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HomeMy WebLinkAboutMiscellaneous - 99 CORTLAND DRIVE 4/30/2018C r-' MM I°'�7 d MOR1M f CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 233 .(9 -29 -?nn,; � Date: Febru 3 2006 THIS CERTIFIES THAT THE BUILDING LOCATED ON 99 Cortlan Dr - Unit #24 MAY BE OCCUPIED AS Sin le Famil Dwellin WITH THE PROVISIONS OF THE MASSACHUSETTS S ATE B IN ACCORDANCE SUCH OTHER REGULATIONS AS MAY APPLY. BUCODE AND 0 0 a `5 M 14 1 NJ A � W p C ui I x53 I. - 04) c-� y E LU a H CLMU 0 vI vl NJ A dv ?' cm e � Z 0 d0 ;a*0 ri CLN r c 10 NICE 0% an 25_ ��� s dim M 0 w a a� C' COS 10-0 .�. .L40 �m O m m O 10 = Z 0� �3 CDcao �a cc .a c ca 0Z C v y — w U) oe W C9 W U) c I — W CO C ui I I. - _c y E LU a H CLMU dv ?' cm e � Z 0 d0 ;a*0 ri CLN r c 10 NICE 0% an 25_ ��� s dim M 0 w a a� C' COS 10-0 .�. .L40 �m O m m O 10 = Z 0� �3 CDcao �a cc .a c ca 0Z C v y — w U) oe W C9 W U) c I — .� C I _c y SUCH OTHER REGULrA.AS MAY APPLY. Certif�cate,ssue t Iet�rhouse Cotriinon LLC m m X 4 m m y v m y � CD a Z y CD 0 � O O.� Co. a� C-) CD o p CDCL O �dCD CD CD C O H� CL p CO) co CD I CAo CA Z CD O -e CCD G N Z' lO Wcp O 9 QN O d Ilk LC) CC42 Go ca Z PTI 0. P* a CL �* m �0 O H o •.• o N a co H O Z.�•H N O O C O . ' C O Cn a a o h. CL �m I C O 0: d-% • 08 w 10 N _: CL C o ODCL — N �111JJ r. m 24 H IA moi y3 m sm cn 3 �N o ?: CD � m a� =o: C � C, 7� . N Z' lO Wcp o 9 Ilk Go ca PTI a WWW N V Q 0 6 2 *t 4 Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that....................................................:........................................ has permission to perform ................................. vW ....................................... r` wiring in the building of ............ C... ��........................................................... at 9 7`-' e Ir4^� ,6 J� ........ ,North Andover, Mass. �.�J Fee.. ................... Lic. No.................................................................... s, . ELECTRICALIxsPECTOR Check # � a 07 No. at Fees Checked .. r "pUCATTONFOR PERW TSO PFHORM ELE=CAL WORK ALL WOR[ TO BE PFRRMBD B1 ACCORDANCE WITH THE MASSACHUSST9 ELECTRICAL CODE, 527 CMR 12:00 PO (PJ,EASE PRINT IN INK OR TYPE ALL INFORMATION) Da G Jam- G Town of North Andover To the Inspector of The undersigned appliea for a permit to perform the electrical work described below. Location (Street 3 Number) Owner or Tenant i A, L. L,(64 ( �9U Owner's Address Is this permit in conjunction with a building permit: Yes ONo Q (Check Appropriate Bos) Purpose of Building S 1-1�5z11 Utility Authorization No. Existing Service Ampa�V old OverheadUnderg<ourmd No. of Meteta _ New Sender �r,� �Pa(�`�Ovolta Overhead Urxierground No. of Meters J Number of Feeiea and Ampecity Location and Nature of Proposed Electrical Work (,cJ L u–f, l c7x f/ Na of Ughdng Oudo Na of Hot TuM No. of Tnaslbmm Tod KVA Na of Ugbdq FGttmes Swbruning Pool Above 1:3 Below Omantaa KVA No. of Receptacb Oudsts UV_WW No. of OU Burner Ong 17 Na of Emergency Lighting Binary Units , No. of Switch Outlet! No. of On Burnma I FIRE ALARMS Nd of Zones Na of Ranges No. of Air Cond. Tod Taos No. of Deacdon and No, of Dispoab Na of Hat Tod Tod Pbuys Ton Kw Wde tg DrAm Na of Soumft Dodoes I No. of Dishwashers Spice Ara Hating Kw Na of Self Contmined Delecti Lord D � a No. of Dryers Hating Dedra Kw Coronation No. of Wear Herten Kw No. of Na of Siam silai I No. Hydra Mmga Tube Na of Moron Tod HP lhme&bn&dve PWbfNWlDtzCMZYMLT MRANa F-1 BM 0 amm 0 WcdcOut HRMNAM (_.A4 A•f_ r nrlrinae -:?, (-. L t—s -A � 0WNElVS1NStJRMaWAIVDkI9m fattfreLicaee �i arddA y*AzoneibptaritappI dQmueisafr:nrggit3M (Please check one) Owner CM Agent Sagnamm ol Ow or Agent YES �No I p F�om�dVAleaflElec"wak s Lk=NbL Y.Vl X-�l Id Li.."', 1L– Z'-� "o S AtTal.Na Telephone No. pgtLw I v jf f ! (PcEAsEP ,��+1CArc 7+rp Of Ivoro OR ?hc �ndefs' 'lova �rZ �eation �ar aPPGed fot p ;0?fpz" fe Owner (Stria Num aPeWtto ��,U�Oftf�'�� 0 TendPerf0nn �e f;/ �,�.