HomeMy WebLinkAboutMiscellaneous - 85 WINDKIST FARM ROAD 4/30/2018a�
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Commonwealth of Massachusetts
City/Town of REGI
VED
° System Pumping Record
Form 4 NOV 15 `Loll
4M s y`'v
DEP has provided this form for use by local Boards of Health. Other fMR-
rF43^fPf edNbp
information must be substantially the same as that provided here. Bef H M�Yidck ith 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.
A. Facility Information
1. System Location: Left / Right front of house, Left / Right rear of house, Left / right side of house, Left /
Right side of building, Left / Right front of building, Left / Right rear of building, Under deck
Address � � uj\
Cityrrown J �i
2. System Owner: C;
Name
Address (if different from location)
Cityrrown
B. Pumping Record
1. Date of Pumping
3. Type of system: ❑
❑ Other (describe):
State
10-3(—ir
— 2. Quantity Pumped
Septic Tank
Date
Cesspool(s)
Zip Code
State Zip Code
< -? -3
Telephone Number
Gallons T
❑ Tight Tank
4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No
5. Condition�of System:
6. System Pumped By:
Neil Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc
Company
7. Lo- h _ contents were disposed:
G. L Lowell Waste Water
Date
t5form4.doc• 06/03 System Pumping Record • Page 1 of 1
07 ss ussr�s
YigGc &—e 4 P -R& S144
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
Office Use Ony
Permit Na t (jf�
Occupancy & Fee Checked
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00
Date S -2--q-73
To the Inspector of Wires:
(Please Print in ink or type all information)
Town of North Andover
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number �� / ►� U X/S �� / M b
Owner or Tenant L in in i a l V1 //4
Owner's Address
Is this permit in conjunction with a building permit Yes .� No ❑ (Check Appropriate Box)
Purpose of Building_ k-ec I0�n � (o, / Utility Authorization No.
Existing Service Amps Voits Overhead ❑ Undgmd ❑ No. of Meters
New Service Amps Voits Overhead ❑ Undgmd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work Sp-,
r
OTHER
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws
I have a current Liability Insurance Policy including Com feted Operations Coverage or its substantial equivalent YES kNO =
have submitted vaay proof of same to the Office YESLNO = If you have checked YES please indicate the type of coverage by checking the appropriate box
INSURANCE IYBOND = OTHER = (Please Specify)
(Expiration Date)
0/60,040
Estimated Value of ectric Wo E
Work to StartZ L Inspection Date Resquested Rough Final
Signed underthenes of perju
FIRM NAME SU // / U/1 A /`//�/ i� i41.r /'M LIC. NO. a 7
D,-GA/ver h
NO. 0.2 (17 O
Bus. Tel No f -2.9– G F'2 ` 6 r?
Address .Z% ^11,06410D Aft Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that fhe Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one)
Telephone No. PERMIT FEE $ t � —
(Signature of Owner or Agent)
Total
No. of Lighteng LightenOutlets
No. of Hot fuse
No. of Transformers INA
Above ❑
In ❑
No. of Lighting Fixtures
Swimminq Pool gmd ❑
gmd ❑
Generators KVA
No. of Emergency Lighting
No. of Receptacles Outlets
No. of Oil Burners
Battery Units
No. of Switch Outlets
No of Gas Burners
FIRE ALARMS No. of Zone
No. of Detection and
Total
No. of Ranges
No of Air Cond
Tons
Initiating Devices .
