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Home My WebLink AboutMiscellaneous - 1077 OSGOOD STREET 4/30/2018 (21) 1077 f i i i i i ration A-1-7 0-j OT-0 ori S 7 o. 5 -0 3 Date of` &ORT" TOWN OF NORTH ANDOVER11 p Certificate of Occupancy $ o }�a Building/Frame Permit Fee $ 6v C Us`� Foundation Permit Fee $ Other Permit Fee $ — - Sewer Connection Fee $ Water Connection Fee $ TOTAL Building Inswor fi 9501 1 - ' 9 50 1 Div. Public Works t PER11IT NO._ >(o n 3 APPLICATION FOR•PERMIT TO BUILD — NORTH ANDOVER, MASS. LOO..' PAGE 1 n MApP d40. � LOT NO. c-4- 2 RECORD OF OWNERSHIP IDATE BOOK :PAGE ZONE I SUB DIV. LOT NO. I LOCATION�� 'Q PURPOSE OF BUILDING _Up JJ C. rte. OWNER'S NAME h00%o vc-c /0H0,-,-o OF /�i NO. OF STORIES SIZE OWNER'S ADDRESS /0 r7/J f)Saoc_o -'r,— VAilT Ok 7 BASEMENT OR SLAB V ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD ZUILDER'S NAME ] /" /� c SPAN -- DISTANCE TO NEAR ST BUILDING r ' (sQ DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION TELA i �t,r, u� IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST o dbr�, PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. y ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILLED AND /APPROVED BY BUILDING INSPECTOR DATE FILED YYY BUILDING INSPKCTOR SIGN U E OF OWN R ORA ORI ED G JV FEE OWNER TEL.# •PERMIT GRANTED �j �! 0 CONTR.TEL.# /7 19 CONTR.LIC.# 0 ` L? I 7 / ? H.I.C.# a0��-�_ BUILDING RECORD ' 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM - MULTI. FAMILY OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE B I 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL (TNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ '1 72 1/ FIN. ATTIC AREA _ N_O B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH _ ASPHALT SIDING HARDIIJ'D _ ASBESTOS SIDING _ COMMON VERT. SIDING ASPH.TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. 8 FIOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR 1--i POOR ADEQUATE NONE 5 ROOF 10 PLUMBING " GABLE I HIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. &COLS. HOT W'T'R OR VAPOR - WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T ELECTRIC 1st 13rd I NO HEATING NORTH F ToVM of over No.96'0 3 ' - dover, Mass. ►3u 2 1991 COCHICHEWICK ORATED 5 BOARD OF HEALTH PERMIT T Food/Kitchen Septic System THIS CERTIFIES THAT14.Nru.......... . iR. t. Dt .Pl.�f��...� ••• � FoundationIDING INSPECTOR BU "� ................ uildin s on I.. O! ►.�'�' '�lv..y`........7 has permission to wrt....................... g . . ....,�............. . .. . .... .......... . ../ .... Rough to be occupied as........................... P..... *... ..................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR • � �� N � Rough Mdip�/�1 ""'`r""�' ' ............................................................ Service �r �� BUILDING INSPECTOR O� �a�� Final PAP ld1Occu an Permit Re ureo ccu uing GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough P Y P Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. Smoke Det. FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. *****************Applicant fills out this section***************** VAPPLICANT: 12 , �c�c� 17 . l� 01�,.� Phone Sa-t LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) reet 10'Z-7 Oscr o c:J St. Number Use Only************************ RECO DA O S317 . TO AGENTS: Date Approved Conservationminis rator Date R jected r 2 � Comments � - Date Approved Town Planner Date Rejected Comments _ {> C '�QJYYLa CQJIL� Ztt'\Q A a`_Uy I naa n )(19 Date Approved Food Inspector-Health Date Rejected __'J'J /at-L't-) Date Approved Septic Inspector-Health Date Rejected Comments //O ��GN��C� OF G�yE/iliC�G s �it/TD <SE�i�T/G S ySTerry OPV //D1-r `�/ O/9 D lam- E,e/L!