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HomeMy WebLinkAboutMiscellaneous - 87 LEANNE DRIVE 4/30/20180 F- W _i Insurance Adjustment Service, Inc. 139 Billerica Road, Unit A-1 Chelmsford, MA 01824 (978) 256-3334 Fax (978) 256-3354 UNDER MASSACHUSETTS GENERAL LAWS CHAPTER 139 SECTION 3B TO: Board of Health/Building Inspector RE: Insured: Kwang Soo Property Address: 87 Leanne Dr No. Andover, MA 01845 Date of Loss Policy Number: Type of Loss: 4/18/2007 H004018326 Date: April 23, 2007 RECEIVED APR 2 6 2007 TOWN OF NOR Tr- "V,DGVER HEALTH DEPARI,. vT Strong winds knocked over and damaged multiple sections of PVC fencing. File or Claim Number: 40767-tm Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6, to be applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 38 is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, locations, policy number, date of loss and claim or file number. Thank you for your cooperation. Very Truly yours, L Tim Martino Adjuster Ext. 135 Insurance Adjustment Service, Inc. 139 Billerica Road, Unit A-1 Chelmsford, MA 01824 (978) 256-3334 Fax (978) 256-3354 UNDER MASSACHUSETTS GENERAL LAWS CHAPTER 139 SECTION 3B TO: Board of Health/Building Inspector RE: Insured: Kwang Soo Property Address: 87 Leanne Dr No. Andover, MA 01845 Date of Loss Policy Number: 4/18/2007 HO04018326 Date: April 23, 2007 RECEIVED APR 2 6 2007 TOHEALOF TH D R NORTHANDOVER Type of Loss: Leaking plumbing pipe caused damaged to finished basement. File or Claim Number: 40766-tm Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6, to be applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 38 is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, locations, policy number, date of loss and claim or file number. Thank you for your cooperation. Very Truly yours, L Tim Martino Adjuster Ext. 135 7 5 �� , C e a6i) �Q�v � Location, D No. Date c,2-tPO-61 Nom,. TOWN OF NORTH ANDOVER o Certificate of Occupancy $ �— y�s���.;5 t� Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee TOTAL Check #/ Q l f � r Jo( Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: j DATE ISSUED: SIGNATURE: ( , Building Commissioner/InEector of Buildings Date I SEC:1'I0N I- SIIE IN OKAIA11VN I 1.1 Property Address: !!77 1.2 Assessors Map and Parcel Number: Map Nu Parcel Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: 2 1?, G e,3 5G /.�--o Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R red Provided Re aired Provided -301 3) , 1.7 Water Supply M.GL.C.4o., 54) Public Private Of, Zone 1.5. Flood Zone Information: Outside Flood Zone 1.8 Sewerage Disposal System: Municipal On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record rPo06f11V, ov.✓/P #-4pt- S �/ o �sX J'-?/ /11- i9 Nis V Nament) %j Address for Service Telephone 2.2 Owner of Record: Name Print SECTION,3 - CONSTRUCTION SERVICES 3.1 Licens 's Construction Supervisor: Licensed Construction Supervisor: /ys'1 Ad 672 gnature Telephone 3.2 Company Name Address Address for Service: F E 8 13 2DO] Not Applicable ❑ ,47350% License Number ,?/J/Qz Expiration Date Not Applicable ❑ Registration Number Expiration Date SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the bui4lingrmit. Signed affidavit Attached Yes ...... X No ....... ❑ SECTION 5 Desc ' ion of Pioposed Work check all applicable) New Construction Existing Building ❑ 1 Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ 1 Demolition ❑ 1 Other ❑ Specify Brief Description of Proposed Work: SIN I tp M: 44 I SECTION 6 - ESTIMATED CONSTRUCTION COSTS I Item Estimated Cost (Dollar) to be Completed by permit applicant 1. Building (a). Building Permit Fee Zoo 0 o O , Multi lier 2 Electrical / 0 0 U (b) ;Estimated Total Cost of Construction 3 Plumbing / er 0 0 Building Permit fee tel X tbl l Yah / 4 Mechanical HVAC /S-, 0 o 5 Fire Protection .