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HomeMy WebLinkAboutMiscellaneous - 102 SUGARCANE LANE 4/30/2018.. a The Commonwealth of Massachusetts o:iicc Use Only Department of Public Safety e J Occupancy 6 Fee Checked / BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 3 .9L City or Town of tJ �)/�i��G°�%t' To the Inspector o Wires: The undersigned applies for a permit to perform the ee_ectrical work described below. Location (Street & Number) /0."- JL,' 4"Ver Owner or Tenant_i !� ,x �/If S �IJs1Jl1/s tfa6/a 0 Owner's Address Is this permit in conjunction with a building permit: Yes l'J No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization NO Existing Service Amps / Volts Overhead ❑ Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity No. of Meters No. of Meters Location and Nature of Proposed Electrical Work S, lrpUw o Q vy ,,y urs/.7 1-30o C No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. Generators KVA No. of Receptacle Outlets No. of Oil Burners No. o tsncy Lighting Batter Unif Emerge No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices" No. of Self Contained Detection/Sounding Devices Local Municipal ❑Other 11Connection No. of Ranges No. of Air Cond, Total tons No. of Disposals No. of Pumps Total Total Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers heating Devices KW No. of Water Heaters KW Not of No, of signs Ballasts Low Voltage Wiring No. Hydro Massage Tubs No. of Motors Total HP OTIIER: INSURANCE COVERAGE: ursuant to the requirements of Massachusetts General Laws I have a current Li ility Insurance Policy including Completed Operations Coverage or ir4, substantial equivalent. YES NO EJ I have submitted valid proof of same to this office. YES ®' NO If you hav�BO the ed YES,..please indicate the type of coverage by checking the appropriate box. INSURANCE ND ❑ OTHER ❑ (Please Specify) Expiration Date Estimated Value of Electrical Work $ Work to Start -'�� Inspection Date Requested: Rough Grii1-L Final ls,,,�_L L Signed under the penalties of perjury: FIRM NAME /t?L C _ J 1 E EC /?/ /a/tJ LIC. NO. �- •� s� Licensee Signature LIC. NO. Address Bus. Tel. No.--rcls- �D /� s/�iz 3�/ �%%��J7t�� d/�� D/ oe `1st. Alt. Tel. No. 014NERIS INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) PERMIT FEE S �(� • (/// Telephone No. Signature of Owner or Agent 1 (u ' �. S-. o x H � N Q i -J w .� c V ,•d ►` O ; z W 0 o 0 lo — REMARKS BY ELECTRICIAN: li- (u ' �. S-. o x H � N Q i -J w .� c V ,•d ►` O ; z W 0 o 0 lo — REMARKS BY ELECTRICIAN: li- 01 4C &MMUnWr# of fflaggar4agettli Mepartment of Public 2+ttfetg BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Only �G/ /a, Permit No. Occupancy & Fee Checked J� 3/90 (leave blank) 1 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 52i7�!� (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date(XW or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) l LnC CYy 6"y1 - Owner or Tenant C C,L(' /A 114C if t L c,� Owner's Address _-J&% / 4"Tog/y )Piet -TT— r—t Is this permit in conjunction with a building permit: Yes V. No ❑ (Check A e ox ::::D Purpose of Building 5,,4 G,1- �o�MI G -y wi L(,/.CVG Utility Authorization N Existing Service Amps _J .Volts Overhead 'El Undgmd ❑n No. of Meters New Service 461) Amps ��volts Overhead ❑ Undgrnd x No. of Meters _ Number of Feeders and Ampacity �� ( Location and Nature of Proposed Electripal Work' W 1 A"/ ,, ik% ' J (� �,,yL e i, 6±zzl C_ U14 L Cid', OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws ^ I have a cuont Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES %f-2 NO I have submitted valid proof of same to the Office. YES X NO � If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSU. iANCEA�_ BOND = OTHER �_ (Please Specify) (Expiration Date) Lr�pp Estimated Value of Electrical Work S , Work to Start Inspection Date Requested: Rough Final Signed under the Penalties of perjury: �j FIRM NAME b/)I n ' ie7-1 �f L L LIC. NO. Licensee �� �� r 7 )C*hV— Signature LIC. NO. �/ 4 ,/ 8 s. Tel. No. AddressdtJ ��'� ITT_ �t/r�PJ� "' Alt. Tel. No. OWNER'S IN WAIVER: I am aware that the Licensee does not havethe insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit applicaEion waives this requirement. Owner Agennt (Please check 'one) td Telephone No. PERMIT FEE 5 < (Signature of Owner or Agent) x-6565 Total No. of Lighting Outlets I No. of Hot Tubs No. of Transformers KVA No. of Lighting Fixtures Above Swimming Pool Abov ❑ I n- n - ❑ i Gene:atcrs KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Total No. of Ranges No. of Air Cond. tons Initiating Devices No. of Sounding Devices No. of Self Contained Disposals No. of Dis P No of Heat Total lbtal I Pumps Tons KW —� No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices Municipal li Other Local _ 11Conneruon _ Low Volta e g No. of Dryers � � Hoa.°nr,' Com•:^.yes No. of No of f.o. of Water Heaton, KW I Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws ^ I have a cuont Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES %f-2 NO I have submitted valid proof of same to the Office. YES X NO � If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSU. iANCEA�_ BOND = OTHER �_ (Please Specify) (Expiration Date) Lr�pp Estimated Value of Electrical Work S , Work to Start Inspection Date Requested: Rough Final Signed under the Penalties of perjury: �j FIRM NAME b/)I n ' ie7-1 �f L L LIC. NO. Licensee �� �� r 7 )C*hV— Signature LIC. NO. �/ 4 ,/ 8 s. Tel. No. AddressdtJ ��'� ITT_ �t/r�PJ� "' Alt. Tel. No. OWNER'S IN WAIVER: I am aware that the Licensee does not havethe insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit applicaEion waives this requirement. Owner Agennt (Please check 'one) td Telephone No. PERMIT FEE 5 < (Signature of Owner or Agent) x-6565 7KI Date.......... .......... 421 0 0 TOWN OF NORTH ANDOVER, PERMIT FOR WIRING This certifies that.... cp.al ...... .. .. .......................................... has permission to perform ...... wiring in the building of ..... C -f-4. C ............................................... V at ............ LI...................... . North Andover, Mass. Fee...'...... Lic. No. .. ................... ; ...................... ELECTRICAL INSPiCiOR— C r l 09/04/% 11:35 35.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer ''lir-•���'"�"�'�``� �.5,,���.;�.:-�'s�=w•-ti►x,.�'--"-'.,��"�;- � ..._ _. _ . Date.. �?..:....Q. / 381 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........ d.......t la5.......p.Q. �,�-�u �-t cl i?, ! has permission to perform .....1 V;Q;.ch%............'.. ......................�............ wiring in the building of ..... C �..I>, �.<a ! .... v. -. � 4. qy 9 !p at ...16.9. ...... cS.u.r�V f�t.dl.��t ..... ... , North Andover, Mass. Fee .... ! Lic.No...mCyd ................. WHITE: Applicant CANARY: Building Dept. PINK: Treasurer .r . ..'r w� { ~'011lco Uso Only r} �1je �DII1111QI1tueillfij Qftt13ttf1IUiaett1 y Pormlt No. 141lurttitcnt of Public $ttfctu Occupancy b Foo Chocked t/ BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/49 (loavo blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK .All work to be performed in accordanco with the Massachusetts Electrical Code, 527 C14R 12:00 rf (PLEASE PRINT IN INK OFEk�L, (NFZk�N�� r Date O '( City or Town of �J T� To tho Inspoctor of Wlros. The udorsignod applios for a ]pormit to rform tho electrical work described