�tC7wAcr'sgddreftJ`�ec�ca/ e0527 thi l ' `'�t w04 dek Q 11 nNd QO NI.- unit )o coni �� b 4 / �L below. A Service Number of` Amps � 44' .1.. a' Am V atio° N and qm� ps ` of(old ^�a orU ahrrt p� �' `� Yo Vo/4 Ka Of � a't P°81ec�cL W fm.. °sir C A%L �Z T° 0f V No APpro Oye� � 80jtI O0. f A4104 Fft t Q'ygs xw Ak�-. � aft Ab. llfzk7ft of o�f 44fta% o r� „d 4 ,o e ��► Y E: 3 sc �� Location Adc1 0vr11,wJ �,e- No. C� 33 Date Qy A 9 c s- o too i s i } ,ssAC Nuri 4 Check # / 3 186,19 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ /b 0 .c: <— Building Inspector Location / CO3" -1% Aw _/r� No. 3 Date %� /`i D fel / NORYN TOWN OF NORTH ANDOVER � A 9 i � • Certificate of Occupancy $ s` ' sACMUSEBuilding/Frame Permit Fee $ . Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 13775 ilding Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: C/>a C/ S r( ,. SIGNATURE:z/0 Building CommissionedI or of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: A4,at Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: �F j:> d+� - 30 •Z Ac -7,5 ' Zoning District Proposed Use Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard R red Provide red Provided Required Provided 1.7 Water Supply M G.L.C. 54) 1.5. Flood Zone Information: Zone Outside Flood Zoae .8 Sewerage Disposal System: MuniDipal Public Private 0 On Site Disposal System ❑ SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENTis oric _ is r►c : Yes No 2.1 Owner of Record M,Pjt"Ke"s C 2 I Name (Print) Address for Service /� �7 Q `-1 / �O74 Sirnre Telephone er of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Constructtioonn Supervisor: S Not Applicable El- TkA"S.1J . per/% Licensed Construe ion Supervisor - License Number r'lddress / _ v �0 7 Cj a Expiration Date Si re Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name I� I Registration Number Address I Expiration Date Signature Telephone T M X E "'l Z O / z_ J w O g 5 9 0 IL O.zip Z Q LAJD wu_2 �OD 6,iJ �p ZwY� tn �} 500 rcn ww1� zk' ix fx O 3apxapoz 0 P �z O -W(n It 4� �w z° 4 02 cno =z>�� z��x; v r^o�w jt)-j—nw�' z"' w zo zc� c W, x wu. x� �� iE N� VipD S� Ir. � uj zau0;-r.zr aNLL-�i� rn �� X00 i�v�eo 0� 9wo aui two d`p¢on,$`sw " l�LLzOIn (4 ZWj Lij N �5�i- �4z� co S 0 cHQri OmDw�4—WC2l,ix� �'_N}roZaU�� wU - �Wo+ ' �_ TJ wzr�o =WR N i, (IVO [ J P pA vioiR'-0 gpI01I01 E.C'�'J9p01 \IMPOD l�4I���Pl�A/C�li in N 5 9 9Z H�p ^ ix fx O Q � (A � a C, da -K z° 4 02 1AXoZ emu. 0 v z b _F !—I 8 P pA vioiR'-0 gpI01I01 E.C'�'J9p01 \IMPOD l�4I���Pl�A/C�li 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*********************** APPLICANT M II 6 Q. . rino7)S LL(_ PHONE 9' 8-0.7-2635 LOCATION: Assessor's Map Number /��� PARCEL 3 SUBDIVISION (" fe l� �06S2 /�? 