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HomeMy WebLinkAboutMiscellaneous - Nutmeg Ln 50 Lot 6Date..%5 .............. A .... ............. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ...... ...... .. ... ... .............................. has permission to perform ..... h .. ....... . irje�� .......... I ............. plumbing in the buildings of ........ FeeM....W ..... Lic. No. Check # ............... ! ....... L/, North Andover, Mass. tl PLUMBING INSPECTOR r P TYPE OR PREN'T CLEARLY f1�lA.S.C�r`�i icrrT.. . UNH-URMI APPLICATION FOR A PERMIT TO PERFORM PLUME3ING WORK CITY ❑� ty� DATE I JOBSI T E ADDRESS LSO w j PERMIT f �DVVNE�RE i OVVN+ER ADDRESS: TEL:FAX: OCCUPAtNCY ?YPE COIt/Ivi_RCIAL ❑ EDUCA?ION I r,L ID RESIDENTIAL❑i.► ❑ REPL„ CJt/ENT: w FIXUTRES I FLOORS— BATHTUB I CROSS CONN DEVICE I DEDICATED SPECT,-.! 'dVASTE SYS I DEDICATED GAS/OIL !SAND SYS I DEDICATED GREASE SYS?EIv DEDICATED GR;;Y 4'V,;? E;R SYS DEDICATED VV ISR cEi USE SYS DfSHWASHER DRINKING FOUty T A!N j FOOD UJAS T E GRINDER UN'? LOUR /.AREA DRAIN+ INTERCEPTOR i.NTERIO:R KITCHEN SINK LAVATORY ROOF DRAIN SHOVVER STALL I SERVICE : fvIOP Sltv'K i r01, F T I URINAL i WASHING MIACH!NE C vONNECT!ON � WATER HEATER ALL TYPES WATER HIHING Bsml PLANS SUBIAiTTED: YES ❑ NO ❑ COVt I have a current iiabifity insurance policy c:INSURANCE r it., substantia. equivalent uivalEnt which Meets the requirements of MGL. Ch. 142 YES �0 If you have checked ES please indicate :ie iL /Pe Of coverage b c ❑ g y checking the appropriate box below, LIABILITY 1!N'SURAN,-E POLICY OTHER TYPE 1NDEIVINITY ❑ BOND ❑ OWNER'S INSURANCE WAIVER, I am awa-e that the licensee does not have the insurance Massachusetts General Laws, and that my .; gnature on ` e coverage his permi'application waives this requirem nt9uired by Chapter 142 of the SIGNATURE OF OVJNE? OR AGENT CHECK ONE ONL Y: OWNER ❑ AGENT 1-7 hereby certify t"a! all of the details and informailon ! ha v Knowled e an g �c submitted;or entered; regarding this ap licati g the that ali piumbin work and ins._aatio;, perormed under the Permit issue ' ` a ue and accurate io the best of my f provision of the Massachusetts State Plumbing _ p o or this ap , aclon wi e in cpm Tian with all Perfi + -ode and Chapter i�2 of the Genera! Laws. p I PLUMBER NAME: 01�= -_ �M ! ICENE COMPANY NAME: -; Ig SlGIN'A I URE VL /� A F: i t �tl j .ADDRESS: 1 6 �E j IS!ATE: P !! TEL: ,, .Qj--79y- �Sy I - : ,AX: j _ � =L- ia03-�23y-GSo6i EhhAJL MASTER T .0 !Yj S � i JOU,Rh:EYIJ:'tfN' ! C:;;)RP i ORAI!OIN+ °A� vR F ERSHiF LLC h CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number a 92 Date / 3 _a p THE BUILDING LOCATED O N MAY BE OCCUPIED AS THIS CERTIFIES THAT /d 61 - /2'm Dale ///x) IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS ASY APPLY. 3/9 3 �, CERTIFICATE ISSUED TO �N��we U'�S �'�e// �I ADDRESS 'SACHus� Building Inspector Lil CD m m U) 0 m Lei C1 CO) Cl) CD n Z CO) O O -C CL r �• o d �• y CD CD o c� =r �G d CD CD o CD C CD y CD CL O CO) CO CD I S- CO) O 1 Z CD Cl) oCD 0 CD C cc C X17r� O d = • ca Q N n O. � C"0CO) O A m Cl) CD Z H d = ?'O N ?a .. a o C O m y G y N� o i m CO) CD �m n 0 CC* 0 = y� CD ? N _ M z. Amy ►� Cn ca C-)= �..�.y y d V! z H a :DC7 W=i ;4 9 ci 3D CA -CID y 0 Cn a (v y O Cy� m - y- -� O CCD Fw do cc 01 ;f Z lo� Z D o I� y ...r ,r ;� m =n l CD �c � m O im 11 CD cn cn N low d m 17D r = = tz 1 1 = C O ►� : ail i /cam o _ !D: troop:�1 C C/) 0 r� 7 OTI w C G rij w w x G G r� 'U p 1 1 O O 0 I A iy 0 c (46a Town of North Andover NoRYk O ttieD 'q�r Building Department 0? yt� 27 Charles Street North Andover, Massachusetts 01845 -V (978) 688-9545 Fax (978) 688-9542 O cocwa«iw«« 1' A 4 7 40q^TED APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS '-�-o '�' & 7"- 5 III-;-e- LOT NUMBER % SUBDIVISION AA/1�— DATE REQUEST FILED �% / `� a zG 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 TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE r ROUTING CONSERVATION r^^ DATE �6 PLANNING ��. �C� H E rp�� D.P.W. - WATER METER Q10O ,1 DATE 79-4a AeA D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIG O �PEUEST DATE. —L Z�— - 4Z��� SIGNATURE / DPW AUTHORIZATION r4 cr -It °0 W w If 0 Date ...... /-./ �/ �2.. TOWN OF NORTH ANDOVER PERMIT FOR WIRING Z - This certifies that ..................................................... .......... / ...... Thas permission to perform ..... .. ................................. wiring in the building of ...... i,4-,,dd1vxzZ ..... (MS/: .................................. at ..... Zr2L.