&'$ c 0 6 Total 1+2+3+4+5 Uf', c 0 (l Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING. PERMIT I, as Owner/Authorized Agent of subject property 7 Hereby authorize �le e, S /°� 7 P to act on My behalV'rsii all matters relativ to work authorized by this building permit application. jZ1 ZIJ Signa of 5Frmer Date SECTION 7b OWNER/AfUTHORIZED AGENT DECLARATION I,�/��f� ©F� �� 1'1'7 -v ley 9 S 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 Date NO. OF STORIES -1 SIZE BASEMENT OR SLAB 94 ie M e - SIZE OF FLOOR TINMERS 1 2'V 1 0 2 Z4 J 0 3RDX SPAN DIMENSIONS OF SILLS -- DIMENSIONS OF POSTS L 1 S o / �• ? DIMENSIONS OF GIRDERS y 1 X 1 0 - - HEIGHT OF FOUNDATION o " THICKNESS 10 SIZE OF FOOTING /v A 3o X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND S0 /,/,) IS BUILDING CONNECTED, TO NATURAL GAS LINE ' yr 5 966 Date.."..? .... . �'.; •� : ti TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... r!�.:U�.... �.Cs�l6r.�........ . has permission to perform ......t.t L`.�A.(--�......h ...... plumbing in the buildings of ....kUjexM 1 ..... C>.H ........... at�North Andover, Mass. F-�().. 00. Lic. No. � .Cc'% . ......./.M.f PLUMBING INSPECTOR Check # Installing Company Name: PZ+ -uho Address:/,4��y�Town:!(/E' V�/� Stater Business Tel:6e,> -� �Y?gy 3 1 Fax: Name of Licensed Plumber: Check One Only Certificate # ❑ Corporation ❑ Partnership ❑ Firm/Company INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes M No ❑ If you have checked Yes, please indicate the .type of coverage by checking the appropriate box below. A liability insurance policy. ( Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's A ent Owner ❑ . Agent ❑ 1 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 compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chap 142 of the General Laws By_ Title City/Town Type of License: - ❑ Plumber orgmture of LIcIrl1sed Plumber ❑ IjAaster � n EKourneyman License Number: MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town: / /d/�'I�l�'� MA. Permit# Building Location: — lop Owners Name: Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Plans Submitted: Yes ❑ No ❑ FIXTURES DEDICATED LU zLUZ z SYSTEMS q W z y U Y Q _j U w O O YY Z WEn O m h CCw z F- _W Z F a N _Z O W p F- �' CC Y En V1 C7 a X a Q W v1 F- L. Q W Q LL I" UY F= -H QJ Z LL W N jO = H O 'Z >m 6= 02 W aa cc:HO Co O YW v ° N N 3 3 3 o a V)W a -SUB BSMT. 3 BASEMENT 1' FLOOR 2ND FLOOR 3" FLOOR 4T" FLOOR ST" FLOOR 6T" FLOOR 7T" FLOOR BT" FLOOR Installing Company Name: PZ+ -uho Address:/,4��y�Town:!(/E' V�/� Stater Business Tel:6e,> -� �Y?gy 3 1 Fax: Name of Licensed Plumber: Check One Only Certificate # ❑ Corporation ❑ Partnership ❑ Firm/Company INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes M No ❑ If you have checked Yes, please indicate the .type of coverage by checking the appropriate box below. A liability insurance policy. ( Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's A ent Owner ❑ . Agent ❑ 1 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 compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chap 142 of the General Laws By_ Title City/Town Type of License: - ❑ Plumber orgmture of LIcIrl1sed Plumber ❑ IjAaster � n EKourneyman License Number: 76� f Date .. 