Heat Total Total
No. of Diposal
No. Pumps
Tons
KW
No. of Sounding Devices
Nod of Self Contained
No. of Dishwashers
S ace/Area Heating
KW
DetectionlSounding Devices
❑ Municipal ❑ Other
No. of Dryers
Heating Devices
KW
Local Connection
No. of
No. of
Low Voltage
No. of Water Heaters KW
Signs
Bailases
Wiring
No. Hydro Massage_ Tuds
No. of Motors
Total HP
OTHER
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws
I have a current Liability Insurance Policy including Com feted Operations Coverage or its substantial equivalent YES kNO =
have submitted vaay proof of same to the Office YESLNO = If you have checked YES please indicate the type of coverage by checking the appropriate box
INSURANCE IYBOND = OTHER = (Please Specify)
(Expiration Date)
0/60,040
Estimated Value of ectric Wo E
Work to StartZ L Inspection Date Resquested Rough Final
Signed underthenes of perju
FIRM NAME SU // / U/1 A /`//�/ i� i41.r /'M LIC. NO. a 7
D,-GA/ver h
NO. 0.2 (17 O
Bus. Tel No f -2.9– G F'2 ` 6 r?
Address .Z% ^11,06410D Aft Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that fhe Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one)
Telephone No. PERMIT FEE $ t � —
(Signature of Owner or Agent)
N2 I Date....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
CS
... 51-A (` "J C"A n.....
This certifies that... . ........................... ......
has permission to perform ...... Al.aiPI ...... **"*** 8
wiring in the building of ..... ........ ...... ...................
at ..... .............. . North Andover, Mass.
cc
Fee... .... Lic. No... O� . (. ............... . ..........................
i�i iNSPECTOR
&0
Ck ���5
-
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
I
f�fir
?JpaHr.»drt o6 r'a6lle 544
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
Office Use O�nnlly
Permit No_ O
Occupancy & Fee Checked
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All worts to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00
(Please Print in ink or type all information)
Town of North Andover
The undersigned applies for a permit to perform the electrical worts described below. ! /
Location (Street & Number L Z)
Owner or Tenant L C>L DIV 1 4-e V r L L iit J� L c�
Date
To the Inspector of Wires:
Owner's Address. J � yy -rk I r
Is this permit in conjunction with a building permit q Yes � No ❑ (Check Appropriate Box)
Purpose of Suilding 5 / � V L 1 �f � 114f L Y lO � c, N6 Utility Authorization No. � �'� 6 3 -
Existing Service Amps Voits
New Service � ( ) 0 Amps _114140fb
Overhead ❑ Undgmd ❑ No. of Meters
Overhead ❑ Undgmd ❑ No. of Meters
Number of Feeders and Ampacdy /—
Location and Nature of Proposed Ee=cal Work TA 4_J 4 --ft _ L (,(� J 1 &:�6
OTHER:
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General taws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO =
have submitted valid proof of same to the Office YES = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box
INSURANCE = BONO = OTHER = (Please Specify)
(Expiration Date)
Estimated Value of Electrical Work$
Work to Start Inspection Date RWuested Rough Final
Signed under the Penalties of perj ��� LIC. NO.
FIRM NAME (� n �rQ�� d i
Licensee T«% 1,�1 ✓% i� . !ll /'z.�Ly T_ Signature _U'64 1 l LIC. NO.
' / _ 2 , . f �BAlt Tel No.
Address � 14 O G % Amt Tel
No. 7
OWNER'S I URANCE WAIVER: I am aware that the Licenses does not have the insurance covers a or i substantial equivalent as regwred by Massachusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one)
PERMIT FEE 5 %W r
Telephone No. �f �
(Signature of Owner or Agent)
Total
No. of Light8nq Outlets
No. of Hot fuse
No. of Transformers KVA
Above ❑
In ❑
No. of Ughbnq Fixtures
Swimminq Pool gmd C
gmd C
Generators KVA
No. of Emergency Lignang
No. of Receotacies Outlets
No. of Oil Burners
Battery Units
No. of Svntcn Outlets
No of Gas Burners
FIRE ALARMS No. of Zone
No. of Detection and
Total
No. of Ranges
No of Air Cond
Tons
Initiating Devices
Heat Total Total
No. of Moo"
No. Pumos
Tons
KW
No. of Sounding Devices
No./ of Self Contained
No. of Dishwashers
Soace/Area Heating
KW
OetectioniSounding Devices
Municipal ❑ Other
No. of Dyers
Heatnq Devices
KW
Local Connection
No. of
No. of
Low Voltage
No. of Water Heaters KW
Signs
Badases
Wiring
No. Hydro Massage Tuds
No. of Motors
Total HP
OTHER:
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General taws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO =
have submitted valid proof of same to the Office YES = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box
INSURANCE = BONO = OTHER = (Please Specify)
(Expiration Date)
Estimated Value of Electrical Work$
Work to Start Inspection Date RWuested Rough Final
Signed under the Penalties of perj ��� LIC. NO.