�� ........ 4. /M. N rth An/dove , ]�V. �u-,—,No I ... .................. Fee..�.�.,...� Lic. No. 1.8'171 ...... f/ 9LEerRICAL INSPECMR . ........... Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer ME COAMONWEALTHOFLU ' QIUSMS Office Use only D0?4RTAfi�NT0FPUW1C&4= Permit No. _ tl BOAM0FF7REPRLV©M0NREGUTAMAN 527GM12-09 Occupancy & Fees Checked APPLICA TTONFOR PF T TO PERFO"ELE=C'AL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 ov (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. PARCEL �Location (Street & Number) � � 6 Owner or Tenant A, )A n,, `A CO rJS Owner's Address Is this permit in conjunction with a building permit: Purpose of Building JI Yes M No %u /1 (Check Appropriate Box) Utility Authorization No.Q�7'' Existing Service Amps V / Volts J Overhead a Underground No. of Meters New Service '' Amps / Volts Overhead Underground No. of Meters t Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtmcs Swimming Pool Above Below Generators KVA ground ground No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Cas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Au 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 LocalMunicipal F-1 Other No. of Dryers Heating Devices KW Cormcctions No. ,#f Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER - r .r2 • u 1`.4 r'•1 ri •n ! 0 .•.2r ••:.n.• • 2141. • i� r.� u. :• • �• m�:• a 1• • •r •' �� • .• 1 - •il•• 0^ l,1 • • • • 2042• • �:• i•u�rr.• 1 - •' r •• _• • • :•a : i - 1 �, .• 11 • I•' ' �c •2411 lot .n.• a1 M1 I's •e • �.� • i 1 10:610 •:r.•':0 2-140 '• !r / • • Licer�e (, % r- i C LavJ r2 r� ce Sig�.ne •2 :• ...�: A&k= 2L77n� 4�5lf ,QjJJ4 /7102-k4 G—i t A1t..TeLNa OWNER'S 14SURANUWAIVERIamawmtatheLxmdoesnothmethemsr&=cmcmFcr&sksortialegreialasmgmedbyNbsmdms&CtroaiLaAs andthatrnysigr a cndmpmuirapplimt'cnwaicest-nsreq.xwxmi (Please check one) Owner r7 Agent Telephone No. PERMIT FEE $ t/ 7� , v 6 Ignature ot Uwner or Agent C v N2 2 6 21 2 Date ......... 71a. � -//Z �� TOWN OF NORTH ANDOVER PERMIT FOR WIRING /,�, ( ro - This certifies that ... ....... ........................................ has permission to perform ....... N.n��.,/ ..... wiring in the building of .... ...... I .......................... . .. ....... .. at ............... North Andover, Mass. Fee ....... 1.0 .:<,�/Lic. No. ...... INSP ECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer utticlaiuse uniyy Permit No. O2 � v �_ �S e�2�t�2rr��.�� 6� n�ss���s��s vo-rl s 4 P- Pea s4alt Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 bu aM APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527C R 12:00 (Please Print in ink or type all information) Date �-/ To the Inspector of Wires: Town of North Andover — The undersigned applies for a permit to perform the electrical/work described below. L Location (Street & Number *jV Owner or Tenant "4 c V e A Ca iiJ5 Owner's Address —% Q/ C)(hSC-al�►1b"'�'�l'" Is this permit in conjunction with a building permit Yes" No ❑ (Check Appropriate Box) Purpose of Building /t dA jC(�N Utility AuthorizationNc Existing ServiceAmps Voits Overhead ❑ Undgrnd ❑ New Service -Zej-0 Amps �� "(() Voits Overhead ❑ Undgrnd, Number of Feeders and Ampacity Location and Nature of Proposed Electrical WoI/LA-riA a 001 977 No. of Meters No. of Meters f 0TH ;OVERAGE. Pursuant to the req,,u����ii 6ts of Massachusetts General Laws it Liability Insurance Policy inclu Com leted Operations Coverage or its substantial equivalCjtESNOi valid proof of same to the Offi