HomeMy WebLinkAboutMiscellaneous - 1 BRECKENRIDGE ROAD 4/30/2018 (2)N
`O m
O �
V n
� m
o z
ao 0
o �
g �
O Q
0 0
f
�J
3 3 4 z"-"
Date. ............ 1�1�.
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
e
This certifies that
has permission for gas installation ........
in the buildings of .......................
orth Andover, Mass.
at
Fe.e - ......... Lic. No.
GAS INSPECTOR
L
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type)
ki?i�2060
MA Date Receipt# Permit#
Building Location Owner'sName
Map: Lot: Zone: Type of Occup
New Renovation ElReplacement Plans Submitted: Yes 13No ❑
�T
JY
Installing Company Name EASTERN PROPANE & OIL, INC.
Address 131 WATER ST DANVERS MA 01923
EstimateValueof Work:
Business Telephone 800-322-6628
Name of Licensed Plumber or Gas Fitter✓� ��G'�
Checkone: Certificate
/"` Corporation
❑ Partnership
❑ Firm/Co.
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes ❑ No ❑
If you have checked /Les, please indicate the type coverage by checking the appropriate box.
A liability insurance policy ❑ Other type of indemnity ❑
Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement.
Checkone:
Owner Agent
Signature of Owner or Owner's 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 the permit issued for this application will be in compliance with
all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the G neerrall Laws.
By Type of License: W
Plumber SigA'alureof License lumberor Gas Fitter
Title ase
Master
Mastterr License Number
City/Town RJourneyman
APPROVED (OFFICE USE ONLY)
Revised 05/17/00 - -
e
v
m
p a
CA
PK
O
a
m
a
z
0 .
m
v
O
D
m
M
N
v
m
m
O
z
N
z
v
r
O
m
O
CA
r
p
m
c
r
O
V
f
71
O
1
�
O
CA
PK
m
0 .
m
N
v
m
m
O
z
a'
v
r
O
m
T
-a
r
p
m
c
r
O
f
71
O
a
�
�
n
O
c
•
p
to .
O
D
T
O
=
�1
Z
A
MR
2 4 9 3 Date ........
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
Ar la� -C /, C 64,t�l
Thiscertifies that ......................... ............ .................................................
has permission to perform .. g. e :koh / .................................................
wiring in the building of ........
North s.
Iqat ....... / ........ f ...... . . ........
Fee ..... .... Lic. No.
r �C
�E P
Check #
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
1� ��i��i�����6 t`���'�C_.A�dJ�i� �� _mss nCw®.w.ia.�s
DEPAR7Afl7VT0FPUBLICSAFEN Permit No.
�M3
BOARD OFFMPREYEAWONREGM770AS527CIIR 12:00
Occupancy & Fees Checked
A PLICATION FOR PERMU TO PERFORM EL EOWCAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date--O'U
Town of North Andover To the Insp or of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number) / �/21�f/•E/�/��sG 2
Owner or Tenant 1190 T/•1 U/1
Owner's Address 6/2G_ EKG-G11lJ6-C- /14
Is this permit in conjunction with a building permit: Yes t��No ® (Check Appropriate Box)
Purpose of Building ,S/�t1(,/� ,�// Utility Authorization No.
Existing Service Amps U / 1! Volts Overhead Underground No. of Meters
Ni v Service �® Amps / Volts Overhead ® Underground No. of Meters
Number of Feeders and Ampacity
Locution and Nature of Proposed Electrical Work /yIfs��T��/N/�/�
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers
Total
KVA
No. of Lighting Fixtures
Swimming Pool Above
Below
Generators
KVA
and
round
No. of Receptacle Outlets
No. of Oil Bumers
No. of Emergency Lighting Battery Units
No. of Switch Outlets 1
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
i
_1
Dryers
Detection/Sounding Devices
k --No. of
Heating Devices
KW
Local Municipal
Other
1
® Connections
1-44o. of Water Heaters KW
No. of No. of
Signs
Bailasis
No. Hydro Massage Tubs
No. of Motors
Total HP
OTHER-
WodcbSM
Sigh ut cry ofpetjtey
FIRM NAME
EVirzem D&
Elima d VahrdEkcftical Work $
Ruga Fstal
• I•• t Ly • • •i �•
and � my �m this p�t� t waives this ttraer�t.