FIRM NAME (� n �rQ�� d i
Licensee T«% 1,�1 ✓% i� . !ll /'z.�Ly T_ Signature _U'64 1 l LIC. NO.
' / _ 2 , . f �BAlt Tel No.
Address � 14 O G % Amt Tel
No. 7
OWNER'S I URANCE WAIVER: I am aware that the Licenses does not have the insurance covers a or i substantial equivalent as regwred by Massachusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one)
PERMIT FEE 5 %W r
Telephone No. �f �
(Signature of Owner or Agent)
JrN2 'i 47
Date ... .,� / .
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies thatY!........�.Q. �! �� . `(`/......,' �. �.,......................
has permission to perform ......... �J yk .�........1�.� i!}`�.. �- ..........................
wiring in the building of ...C.0.1..... . ......... ..:.......................
at .....h.v.L. ........ ..... ��!�"' .c t ......... .. r .............. . North Andover, Mass.
...........
Fee. �.Nd . L). Lic. No.0.4�24 .....................................................
/ ELECTRICAL INSPECTOR
C Q1/98 08.41 300.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
r
Location�`���N[ <r /D
j NP. Date -5 13612 7
,►ORTh TOWN OF NORTH ANDOVER
Certificate of Occupancy $
} Building/Frame Permit Fee $
Foundation Permit Fee $ %� d
s�cHust
rimer Permit Fee $ Z
Sewer Connection Fee $
Water Connection Fee $ �D�7
TOTAL $ 2703 vJ
1, 521. M PTD Build' Ins to
_ Q // Div. u is Works
Location
No.
Date 7
v40IIIT#j
TOWN OF NORTH ANDOVER
Certificate of Occupancy
$
Building/Frame Permit Fee
$
q!V.l
CHU
Foundation Permit Fee
$
Ca
Other Permit Fee
$
Sewer Connection Fee
$
•
Water Connection Fee
$
TOTAL
$
Building I tor.
E-11. v ;kll
9 2 C'3
Div. Pubtic Works
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4 -
FORM U - VERIFICATION FORM
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
APPLICANT: 111�/.�5/ �i9%?r�IS LL C- Phone
LOCATION: Assessor's Map Number _1U % Parcel
Subdivision _G�'/!t/J45 Lot (s) _
Street St. Number
F
ficial
RECO ATIO S OENTS:
Conservation Administrator
Comments
Pi
Use only************************
Comments �/ _ (1 I �> (rGvCCL
Food Inspector-HHealth
pt•c Inspector -Health
Comments
Date Approved
Date Rejected
G19
Date Approved It
Date. Rejected
Date Approved
Date Rejected
Date Approved
Date Rejected
Public Works - sewer/water connections (� L/-77
- driveway permit IT(C )
Fire Department
eceived by Builaing
inspector, Date
03/13/88 13:27 FAX 508 6888556 .i NORTH ANDOVER .0001
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 a.7.6 of the
Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information
as requested below.
Name of Applicant an BuildingProperty Permit (below) Address of Prop�rty for Permmii�t (below)
r*&5l aC R-,5-�/iNq!>!�lT
3L
Map and Parcel /9 3 -/Purpose of Application (check below).