YES = NO = If you have checked YES please indicate theoverage by checking the appropriate box BOND = OTHER = (Plea a Specify) (Expiration Date) Estimated Value of Ejectlejqal Work$ w�� Ca Final Work to Start 7��y Inspection Date Resquested Rough Signed under the Penalties of perjury: / ` FIRM NAME ( '�Q�- C(Q �t1 Coil GO 7� LIC. NO. S Lam. K3 re NC -0 - NO. /✓J� _ Bus. Tel No. Address "" Alt Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the 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. PERMITTEE $ (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above ❑ In ❑ No. of Lighting Fixtures Swimming Pool grnd ❑ grnd ❑ 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 Di osal No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices ❑ Municipal ❑ Other No of p rs Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Bailases Wiring No. Hvdrd Massaqe Tuds No. of Motors Total HP 0TH ;OVERAGE. Pursuant to the req,,u����ii 6ts of Massachusetts General Laws it Liability Insurance Policy inclu Com leted Operations Coverage or its substantial equivalCjtESNOi valid proof of same to the Offi YES = NO = If you have checked YES please indicate theoverage by checking the appropriate box BOND = OTHER = (Plea a Specify) (Expiration Date) Estimated Value of Ejectlejqal Work$ w�� Ca Final Work to Start 7��y Inspection Date Resquested Rough Signed under the Penalties of perjury: / ` FIRM NAME ( '�Q�- C(Q �t1 Coil GO 7� LIC. NO. S Lam. K3 re NC -0 - NO. /✓J� _ Bus. Tel No. Address "" Alt Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the 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. PERMITTEE $ (Signature of Owner or Agent) f N2 2 62. 2 X::�� 0, ene!�) Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... .... .......... ................................................. n ................. has permission to perform ............... .. I..,.: .. . .... . .... ............ ................. I wiring in the building of ....... ...... ....................... at....................................... ............................ . North Andover, Mass. Fee -.R6 ............ Lic. No. ................. �e' .............................................. ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer For Office use Only c� �c]] (Rev. 11199) �.LJaPmEnisrt� o�}iri �sroicas Permitt Number BOARD OF FIRE PREVENTION.REGULATIONS Occupancy & Fee __ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK (AIL WORK TO HE PERFORMED WTfH IHE MASSACHUSEM ELECTRICAL CODE 527 CMA 12:00) PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date:_ /0 - y — 0-0' City or Town of: 4#',v ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location: (Street & Number) �� N U T,M•P / Owner or Tenant: /'P4 VZ �7 7. 411 Owners Address: Is this permit in conjunction with a Building Permit? Yes 01--101 No c (Check Appropriate Box) Purpose. of Building:%2�,��.� f j,� Utility Authorization Existing Service: Amps ! Volts Overhead O Underground.0 # of Meters New Service: Amps / Volts Overhead 0 Under round.❑ 9 # of Meters: Number of Feeders and Ampacity: Location and Nature of Proposed Electrical Work:erY9 /�f. /a"-"4 ..vv�rw�ac: unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation' coverage or its substantial equivalent. The undersigned certifies that such coverage Is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE %r"" BOND o OTHER o Pleases specify: Ify: Estimated Value of Electrical Work $_ ! �Q • Ot'� (When required by municipal policy) Work to Start: tel% Inspections to be requested In accordance with MEC Rule 10, and upon completion. 1 certify, under the pains and penalties of perjury, that the information on this application is true and complete. Firm Name: r arm LIC. # I�� VS - � Licensee: ryr< J (71,111 yo- Signature: d !