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HomeMy WebLinkAboutMiscellaneous - Exception (172)Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 RE: Insured: Property Address: Policy Number: Date/Cause of Loss: File or Claim Number: David & Diane Webster 212 Gray Street H017057009 2/9/2015, Water/Ice Dam 30967-R Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. Ryan Werner On this date, I caused copies of this Notice to be sent to the per ons named above at the addresses indicated above by First Class Mail. Signalyfe and Date ANDERSON ADJt;'STMENT CO., INC. 50 Nashua Road, Suite 303 PO Box 1098 Londonderry, NH 03053 JIM LU=Y1U1vrrrJUJnUriYk*ta M%,11VLMliu DEPIIRMWOFPUSKSOE1Y Permit No. v.- B0A00FFWPREVEN1=RDGULAT W517a212-W Occupancy & Fees Checked z c APPLICA77ONFOR PERMITTO (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) 0 Town of North Andover The undersigned applies for a permit to perform the electrical work Location (Street tit Number) G re Owner or Tenant 70MELECTRICAL WORK s ELECTRICAL CODE, 527 CMR 12:00 Date _rf �G`� To the Inspector of Wires: below. Is this permit in conjunction with a building permit: Yes -No a (Check Appropriate Box) rr-�� Purpose of Building U C Utility Authorization No -31L L -a2 Existing Service Ampi Volts Overhead 13 Underground 1:3 No. of Meters New Service C) Amps 2` olts Overhead Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers TOW KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground 0 ground 171 No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Barriers FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Had Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Ares Healing KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW Connections No. of Water Heater KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP R. CVMW Aasuettblheltx}iaile dWtMdW0C=3dLaM aibsba3tWagtivalat YESEl NO akmkWdvddpwofofsattletode0ft YM n r)mhmdzclzdYfSi ,pleaseidc*dr y'peafoovwpby the box. rAFEMMl EsmttatdValroefT~]acttital Wade $ —7 f n Fid ^7 —0 5- a Lio veNd, LoU �l LioenseNo r f22�0 ' &id= MNo, 75r l - ��2 - t 9 (a J 1 b9gnetiaonthspeQn[appicahonwat�estMteq�attelt - - - check one) Owner � Agent Telephone No. ....PERMIT FEE S Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS 4� K Utli..ai t:,e Pert,rit No. i IOccupancy and Fee C}tcci.,:d _�� [R�--- l l �)a� t caw blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be pertormed in accordance . nn the \IdiSd.;:7 ClIS kI"tncal l..ie \ILC , .' - t \1R I:.uU (PLEASE PRINT IN INK OR TYPE .-I LL I.VFOR,II.-I TION) Date: r -q'—Q+-i— -- I City or Town of: W6 r+fi-odbu er- To the Inspector of Wires: By this application the undersi led gives notice of pis or her intention to pertbnn the electrical work describedlbelo\y. Location (Street &'-Number) &4- Owner or Tenant L�*.) (�_'t� Li� CC'j(litit/�iy'E�/ Telephone No. 7ql-,:�70 (� Owner's Address a?(- PCL,, Ilue— 6 C/rl Tf24^ ki 1/yjb OIL23 Is this permit in conjunction with a building permit? Yes U" No ❑ (Check App/propriate Box) Purpose of Buildinge� l e `(ll I'Kj Utilitl' authorization No. R. q Existing Service Amps / Volts Overhead ❑ New Service 406 Amps Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Undgrd ❑ Overhead lam"'' Undgrd ❑ No. of :deters No. of Meters i ComplettOn ofthe lnllnu•ino rnhlo r„r,,, ha ..... A-1 Av rhn /ucn.rrrnr n/•Wiv— No. of Recessed Fixtures 5,g No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers K%'A No. of -.Lighting Outlets ao No. of Hot Tubs Generators KVA ' No. of Lighting Fixtures Swimming Pool Above ❑In- El rnd. -rnd. o Emergency Lighting Battery Units No. of Receptacle Outlets 76— No. of Oil Burners FIRE ALAR:1'IS No. of Zones No. of Switches q �" No. of Gas Burners 2 o. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons 1\, 0. of Alerting Devices No, of Waste Disposers --- Heat Pump Totals: I Number' Tons KW No. o Self -Contained p Detection/Alerting Devices I No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating AppliancesKW Security Systems: No. of Devices or Eq uivalent 1 � No. o ater KW Heaters o. o o• or— Signs Ballasts Data Wiring: No. of Devices or E uivalent No. Hydromassage Bathtubs ' No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail ij'desired, or as required by the Inspector al Wires, INSURANCE COVERAGE: Unless waived by the owner. no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [2� BOND ❑ OTHER ❑ (Specify:) ',Cky)-JJ(k _ 'a,,y*. il -of (Expiration Date) Estimated Value of Electrical Work: Df,j} � (When required by municipal policy.) Work to Start: 6 ?~d Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the injoirmation on this application is true and complete. FIRM NAME: 'g -t ch and t�.r>, I E l r C -%t -t • D,.I LIC. NO.: A I b 0J4 Licensee: \,tC rcl � (b Gil i Signature/ LIC. NO.:loe2i— An; 3a3t�� (!f applicable. enter "exempt " in the licen tum er line.l 1 , ¢¢ Bus. Tel. Address: �, T hr,e ( irclt '13111erlu MA Ol&' 0f -It Tel. No.:15-15i SCR"sR J1,9- OWNER'S aOWNER'S INSURANCE WAIVER: I am a arc that the Licefisee does not have the liability Insurance coverage nunnally equired by law. By my signature below, I hereby waive this requirement. I am the ( check one) ❑ owner ❑ owner's a¢ent. wner/Agent ignature Telephone No. PERMIT FEE: S h3 Xovoe.., vac S-C(--a� -7, 1 oS Pry �Q /,� Date ....., �oTOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that 1? 13 h � -.-,/ V � � `` .......................................................................................... has permission to perform �- wiring in the building of C � �c � (� �" ................................................................................... —� �� '�° .................. . North Andover, Mass. it ....' .........^.. Fc�..... Lic. No. /�i f + ELECTRICAL INSPECTOR Yeck # 533 515/! Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULA/ONS Otli.:,ai L.3e )ni :i ,5 �S , Permit No. Z - Occupancy and Fee Check,:d 11 99] (lea,.e b!ank) APPLICATION FOR PERMIT TO ERFORM ELECTRICAL WORK All work to be performed in accordance a nth the %1; sacrnsetts Electrical C ,ie %tt{C .:'_" (AIR 1-.00 (PLEASE PRLVT IN INK OR TIDE .4LL INFOR.V.-1 TIO. '1 Date: —,?-o � City or Town of: tjt''�' G) To Me Inspector ol' {hires: By this applicationthe undersigned gives notice of is or he intention to perforin the electrical work described below. Location (Street & Number) 'Q �9 Owner or Tenant L. Owner's Address �f i 0 Telephone No. 7q1 - ,;170-6y 11 Is this permit in conjunction with a building permit? Yes [�t- No ❑ (Check Ap ropriate Box) Purpose of Building �� we �1 Utility .authorization No. �q ty -a �& Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of :deters New Service 't f&J Amps Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Overhead � Undgrd ❑ No. of Meters Contoletion ofthe 1611otritw table may be xaiverl by the hispector of lt•'irc- No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Dotal Transformers KVA No. of Lighting Outlets a 0 No. of Hot Tubs Generators KN� No. of Lighting Fixtures Swimming Pool Above ❑ In- ❑o, rnd. �rnd. o mergency Lighting Battery Units No. of Receptacle Outlets 75- No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners 2 o. of Detection and Initiating Devices No. of Ranges '� No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Dis osers T P Heat Pump Totals: Number Tons KW No. o Self -Contained Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW P g Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: / No. of Devices or Equivalent 1 ' No. of Water KWo. Heaters of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent 1c;z No. B Hydromassage athtubs No. of Motors Total HP Telecommunications 1Viring: No. of Devices or Equivalent OTHER: Attach additional detail ij'desired. or as required by the Inspector o1 Wires. INSURANCE' COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [� BOND ❑ OTHER ❑ (Specify:) �,C�%'t��� 1 - v:,'rr�f1- j I - 06 �� /j� (Expiration Dani Estimated Value of Electrical Work: ®t/ (When required by municipal policy.) Work to Start: Y" Q -O Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: 'iZ, r h ark `P�rara;� t F l r C -Et -t 1' &I N,'Ira ice_ LIC. NO.: A i a Date ......