(Please check one) Owner Agent ED
Telephone No.
I1ar>SeNa
,--If 0 i i Ak TeL Na
WArgdegm�asmqLmWbyMmwbls&Urfr,iLzm
PERMIT FEE ! CJyv
-P
N
N2 9-294
Date ..... �.///.7***/"�"�*.� .....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ....... T..-.( ....... C., ....... ....... ..................
has permission to perform ......... 4
...........................................
wiring in the building of ........ C ..............................................
CA
....... .......... . NorthAmdover, Nw��
at ..... ......
17
Fee .... .... Lic. No..,,.4..1(,71r11 .....
�� �R'Q:i��PE&OR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
TI& oomoNwF.ALmoFMASSAC RsEm Office I e onnly9
DEPARTAIENTOFPUBLICS MYr Permit No.
BOARD OFFIREPREVE M0NRWM4TI0A S527CMR 120
Occupancy &Fees Checked
UVA4ppUCATIONFOR PERMIT TO PERFORM ELECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 1
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date `
Town of North Andover To the Inspector of Wires:
The undersigned applies fora permit to perform the electrical work d,jscribed below.
Location (Street & Number) ' %T—C C K e
ZC-(kCA__---
Owner or Tenant ca, rn
Owner's Address
Is this permit in conjunction with a building permit: Yes No �' } (Check Ap ropriate Box)
Purpose of Building 15fi �(ocqt— 6jR�hk oo PooV CLr�Utility Authorization No.
Existing Service *aoc) Amps12-0 olts Overhead Underground Q No. of Meters
New Service Amps'-` /-'- Volts Overhead Underground No. of Meters �r
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work �■� �d2, O rA -
A
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers
Total
KVA
No. i+f Lighting Fixtures
Swimming Pool Above
Below
Generators
KVA
and
ground
No. of Receptacle Outlets
No. of Oil Burners
No. of Emergency Lighting Battery Units
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS
No. of Zones
No. of Ranges
No. of Air Cond. Total
Tons
No. of Detection and
No. of Disposals
No. of Heat Total Total
Pumps
Tons
KW
Initiating Devices
No. of Sounding Devices
No. of Dishwashers
Space Area Heating KW
No. of Self Contained
Detection/Sounding Devices
Local � Municipal
Other
No. of Dryers
Heating Devices KW
Connections
4D. of Water Heaters KW
No. of No. of
Signs
Bailasis
No. Hydro Massage Tubs
No. of Motors
Total HP
OTHER
hstra mCaa-age, AlrstttofheteWn maisdk%mdltseZCtner lLaws
YES l...J
Iha�eaamartLiabtldyhstranczPbhyrtx3udmgCcmp O Caa'ageorits>tralecvaiat NO
lfimesthnibdvafidptooffof 10froliim YES M
No r Ifjmha%edwdWYFS,plemeudirr&ttte ofoomaWby ' the
fflxcpd*bcDLINSURANCE BOND O UMER r-1FeweSpeffy)
�iAPO �1 ��'i
FYnir,>tirn
WadctioSla:t
sigiteatadet�iePlS_gfnajt�y:e � r � (C'C�Y'y\C �} I �
FIRMNAME
n I V sigr> IHe
AAA- Cc me
OWNERS INSURANCEWAIVER;Iammm hatthelioam,edvymmw== Lien= >aw)s �J
ancl�atmys�ahaeatihispemi�appltwai�sdas�ac�teenad Sl �l/ • �/ d
(Please check one) Owner Agent Q y�
Telephone No. PERMIT FEE $
To whom it may concern: July 27, 2000
We hereby authorize Patrick McGrath to complete the electrical work that
was started by TCB Electrical.