bolow. /� Location (Strool & Numbor)Vendor Code Olp�) Owner or Tenant e I 1 Owner's Address Is this pormit in conjunction with ct building pormit: Yo ❑ No (Chock Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps _/ Volts Ovorhoad ❑ Undgrnd ❑ No. of Motors Now Service Amps —J Volts Ovorhoad ❑ Undgrnd ❑ - No. of Motors Nurnbor of Foodors and Ampacity __ Location and Naluro of Proposed Eloclrlcal Work - T,f)WynT TAGE_A.LAIRM • PYgTPM No. of Lighting Outluts I No. of 1101 Tubs No. of Lighting Flxturos Swimming Pool Abovo grnd. Elgrnd. In• ❑ No. of Rocoptaclo Outlols No, of Oil Durn0r3 No. of Switch Outluts No, of Gas Durnors No. of 110(1903 No. of Air Cond. Total tons No. of Disposals No.of Hoat Total Pumps Tons Total KW No. of Olshwashurs Spaco/Aron Hoofing KW No. of Dryors Hooting Dovicos KW No. of Walor Hoalors KW No. of No. of Signs Ballasts No. Hydro Massago Tubs No, of Motors Total HP OTHER: No. of Transformors Total K VA Gonoralom KVA No, of Emorgoncy Llghling BaUory Units FIRE ALARMS No. of Zonos No, of Dotocilon and Initiating Dovlcos No. of Sounding Dovlcos No. of Suit Contalnod , Dolocllon/Sounding Dovlcos Local Municipal Conn ctlon g Other LowVolt.goBurgFire Wiring Q Card Access CCN INSURANCE COVERAGE: Pursuan! 19 the r^gviromonts of Massnchusntls gonnral Laws I havo a currant Liability Insura(1co Policy including Complotod Oporolions Covurago or Its substantial oqulvalont. YES O NO O 1 havo subrnittud valid proof of so n1 to tho Oflico. YES O NO .0 11 you havo chuckod YES, ploaso Indlcalo Iho typo of covorago by chocking Iho appropriato box. INSURANCE a BOND O OTHER (F'ly o S_ poa1y)10/8/9�_ Estimatod Valuo of Eloclrical Work S _ (Expiration Data) Work to Start Inspoction Dalo Roquustod: Rough — Ft Sipnod undur the Penalties of pur)ury: �. J FIRM NAME aecurity Systems, Incd/b a Sentr P o e ti LIC. No. 109 C Uconsoa J��1T1eS W _Leg Signature 000080 ._LIC. N0. (Pil2lO Addross 110 F'lSf-rl#- Nlilrn Bus. T.I. No. 617-388-9700 Safety) All. Tol. No.QgS QHS OWNER'S INSURANCE WAIVER: I am sworn that Ilio Llconsoo clou3 not havo tho Insuranco covorago or Ila substantial oqulvalont as re- quirod by Masaachusotts Gonoral Laws, and thal my slgnaluro on thla pormit application walvos this roquiromont. O.Nnor (Pluaso chat'.. ono) Agont ^tel —.. Toluphono No. PCRMIT FEEr,- _\W (Sionaluro of Owner or Agoni) N2-'1 3 Q 9 �//.�..�. .aDate...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....... e C u i vh has permission to perform .... .... .... ........................ �.�s........................... wiring in the building of ........ ...... ................................... at ... ......... ..............................Z' (V........... ,North Andover, Mass. . Fee..,-). 06 .5 ...:......... Lic. No. 1 ELECTRICAL INSPECTOR f # 2/05197 11.16 35.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Loc -tion ,No: Date N°RT" TOWN OF NORTH ANDOVER I-. Certificate of Occupancy $ Btiiiding/Frame Permit Fee $ Foundation Permit Fee $ mer Permit Fee $ Sewer Connection Fee $ YVater Connection Fee $ TOTAL . $ >' Building Inspector g 11:24. 47.50 PAID i Div. Public Works 0 Z O 0 LL 4 O W N N O \� a N ZLL N� 8 C m z o uoI i d 0 W > N W0 I W 0 F U. 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WILLIAM C POULOS Pesach bottom, fold sign on 92 S BROADWAY +, back, and laminate license card. LAWRENCE, MA 01843 ,Keep top for receipt and change '/of address notification. fie V/ Oill7i))ZO�I2LIIP.CLl�Ci2 a�✓�%raoar/�,�.�aP,tla DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Nu®berg Expires: Birthdate: 6:141.0103-* ; 0111911991 0111911960 WILLIAM C POULOS 92 S BROADWAY . LAWRENCE, MA 01843 Restricted To: 00 00 - None lA - Masonry only 1G - 1 & 2 Family Homes Failure to possess a current edition of the Massachusetts State Buiilding Code is cause for revocation of this license. FORM U - VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: 3tt.