/l/` -� LIC. #-,;2.;Z V% O ,�A (If applicable, enter "exempt" in the license number line) Address: 2 Z / //� L/g/i/Q Sl- Bus. Tel. # & LI�Gi%%Zfi�Ui ` �.vncr< a mSUKANCE WAIVER: I am aware that the Licensee does not have the liability waive this requirement. I am the (check one) Owner o OR Agent o Signature of Owner/Agent: Telephone # coverage normally required by law, By my signature below, I hereby PERMIT FEE: �� 333 1 Date..4'..-.. �e� - - - - - TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ... 1. / . .4 - '. j I ) / /,,,- ................... has permission for gas installation in the buildings of .1 ...................... ........... at ... .................................... North Andover, Mass. Fee. . f ....... Lic. No....� ....... ..... * * * ' ' * * . * * * * I * 1 1* * * * * * * * * GASINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer vIA.SSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO or print) tvvxI H ANDOVER, MASSACHUSETTS Building Locations LU tivT-` QA> i . k -\A \ \pg, Owner's N New 0 Renovation ❑ Replacement ❑ Plans Submitted FITTING Cj(�A- L4 19G.. Permit 9 3' 3 l Amount S (Print oy�type) Check one: Certificate Installing Company Name t—'trv�`,�L1Cl �y�,i1��.JG C4D1-31r11AC,6 Corp. Address LA i� z��J�e- F-1 Partner. Business Telephone asL)U ©' Firm/Co. Name of Licensed Plumber or Gas Fitter �A t1L,,-, NA A j `Ly, INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes M No� If you have checked ves, please indicate the type coverage by checking the appropriate box. Liability insurance policy ^® Other type of indemnity M Bond 17 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 01 I nerenv certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By: Title CityiTown APPROVED (c)Fflcr USE 01\11. Y) Signature of Licensed Plumber Or Gas Fitter Plumber I i3 Gas Fitter License I umoer Master Journeyman N2 Date TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that :75. /��z has permission to perform ... A.'� -C ........................ plumbing in the buildings of . ......... at. . A.)s,:4A � r� - ................. I North Andover, Mass. Fee Lic. No.. . .// 3-, -) ..... I .. l7f ...... .... % . ..... ........ Check # �,PLUIVIBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date Building Location E)l: `oV V ; c1 V� \� �l-r �, Owners Name PPV 1Z441 ,z. Permit # Amount Type of Occupancy S New M Renovation F1 Replacement 1:1 Plans Submitted Yes [:] No FIXT'IRES • a ------------------------- (Print or type) ^ Installing Company Name Ds""tt(Z1C.f`� ►!l^Jc��� ny i L � 2-+7C -�✓� Address Check one: Certificate Corp. Partner. El Firm/Co. Name of.Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: ❑ Liability insurance policy R Other type of indemnity Bond Insurance Waiver. I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ®j Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By: Signatureof Licensea riumoer Type of Plumbing License Title City/Town 1cense Num5er Master Journeyman ❑ APPROVED (OFFICE USE ONLY Location N9. s-�'7,2 J, Date IV TOWN OF NORTH ANDOVER 4. IW74"'"wo, Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL s V-64 Check # Building Ins6?ctor Location No. Date C-) TOWN OF NORTH ANDOVER Certificate of Occupancy $ CHU Building/Frame Permit Fee $ $ Foundation Permit Fee Other Permit Fee $ TOTAL $ AS -0, Check # 31:>08 ,1 -7 /p/p/ (�� Bu'ilding Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR. RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING T>ais Sectia� for O@dmt Use == BUU-DING PERMIT NUMBER: 0 DATE ISSUED: :ry a -ora SIGNATURE: Q Building Commisfionerlltor of Buildings Date ar,1_11%J11 t -311r, ll`1CVtUV1LAJLJLVN 1.1 Property Address: 1.2 Assessors Map and Parcel Number. Map dumber Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: l � &5 -3 33 019' 17 d, Cf 51 Zoning District Proposed Use Lot Area (sf) 5roniage (ft) 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided Required Provided 1.7 Water S 1y M.G.L.C.40. § 54) 1.3. Flood Zone laformation: 00�Municipal Zone 1.8 Sewerage Disposal System: Public Private ❑ Outside Flood Zone 0 ji," On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSEIMAUTHORIZED AGENT 2.1 Owner of Record - Name 