare WALLS: 1. Wood Frame 161, O.C, Comments/Location '* W114DOWS AND GLASS DOORS: 1. U^value: 0,33 For windo s without lab� d U -values, describe featu # Panes Frame e Vl Therm 1 B eek? [ r Xes ( ] No Comments/Vocation SKYLIGHTS: 1, U -value: 0,4 For skylights without la1b.-��jled U -values, describe feat es: # Panes - Frame Type lab Thewal Break? [ Yes [ No Comments/Location DOORS: 1. U -value: 0,28 Comments/Location 2. U -value: 0,18 Comments /Locat i on___A&!!j02j� FLOORS: 1. Over Unconditioned Spac , R-30 Comments/Location 2. Over Unconditioned Space R-•;1 )� Comments/Location HVAC EQUIPMENT: 1• Furnace, or higher Make and Moodeldel Numb Number AIR LEAKAGE: Joints, penetrations, and all other such openings in'the building, envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures Shall meet one of the following requirements: 1, Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0-ofm (0.944 L/s) air movement from the the 'JUN.29.2001 10:19AM PULTE HOME CORPORATION OF NE NO.094 P.10✓19 conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: 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 j or specifications. DUCT INSULATION: [ ] ( Ducts shall be insulated per Table J4.4.7,1, DUCT CONSTRUCTION: C ] All accessible joints, seams, and connections of supply and return ( ductwork located outside conditioned space, including stud bays or ( joist cavities/spaces used to transport air, shall be sealed ( using mastic and fibrous backing tape Installed according to the ( manufacturer's installation instructions. Mesh tape may be ( omitted where gaps are less than 1/8 inch. Duct tape is not Permitted. The HVAC system must provide a means for balancing air and water systems. ( ( 'TEMPERATURE CONTROLS; I ] 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, ( RVAC EQUIPMENT SIZING; [ ] Rated output capacity of the heating/cooling system is f not greater than 125k of the design load as specified 'in Sections 780CMR 1310 and 74.4. C.] ( 8WIMMING POOLS: ( All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. j HVAC PIPING INSULATION: IRVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in.); PIPE" SIZES HEATING SYSTEMS: TEMP (F) 2" RUNOUTS o-1" 1.25-2" 2.5-4" Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 Low temperature 120-200 0.5 1.0 110 1.5 Steam condensate any 1.0 1.0 1.5 2.0 ( COOLING SYSTEMS: ( Chilled water or 40-55 0.5 0.5 0.75 1.0 T_-_-- --JUM.29.2001 10:19AM PULTE HOME CORPORATION OF NE NO.094 P.11i19 t i refrigerant below 40 1.0 1.0 1.5 1.5 I [ 7 i CIRCULATING HOT WATER SYSTEMS: Inoulate circulating hot water pipes to the following levels (in,): I f PIPE SIZES (in.) NON-CIRCU14ATING ! CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F): RUNOUTS 0-11" 0-1,2511 1.5-2.00 2.0+11 i 170-180 0.5 ( 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 I 100-130 0.5 0.5 0.5 1.0 i ----NOTES TO FIELD (Building Department Use only)------------------------- I..__'-----JUN.29.2001 10:19AM PULTE HOME CORPORATION OF NE i NAME SUBJECT NO.094 P.12✓19 PAGt�-~-_,___OF DATE % LOCATION, �..'JUN.29.2001 10:20AM PULTE HOME CORPORATION OF NE NO.094 P.13i19PAGE _6F , -DATE NAME SUBJECT LOCATION 2- 00 ��4- z (zr( ep oy - 1 ����4E\) �m wo na n � m -1 o a! �� a)� 13 -n 3 cc rr a cli ET C CL O O n m m CL C Ul C A. n O E 5 O" Ul fD x al a Ca E m a� 0 C .-r 0 Z 0 ft O 0 C. _a �Q C 0 7 N O CL 0 0 3 05, zr 11 Q (D O H N tD C � M� n oa f�D n H �, H n M a Q' O' o -� (D (D N r► O CD fD CL 3.. a O C N C � � O C7 a cD 50 O N � =r fD CDCD o PJ CL n o :- Ln � ID k rL o (DD n q CL � o o m x n 0 z Z v z 0 C CL m m m Cl) 0 m ...: d O t0 CD a) CO) d _ CO) CO) n� O y d co 0 cc CD 3. y CD O 0 CD 0 dc CD C c .0 p _ d < m C/) to Cl) m C7 O N�ac. 