/J7Er� Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date Richard D. Nolan 1 Edward Court Haverhill, Massachusetts 01830 i October 25, 1995 i Mr. D. Robert Nicetta Inspector of Buildings Town of North Andover 146 Main Street North Andover, MA 01845 Dear Mr. Nicetta: As you know, I am attempting to secure a permit to operate a.retail store that is to be located in the new Butcher Boy Plaza on Osgood Street in North Andover_ This business, known as Advanced Photo of North Andover, will offer one-hour film processing, a portrait studio, picture frames, and the sale of photographic equipment and services to customers. Given that this plaza is in a protected watershed area, it has become necessary for me to plan for the rental of an additional site for the entire film development portion of this business. This other location is at 210 Holt Road in North Andover. As a result, there will be no picture development or chemical-based activities at the Osgood Street facility. In accordance with the guidance given to me by Susan Ford of the Town Health Department, I am providing you with the following assurances: 1. 1 understand that film processing at the Butcher Boy Plaza site is prohibited; 2. 1 understand that the storage of chemicals at the Butcher Boy Plaza site is also prohibited; 3. 1 understand that a violation of these prohibitions may result in the loss of a permit to operate this retail business. I have attached a copy of the site plans for both the Osgood Street and the Holt Road locations. Please note that the film development machines are situated at the latter site. Con- sequently, all such activity must occur at that facility. It is my hope that this communication will resolve any uncertainty on the part of town officials and that the appropriate permits will be forthcoming. These are very much needed in order for us to not loose options on equipment and fixtures. Thank you. i Sincerely, Richard D. Nolan i c: S. Ford File Attachments(2) LTNA1095 MSW.1002P Interoffice Memo Date: 10/18/95 To: Bob Nicetta, Building Inspector From: The N.A. Watershed Council Susan Ford, Health Inspector Subject: Proposed Photo Processing Establishment In response to the proposed photographic processing establishment, the Watershed Council has the following comments. The Butcher Boy Plaza is located within the Watershed District which protects North Andover's water supply. The committee has found that the proposed use of photographic processing is not a permissable use within the Watershed. The Watershed Bylaw, section 4.136, paragraph 3 a iii, 16, specifically refers to photographic establishments as a prohibited use(see the attached copy of this section). There is no appeal avenue for prohibited uses in the Watershed Bylaw. However, if the establishment proposal is altered to eliminate all chemical processes on the premises, as discussed with the Town Planner, the council could support the project. This approval would be contingent upon a binding agreement which would prohibit any use of processing chemicals on the premises. If the intent of the establishment is to process off site, please indicate the location with your proposal and your intended method of operation. In addition, the agreement would state that the owner of this establishment understands that any violation of this condition would result in the revocation of the permit to operate. The Watershed Bylaw has been adopted to protect North Andover's water supply by the residents of the town. It should be understood that at this time there is no intention of the council to recommend any alterations to this bylaw. Any hardship that is incurred by the applicant by choosing to locate under these circumstances will not be a compelling factor in future actions. If this option is one which the applicant would consider, please contact us for further recommendations. Please feel free to contact me if you have any further questions regarding this issue. cc: Dick Nolan Watershed Council TomYameen Kevin Mahoney, Acting Interim Town Manager CrT25 " srroa fZ i�T✓-�-�1 t-. 