///.............. . ",\! NOrtry °f of ` TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION • h SACHUSE4� J 1 This certifies that . AS�t '� C has permission for -gas installation . s)4/.�— in the buildings of ,/ .1 - ...:�k�!!���.... at .?�...... !P 1, '"�` ,� .. , North Andover, Mass. /GAS INSPECTOR J r1� ✓ s Check #��( Sill MASSACHUSETTS UNIFORM, (Type or print) NORTH ANDOVER, MASSACHU T' Building Locations TON FORPERMTODO GAS FMT14G Owner's Name Newff Renovation ❑ Replacement ❑ Date �,— // -6 S � Permit # mount $ Plans Submitted ❑ (Print or t, Aima Lti one: Certificate Installing Company Corp. Address / i / C f</t ❑ Partner. Tusiness Te ep one ! Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes toNo 13 If you have checked yes, plegse indicate the type coverage by checking the appropriate box. Liability insurance policy II�g7.71 Other type of indemnity [3Bond ❑. 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 mtormaUon 1 nave sunmittea kor enterea) in avove appucaaan arc uuc anu accuia t; w uic 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. awn VED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber 3121-2-7 ❑ Gas Fitter Icense um er ❑ Master ❑ Journeyman FLOOR l!jIST. (Print or t, Aima Lti one: Certificate Installing Company Corp. Address / i / C f</t ❑ Partner. Tusiness Te ep one ! Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes toNo 13 If you have checked yes, plegse indicate the type coverage by checking the appropriate box. Liability insurance policy II�g7.71 Other type of indemnity [3Bond ❑. 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 mtormaUon 1 nave sunmittea kor enterea) in avove appucaaan arc uuc anu accuia t; w uic 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. awn VED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber 3121-2-7 ❑ Gas Fitter Icense um er ❑ Master ❑ Journeyman r It Date.. �.� :.6L. ... N TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION 9 This certifies that . .... ...�..........!......!7^ has permission for gas installation . .... ............... in the buildings of .?-- 'f�"�>!................... . . ...... North Andover, Mass. . Feely r.. Lic. No ........ .......... Gi4S`{I�Pic Check # 115 .j MASSACHUSETTS UNIFORM (Type or print) NORTH ANDOVER, MASSA Building Locations New 0- Renovation ❑ PIItMIT TO DO GAS FrFMG Date f -- `/ — O� s Name 1-3Plans Submitted ❑ Permit # 115-112, Amount $; pal (Print o�,Ype) a p r / Chec one: Certificate, �r►stalling Company Name f� Corp. rf�� Address 1 30y--,tcC,O�� "' `C�` ❑ Partner. ,94, or Tuusiness Felephone ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter c> �r i� C> C"-\ INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ED - If No❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. ❑ Liability insurance policy 0-- 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 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 ❑ 7 harvhv certifv 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 Issu o this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and gapter 14o General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed PWmber Or Gas Fitter Q Plumber ,3 0 4 ❑ Gas Fitter tcense Number 13-M ❑ Journeyman v FLOOR 4TH. FLOOR 7—TH. FLOOR (Print o�,Ype) a p r / Chec one: Certificate, �r►stalling Company Name f� Corp. rf�� Address 