�_ F C�f/l�S ( rc�r/�fliNl <//J�f Phone LOCATION: Assessor's Map Number Ibfc Parcel Subdivision Lot(s) Street IInnSu�I��C,�i,�%F LA�� St. Number 1 6-Cn 01 *** ***** *************Official Use Only************************ .W' 6MCAT OF TOWN AGENTS: i �AservNa'tti$n Date Approved Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments I Date Approved Food Inspector -Health Date Rejected f4, _fes Date Approved Septic Inspecf-or-Health Date Rejected Comments h/o Oil 3 Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date SUGARCANE LANE R=60' L=100' AV a1 AS -BUILT SEPTIC SYSTEM LOCATED IN NORTH ANDOVER, MA. SCALER"=40' DATE: 7/20/96 Scott L. Giles R.P.L.S. 50 Deer Meadow Road North Andover, Mass. LO 7 AIR r� 2A 5V F CHRIS 1. "A)A) aJr IA/Vi S59- / u s9 iu r"I PajiF LrtuF , A1. Xu EP, MR Z00 14 S3119 111008 5tr9229 805 9 Ct:8T 96-£2-L0 4 Location A No. Date Other Permit Fee $ Sewer Connection Fee $ Water= Connection Fee $ TOTAL $ Building Inspector 06/11,/,96 13:3 7 g�1.95 .. PA�p, Div. Public Works VOW, TOWN OF NORTH ANDOVER p Certificate of Occupancy $ > ; • moo, Building/Frame Permit Fee $ .•>'• Foundation .Permit Fee S Other Permit Fee $ Sewer Connection Fee $ Water= Connection Fee $ TOTAL $ Building Inspector 06/11,/,96 13:3 7 g�1.95 .. PA�p, Div. Public Works 'Loc ation No. bate /Z i5 9i ". NpR*h TOWXOF NORTKANDOVERof . A Certificate of Occupancy $. Building/Frame Permit Fee $ s�CMUSE. Foundation Permit Fee $ `- Other Permit Fee $ w. y" Sewer Connection Fee $ AX, '774 Wntar r..nnnantinn Faa - !D7% S� TOTAL $ �L r _--Building c or r T Div/P49iic works Location , No. Date . N°RTM, TOWN .OF NORTH ANDOVEM y' A Certificate of Occupancy $ } Building/Frame Permit Fee $ Foundation' Permit Fee $ ! D6 J�cNus t a Other Permit Fee Sewer Connection Fee.. $ LO Q. Water Connection Fee $ TOTAL $ 8 Building Inspector 9788 Div. 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This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: dL &,C_ Phone 7 320 LOCATION: Assessor's Map Number %off 9 Parcel % y Subdivision �7 041GS Lot (s) Street S'orAa tgwA- t St. Number 16Z 0.0 fficial Use Only************************ RECO ATIO S AGENTS: 79 Date Approved l�/ r Conservation AcTmiAlstrator Date Rejected Comments P /7 � / Date Approved Town Planner Date Rejected Comments Food _'Inspector -t�o-r-Health Gi•� it 1 /�i/L/� Septic Inspector -Health Comments Date Approved Date Rejected j Date Approved Date Rejected Public Works - sewer/water connections `% j��-cJ z - �S - 7 W -i Fire Department Received by Building Inspector Date 5 b4 - DL+ 41t v v C 1 l� IN Oma- 1 •1.� �� ,� O\ JER * I01 1., CQqR a OU� a U A:z 0 �u� W \ 0-4 {!1J� i.., � �1�J✓ w � \ O fir V, w w~ /j p 0 z r C N � ~ CD m " /y W Woo CD w CO o G oo bG v:3 :3u. v� 0 U u. 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RM -n m n `fin n z 3 3 X X X X X X X X xa C x cs �E as a a � xxm a % as �a a x NN, xx x x x a a R a 0` Z N x N x N x N x N x N N x r x x x x x xa a v, • 41 l'�•� 1 r 'I' O 4 a �2 0 :o ca X � o ■ Q r 'I' � A x o 6 m a � 0 X a � A x O 6 m a � 0 X a � t � N b � r CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number____Date��j?ad--rP, Sy r� C� THIS CERTIFIES THAT THE. BUILDING LOCATED ON MAY BE OCCUPIED AS __ S%^'� : �_�"'--- �- -� ``-'c ,L,l�'ul -- IN ACCORDANCE WITH THE PROVISIONS OF THE. MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CRT CERTIFICATE �j y i. FICATE ISSUED TO _.10 49 -T" iz i,; 1�r S-M� t� ♦._. 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