7-//6 �... . i TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .... DA. (e. ( d ...... (' 4 4�,4n .. ! . { has permission for gas installation ....�%r-! / . in the buildings off ..... K !'^ ............................ at North Andqver, , ass Feb '. 4PO. Lic. No,<A Q 731.. ..... r . . GA;INSPECTOR Check # 3,r( � CIVTI IGCL+ W W W LLj MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town:" IQLj&jtb%y MA. Date: J� // Permit# Building Location: �C: �%U�� V(/�f �) �� Owners Name: Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential ❑ New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Plans Submitted: Yes ❑ No ❑ CIVTI IGCL+ W W W LLj U) Y Cd FQ' m= O W U H 2 W W Z F- W H Z —1 } (D W Z to O= O O W a' F- n y W W W m Q~ a IW- 0 0 W X W N V W W Z O _ U) OLLJ 0 W = F- W 0 = tZ W W 0 W Z J F— F- O Z J 0 LL I� F- LLL( t.� 0 13LL 0 = z O a0 FW- > > > O 1 1 SUB BSMT. BASEMENT -f FLOOR 2 NLFLOOR 3 FLOOR 4 FLOOR -9'FLOOR 6 THFLOOR 7 FLOOR -8 'FLOOR //7� ac �C(y�3�j�1-� �, Check One Only Certificate # Installing Company Name:'O"'Q to - J' 1S��j0 v/ /'' Address:l��JO / //Ql/�% City/Town:/ �l�i)� State: El Corporation / Business TeI42 � � �0 Fax: ❑Partnership ❑ Firm/Company Name of Licensed Plumber/Gas Fitter: INSURANCE COVERAGE: I have a current liability,insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes g—1 to ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy L?,*" Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner [-] Agent E] By checking this box ❑, I hereby certify that all of the details and Information I have submitted (or entered) regarding this application are true and --�- •�• ... ..y cuyc duu treat du piumoing worK ano mstauatlons perrormed under the permit issued for this application will be in --•••r••�••�� •••••• a•• �_••������. N..,.'Ull VA LIM IVIdSsdcnusetts Mate r1umpaig erode and unapter 143 ofthe General Laws. Type of License: By ❑ Plumber Title ❑ Gas Fitter Signature of Licensed Plumber/Gas Fitter City/Town ❑Journeyman License Number: 1;21J 73 APPROVED (OFFICE USE ONLY► ❑ LP Installer — .'k, '��C Wje c FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all -necessary approval/ permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT (ee (Ur C t-) G�°y i e;n C 5 PHONE ASSESSORS MAP NUMBER 77 LOT NUMBER .� SUBDIVISION �� S L T S LOT NUMBER STREET Z e i ✓✓'ve STREET NUMBER 9 l OFFICIAL USE ONLY ............................. •SSSS■ ■..San RECOMNIENDATIONS OF TOWN AGENTS .*.rf................................................r.......... .....Samoa. `% ,,� ' �TRATOR DATE APPROVEDV SERVATIO ADMM D DATE REJECTED COMivIENTS FOOD INSPECTOR -'HEALTH DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED LltEPTIC INSPECTOR - HEALTH CONDAENTS DATE REJECTED - SEWER / WATER CONNEC ONS DATE REJECTED COMMENTS (� RECEIVED BY BUILDING INSPECTOR `_ DATE Y c C c N LEANNE k 1 P9 I PROP. B.F. DWELL, Prop. B.C. TFa241.5 Driveway OF -234.0 0 LOT f n rt _Qfl�JNAGE EASEMENT - - - -- -- -- - � - 30 WIDE NO -CUT - - - --- -- EASEMENT _y LEGEND SCWFR SERVICE S FOUNDATION DRAIN FD WAFER SCRACE W THE CONTP.ACTOR SHALL VERirY THE LOCATION h CAS SERVICE —C 500 [LCV. OF All UTIIITIFS EXIST, CCIJTOUR PRIOR TO EXCAVATION OF THE FOUNDATION TO ASSURE PROP. CONTOUR 300 CRAVITY D.RAIN.ACE OF THE FOOTING k SEWER WIIL BE ROCK RET. WALL PROVIDED. NOTIFY DESIGN ENGINEER IF ANY CHANCE'S ARE NEEDED. CR05roN CONiRM r.0,sr. PROPOSED SITE PI_A.N LOT 6 1 FANNE DRIVE MARC;HIONDA & ASSCC.,L.P. NORTH ANnOVFR, MA rNmNrrRwc AND rLANNINO CONSULTANTS PREPARED FOR 62 MONTVALE AVE. SUITE I BRDOKVIEW COUNTRY HOMES 5TONFHAM, MA. 02100 P. 0. 