1 30y--,tcC,O�� "' `C�` ❑ Partner. ,94, or Tuusiness Felephone ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter c> �r i� C> C"-\ INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ED - If No❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. ❑ Liability insurance policy 0-- 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 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 ❑ 7 harvhv certifv 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 Issu o this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and gapter 14o General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed PWmber Or Gas Fitter Q Plumber ,3 0 4 ❑ Gas Fitter tcense Number 13-M ❑ Journeyman v Location No. Date N�RTh TOWN OF NORTH ANDOVER O F s A� Certificate of Occupancy $ .-- Building/Frame Permit Fee $ s�cwus Foundation Permit Fee $ DO Other Permit Fee $ TOTAL $_.- 4 Check # o7s�70 4 t 7 8 9 ,% Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVAT& OR DEMOLISH A ONE OR TWO FAMILY DWELLING '7 a BUILDING PERMIT NUMBER: / / c� DATE ISSUED: SIGNATURE: �u Building Comniis6onefflngxctor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: Lot 6 Gray Street 4/- 1.2 Assessors Map and Parcel Number: 107D 6 Map Number Parcel Number 1.3 Zoning Information: R2 Single Fami l)E Home Zoning District Proposed Use 1.4 Property Dimensions: 44,902 150 Lot Areas Fronts ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R red Provided 1.7 Water�,S°h M.G.L.C.40. 34) 1.5. Flood Zone Information: Public jv Private 0 Zone Outside Flood Zone XX 49&SECTION 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System RX 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT ' "' C'i Fc +StfiCt: ;ung XX 2.1 Owner of Record Litcaijlld ConAny, Inc 26 Ray Avenue Burlington, MA ._01803 Name (Pri Address for Service 791-270-6859 Signa re Telephone 2.2 Owner of ecord: w Name Print Address for Service: Signature Tel hone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Paul Litchfield Licensed Construction Supervisor: 26 Ray Ave Burlington, MA 01803 Address 617-212-0381 lure Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address A Expiration Date Sig_qature Telephone 00 rn X aaa� 0 z M 90 0 ass r M r _r z G) SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 S 25c(6) Ba Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. -Signed affidavit Attached Yes ...... AX No ....... ❑ SECTION 5 Des ri tion of Proposed Work check ad a cable New Construction Existing Building ❑ Repair(s) ❑ terations(s) ❑ T Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: New Construction - Single Family Home 4 Bdrm - 2 1/2 Bath Colonial 9' Ay66 z, o?l ';� CY q q 91' SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building 40, 00 (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbin Building Permit fee (a) x (b) �F v 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, Gary J. Litchfield as Owner/Authorized Agent of subject property Hereby a o i e f i to act My beha al i thorized by this building permit application. Signature er ate SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, Paul Litchfield as�RAuthorized 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 eA Print Nam i ah of nt Date NO, OF STORIES SIZE a X BASEMENT OR-&EA513- SIZE OF FLOOR TIN BERS L L� 15 Z & 2ND 3RD SPAN Lf DM ENSIONS OF SILLS y Y 7 7— DlMENSIONS OF POSTS DEV ENSIGNS OF GUIDERS iv I HEIGHT OF FOUNDATION - THICKNESS ( d SIZE OF FOOTING ( v Y20 X MATERIAL OF CHUvINEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE N CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 469 (1/25/2005) Date: July 21, 2005 THIS CERTIFIES THAT THE BUILDING LOCATED 212 Gray Street MAY BE OCCUPIED AS Single Family Dwelling 9 room, 2 % bath, 3 stall garage under IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Litchfield Co. Inc 26 Ray Avenue Bulington MA1#94&f Building Inspector y m m m C m x m y m C4 CO) 10 CD 0 CD CIO CD CO) 0 z CD C CD C C ,0 ? O mr m = go ao-• Ns S m man m m Z m C Z a PCL -40a� 0 y 7 o C-Olm O o Zg m n � oyn� c =r0 CO ca %rfn^ m c =r :A V/�/ m • O N As VJ C d � 0cr >?; ' e"• y ,(.