14D��cGD Pr�o—o C�Sb NdRT rt NDavE►^� 6� LA C-4 rr 7 G o T7 oS4eoD 5Tv2EE T D ► sn �►� y 16 4-S R P IS Ptr}y PQM Preis-u� TAX Gv3'Tb►'�� oQ.K ri,�pla DrS�'l.fl�y •�.J�l�1 w.t« S�uD1p � I v b' moo,R 10� 4 , WaR1L a-O � X 4�0 � RtsR R � 00 l CERTIFICATE OF USE & OCCUPANCY Town of North Andover • f j Building Permit Number q(o- b 3 Date 70fv WAR, S i THIS CERTIFIES THAT I THE BUILDING LOCATED ON 15)11 O5G,001) STL1��'► - "Z MAY BE OCCUPIED AS 7--A1A i L Pt�� &AnP No SYR-cP1 YN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO /ADVAWFh!j".CILNa. p ADDR S o I �N„s�`y. � Pt�o S-1vO�c, 0K4y 'Old Building Aspector f '��oC.EsStN� �UwWI� - 1 1 f I I s Offtce Use Only / The Commonwealth of Massachusetts t ��Perak W. Department i:,f public Safety Occupancy S Fee Chocked BOARD OF FIRE PREVEN'r'.ON REGULATIONS S27 CMR 1200 3/90 cleave Eland) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetu Electrical Code, $27 CMR 12:00 (PLEASE PRINT IN INK OR TYPE A-L INFORMATION) Date 91� City or Town ofe7& To the In.;pector of Wiress The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number)— Owner or Tenant Owner's Address 6)77 Is this permit in conjunction with a building permit: Yes ❑ 110 ® (Check Appropriate Box) Purpose of Building Utility Authorization NO. Existing Service Amps / 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 tlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators INA 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 No. of Detection and tons Initiating Devices No. of Disposals Heat Total Total P No. of pumps Tons KW No. of Sounding Devices No. of Dishwashers Space./Area Heating KW No. of Self Contained Detection/Sounding Devices No. of Dryers Heating Devices KW Local❑ Municipal []Other No. of Connection No. of Water Heaters So f Ballasts WirLow Voltage No. Hydro Massage Tubs No. cf Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance I'Olicy including Completed Operations Coverage or its substantial equivalent. YESU@ NO ❑ I have submitted valid proof of same to this office. YES M NO ❑ If you have checked YES, please indicar.e. the type of coverage by checking the appropriate box. INSURANCE Q BOND [] OTHER ❑ (Plea::e Specify) Estimated Value ofElectrical Work $ (Expiration Date Work to Start ` � Insp :ction sate Requested: Rough Final Signed under the penalties of perjury: FIRM NAME 4*2 (� LIC, NO. Licensee /_&,1_1 6_7-- Signature LICNO., Address . , d1,Pv`- �T L wY Y►'l_.i� Bus. el. No.__.S<s -'!1,-1 S _ OWNER'S INSURANCE WAIVER: I am aware :hat the Licensee does not have tht. Tel.insurance Com T g or is su'- � K stantial equivalent as required by Mas.;achusetts General Laws, and that my signature on this permit application waives this requirement. ',w4ner Agent (Please check one) _ Telephone No. PERMIT FEE $�� Signature of Owner or Aeent • - // �...! Date............... 1-' 479 t HORTN 1 `.°.,° TOWN OF NORTH ANDOVER + PERMIT FOR WIRING �,SSACNuSE� This certifies that ........./ ...t\j..�............................................................... has permission to perform .........��..C....rZ.�.........�.T.................................... wiring in the building of.........A.e�A...fi...l-.�.0�t.�.................................. at.....V.!.�.A.4.k.t-A...�''f.....t".L. ........................ .North Andover,Mass. Fee... .S..:vU... Lic.No...1 Y..?16q............................................................ R ELECTRICAL INSPECTOR C 09/30/96 13:40 25.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Location OSG Cr� '17- No. 3 Date o ^T� TOWN OF NORTH ANDOVER p Certificate of Occupancy $ s Building/Frame Permit Fee $ b �� Foundation Permit Fee $ s�CH 1 Other Permit Fee $ z Sewer Connection Fee $ Water Connection Fee $ _ TOTAL $ (&uilding Inspector .- 93'79 Div. Public Works d Danny Y.Chang Joddi S.Chang 13ART& FRAME SOURCE, INC + • Creative Custom Framing•Framing Needleart • Serigraghs/Lithograghs•Art Posters&Prints •Limited Editions•Framing for Industry Methuen Mall 90 Pleasant Valley St. Tel.