Phone IN#zber�of p hcant: 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 EXEMPT)ON 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 iEXEMPTiON status is subject to review by the Building
Department and is only aftialally accepted when the Building Permit iia 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 Ipt, in the building permit application and associated attachments, complies with one or more of the
following sectons as indicated by a check mark.
This is an application for a building permit for the enlargement restoration, or reconstruction of a dwelling in
�
iAence as of the effective date of this by-law, provided that no additional residential unit is Created.
pL The lot(!) were/was treated prior to May 6, 1946 are amempt from the provisions of this Section 8.7 of the Zoning
'Bylaw.
This application is for dwelling units for low andfor moderate income families or individuals, where all of the
condiliam of 8.74c•ero mat andfor represents Dwelling units for senior residents, when: occupancy of the units is
restricted to senior persons through a properly executed and recorded deed restriction running with the land. For
purpasea of this Section 'senior shall mean persons over the age of 55.
This application is a part of a devebpment prolan which voluntarily agreed to a minimum 40% permanent
rwuCdan in density. (buildable lots), below the density, (buildable lots), permitted under toning and feasible given the
environmental conditions of the tract, with the surplus land equal to at least ten buildable acnes and permanently
designated as open space andfor farmland. The land to be preserved shall be protecmd from development by an
Agricultural Presematlon Restriction, Conservation Restriction, dedication to the Town, at other similar mechanism
approved by the Planning Board that wig 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 a.1 shall receive a onetime exemption from the Planned Growth
Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the
Parcel.
This appllo0on represents a lot which is ready for building pennrts.li,e. all other permits from all other boards and
commissions have been received and the protect is in compliance with those permits). and the Development Schedule
does not accommodate issuing a building permit in that Year. ane building permit will be issued per Year per
Oeveloomerit until such time as the Development Schedule accommodates issuing building permits. Applicant must
supply approved farm 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 E)(EMPTIONS.
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.
,?- /9 z
ignature at Qvfner or Authonted Agent wria signed the Anacned Burldin Permit to
This form must be attached to the Building Permit upon application for such permit
i
MAScheck COMPLIANCE REPORT
Massachusetts Energy Code
MAScheck Software Version 2.0
CITY: Lawrence
STATE: Massachusetts
HDD: 6235
CONSTRUCTION TYPE: 1
HEATING SYSTEM TYPE:
DATE: 3-25-1998
DATE OF PLANS:
TITLE: 85windkist
COMPLIANCE: PASSES
Required UA = 792
Your Home = 782
or 2 family, detached
Other (Non -Electric Resistance)
Permit #
Checked by/Date
Area or Insul Sheath Glazing/Door
Perimeter R -Value R -Value U -Value UA
CEILINGS
1946
38.0
3.0 54
WALLS: Wood Frame, 16" O.C.
3600
15.0
3.0 241
WALLS: Wood Frame, 16" O.C.
198
19.0
3.0 11
GLAZING: Windows or Doors
702
0.500 351
FLOORS: Over Unconditioned
Space
1927
19.0
92
BSMT: 4.0' ht/0.0' bg/4.0'
insul.
68
10.0
6
BSMT: 8.0' ht/7.0' bg/0.0'
insul.
120
0.0
27
HVAC EFFICIENCY: Furnace,
86.0 AFUE
COMPLIANCE STATEMENT: The proposed building design represented in these
documents is consistent with the building plans, specifications, and other
calculations submitted with the permit application. The proposed building
has been designed to meet the requirements of the Massachusetts Energy Code.
The heating load for this building, and the cooling load if appropriate
has been determined using the applicable Standard Design Conditions found
in the Code. The HVAC equipment selected to heat or cool the building
shall be no greater than 1250 of the design load as specified in
sections 780CMR 1310 and J4.4.
Builder/Designer,
Date
0
{
dIdOOH 6160--
NOI VAjlj;NO�U : ,,,,
SIWOH INIA :�O �iici ino
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Building Permit Number �� 9 Date �� 9
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