Arthur Williams
z a C )4� v N A
Location PC()
No. Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee
Other Permit Fee
TOTAL
—2)6
Check # 5-
13689
�j
111114�,
"Building Inspector
I TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
Tis SeCtiOg for Uti"iciat Use 01d
BUILDING PERMIT NUMBER: n
DATE ISSUED:
If !/
L
SIGNATURE: ZIA101
Bu'In Commissioner/In ctor of Buildings Date
Clu^f'TiAN 1 CrTC 1NL`f%na ♦mT�X, f-
1.1 Property Address:
lredeem► �,l�.r�e.� Pel
1.2 Assessors Map and Parcel Number:
Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimarsions:
Zoning District Proposed Use Lot Area (sf) — Frontage ft --- -- --
1.6 BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard
Required Provide Required Provided Required Provided
1.7 Water Supply M.G.L ('.40. %.14) 1.5. Flood Zone Information: - 1.8 Sewerage Dieposal Syslen):
Public 0 Private 0 1 Zone Outside Flood Zone I:1 Municipal 0 On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
Name (Print) Address for Servicc
Signature
1.4 vwner of Kecora:
Name Print
Telephone
Address for Service:
Jam' CTION 3 - CONSTRUCTION SERVICES
ILicensed Construction Supervisor: Not Applicable ❑
Licensed Construction Supervisor:
bq f) AY Pfdb"4 Ilam Pd l�u�tltit��
Address
qjZ�' 17
Signalful-i Telephone
3.2 Registered Home improvement Contractor
Company Name
S
Address
T
License Number
__H- � 9 - D 1
Expiration Date
Not Applicable 0
1 �2UoL/
Registration Number
Expiration Date
SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Si ned affidavit Attached Yes ...... 2r--' No ....... ❑
SECTION 5 Description of Proposed Work check all applicable)
New Construction ❑
Existing Building
Repair(s) ❑
Alterations(s) 0/
Addition ❑
Accessory Bldg. ❑
Demolition ❑
Other ❑ Specify
Brief Descriptionof Proposed Work:
tI il�ll/` 0 U r�'� U 0 At L V,% c.� k ,M `Al f %e
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item
Estimated Cost (Dollar) to be
Completed by permit applicant
OFFICIAL USE ONLY
1. Building
o
(a) Building Permit Fee
Multi Mier
2 Electrical
clo
(b) Estimated Total Cost of
Construction
3 Plumbing
Z�S-O O
Building Permit fee (a) X (b)
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, as Owner/Authorized Agent of subject property
1-fereby authorize to act on
My behalf: in all matters relative to work authorized by this building permit application.
Sionature o1'O�Niier Date
SECTION 7b OWNER//AUTHORIZED AGENT DECLARATION
L e�L7-
i L t cA—r ea,i,r_ t as Owner/Authorized Agent of subject
propertv
1 lereby declare that the statements and inliamation on the foregoing application are tnte and accurate, to the best of my knowledge
and belief
Print Nan
Si nature o 0xvncr/A Fent Date
NO. OF S ['01ZIFS SIZI-{
13ASI1:MF.Nf OR SLAB
SIZE, OF FLOOR T lMI3I :RS I s 2' 3 RD
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
I lF.IGI IT OF FOUNDATION TFIICKNESS
Sl/F01: FOOTING X
MAT IJUAI, 01' C1 I1MNF.Y
IS 13MI]NNG ON SOLA) OR FILLED LAND
IS 13UI1,DII�IG CONNECTED TO NATURAL GAS I,INI;
BUILDING DEPARTMENT
DEBRIS DISPOSAL FORM
In accordance with the provisions of MGL c 40 S 54, a condition of Building Permit Number
Is that the debris resulting form this work shall be disposed of in a properly licensed solid waste disposal facility as
defined by MGL c 11, S 150A
The debris will be disposed of in:
Location of Facility
4., 7�?
Signature of Permit Applicant
17_06
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of
the Building Inspector
), r
•,i
t c71.