� 7d cncn 11. =r Cal 0 . ON :a 0 0CD. cn � ?'_:` � CDq. • �]cn ata ti cn r: V: L C=L -co oma. o s. �q El 4 tbcn ►� \( 1 (� V J (( 4/ A O v 4 G� CA CA v 0=3 0 0 c Town of North Andover Building Department 400 Osgood Street North Andover MA 01845 978-688-9545 Fax 978-688-9542 APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS/LOCATION OF PROPERTY: 4-1 a S� �IU/1 � I-�+rt�vw{ice DATE'REQUESTED FILED/READY FOR INSPECTION CLOSING DATE ON PROPERTY: FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A REINSPECTION FEE OF TWENTY DOLLARD $20.00) WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. re Y ROUTING D.P.W. - WATER METER I(�S`f t�',t� _ DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE/DPW AUTHORIZATION APPLICATION CERTIFICATO OF OCCUPANCY MVWed 11 .15-2004 ,I ' FORM U -LOT RELEASE FORM =w, 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 —+he=applicant=and/or-Aandowner=fr,oral-compliance with-any-appiicable-=or-mquirements: *'"�`***APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT_ 1'/�(,/ LOCATION: Assessor's Map Number O� %? PHONE PARCEL C� SUBDIVISION LOT (S) STREET �i s/ ST. NUMBER1\1 "*** OFFICIAL USE ONLY****** ********** Co s�ERVA COMMENTS c WN PLAN COMMENTS OF TOWN AGENTS: DATE APPROVED DATE REJECTED DATE APPROVED 2- –y — DATE REJECTED DATE APPROVED DATE REJECTED �EPT1C INSPECTORSHEALfH DATE APPROVED / �,S PUBLIC WORKS - SEWER/WATE CONNECTIONS R( � D S DRIVEWAY PERMIT � FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm w&OLIC-1 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print Name: Location: City A4 • Phone # I am a homeowner performing all work myself. . I am a sole proprietor and have no one working in any capacity EO'-� I am an employer providing workers' compensation for my employees working on this job. Company name: Address City: Phone #: Insurance Co. Policv # 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_w.ell_as_civil,penattiesiniheformnf_a_STOP WORK ORDFR.and..afine.af.(.$1D0.DD)_aday 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 I do hereby certify under the pains pnd penalties of peiluty that the information provided above is true and correct. Signature Print Official use only i do not write in this area to be completed by city or town official' City or Town Permit/Licensing Building Dept ❑Check if immediate response is required Licensing Board p Selectman's Office Contact person: Phone #: I] Health Department n Other North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The! debris will be disposed ofin: (Locatio of Facility) Signat re of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector RE,Schcck Compliaucc Certificate Massachusetts Energy Code REScheckSofiware Version 3.6 Release 1 Data filenatnc: C:1Progratn Files\Cheek.\REScheci<\L,itchfield Co mpanies.rGk PROJECT TITLE: The Rosewood CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: l or 2 Family, Detached HEATING SYSTEM TYPE. Other (Non -Electric Resistance) WINDOW / WALL, RATIO: 0.20 DATE: 12/27/04 DATE OF PLANS: December 27, 2004 V PROJECT DESCRIPTION. Litchfield 9mpanies COMPLIANCE: Passes Maximum UA = 562 Your Home UA = 545 3.0% Better Than Code (UA) Ceiling 1: Flat Ceiling or Scissor Truss Ceiling 2: Cathedral Ceiling (no attic) Wall 1: Wood Frame, 16" o,c. Window 1: Wood Frame:Double Pane with Low -E Door 1: Solid Floor 1: Ali -Wood loist/Truss:Over Unconditioned Space Furnace 1; Forced Hot Air, 90 AFUE Permit Number Checked By/Date Gross Glazing Area or Cavity Cont. or Door LuiMW $;Value &Y " UIAW UA 1169 30.0 0.0 41 748 30.0 0.0 25 2848 13.0 0.0 184 565 0.350 198 38 0.370 14 1764 19.0 OA 83 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 RES checkVersion 3.6 Release 1 (formerly MECchecR and to comply with the mandatory requirements listed in the RES checklnspection Checklist. 