11 (Print Address for Service ' 7 el �u Si6aillte-r Telephone 2.2 Owner of Record: Name Print Address for Service: Sianature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable G /✓� v l _ /Y� //i� //r' Li ecLi nsed Construe ion Supervisor. (�' 0 911F 0 License Number 91,� �1 �S� 4N / ��� AAg I,J �j ,t'/ Ad*n.e Expiration Date S Telephone 3.2 Registered Home Improvement Contractor Not Applicable Company Name Registration Number Address Expiration Date Signature Telephone Mu M X _E Z O v D M 91 0 O O Z M O r v G M r r ^Z L♦ 0 JXe 1°mm" Gl BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 009802 Birthdate: 0824/1939 Expires: 08242001 Tr. no: 3567 Restricted To: 00 PAUL J STHILAIRE 5 HANSON DR (•�•-� MERRIMAC, MA 01860 Administrator 00 - 35,000 d enclosed space (MGL CA 12 S.60L) 1A - Masonry only 1 G -1 & 2 Famiy Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DIG SAFE CALL CENTER: (888) 344-7233 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 buildipg permit. Signed affidavit Attached Yes ....... JK No ....... 0 SECTION 5 Descriptillin oTProposed Work(check all applicable) New Construction V Existing Building ❑ Repair(s) ❑ Alterations(s) 0 Addition 0 Accessory Bldg. 0 Demolition 0 Other 0 Specify Brief Description of Proposed Work: �7 a lll1-2 f 11_(2o hOrbf U 4f—i"21 SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY I. Building (a) Building Permit Fee Multiplier 3 2 Electrical (b) Estimated Total Cost of Construction O D D 3 Plumbing Building Permit fee (b) 4 Mechanical (HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) • Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I. ''/ ' y / S�- 41, /4 /d 4 � � as Owner/Authorized Agent of subject property Flerebv authorize 9, 0�v ✓ eA to act on My beh f in 11 matters r' t ve to work authorized by this building permit application. Sig a ure of Ov<lrer Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, _ / S7j ,/�'' /� //1 & as Owner/Authorized Agent of subject property Herebv declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge . and belief' Print Na Signa&j of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB � SIZE OF FLOOR TIMBERS 1 2 Y /, 3KD SPAN b DM ENSIGNS OF SILLS DM ENSIONS OF POSTS / i DIMENSIONS OF GIRDERS I-IEIGHT OF FOUNDATION / THICKNESS J el SIZE OF FOOTING 142 X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE S *4 30 'YaO a a D a �f oaha 9 0 f� EU �U 114 (Ilp 0 l� —, O Ur P I oU v� a �3 S-1 d Growth MCI -a Bylaw Exemption sile ate.�nt Town of North Andover Euilding Department This form shall be used to assist the Euilding Cepartm.ent in their determination of exemctions under sec:;en 3.7.6 of ;he Town of,Narth Andover Growth Management 5yiaw. Tile building aeplicznt shall provide all of the nec:�ssari information as requested 'below. Name f Applicant an -Cui ding Permit (be!cw) Address cf Frccerv/ for Permit (be!cw) Nlap and Parcel : Purpose of Appiicatjcn (c: eck below) Phcne Number of Applicant: r/tingle Family Two Family I the undersigned applicant rcr the above property attest that the attached building permit `t;r which this form is completed does comply with the E<E /lP7GN section 8.7.6 of the Norh Andover Growth Management Bylaw. I also understand providing this form does not absolve me cr ary parr to this permit from the requirements of obtaining other permits required prior to the issuance of the 7-uilding Permit. Further I understand that my interpretation of the E<ENIP T iGN status is subiec; tc review by the Euilding Department and is only cfi'caliy acaepted when the Euilding Permit ig issued. Based an section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as acpiied for on the above lot, in the building permit application and assccated attachments, crmclies with one or more of the following sections as indicated by a chec!c mark. This is an application for a building permit for the enlargement, restoration, or reccnstructicn of a dwelling in existents as of the edecdve date of this by-law, provided