40707 i LOT (S) 2 STREET . CO -f Iq JD (Dm ST. NUMBER_ USE ONLY**** RECO NDATIONS OF TO AGENTS: CO ERVATION ADMINISTRATV DATE APPROVED DATE REJECTED COMMENTS _ TOWN PLANNER, DATE APPROVED _ DATE REJECTED COMMENTS C h, 40-B TH SEPTIC INSPECTOR -HEALTH COMMENTS (3 �j Is ii WE DATE APPROVED DATE REJECTED APPROVED DATE REJECTED- ­z- PUBLIC WORKS - SEWERIWATER CONNECTIONS X,'" DRIVEWAY PERMIT FIRE DEPARTMENT 1 ' R CEIVED BY BILDING INSPECTO Revised 9197 jm TE _22-01S 22--4)5; BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: ;CS 055417 Birthdate: '04-105/1960 Expires:.b4/0512006 Tr. no: 21033 Restricted: 00 'THOMAS D ZAHORUIKO 121 CARTERFIELD RD 'Q N ANDOVER, MA 01845 Acting Ca mis oner R The Commonwealth of Massachusetts Department of Industrial Accidents _ Office of Investigations ° 600 Washington Street W Boston, MA 02111 GSM S" www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lev ihw Name (Business/Organization/Individual): Address: )_2 1 ( 6 LL C City/State/Zip: , A� A4 Q gq Phone #: 17?! { 8 --2 3� Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time). 2. KI am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t have hired the sub -contractors listed on the attached sheet I These sub -contractors have workers' comp, insurance. ❑ 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): 6. New construction 7. ❑ Remodeling 8. ❑ Demolition 9• ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12•❑ Roof repairs 13.❑ Other *Any applicant that checks box #I must also fill out the section below showing their worker;' compensation policy mforrnation t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, xContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. 1 am an employer that is providing workers' compensation insurance for my employees. information. Below is the policy and job site Insurance Company Name: Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: 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 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-yeaAmprisonment, 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 rage verification. I do hereby certify under tie pains MOM OJ perjury that the information provided T _1. ! Oficial 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 yove is true and correct: J,�1n (-- Contact Person: Phone #: Permit Number MECcheck Compliance Report Checked By/Date Massachusetts Energy Code MECcheck Software Version 3.3 Release lb Data filename: Untitled TITLE: The Vineyard at Meetinghouse Commons CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 09/16/05 DATE OF PLANS: 4/15/05 PROJECT INFORMATION: Meetinghouse Commons North Andover, MA 01845 COMPANY INFORMATION: Meetinghouse Commons LLC COMPLIANCE: Passes Maximum UA = 445 Your Home = 402 9.7% Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R -Value R -Value U -Factor UA Ceiling 1: Flat Ceiling or Scissor Truss. 1580 0.0 30.0 49 Wall 1: Wood Frame, 16" o.c. 2160 0.0 13.0 177 Window 1: Vinyl Frame, Double Pane with Low -E 281 0.340 96 Door 1: Solid 35 0.340 12 Floor l: All -Wood Joist/Truss, Over Unconditioned Space 1580 0.0 19.0 68 Furnace 1: Forced Hot Air, 90 AFUE Air Conditioner 1: Electric Central Air, 10 SEER 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 Massachusetts Energy Code requirements in MECcheck Version 3.3 Release lb and to comply with the mandatory requirements listed in the MECcheck Inspection Checklist. i i The heating load kdesign ing, and the cooling load ' propriate, has been determined using the applicable Standard, Design Conditione Code. The HVAC eq ent selected to heat or cool the building shall be no greater than 125% of theas spe ' ed in Section 7 OCMR1310 and J4.4. Builder/Designer Date MECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.3 Release lb DATE: 09/16/05 TITLE: The Vineyard at Meetinghouse Commons Bldg. Dept. Use Ceilings: [ ] I 1. Ceiling 1: Flat Ceiling or Scissor Truss, R-30.0 continuous insulation Comments: Above -Grade Walls: [ ] I 1. Wall 1: Wood Frame, 16" o.c., R-13.0 continuous insulation I Comments: Windows: [ ] I 