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 13 l0 and J4.4. REScheck Inspection Checklist Massachusetts Energy Code REScheckSoftware Version 3.6 Release l DATE: 12/27/04 PROJECT TITLE: The Rosewood Bldg. Dept. Use ! I 1 [ ] I [ � I Ceilings: 1. Ceiling 1: Flat Ceiling or Scissor Truss, R-30.0 cavity insulation Comments: 2, Ceiling 2: Cathedral Ceiling (no attic), R-30.0 cavity insulation Comments: _ Above -Grade Walls: 1. Wall 1: Wood Frame, 16" o.c., R-13.0 cavity insulation Windows: 1. Window 1: Wood Frame:Double Pane with Low -E, U -factor: 0.350 For windows without labeled U -factors, describe features: #I Panes Frame Type__ 'Thermal Break? [ ] Yes [ Comments: Doors: 1, Door 1: Solid, U -factor: 0.370 Comments: I No Floors: 1, Floor 1: All -Wood Joist/Truss:Over LJnconditioned Space, R-19.0 cavity insulation rnmmantc• Hleating and Cooling Equipment,. 1. Furnace 1: Forced Hot Air, 90 AFUE or higher Make and Model Number __ Air > nkage: 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: I . Type 1C 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 1C rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 Us) 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. I Table 1: Minimum Insulation Thickness fir Circulating Hot Water Wipes. i raring ain5 and Runouts Heated Water - e TPmM„Wrat►rre i Fl. 170-184 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 4.5 0.5 0.5 1.0 Table 2: Mblimum Insulation Tisickness for HVAC Pipes. I NOTES TO FIELD (Building; Department Use Only) Fluid Temp. BAUC (0. P;nin¢ tem_TVD Pleating Systems 201 250 1.0 1.S 1.5 2. Low Pressure/Temperature 120-200 0.5 1.0 1.0 1.55 Low Temperature 1.0 1.0 1.5 2.0 Steam Condensate (for feed water) Any Cooling Systems Chilled Water, Refrigerant, 40 -SS O.S 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.S I NOTES TO FIELD (Building; Department Use Only) Vapor Retarder: [ ] f all non -vented framed ceilings, walls, and doors. Required on the warm -in -winter side o Materials Identification: Materials and equipment trust be identified so that compliance can be determined. ent and service water heating Manufacturer manuals for all installed beating and cooling equipm 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. I Heating and Cooling Piping Insulation: [ j HVAC piping conveying fluids above 120 OF or chilled fluids below 55 °F must be insulated to the I levels in Table 2. i Date Builder/Designer . . I Torun of North Andover planning Board This form represents the schedule for allowing the following lots to be considered as eligible for building permits under the Town of North Andover Management by-law Section 8.7 of the zoning by-law. Pursuant to 8.7 this Development Schedule must be filed in the Registry of Deeds and be referenced on the deed of each of the lots below and be filed with the Planning Board prior to the issuance of any building permit or permit for construction. Name and Address of Applicant for Litchfield Co.; Inc 26 Ray Ave., Burlington, MA Name of Development: Gray & Boston Streets North Andover, MA. Map and Parcel of Original: 107D, Lots 6 & 10 Date of Application for Lot(o Division: March 25, 2003 Lots Covered by this Schedule 1,2,3,4,5,697,8 10,11,12,14,15 15 tot The Planning 'Board by their signature below, or a signature of a duly authorizes representative, do hereby establish for the above named development for the following Development Schedule for the purpose of Section 8.7 of the Growth management By -Law. The applicant, their assignees, successors and or subsequent property owners shall confirm to the following schedule