80K 531 (781) 439-9121 NORTH ANOONER, MA 01649 SCALE: 1"-30' DATE: 1/3/00 -104-1 APPLICATION FOR WATER SERVICE CONNECTION )O/ North Andover, Mass. Application by the undersigned is hereby made to connect with the town water main in 22&W ��/ fir✓ Street, subject to the rules and regulations of the Division of Public `Works. C The premises are known as No. Leg if Pr/`ilk Street or subdivision lot no. rook— t e Owner Contractor d u 6 Address Addr s `/A cant's Signature PERMIT TO CONN The Board of Public Works hereby grants permission to v to make a connection with the water main at Z- e,; 4 Street subject to the rules and regulations of the Division of Public Works. A(ITH WATER MAIN Inspected by Date ' 0P) ;I V� Board of Public Works By l/(/ See back for rules and regulations J.WILLIAM HMURCIAK, P.E. DIRECTOR TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 IAORTI t^ DRIVEWAY PERMIT Telephone (978) 685-0950 Fax(978)688-9573 DATE LOCATION EA Al Al .1 IVVC 9 ( 6 BUILDER phone OWNER C'ouA1TZY 4PwE'S hone GBd - 558 THE NORTH ANDOVER SUPERINTENDENT OF OPERATIONS MUST BE NOTIFIED OF THE GRADE AND SETBACK FROM STREET. CALL THE SUPERINTENDENT'S OFFICE BEFORE FINISH GRADING AND SURFACING FOR APPROVAL OF SUCH ENTRY. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. 1637 APPLICATION FOR SEWER SERVICE CONNECTION North Andover, Mass. -Jez 14 Z; 19� Application by the undersigned is hereby made to connect with the town sewer main in Ze--a 0 /1 �P Pl" Street, subject to the rules and regulations of the Division of Public WorksZe, The premises are known as No. 97 n e Street or subdivision lot no. _ 101�1-ykvi e Owner Contractor Address Addres Applicant's Signature '53 6N_6559 PERMIT TO CONNECT WITH SEWER MAIN The Division of Public Works hereby grants permission to �l e4d to make a connection with the sewer main at Street subject to the rules and regulations of the Division of Public Works.. Inspected by Date Div�n of Public Works By See back for rules and regulations DPW 309 Date ...... 1. TOWN OF NORTH ANDOVER RECEIPT This certifies that .......... F 4: �,� ................................ hasP........................./. ........ %............................................... ► rfor ... . ....... Pr Cad- K Received by .................... �7� ... 141� de -1 e ....................................................... Department ......................... PUU�e_ U)0'14--71 ......................................... WHITE: Applicant Dpvv 310 CANARY: Department PINK: Treasurer Date ... TOWN OF NORTH ANDOVER RECEIPT This certifies that ..................................... .... haspaid ...................... .............................. Received by .................................. I§e ....................... Department ................................... . TV. �. /)., .... a.ckf- .5 WHITE: Applicant CANARY: Department PINK: Treasurer GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT TOWN OF NORTH ANDOVERBUILDING DEPARTMENT . This form shall be used to assist the Building Department in their determination of exemption under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The applicant shall provide all of the necessary information