that no additional residential unit is created. ;e lot(s) werelwas created prior to May 6, 1996 are exempt from the provisions of this Sec-:cn 3.7 of the Zoning Bylaw. This application is for dwelling units for low and/or moderate income families or individuals, where all of the coneitions of 8.7.6.c are met andler represents Dwelling units for senior residents, where eccuaanc/ of the units is restricted to senior persons through a property executed and recorded deed restricicn running with the land. For purposes of this Section "senior" shall mean persons over the age of 55. �I This application is a part of a development proiect which voluntarily agreed to a minimum 40% permanent recut ten in density, (buildable lots), below the density, (buildable lots), permitted under zoning and feasible given the environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently designated as open scats and/or farmland. The land to be preserved shall be protected from develeement by an Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism approved by the Planning Board that will ensure its protec."on. This application represents a tract of land existing and not held by a Developer in common cwnershio with an aclacent parcel an the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development scheduling provisions for the purpose of constructing one single family dwelling unit an the parcel. This application represents a lot which is ready for building penmits,(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 ac=mmcdate issuing a building permit in that Year, one building permit will be issued per Year per Cevetapment until such time as the Development schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPT ]ON. 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 EXEMPTiGNS. By signing below I attest to the accu acy of the information provided and that the attached building permit is allowed an EXEMPTiON as cited above. Further I understand that the submittal of misleadinc and or inaccirate 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 Euilding Department to issue a Euilding Permit. t re of Cwrf6r e Autnonzed Agent who signed the Attacned Building Permit Oate form must be attached to the Building Permit upon application for such permit. 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 eo,4-S`* <1- Ore - 1 OOH( /' PHONE 978- 73 ASSESSORS MAP NUMBER 3�F- LOT NUMBER R &-,C SUBDIVISION .06 6& 7Y ?/.J��G LOT NUMBER 1G STREET � " d4 "1 STREET NUMBER 1 ........ ................................................................. OFFICIAL USE ONLY I........................................................................... RECONIlVIENDATIONS OF TOWN AGENTS ,.... ........j............................................................. DATE APPROVED b 06 CONSERVATION ADMINISTRATOR 4 4DATE REJECTED COMMENTS FOOD INSPECTOR - HEALTH r -;ZL SE SPE R - HEALTH COMMENTS �i S� PUBLIC WORKS - SEWER / WATER CONNECTIONS DATE APPROVED &��c-�) /Z)C)) _ DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED o DATE REJECTED DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR no Town of North AndoverNORTH Of��teo q{. r616 O Building Department o ' 27 Charles Street * _ North Andover, Massachusetts 01845 * ?, e^ (978) 688-9545 Fax (978) 688-9542A_04 DEBRIS DISPOSAL FORM 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: Facility location Signature of Applicant 5-1 2- :2::— CC) Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. The Commonwealth Of Massachusetts Department of /r�usrral.:-cc.cents 0f,=res cf Investications == `f . , EcstcnMass0� — 11� y Ncrker.;' Ccmcensaucn Insu2: ce Al rCcvrt dame .;::ie8se -^n; Mai e' A- A; -Y A (70 A,5 0"1 Z (lc /1 1-cc3-ticn: 9,< 2)4-57 4 ,4 CI am a homeowner rerrcmiirc all work mysa!f. CI am a sole prccretcr and have no Cne `Nor kino In any cc 2d; -y I am an eTcicve/r --rcvidire wcrl<ers' CcmFensaticr, icr my eTFicvec-s 'NCrkinc cn 'Ll -.is Jcb. Ccrrcanv nary e:/QrJt/ty� AddreEs 7 Insurance Co IL47fY Z4 f�!4z Cemcanv name: Address Cit r Phcre Insurrce Co. Fciic� Failure to sed :7e =jerace a5 recurec uneer Se--:cn 2aA or MGL 152 can lege :o the ;macSInc1I df c.rrtr.