that limits the eligibility of the following lots for building permits. This form must be filed in the Registry of Deeds by the property owner or representative and be referred on each deed for each of the following lots. Such deed references for the deed of each lot shall at minimum reference the book and page in which this development Schedule is filed and contain the language; This lot is subject to a Development Schedule pursuant to the Town ofNorth Andover Zoning By-Layr, "This lot is subject to a Development Schedule pursuant to the Town of North Andover Zoning By -Law all owners, representatives, and future purchasers should avail themselves of said restriction by reviewing the approved Development Schedule as filed in Book and Page . The fact that a lot is eligible for a building permit is subject to the'imitation of the number of building permits per year pursuant to section 8.7.2d of the Zoning By Law." The Planning Board hereby schedule the lot(s) for the above development as follows; Numbr of lots Year Eligible Eligible Building Office Use Building Office Use Notes Date Lot Eligibility Completely Utilized Fiscal 04 16 Fiscal 05 6 Fiscal 06 2 I 10/15/2004 FRI 10:17 [JOB NO. 74411 0001 i Signature o,P I am= Hqpw Of Deft +t%tiNorth DI&M 11 t or Authorized Representative Date:—4 Date: / G COMMONWEALTH OF MASSACHUSETTS Then personallyappeared Raqse Applicant or histits authorized agent and acknowledged the foregoing ' ent to be his or her free act and deed and the free act and deed of the Applicant, before me. r COMMONWEALTH OF MASSACHUSETTS i •:�,�,'• v ARY ss 2 0 1 0 /lf lllill Then personally appeared c % A�A the Planning Board Chair or his/its authorized agent and acknowledged the foregoing instrument to be his or her free act and deed and the free act and deed of the Applicant, before me. %-,-1 • Notary Public My Commission Expires: MAW LEW4PPOLTTO Nolory Public Commc&^w11h of Mossuchusass My Commission Enpires June 7,2M7 10/15/2004 FRI 10:17 (JOB NO. 74411 R001 FlSY/7 -r: QO�QOPOLn�CI �OP�O� QB40Q�F140fl, DOQo Professional Land Surveyors & Civil Engineers ESSEX SURVEY SERVICE 1958 - 1986 OSBORN PALMER 1911 - 1970 BRADFORD & WEED 1885 - 1972 PIAT PLAN OF LAND LOCATED IN 1YJ RTN 114 DO'I(Cf2 , MASS. DATE: F69 / 0 ZOUZ-- REFERENCE: BK 11G This Plan has been prepared for Building permitting purposes only for the above party, and is not to be used for boundary measurements, land conveyancing or mortgage loan inspections or plot plans. I hereby certify to the &611 /lA oO ,FZ Building Inspector that I have examined the premises and the buildings are located on the ground as shown, and buildings shown conformed to the dimensional zoning laws, of /IXIV ati3O,0 '2 MA when constructed. J% vW'v 'i (97.8) 531.8121 ..; Location �� b aIQ, �jt`a`i S4— No. 14 (o ef Date ' `� c�U0 C— TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ L/ TOTAL $ Check # 1 8L 3b- v Building Inspector BoaQo� �aad �aQoo� a�000�ofl�no �ooa" Professional Land Surveyors Et Civil Engineers ESSEX SURVEY SERVICE 1958 - 1986 OSBORN PALMER 1911 - 1970 BRADFORD & WEED 1885 - 1972 PLOT PLAN OF LAND } LOCATED IN 11./771i M.A00 ZONE: 22 LOT AREA: 43.E LOT FRONTAGE: /5Z�-1 FRONT YARD: 3�O SIDE YARD: /G/ REAR YARD. SCALE: u i DATE: JA III ZDD S i REFERENCE: BK PG 104 LOWELL STREET PEABODY, MASS. 01960 i �- (978) 531 _8121 2�� s I hereby certify to the Building Inspector that the pro- posed construction shown conforms to the dimensional zoning of R. Mello CHRISTOPHER R. (CELLO 501 m m X C m m v m —M uNim t @ O ;41 X. mto D � O Z' aj 0. aj = fD ? H N m C C �m fD ,� �> > oc 3 x o aj Q s 0 o m o' M� �� � 0 o � N 0 M W o _ m " a cc� d C C rt CL =D (0 N rt ;d n O cD IU � C � CL Ln o �� 't cu0ca c It 0 E ocr CL Tpw� cr 77 0 1' W CL CD CD Ir po r -v E CD All mFm I a 3 an:�;O Z ® N q- 0 0460 0 � d.j AZ Zs S e 1� N C CD V 1 ~ Ali 0 0 :^ o y cfl id m �o o ;a . Z Q M—] � I CA m m rn y m m° c y d CA CO) CD aZy CD -o o. C. o CL =' y � O � o c CD CD `� o c� `C d CD CCD O CD C CD y. _. CD CL o CA co CD v y O to Z S O CD0 CCD C C to O Q coal = ra S: c So y y 3f CLo Cl) t0OCC09 M Z y =r=H� �. � .d.