as requested below. Permit Applicant e / 1,4NA'( 42e . Property address �W llo 7 X 6 Map / Parcel Applicant's Phone Number Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the building permit. Further I understand that my interpretation of the exemption status is subject to review by the Building Department and is only officially accepted when the building permit is issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement, restoration or reconstruction of a dwelling in existence as of the effective date of this bylaw, provided that no additional residential unit is created. _ X The lot(s) was / were created prior to May 6, 1996 and are exempt from the provisions of section 8.7 of the Zoning Bylaw. This application is for dwelling units for low and or moderate income families or individuals, where all of the conditions of 8.7.6 are met and or represents dwelling units for senior residents, where occupancy of the units is restricted to senior citizens through a properly executed and recorded deed restriction running with the land. For purposes ofthis section "senior" shall mean persons over the age of 55. This application is part of a development project which voluntarily agreed to a minimum 40 % permanent reduction in density (buildable lots) below the density permitted under zoning and feasible given the environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently designated as open space or farmland. The land to be preserved shall be protected from development by an Agricultural Preservation Restriction, Conservation Restriction. dedication -to the Town, or other similar mechanism approved by the planning board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 and 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 application represents a lot which is ready for a building permit ( all other permits from all other boards and commissions have been received and the project is in compliance with those permits), and the Development Schedule does not accommodate issuing a building permit in that year. One building permit will be issued per year per Development until such time as the development schedule accommodates issuing building permits. Applicant must submit an approved FORM U with this EXEMPTION. PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A DETERMINATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE EXEMPTIONS. BY SIGNING BE I ATTEST TO THE ACCURACY OF THE INFORMATION PROVIDED AND THAT THE ATTACHED BUILDING P I LOWED AN EXEMPT ON AS CITED ABOVE. FURTHER AND THAT THE SUB OF MISLEADING OR INACCURATE INFORMATION OR THE CHEC F A�� BMPTI I DOES NOT COMPLY, WHETHER DONE TO MY KNOWLEDGE OR NOT I RO S FO ING DEPARTMENT TO ISSUE A BUILDING PERMPf. / /l d! DATE THIS FORM TO BE ATTACHED TO THE BUILDING PERMIT APPLICATION The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Name: �P�o r` FJr GJ (ev,v%ey �ia u e S Location: City Ov 6%N�or�� Phone = am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing. workers' compensation for my employees working on this job. Comoanv name: '0/r 0 r / V' e 1'_J f ° v ^' le / ,41 , ^ < S Address d �x City_, �- i9'VO)1t,e Phone Insurance Co. ��J 7e [ ry s� e W / `/ Policy # ?4 S� s Company name: Address City- Phone* Insurance Co Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify unde the in a d penalties of pemjyat the information provided above is true and correct. Signature Date 2I Z a Print name C4e`5TP Sr`2 /4� '?e-Cti-9S Phone# o!