1. Window 1: Vinyl Frame, Double Pane with Low -E, U -factor: 0.340 For windows without labeled U -factors, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: I Doors: [ ] I 1. Door 1: Solid, U -factor: 0.340 1 Comments: Floors: [ ] I 1. Floor 1: All -Wood Joist/Truss, Over Unconditioned Space, R-19.0 continuous insulation Comments: I Heating and Cooling Equipment: [ ] I 1. Furnace 1: Forced Hot Air, 90 AFUE or higher Make and Model Number [ ] I 2. Air Conditioner 1: Electric Central Air, 10 SEER or higher I Make and Model Number I Air Leakage: [ ] I Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] I 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. Vapor Retarder: [ ] I Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. i Materials Identification: [ ] I 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 -factors, 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: 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. Heating and Cooling 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. Circulating Hot Water Systems: Insulate circulating hot water pipes to the levels in Table 1. 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. Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 120 °F or chilled fluids below 55 OF must be insulated to the levels in Table 2. Table 1: Minimum Insulation Thickness for Circulating Hot Rater Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non -Circulating Runouts Circulating Mains and Runouts i Temperature ( F) Up t0 1" Up to 1.25" 1.5" to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. NOTES TO FIELD (Building Department Use Only) Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System TypesRan e F 2" Runouts l" and Less 1.25" to 2" 2.5" to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate (for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water, Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD (Building Department Use Only) `�' a z E d 3 c N c ro e a inf c 3 ow O o' u R in, 2 m c� M E� m a 0 o w ,o m c '„ c c �- n of ug a, r �CL .. O w t Z O ++ gaj IU u g r o > �m W W 19 W LU W U) N aZ Z � O � C7 A E d 3 c N c ro e a inf c 3 ow O o' u R in, 2 m c� M E� m a 0 o w ,o m c '„ c c �- n of ug a, r �CL .. O w t Z O ++ gaj IU u g r o > �m W W 19 W LU W U) N aZ . � �w U W W E d 3 c N c ro e a inf c 3 ow O o' u R in, 2 m c� M E� m a 0 o w ,o m c '„ c c �- n of ug a, r �CL .. O w t Z O ++ gaj IU u g r o > �m W W 19 W LU W U) _s 6 z 9c 'A 3 Z o o � � lit a � o C LL '� a Q Z : Eo Q ou V. ~ LL a E 030 � �1. =00. _:Em -0 O ` CL O w a0 0w0 0 O o Ut — o- c 0o� n. � 0 a� - L) o 0 H V) C. M UJ . o a � � N C � � rn a N.0 :2C = 9° c 3 c o w o u a 'D 2 a �o V E.0 CL ` m 0 001 c m 'E N of a r � cl m t •,, O w L Z O '-' W u g t o zm W W W LLI I% W N 1 Q N I � � L ' Q v J ' I N C G N E N i a r0 'L7 �0 G C � 0 -a 0 v u�• z o 'O I g ��^r�-•�N N � N i / ,p Y+ ----- I------ L. J Q.. S Ar � �j���t�' ,•J r I i I I M V LL. N W Gf r W I _ ..._ cc til CD l-- � - - - - I Al o co o 6 r* ��-' • I p p 4 � r' 17 2 _ n 00 N C Bol — U 1_ ` • �,•-- I��.___.________ ?ham { o �i S Q N L 0 N C t� C 0 O EE0 th I � � s O `� c Q i < E ) o Ity JU _C 0 v �I Z 0 Y o J I _ I g 1=0%A � tL Q CO y N. t_ y � �Y4 •r 4r --------------------- � f 0 i �9 to r T�7 I r b H �r uy N 49 W tl r y, r o w 1 11II I +� _�I Cco O II ht 2 O CO o r 6 ' r `1ldH wvnU co a r Cfl- J M1 00 J 0 1 O -z l � O C I ' I C) o �S :i CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 233 (9-29-2005) Date: FebrugU THIS CERTIFIES THAT TNF RITTT.ntNf_ l.