* m— = y T. =r mCL ?n T o Oo y O y NN _> > o y o 2 O,� .O.► oo Z O S.no. f .d ti�o.'L r CL '3 OCL A Er� (� CO). co mC. m CD P1 OC c (� y J mId co �o ? O y fk- = M-9 • FW z y bd s : • CD 4% y o� _ 'go a► mo. C C7: o C a% 02 M c o p w 0 o o Q� rz 0 c C Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING '1SSA\C�f(` ., 'J This certifies that ...... 7. �J ����- '`�^�!. i.... fes. has permission to perform .-- l• ..... .................... plumbing in thePuildin/gs of .. � ............ . at..,=-l........r.:..., North Andover, Mass. V �, ,� R Fee�.��•. Lic. No. ge-DZ? .. �..",�.a'-�`�'.r? PLUMB. ; INSPECTOR Check x� v 6452 i 1 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location/© 4�-g G'!% New Renovation lame CC) Date Elsa Permit # S Amount Jt7 ❑ Plans Submitted Yes ❑ No (Print or type) l Check one: Certificate Installing Company Name ,c�s>z_x-a.� 5 1 \ �� YetCorp. ,�`Y� Address +A01"I" r -e-- 9,(k— 'C�u k' 0 Lj ElPartner. Business Telephone Q 7 O Cd Firm/Co. — rr Name of Licensed Plumber:r1 Insurance Coverage: Indicate the t e -of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity 1-3 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 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: Signature Of icense um er Type of Plumbing License Title 3 C)o C/ City/fownicenL' nse Num ear MasterEr Journeyman ❑ APPROVED (OFFICE USE ONLY IN d• Date.... a �� TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .......................................... .�................................. has permission to perform .......�fc �P wiring in the building of ..... t.h 4-(e Y ct! at .... 2.f.d GA?d'h `� �........................ . North Andover,, Mass. Fee...... ... Lic. No. .i4../.6a?r........... � ELEcrRICAL &SPECTOR Check # '� 47 5L31 11W LUlMV1UIV vyraftull Ur Irgrf a3MLrJv.u..siu �••• DEPARn T OMBU UM Permit No. BOAMOFFMPREVffMNREGULMOAN270M1Z- Occupancy & Fees Checked APPLICATIONFOR PERMITTOPERF ELECTRICAL WORK ALL WORK TO BE PERFORMED W ACCORDANCE WrrH THE MASSACHU S ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat Town of North Andover The undersigned applies for a permit to perform the Location'(Street & Number) Owner or, Tenant L G -k Owner's Address oZ /,-, K Q � r ffi-* Is this permit in conjunction with a building permit: To the Inspector of Wires: below. Yes- No a (Check Appropriate Box) Purpose of Building U C Utility Authorization No.3)7 Existing Service AmpVolts Overhead 0 Underground No. of Meters New ServiceCD ,L_ Amps / 2, olts Overhead [M Underground No. of Meters 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 Fixtures Swimming Pool Above Below rl Generators KVA ground and 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 MunicipalOthe No. of Dryers Heating Devices KW Connections No. of Water.Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER. is =xeCowrt Pt>=1k)thetegumnftafNlassadt=0GazsdLaws Ihmamne tLiat:tl'tylnvanaeR yir iu&g oricakastialepvabt YESET NO Ihws km&dva1dptoefe(sar 0ft0ffi= =if)cuhmched edYMp1ea�eittdcalethetypeofcova eby � 1PJ:iURA VIE [3 --BOND GUM L��Iriese6rx � o FfrntadvakL-dE1xtacdWcdc $ WodwSiat�.�.`" kgecdmDAeRe4xsbd FkA Z —7 "0 -"i- SigLedurlder�ieP�afp�'uy. RRMNAME 1` F Liar�seNo !Q/ 2 �i LicamLioat�eNo r �� ?l Bu*faTdNa 79l -;i2 --I961 r arrbm (Q � lA 1/I C� 'I f' 1� 1�"Ji � i� � l \` C�G Ak Td Na 975-50'7-V1? OWNEIL'SIlVS RANMWAM3kIarn waeltlattheLioaee"nOtbtfietheinazaucuo u*cr]&tg"degidstasttx}aedbyMmduMCeimWLaws arcltbetmysgl�seenthspe�appBcaornwalwsthtvtaqurana�t (Please check one) Owner 1 1:3Agent Telephone No. PERMIT FEE signature Owner