=l penal ies cf a rine uc to s °C0.CC anc to one years' irrprscrrrent s .Ye!! as coli cenatttes in :.`e r.c-m c a s C- `r/CRK CRCe.= anc a :ire c." (StC0.00) a day _Sslrs: me. I understand that a c#y cr ;hls ::aerrert may --e rcrvarcea to the Cf`c= cf !nvesrsaacns cr he 21A. ,cr c��er-_-4e verlflc=tics. /c C Print name �— ��—��`�J�/X F^ore T �!, C'lcal use only cc nct wr;<e ;n this area :c to ccrrc:e:ec dy cry cr :c.vn c .c:cf Cty or Tcvrt C Euiicirc Cecr [C`ec c .f ;mrre^iate re_<c ^se s ; ecu:red [ L'CC!1SInC C2tC ^c.^e r [ i=ec'l�r rE�-ari,T,Er:t L Cther 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: 5-31-2000 TITLE: ABBOTT VILLAGE SALEM ROAD PROJECT INFORMATION: PAUL ST HILAIRE 96 DASCOMB ROAD ANDOVER MA COMPANY INFORMATION: J&J HEATING & AIR COND 17 ARLINGTON ST DRACUT MA COMPLIANCE: PASSES Required UA = 626 Your Home = 617 i Permit # j Checked by/Date Area or Cavity Cont. Glazing/Door Perimeter R -Value R -Value U -Value CEILINGS 1728 30.0 0.0 WALLS: Wood Frame, 16" O.C. 2692 13.0 0.0 2 GLAZING: Windows or Doors 458 0.460 2 GLAZING: Windows or Doors 42 0.490 DOORS 39 0.600 FLOORS: Over Unconditioned Space 1728 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 Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date 5 -'r-d s Massachusetts Energy Code MAScheck Software Version 2.01 Release 2 ABBOTT -VILLAGE SALEM ROAD DATE: 5-31-2000 Bldg.l Dept. Use I I 1 [ � I I 1 I [ ] I I I I t � I I I [ ] I I I I CEILINGS: 1. R-30 Comments/Location WALLS: 1. Wood Frame, 16" O.C., R-13 Comments/Location WINDOWS AND GLASS DOORS: 1. U -value: 0.46 For windows_withaut labeled.U-values, describe features - # Panes Frame Type Thermal Break? [ ) Yes [ ] No Comments/Location 2. U -value: 0.49 For windows without labeled U -values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ].No Comments/Location DOOMS: 1. U -value: 0.6 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. 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 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 1I8 inch. Duct tape is not permitted. The HVAC -system must provide a means,forbalancing air- and water systems. TEMPERATURE CONTROLS: Thermostats are required- for each- separate HVAC system. A manual or automatic means to -partially restrict or shut o-ff 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- 780 -CMR 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.): HEATING SYSTEMS -:- Low pressure/temp. Low temperature Steam condensate COOLING` SYSTEMS: Chilled water or refrigerant CIRCULATING HOT WATER SYSTEMS: PIPE SIZES (in.) TEMP (-F)- 2" RUNOUTS- 0-1" 1.-25-2" 2.5-4 201-250 1.0 1.5 1.5 2.0 1-270-2700 0.5 1.0 1.0 1.5 any 1.0 1.0 1.5 2.6 40-55 0.5 0-.5 0.75 1.0 below 40 1.0 1.0 1.5 1.5 CIRCULATING HOT WATER SYSTEMS: 10 Insulate circulating hot water pipes to the following levels (in.): ----NOTES TO FIELD (Building -Department Use Only)----------------------T-- PIPE SIZES (in.) NON -CIRCULATING ) CIRCULATING MAINS &.RUNOUT HEATED WATER -TEMP (F)-. RUNOUTS 0-14' 1 0-1.:25" 1.5-2.0'" 2 .0+ 170:-180 0:..5_ 1-0- 1...5_ 2.0 1.4.O.-1_60 0_.5_ 1 0-.5-. 1...10: 1.5 1OD-130 0 ..5 .1 -0.5 0_5 ----NOTES TO FIELD (Building -Department Use Only)----------------------T-- r w 0 BOARD OF BUILDING REGULATIONS ,License: CONSTRUCTION SUPERVISOR Number: CS 009802 Birthdate: 08/24/1939 Expires: 08/24/2001 Tr. no: 3567 Restricted To: 00 PAUL J STHILAIRE a, —e 5 HANSON DR MERRIMAC, MA 01860 Administrator 00 - 35,000 cf enclosed space (MGL C.112 S.60L) 1A - Masonry only 1 G -1 & 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DIG SAFE CALL CENTER: (888) 344-7233 �i 16 ask 0 z O c u O v O Z z 2 c� o :4D O C � o U W p G a o W C40 u W O N E� U 0 G W w U)cn o z 0 W W a I1 2 O y y L CD C O co C3 m r�7 y O V CA C ci O m _m �. 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