� rbl y7o 7 Official use only do not write in this area to be completed by city or town official' Building Dept ❑Check if immediate response is required Building Dept p Licensing Board p Selectman's Office Contact person: Phone #: Health Department Other FORM WORKMAN'S COMPENSATION ♦, Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 DEBRIS DISPOSAL FORM f NORT}i .q Y1� 9t'�� 6Y6�OL 0 e tatxtntwK■ AGPIUS���� In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in /at: w �� j r%d w�✓ Facility location /� , A V A Signature of Applicant Z/� ZZ -1 / Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. x C l �i MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.01 Release 2 CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 12-19-2000 TITLE: HERITAGE ESTATES BRENTWOOD PROJECT INFORMATION: BROORVIEW COUNTRY HOMES INC PO BOX 531 N ANDOVER MA COMPANY INFORMATION: J&J HEATING & AIR COND 17 ARLINGTON ST DRACUT MA COMPLIANCE: PASSES Required UA = 617 Your Home = 615 Permit # Checked by/Date Area or Cavity Cont. Glazing/Door Perimeter R -Value R -Value U -Value --------------------------------------------------------------------------- CEILINGS 1800 30.0 0.0 WALLS: Wood Frame, 16" O.C. 2479 13.0 0.0 2 GLAZING: Windows or Doors 510 0.400 2 GLAZING: Windows or Doors 96 0.460 DOORS 39 0.400 FLOORS: Over Unconditioned Space 1800 19.0 0.0 HVAC EQUIPMENT: Furnace, 92.0 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 Cade. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date Massachusetts Energy Code MAScheck Software Version 2.01 Release 2 HERITAGE ESTATES BRENTWOOD DATE: 12-19-2000 Bldg. Dept. Use [ ] [ l [ l CEILINGS: 1. R-30 Comments/Location WALLS: 1. Wood Frame, 16" O.C., R-13 Comments/Location WINDOWS AND GLASS DOORS: 1. U -value: 0.4 For windows without labeled U -values; describe features: # Panes Frame Type Thermal Break? [ j Yes [ ] No Comments/Location 2. U -value: 0.46 For windows without labeled U -values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: 1. U -value: 0.4 Comments/Location FLOORS: 1. Over Unconditioned Space, R-19 Comments/Location HVAC EQUIPMENT: 1. Furnace, 92.0 AFUE or Make and Model Number 2. Air Conditioner, 10.0 higher SEER 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 cfm (0.944 L/s) air movement from the the 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. c VAPOR RETARDER: m -in -winter aide of all non -vented framed Required on the. war ceilings-, walls, and floors. ! MATERIALS IDENTIFICATION: Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be provided. Insulation R -values, glazing U -values, and heating equipment efficiency must be clearly marked on the building plans or specifications. DUCT INSULATION: Ducts shall be insulated per Table J4.4.7.1. DUCT CONSTRUCTION: 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: r each separate HVAC system. A manual Thermostats are required fo or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. SWIMMING 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. HVAC PIPING INSULATION: HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in.): PIPE SIZES (in.) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4 2.0 Low pressure/temp. 201-250 1.0 1.5 1.0 1.5 1.0 1.5 Low temperature 120-200 0.5 1.0 1.0 1.5 2.0 Steam condensate any COOLING SYSTEMS: 40-55 0.5 0.5 0.75 1.0 Chilled water or below 40 1.0 1.0 1.5 1.5 refrigerant CIRCULATING HOT WATER SYSTEMS: C C Insulate circulating hot water pipes to the following levels (in.): ----NOTES TO FIELD (Building Department Use only) ------------------------- PIPE SIZES (in.) NON -CIRCULATING CIRCULATING MAINS & RUNOUT HEATED WATER TEMP (F): RUNOUTS 0-I" 0-1_25" 1.5-2.0" 2.0+ 170-180 0.5 1.0 1.5 2.0 140-160 0.5 i 0.5 1.0 1.5 100-130 0.5 ` 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use only) ------------------------- P o O Q M s D.LLCD Q�c O t 4 w m ,N I ,C i OOO H i ` M.W. t �Nk 'v- LL Oz Do w U .0 ��d N �� LU'.. i 4 ppm .y; %'" LuLU R f 4 f LUiF i Q .Z Ln � < o ui m O . ai s � n CL z JU :� p ai * U r 0 u'I ( C ? N N v -n N =o O o n > >oc 3 � Er n��i cc. a d o - m -, - p ono 3 to 0 m ° oM_ pe -4 3 ° ° O c Q 3. ` x �. M (-D Q, M (c d n r _ a c�IM D - N .+ rn ID M c �3so,CIL c4 rri -n ut : V .c 0 �� O �� O Oc�c 0 7 '' IM E TO E :3o c a TO CL C 3 :D a) mLn ? y' o moo' y D,�°' S U3 CD CD n r ' CD CD mn :4eCD CD o o Z �v `'ID L �. C 1p —I 0 o NET.o o o �� Cl) m C m Cl) 0 m :Z O co CD CO) .0 CD O CO) d d O CO) O C y d co 0 CD CO! 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Building Department 27 Charles Street o North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 O COCnI[Mt KK 1' �iA�g4Ten 1•PayRy. APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION S, �' /N-7 fie: ADDRESS LOT DATE REQUEST FILED I •7/ 0,5- /0 DATE READY FOR INSPECTION 713110 % .�f j119 FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN- 'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE97M INS T , FEE OF TWENT F ($25.) DOLLARS WILL BE CHARGED IFTE DOES I� ALL APPLICABLE CODES. SIGNA `—� OFFICIAL USE ONLY ROUTING CONSERVATION DATE I PLANNING DATE /'-j D.P.W. – WATER TER DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED RI R TO PiF, INSPECTION REQUEST DATE. ATURE /--DPW., A PORN o Town of •`��sAC .srr NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT /SSU PERMIT NO.: PROJECT: X1[ its /0 Irl DATE: I WIT tin • Fi MR- wiNr• BUILDING 0 REMARKS: Z� (ad 7� / ©oo� 1b &ofs� a, S iia -4— 3 S� UNalelz � . k,t..e,_ "v --e DRIV Excavation - depth and soil conditions Framing - Other: Date: 3 — �r �' Date: 510-1 —C?( Date: Inspector /� A �"'� Inspector ,/A /IA l� Inspector Footings and foundations and drains - Insulation - Other: Date: —3 `� — co Date: S� a 3 I Date: & � Inspector Inspector Inspector Electrical - rough - Plumbing and/or gas - rough - Other: Date: 5—a o "� I Date: Lk ` ao —pc° I Date: Inspector Z ' / Inspector A �\ Inspector Electrical - final Plumbing and/or gas - final Other: Date: a `- ( Date: �— o Date: Inspector Inspector Inspector ire Dept - ,Jil burner, tank, stove, smoke detectors Final inspection C ificate of Use and Occupancy Date: B ` ( _0 ( Date: 8— a` f_ at C of O #� Inspector �J , Inspector AM fi t '' Ins ctor rorm WUM Anon rrese, two-ruuu y 6 R w b n m X n m O C V) m 90 O n n C D z 0 s Z y v d m n m X n m O C V) m 90 O n n C D z 0 m m m 0 m S- M CA Cl) CD CC� CD O 'D CL C7 C CL C� 0 CD ov CL � o ww�`` W CD Er CD O CD ca 41. C CD CA CD CL O y COD � v CA O � Z cD � CD CDa C cp fl = _ C •N O C M a 0 o .0 CA o 0 o Cl) S Ci a• 0 m z _ 7° CD M m r. � � O' -O N --4 90 M 0 f = .-r W M TI s a -O 'CL o =ro ..?d Mn �O @ M 0 '� o ?m ` m 2 O Z�•C2 O M CJ W O m C ?_ n o L (c o =r : 0 CD QCD0. -% :: Im C43 H Q aril, Q CL r.O ' d le y CO) M 1 UP m cc O A O CD o Wim; .