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C43lR cc is C� �Z dC CD o?� y Cf1 m CD �.J \ J O N %GLIM Q � rV1 C Cn a�.W c. y�� �. 0� H � m m O rm !V 0 oo:R:� cn _ 3 �• '"� Cn r ^ �o�?�' "J CD d " 1 d; .� O c'� C 0: O _`°A/' Cn Cin orf o ° Al - �r z O M y C/) al CA ` x O /001 1 �r z O M y Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 & ,Ao��H Q L cHus���� APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS 79- R4)0^i+%1p LOT NUMBER 9 SUBDIVISION /=y:2eSt Vl e w i;�tAf 'rS DATE REQUEST FILED DATE READY FOR INSPECTION FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TMffi FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING i—CONSERVA I»,hll�t� D.P.W. — WA DATE DATE DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED QORZTQ�INSPECTION REQUEST DATE. 4*SIGNATURE / DPW AUTHORIZATIO 1, r In No 4,- '#' U Date. . % z/'. . (/. . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ....................... ,has permission to perform ....................... I ...... plumbing in the buildings of ........... • at North Andover, Mass. Fee.3.7/f. Lic. No. Pr( ... ...... : ...... .......... Check # /- -/611 PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer L24kZI� ), 7'DAJ JT - /6 Fi 11L)ra S I 0 27��°v lr MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) Al, 141460✓E2 Mass. Date Q `l I PermitH ��� Building Location 1& AlWg1A10 Owner's ame Poon, goxie Ca2_f' _ Type of Occupancy New N Renovation ❑ Replacement ❑ Plans Submitted Yes � No E: SUB•BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name_F9AZIC,e tr k) [L$ Address U r�Q x sg Business Telephone_ 978-689-7'17`1 Name of Licensed Plumber OHA/ L£ ' 9AMINS FEATURES zZ z IL Q 8 z 0 U w Y¢ LLO ? a z CL W Q 0 z 0 U n CC 0 Z 2 Y a F- Q Y W LL a. cn �- 8 z z o x.3.0 o LL� o a� cc Check one: g?"Corporation ❑ Partnership O Flrm/Co, W X Certificate 'ZI90_C � INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142. Yes O No ❑ If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNERS 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: 5i nature of Owner or Owner's Anant 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 the permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By e � J Signo,utu 61 uceinseu number -- — Title Type of License: Master )< Journeyman O Ciry/Town License Number 7/S468 APPROVED OFFICE USE ONLY) J (n W (n (n U Z = m Cr co 0 w Q w Q= U > F O _ H Y m (n Installing Company Name_F9AZIC,e tr k) [L$ Address U r�Q x sg Business Telephone_ 978-689-7'17`1 Name of Licensed Plumber OHA/ L£ ' 9AMINS FEATURES zZ z IL Q 8 z 0 U w Y¢ LLO ? a z CL W Q 0 z 0 U n CC 0 Z 2 Y a F- Q Y W LL a. cn �- 8 z z o x.3.0 o LL� o a� cc Check one: g?"Corporation ❑ Partnership O Flrm/Co, W X Certificate 'ZI90_C � INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142. Yes O No ❑ If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNERS 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: 5i nature of Owner or Owner's Anant 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 the permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By e � J Signo,utu 61 uceinseu number -- — Title Type of License: Master )< Journeyman O Ciry/Town License Number 7/S468 APPROVED OFFICE USE ONLY) Date ............. ............ / N2 3-37 ......... TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING This certifies that .................................... ............................................................ has permission to perform ................................................................................ wiring in the building of ........... ...... ....... .................................. at ... ....................... ............ .......... ................... . North Andover, Mass. .... ..... ..... Fee ...................... Lic. No: ......... f:.. ................. R . ICAL . INSP . ..ECTOR ................. ELECT Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer The ,3 he C0171 III )lIt1)callII of Alussclr.lillsetts r.....�t n..I�37 Drportirtr•tlf nJ I'Ithli(: ,Srtft'fi' 1/1n 11..•.. t.l..,�l tlonrl(J or Flee rrlEvFtjll()tl nF:(:u1-ATIO ,S 577 C.i.01 17:(x) APPLICA1-ION FOH PIRMIT -10 P11--d-OHM LLLGEHICAL WORK All u.otlt to be putottned In Arcntdnnre .,III, I,,t Flettnchuttrts 1-.Itculc„1 Code. 577 CHII 17-M (CI.1AiE I'Rf.ttr IN IiID, O1 7Y1'F. AI.1. 11tfOItiIA 1011) I):,tr City or 'Lown or 7n the Jnspf-ctor of t)lres: Tile undersigned applies for a n,trlC t, (of, .I ti,p cicctrical work. d.scrilie d DclOki . Location (Street it,mb".r) ' - 0-ner or Tennnt PULTE HOME; CORP. OF NEW ENGLAND 508- 787-0002 Owner's Address 257 TURNPIKE RD-- SUI -TE 200 _ SOUTHBOROUGH, MA 01772 --_— Is tilts permit in conjunction wlth a bu11dIng pet inIt: Yes 1-1 Ila L (Check Appropriate Box) Purpose of Building TEMP POLE _ - - - utility Authoriratlon 110. Existing Service Antis / Volts Ovrtiread Undpt.f� 11 -------- ----- fjj---1 0. of i,eter llew Service 100--Amps--120--/ 240 -Volts hv�thcad I_,lindprd�) P('. of i(ete. 1 Humber of Feeders and Ampacity 3 - 12 ALUM — location and Nature of rtoposed Flgctt lral llotk 'TEMP POLE --------- - -- 110. of Lighting Outlets z Ito. of lighting, Fixtures Rilo. of Receptacle Outlets No. of Switch Outlets oito. of Ranges No. of Disposals t� No. rc of Dishwashers - ito. of Dryers Ir a ito. of !later Ileaters KW 2 o� Na. Hydra Itassage Tubs M OIl[ER! ito. of Ilot Iubs Swlmtning Pool Above. l-1 In- r -------- 6 t n d.- -- p t n d. U tin. of 011 Burners i,a. of Gas Burners ilo. of Air Coad ----- i'atej — _____ _ tons Ito. of Real: 7011.11 IotaI Pumpstons YW Space/Area Ileating YW Heating Devices YW No, of -ho_o[ --- Signs Ballasts i10. of 110 tors -Total NP ila. of Iranstot mers Total - KVA Generators KVA No. of Emergency Lighting Batter Units _ FiRE Ai.APitS ilo. of Zones No. of betcction and Initiating Devices 110. of Sounding Devices ito. of Self Contained Detection/Sounding Devices Local U thtnIcIpal (-7Other __ _- Connection I,ow Voltage - Wtrtnz INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy Including Completed Operations Coverage or Its substantial equivalent. YES LX1 NO [] I have submitted valid proof of same to this office. YES(A ito If you have checked YES, please Uj indicate the type of coverage by checking the appropriate box. INSURANCE Kj BOND E] OFl1ER C) (Pleas".. Spectfy) _ Estimated Value of Electrical Work S 500. WILL CALL Zlxpiracion I)_ai_eT Work to Start Inspection bate Itcqucstcd: Rough --Final Signed under the penalties of perjury: FIRM NA1(E_--.IAiifS i:. LiC, M,.AI )61Fi Licensee JOSEPH L. FOR'TrIN Signature --- - - -- -LI(, NO. Address P.O. BOR 544 SUTTON MA 01590 --- Bns. 7e1 tin. 508_865-3335 --- - —Alt. lel. tin, OWiIER'S INSURANCE !WAIVER: I am nware that the licensee does not have the insurance co�e�age or Its sub stantial equivalent as required by Massachusetts General Laws, and drat my signature on this permit application waives this tequiremrnt. Owner Agent (Please check one) _ Irlcphnne Nn. PF.R111I FEF $ —�Slgnature of Ovrlc_r br Agnt�tj --- —----------�—.._ No '7 Date................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that. ` ............................................................................................. has permission to perform............................................................................... wiring in the building of ................................................................................... ........ , North Andover, Mass. Fee .....I......!. Lic. No............... Check # ............................................................. ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Me C0111111011iVC-01 1 0f ��(1SS(1C�i11SCi(� r.,. n ►� �" • u.• O..I,�� v 1I_.... 4 / I)rImlillirrif of Public ,itlfr'fy ()'cot—(v b f.. t'h.rL.d �• = nno or rFne inE10VFNTiOPl nr c.tn nilc)f,s !177 (1n 12.wx --._.._._...----------- - APPLICATION I.FOf�mrPIRM11 O PF -Ji ORM LL-GI-RICAL WOR` r♦ with tilt �Intcnrhatrur rlrrlricnl (.odr, S77 C:MR 17,fX) I \ (PJ.f•.nSE Iltctrt L11 InP, Oit 'JYi'17 A1.1, i11F(1HNA11O11) i),P� City or Towtt of� --------------- — ���A_ �?OV�_ To till. Tr'-ctor of Ulres: Thu e undersigned applies for a petmi-t to r(oln he p^- t Clertriral work deseiihed helov- Lo"tion (Street b _. LZE�f` O --ter or Tenant- PULTE IiOME CORP. OF NEW T?NGLAND --- ---- ----------A--D 508 7870002 Out,errs Address 257 TURNPIKE RD SUITE 200, SOUTHBOROUGH, MA 01.722 Is tills Permit in conjunction vitt, a hutldlnR petmt.t:— — ------------- —�— Yes i 1!o i 1 (Check Appropriate pox) Fvrpose of Building NEW iIOME Existing Service _ ------------ --------...Amps / Volt's Ovetl,oad IIn,1P ------- Ile„ of Mete, Service 200 Amps 120 / 2/10 Vo -- `—' -- _--'_--------------'--- its (T,ethea,l I—J llndprd .R Nn. 0 1. 1ltrmher of Feeders and Amp;trl.tyiSets 3 — /1/0 ALIIM. e:— ------ lncntlohIlatute of Propoeed 17errrl nl 11 b Ni;W i10ME _- -- - OMER: llo. of ilot lobs ----- Swimming Pool --------grnd. ifO of Of I Alit ne.rs Flo. n( Cas Ratners — ---------; of Alt con1._...__.lot.;i— - _ tons 110, of heat — Iotal Intal P64 -- Ions ------Ku Space/Area lleattng K17 lieating Devices Kt! Floe of fTo. o� — 51gns Ballasts Flo, of itotors Total lip flo• of irans(nrmers — -Zotaj ----- Geitetatotc KVA No, of F:mrrgency l.iphtinp---------- BaCCCry Urtlts -- — ME AUMIS No• of Zon—t ifo. of Detection ant `------ Im itatinp. Devices — llo. of Snunrting Dcvtces ilo. of Self Corttalned Der.ectino/Soundlnp Devices Local U ihmlcipal j — --- __ Conncctlon�)Other I�u Voltage -- -- — ulC INSURANCF. COVERAGE.- Pursuant to the requtrements of Hassachusctts General Lav< I have a current Liability Insurance Policy int-ludf.np ComPleted Operations Coverage or fts substantial equivalent. YES 110 lJ I have submitted valid proof of same to tills office. YF.S�RJ 1I0 If you have checked YES, please indicate the type of coverage by co til top the f!. YF.';ort I A, box. INSURANCE. RC1 BOND OIIiF.R (Please Specify) EstimatedValve of Electrical Work $ 5000 ------- ---- -- I�Fxpir+tlont�j Work to Start WILL CAiT Inspection Date Requrstad: Rough F Signed under the pr.naltles of Perjury:`---- FIR11 ilA1fF--•fAM1S f. BUCiIANAN hLi;(;'I'R1.0 INC. Licensee_ JOSEPH L. FORTIN ~ -- - -- y _- i.ic.. if.) AI -5616 r —---5(pnatlire _ x L1C. NO --- ___— -- Address P.U. IloJt ,�1/1 SUTTON MA 01590 p„s. -zit. �a� �Ui3-8G5-1 OWFIER'S INSURAIICF, LIAIVER: I am mare that the i.lcensee —Alt. TeI. Fin — stantlnl equivalent as required by flassachusetts Gencraldlays,�oanA'tbatve l'mylslpnaturcronethls e npPltcation untves thiq requirement. Outer Agent f or lie sub-- (Pleese check one) P-tmlt $ _ _ Te lrphnrte 110.. U5, l4- —�S(gnaturc of Outtcr or ARent�-- -- ___-- PFpF1IT FEF; ___- Ifo, of Lighting Ovt.lets u z flo. of Liphtinp Fixtnres No. of Receptacle Outlets _ NO. of Suitch alt Te-ts — c. No, of Ranges ^ No. of Disposals J --------------- rcNo. of Dishwashers - 110. of Dryers tr o. It tIO. i of hater heaters KW Z Q o No. Hydro tiass59e Tubs OMER: llo. of ilot lobs ----- Swimming Pool --------grnd. ifO of Of I Alit ne.rs Flo. n( Cas Ratners — ---------; of Alt con1._...