'33 BOARD OF BUILDING REGULATIONS
1 License: CONSTRUCTION SUPERVISOR
t Nwnbert CS 054843
..:i
!. gird 11/19/1970
;t Expil+ss: 11/19!2001 Tr. no: 9382
- - Restricted To: 00 .
' ERIC D TETREAULT
390 AMESBURY LINE RD j,i
HAVERHILL, MA 01830
Administrator
I�
HOME IMPROVEMENT CONTRACTOR
t Registration 112674
TYPe - OBA
Expiration 04/15/01
E.T. CONSTRUCTION
ERIC D. TETREAULT
AMESBURY LINE RD
ADMINISjggTpq HAVERHILL, MA 01830
The Commonwealth of iLlassac,�use!ts
--1'
Department of Industral_.'�cc;cents
GF ca of Imvestieaticns
Eoston, Muss. 02111
1111crker Come ensarlon lnsurai,ce
Flame Please P iriI 1
flame
Ciw Phcr,e
CI am a hcmecwrer Fe icrminC all work myself.
I am a sole crccrietcr 2nd have no one picrxina in any cacao I/
I am an ernbcver providinc Workers' compensation fcr my emPiGVeeS WCr;<Inc cn this fcb
COmcanv ncr"P' �— . I , Lli,\S -V(—VI.C,4r eA
Address 5, l o V)yL,,j Ltee -c 2
�� d �r. Phcnce j. �S fo s� U
Insurnce Cc. /V Dr -c .0 -aA-G1 _— P^lic / T ETk)L Sr Z 1-77(o
Ccmcanv name'
rens
Ci
Phnne r*
Insurance Cc. Pclic-i
Failure to sec:;re ccverace as rescues unser Sac:ion 2°.a or ,MC -L 15 con lege to the ;mcwiticn cr-nmir-ai cenaities of a rine up to SI .SCO.CO
ane/cr one years' ;mcnscnment as .ve!! as c:wi penaihes in tt;e rcrm (7, a S CF `r/CRK CRCE?1 arc a ire or (5' CO. CC) a day ;must me. I
understand that a cosy ci ;his zzmerrent may ce fcr.varcec to the Ct~;ce cr Investicaticns cr 'he GIA ;cr coverace verirca;icn.
1 do hereby car.,, und:
Clcnature q.
and cenalt;es cr re{ U—.at 'he inPcrmatren crowded accve is `rue arc cc res:.
I:a -= 3-0-00
Print name
EulldinG Cert
L -Te-*,-t-
~"Lid,
Phone=
6-M 5513
i- ea/th Geparment
C
Ghher
0`ic:al use oniy
Cc not write in this area to to ccmcietec
ty c:r/ cr ,c:vn cs.c:ai
C;tv or Tcvn p=rm;i/Lis ns nc
[Check ,T imrrefiate resccrse ,s required
Contac: cerccn:
C
EulldinG Cert
[;
LcanslnC Ecard
ce C -C,, 77an'S 01:1 ids
i- ea/th Geparment
C
Ghher
Soffit 12" out by 8" tall around bathroom
d?
0) d'
r
r
New pock t door
installed in all,
Delete plu in wall
N
60
15'9
15'6 64 3'11
Small recessed ights installed in Save existing shower
sorra for reuse if possible
Plug installed in base cabinet not end lights centered over sinks,
on wall center light centered on cab. base
1 \
w "o
install new
door with
opposite
swing
Relocate AC
duct into
bathroom
ceiling
-----------��
I \/ I
Carpet floor
Kick space heater
%" rec light
Rec light 8"
8" rec light
8" rec light
Exhaust fan only
Kick space heater
7'9 _1
Mud floor and tiled shower with
seat.
Toilet
relocated
with new
door
1
0)
N
.i
I�-
Power for light in
cabinet
il q
Existing
window to
stay.
Cf)
m
m
C/)
m
0
C y O Q y =
E . 0 .0 N!
coco 29c� � m
Z vi --4
o 0 MID. o �1
d .- d 171
O O O N O .-4
N O �m o =
> >CD o;
m �,o =;,
O
O y A � :
CCD
=rN
CL%cm . f
CD CC
C',
y
11�+/J p O1
C=A '
O -C`
W W o
C
CD.