� ?A : CD: 0 � m IW aALeo 00 Qt CR s=: a':A �p C/) d (n by o 0 Gy N.Q C QL x O� A n _. � Location,/,,4& r' ��'VN � No. Lo �` Date—�- U NORT" TOWN OF NORTH ANDOVER .0 A Certificate of Occupancy $ J C NUS Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL Check # 0.5 Building Inspector c 10 _ 11R+_ _ ._� w 12+00 LEANN E DRIVE `~ N24'39'25"W 352.81' momI�6 •� zoo' soma 2100 12 7.11' 46.9' � EK, Foundation 4, LOT 7 �4 40 3' ` LUT 8�'9 28683 S. F, z 0.66 Ac, ORAINACE CAS,"MCNT `- -- — y EXISITNG DRAINAGE EASEMENT i .NG NO GUT EASEME �_ — — — — `-- - .- N7 EXISIIT�'C NO '-uT EA T SEMEid , �1N 4t tw Ab , I iU20'S7';;4"'N 72.76'N24'33I� '09"W 137 MSCiUC1 1 38oo g.Fi N WE HEREBY CERTIFY THAT WE HAVE EXAMINED THE PREMISES AND THE DWELLING IS LOCATED THIS PLAN !S INTENDED FOR ZONING AS SHOWN, THE STRUCTURE SHOWN CONFORMS j PJRPOSES ONLY, IT WAS PREPARED TO THE ZONING LAWS OF THE MUNICIPALITY FROM EXISTING PLANS AND RECORDS WHEN CONSTRUCTED. ALSO, ACCORDING TO THE f 1VI1H THE STRUCTURES SHOWN LOCATED F.E.M.A,/H.U.D, FLOOD INSURANCE RATE MAP, BY AN INSTRUMENT SURVEY. THIS PLAN COMMUNITY PANEL NO.250098 0006 C SHOULD NOT BE USED FOR PROPERTY DATED JUNE 2,1993, THE STRUCTURE IS NOT LOICATEO LINE DETERMINATION. IN AN ESTABLISHED 100 YR.FLOOD HAZARD ZONE, CERTIFIED PLOT PLAN ' LOT 6 HERITAGE ESTATES MARCHIONDA + ASSOC.,L,P, I NORTH ANDOVER, MASSACHUSETTS f ENGINEERING AND PLANNING CONSULTANTS DRAWN FOR 62 MONTVALE AVE. SUITE I BROOKVIEW COUNTRY HOMES, INC, STONEHAM, MA. 02180 T P.O. BOX 531 (781) 438-512; NORTH ANDOVER, MASSACHUSETTS DATE: 2/23/01 SCALE: 1"=40' 10•d VG96 .Et T84 Saj-"130SS11<•!'aNOIHOAA"W 4111 vz:OT T00% -97--33j No 2764 Date.l. AAI& TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... Y .... ,5 1"r- r,-, ) - ................................................ has permission to perform ............ ................... wiring in the building of ...... 0.�64111- at .... .... .................................................................. ,North Andover Ma V!Ir Fee,_..V'.6)() ... Lic. No. ECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer I1 / i s WL rX r1V1 v rrv_fil l n t11' I r1113ae1ilt 11 UJC113 urnce Use only DEPARTA&W0FPUB1ICS4FM Permit No. BOARD 0FFIREPREVEM70NRWMT101 S 527CMR 120 Occupancy &Fees Checked jVPPLICATIONFOR PERW TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date /2- _ 6— (�Pd Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical workdescribedbelow. Location (Street & Number) Owner or Tenant TSV-ubIcu- 1-ctiJ Y`vt q, S Owner's Address r 6 qs t /U- 414,4 Is this permit in conjunction with a building permit: Yes M No Purpose of Building ciwcAj( Existing Service Amps/ _Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work (Check Appropriate Box) Utility Authorization No. 60%1q -Z, Overhead D Underground a Overhead ED Underground Q No. of Meters No. of Meters �Io. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA 'No. of Lighting Fixtures Swimming Pool Above Below Generators KVA groundground No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW Connections l;o. of Water Heaters KW No. of No. of Signs Bailasis N -o. Hydro Massage Tubs No. of Motors Total HP OTHER WorktoSLvt X,/1`;4_ h ectnnDuteRe d Signed ut daM- Raab ofpajW.. FIRM NAME _- ._%lam> r4 �i e Li", eAr J L�.c.J �`� � Sim Z Estarta>ed ValuedUmftxal Wade $ Raft Fatal .�, Alt Tel Na OWNER'Sir�JRAIVCEC W 1.amawarethattheI.ice�edoesnothme$�ec>Ssira>oeoo�erageotess�giale�vaiargaste�u¢a:}byM (,a�ea11mvs anddratmysig nkr--unthisp=-dhartvvai%,tsdtisregimsnetrt. (Please check one) Owner Agent 0 Telephone No. PERMIT FEE ���'" • Gt/