__.lot.;i— - _ tons 110, of heat — Iotal Intal P64 -- Ions ------Ku Space/Area lleattng K17 lieating Devices Kt! Floe of fTo. o� — 51gns Ballasts Flo, of itotors Total lip flo• of irans(nrmers — -Zotaj ----- Geitetatotc KVA No, of F:mrrgency l.iphtinp---------- BaCCCry Urtlts -- — ME AUMIS No• of Zon—t ifo. of Detection ant `------ Im itatinp. Devices — llo. of Snunrting Dcvtces ilo. of Self Corttalned Der.ectino/Soundlnp Devices Local U ihmlcipal j — --- __ Conncctlon�)Other I�u Voltage -- -- — ulC INSURANCF. COVERAGE.- Pursuant to the requtrements of Hassachusctts General Lav< I have a current Liability Insurance Policy int-ludf.np ComPleted Operations Coverage or fts substantial equivalent. YES 110 lJ I have submitted valid proof of same to tills office. YF.S�RJ 1I0 If you have checked YES, please indicate the type of coverage by co til top the f!. YF.';ort I A, box. INSURANCE. RC1 BOND OIIiF.R (Please Specify) EstimatedValve of Electrical Work $ 5000 ------- ---- -- I�Fxpir+tlont�j Work to Start WILL CAiT Inspection Date Requrstad: Rough F Signed under the pr.naltles of Perjury:`---- FIR11 ilA1fF--•fAM1S f. BUCiIANAN hLi;(;'I'R1.0 INC. Licensee_ JOSEPH L. FORTIN ~ -- - -- y _- i.ic.. if.) AI -5616 r —---5(pnatlire _ x L1C. NO --- ___— -- Address P.U. IloJt ,�1/1 SUTTON MA 01590 p„s. -zit. �a� �Ui3-8G5-1 OWFIER'S INSURAIICF, LIAIVER: I am mare that the i.lcensee —Alt. TeI. Fin — stantlnl equivalent as required by flassachusetts Gencraldlays,�oanA'tbatve l'mylslpnaturcronethls e npPltcation untves thiq requirement. Outer Agent f or lie sub-- (Pleese check one) P-tmlt $ _ _ Te lrphnrte 110.. U5, l4- —�S(gnaturc of Outtcr or ARent�-- -- ___-- PFpF1IT FEF; ___- AUG -15-2001 07:32 AM MARCHIONDA&ASSOCIATES 781 438 9654 P.02 ori n STEPHEN � MFl FSCI r 16.1' f — 40.0' N46'15'21 "W 100.00' I i 9 � ( 11500 S. F, 0.26 Ac. I I TOP FOUNDATION ELEVATION= 1 58.20 N46*15'21 "W 100.00' THIS PLAN IS INTENDED FOR ZONING PURPOSES ONLY. IT WAS PREPARED FROM EXISTING PLANS AND RECORDS WITH THE STRUCTURES SHOWN LOCATED BY AN INSTRUMENT SURVEY. THIS PLAN SHOULD NOT BE USED FOR PROPERTY LINE DETERMINATION. 25.5' DRIVE I 25.9 i I I I I I I 0 C! 'N46" WE HEREBY CERTIFY THAT WE HAVE EXAMINED THE PREMISES AND THAT THE BUILDING IS LOCATED AS SHOWN. THE STRUCTURE SHOWN CONFORMS TO THE ZONING LAWS RELATIVE TO REQUIRED SETBACKS OF THE MUNICIPALITY WHEN CONSTRUCTED, ALSO, ACCORDING TO THE F.E,M.A./H.U.D, FLOOD INSURANCE RATE MAP, COMMUNITY PANEL N0, 250098 0015 C DATED 6/2/1993 , THE STRUCTURE IS NOT LOCATED IN AN ESTABLISHED 100 YR.F`LO00 HAZARD ZONE. CERTIFIED FOUNDATIONPLAN LOT 9 FOREST VIEW ESTATES NORTH ANDOVER, MA PREPARED FOR PULTE HOME CORP. OF NEW ENGLAND 257 TURNPIKE ROAD SUITE 200 SOUTH80ROUGH, MASSACHUSETTS 01721 MARCHIONDA & ASSOC.,L.P. ENGINEERING AND PLANNING CONSULTANTS 62 MONTVALE AVE, SUITE I STONEHAM, MA. 02180 (781) 438--6121 SCALE: 1"=20' DATE: 8/14/01 I ��.. LocationIN 1, �� (:� E3/0Apo, (,V � rZ No. 12 ` Date C� TOWN OF NORTH ANDOVER 41 rtifi a of ccupa cy uild' (Frame Permit ee $ b s►cNus oun ation P mit Fee they t Fee $ TOTAL $ / a von b Check # 14991 Building Inspector Location X b-/ ` No. 1,2 t/ ` Date "ORTp TOWN OF NORTH ANDOVER 3? • • OL Jqertifirtle�,3`f OccuP Y a c $ s�CMU5E4� �uildinglFram� Permit ee $� �' G Foundation Permit Fee Other `Pe�rfit Fee $ TOTAL $ cpn & 6 Check # f?eno Building Inspector Location a� g "!11;70 No. Date V- S- d% TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ �6 G Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 14,6 e /Qvbn �6 Check # �' Building Inspector