(Ii ATFil nlV 99 r.nrtlanrl T)r - TTnit 0A MAY BE OCCUPIED AS Single FAp& Dwellin IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. i Certificate Issued to 1Vieetinghouse Common LLC 121: Carterfield Road .,NoidiAndover MA.01845 Badding pector 1 0 A CA m m x m x m y v m i v, y Z y CD O �• O CL y Im CL �o o v cr� s d CD CCD O C��D av y CD <_ c_ z , z O �N O Q N oM d0 10 y 0 H a� 3 Cl)n MIDN �m =ro =rd y m CD COD Otv N O � m; co x IE CD -1O O � �0 0 n O o y O • O C� m ca a OCL - VJ � W O y O y > > Ir: O /z^ o W 0 go -CMD /\��� .rt < y VJ =rO O I So: oa S Z * o O O ON 1�3 o N1 i ; Or O � .cn p'cn s Q I' CO (� s CD Ak cli v Nz I g Qv 0 omi 0 9 0 PMK zl �:0 Z. Cr1 G ' d o .�' —k r� r "` od �y � d x Nz I g Qv 0 omi 0 9 0 PMK zl �:0 Z. A• Town of North Andover ttORTM 1 Building Department O 4t''ID '6* ,I,O 400 Osgood Street 3? a° : V 6 p North Andover Ma 01845 C L 2 (978) 688-9545 Fax (978) 688-9542 �,SSACHUS APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS I ! r�Iq v�,:yl �il �►�, LOT NUMBER 2 7 SUBDIVISION nnl'n(Jn� DATE REQUEST FILED 2 ! % ( �f. I DATE READY FOR INSPECTION a/s/0 I • TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWEN Y -FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NCyfMEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METER I � k DATE i'Z A), D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE / DPWAUTHORIZATION Date.....X.`! �.ao ,eye O TOWN OF ORTH ANDOVER PERMIT FO GAS NSTALLATION This certifies that .... /�rj` .�? ................... has permission for gas installation ... in the buildings of .................... at .. ... ..........,:,, North Andover, Mass. r Fee Lic. No. �.� .9 a .�.. ..�S--INSPECTOR . �.: �:�,�-:�..... . Check # Ke, C /'- .' ' ., 5329 MASSACHUSETTS UNIFORMAPPUCATONFORPERNIlTTO DO GAS FITTING (Type or PT ririt) Date NORTH ANDOVER, MASSACHUSETTS Building Locations (,OafawPermit #Amount $ G Owner's Name New Renovation Replacement Plans Submitted (Print or type)� Ce C� Co rpone• Certificate Installing Company Name U J�� �✓d . Address ��"' ' ❑ Partner. Business a ep one 7 / g' / ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter {' M INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes © No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. Bond [3Liability insurance policy 13Othertype of indemnity Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts Statj�as�de and C�►apte142 of the General Laws. 41 , n/� !/ ty/Town VED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber ❑ Gas Fitter Li nse Number ❑ Master Journeyman t0 Date.��/�i TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ........................ has permission to perform ... i -.S <-�... 1-� c. �: ` plumbing in the buildings of ./�' 0/'./;'1. .............. (-... ...... .. , North Andover, Mass. r Fee. Lic. No..? . ...... .. L.. �..., �L... 1PLUMBING INSPECTOR Check # 6679 s MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS ate ,/ l ,-- Building Location �IOUt Owners Name C/ �1�� (,Permit # Amount. - Type of Occupancy New 0"Renovation 1:3 11 Plans Submitted Yes � No I FIXTURES (Print or type) / Check one: Certificate Installing Company Name l U �� e ❑ Corp. Address �` Pier. I Business Telephone — — Firm/Co. I Name of Licensed Plumber i i Insurance Coveraoe: Indicate the type.of insurance coverag6 by checking the appropriate box: Liability insurance policy Other type of indemnity BondLU I Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance I Signature Owner Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachp" Stat0lu%bing GWand<hhapter 142 of the General Laws. 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