G
o m
Woo o rwAr4b
O �0
,e
z C�
CA
il
O O
We:
CD
�0o m
Npo rm
0 0
CD:
O CD
CO)
.y
C v
;SCI
POI
F
CO)
v
O
1CD
Z
O
CD
C
CD
C y O Q y =
E . 0 .0 N!
coco 29c� � m
Z vi --4
o 0 MID. o �1
d .- d 171
O O O N O .-4
N O �m o =
> >CD o;
m �,o =;,
O
O y A � :
CCD
=rN
CL%cm . f
CD CC
C',
y
11�+/J p O1
C=A '
O -C`
W W o
C
CD.
G
o m
Woo o rwAr4b
O �0
,e
z C�
CA
il
O O
We:
CD
�0o m
Npo rm
0 0
CD:
Eg
f
0=1
0
0
c
9)
POI
�
�
�
z
�
o
�
C1
Eg
f
0=1
0
0
c
No 2001
Date. A le� - ��
..........................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
TA certifies
....................................
has permission to perform ....... ..... ... .
. ........ .. ..... ..........
wiring in the building of ...
at .... ................. North Andover, Mass.
.. ..... ........
. .... ..... .......
Fee? ................... Lic. No'�.F ....... R - ICAL - INsp - EcrOR .................
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
i
Department of Public Safety oGC1r„-y s ret Cheered `
Lvv BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 3/90 (serve baanr)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed In accordance with the Ma"aehusens Electrical Code, S27 CMR I2:00�j
(PLEASE PRINT IN INR OR TYPE .ALL INFORMATION) Date
City or Town of /�Y'Y I ��%(-Vyli To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical ,work described b
elow.
Location (Street & Number) . 0
Ou-ner or Tenant (iv/
Owner's Address
Is this permit in conjunction with a building permit: Yes ❑ No (Check Appropriate Box)
Purpose of Building Utility Authorization NO.
Existing Service Imps / Volts Overhead ❑ Undgrd ❑ No. of Meters
New Service Amps / Volts Overhead ❑ Undgrd ❑ 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 TKoVtAl
No. of'Lighting Fixtures
Swimmin Above In-
g Pool grnd. ❑ grnd. ❑
Generators ICVA
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 Zonts'
No. of Detection and, .
Total
No: of 'Ranges.: , ' ; < _
."
No. of Air Codd.. tons `.
Initiating Devices
No: 'of. Sounding Devices
4 " "
No. of..Disposals,
Heat Total Total"
No..ofs
_ •
_ s _ ., .... _
KW
rw
No: of Self Contained'
Detection/Sounding Devices
Local ❑ Connectio []Other
Connection
No. of.Dishwashers-•
S ace/Area Heating,., KW .. `. _
P g "."•
No. of Dryers
HeatingDevices KW
No. of Water Heaters KW
No, of No. of
Signs Ballasts
Low Voltage
wiring
No. Hydro Massage Tubs
No. of Motors Total lip
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
I have a currentLi ilit Insurance Policy including Completed Operations Coverage or i substantial
equivalent. YES eNO [f I have submitted valid proof of same to this office. YES or
❑
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANC6� VOND ❑ OTHER ❑ (Please Specify)
Estimated Value of E ectri work S d- G (Expiration . ate
Work to Start // Inspection Date Requested: Rough Final r Z4 9
Signed under the penal ies of ury:
FIRM NAME ItJ S LIC. N0. � e
Licensee •JQ_Yl(\ILS Signature LIC. NO.1� & 1 _
Bus: Tel: No.
Address- Alt. Tel. NO;.
OWNER'S-INSURANCE.WAIVER -- I am•aware that the Licensee does no .have the insurance coverage or its sub-
stantial
u -stantial equivalent as required by Massachusetts General Laws, and that my.signature'on this permit
application waives this requirement. Owner Agent (Please check one) ...
" Telephone No._ PERMIT FEF. S
Signature of Owner or Agent