(508)686-7856 Methuen,MA 01844 PERMIT NO. S-21 APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP h40. LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE a — i ZONE SUB DIV. LOT NO CSS L *14 OCATION �- D PURPOSE OF BUILDING Lw to-q-71- o-s 06D �+ WNEWS NAME /1� & NO. OF STORIES SIZE --DPvo ON OWNER'S ADDRESS ?7. ; ll..' ASEMENT OR SLAB ARCHITECT'S NAME N t IZE OF FLOOR TIMBERS IST 2ND 3RD UILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR " " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. JtQISIIi. COST N t ` PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR ✓D/A FILED ILDING INBP[CTOR F E E S'^ OWNERTELAI PERMIT GRANTED CONTR.TEL.# 19 ' CONTR.LIC.k H.I.C., BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY _ S ORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. ~ CONSTRUCTION n 2 FOUNDATION 8 INTERIOR FINISH n CONCRETE B I 2 13 CONCRETE BL'K. PINE BRICK OR STONEHARDWD PIERS PLASTER _ _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. 8 M'T' AREA _ l/ 1/2 1/ FIN. ATTIC AREA _ N_O B MT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARD"'D _ ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. b FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAMESUPERIOR _ ADEO ATE I� NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) _ GAMBRELMANSARD TOILET RM. (2 FIX.) FLAT A SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER i ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 6 COLS. STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 1-3'dNO HEATING G NORTH ToVM of over 0 . No. 5 72 " � br dover, Mass., *t"ON B� 8 199,5 w,CK Al �RATEO PP��.(� BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT../� 6U...... .. ....... !111M`t.... ......� a .................................. Foundation r has permission to erect....CO. .... buildings on .. 6l..)....O.S ............ .......... Rough ...�� . ..... u to be occupied as.To.A .... ' '^. ..........rkg.L......A(. rte{ AML..... ....................... Chimney tin this permit shall in eve respect conform to the terms of the application on file in provided that the person accepting p every p Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings In the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRE IN 6 MONTHS Final UNLESS CON U 'T' ELECTRICAL INSPECTOR Rough Service BUILDING IN CTOR Final ' Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. 11 ' � r T �-. LM 3'0 M . L.Aq. I�KTS . S� O� � N �Xu- NORTH F Town of over OV J. " MBeV_ R 1911S_ob dover, Mass., (OCHICIILWIC.N %ADRATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System y BUILDING INSPECTOR THIS CERTIFIES THAT..�Cl6US., ...... ....... !1K1�{`t......1...... A1� .................................. Foundation has permission to erect..... �4 .... buildings on ..W1-)....�.�,41�?............ ............. . .....�� Rough .. to be occupied as...�l�/ ► ...f"1 '..4! .......... 1 .... ` 1�A. .M .....wSt�....................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Fin this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of ' Buildings In the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRE IN 6 MONTHS Final UNLESS CON U "r ELECTRICAL INSPECTOR Rough Service BUILDING IN CTOR Occupancy Permit Required to Occupy Building ' GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DE ARTM Until Inspected and Approved by the Building Inspector. r Burner Street No. Smoke Det. Ill ` { CERTIFICATE OF USE & OCCUPANCY Town of North Andover f a .•Building Permit Number a THIS CERTIFIES THAT -r THE BUILDING LOCATED ON t0-1-? r MAY BE OCCUPIED,'AS Aar*TkA►nE &mP —249A Ugehi IN ACCORDANCE t WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND i SUCH OTHER REGULATIONS AS MAY APPLY. o ,..•. 1.,�o CERTIFICATE ISSUED TO hiltu .. ! ip F�+ .tr. •-•.• � ;; • ADD 5 3 °• � Building Inspector +f , 11t1t1t�. C 1 idle t!ltTII1IIIUlIt'JCi(IIII Lit aiiascl7u�ctt Deparlrnent of Publir Sajky Permit No. _ BOARD OF FIRE PREVENTION REGULATIONS 527 CMR. 12:0(1 Occupancy d I,r• t I„•c knl Am (leas%,hlankl APPLICATION FOR PERMIT TO PERFORM FI_ECTRICAI_ ' 'FORK All work to be perfurtmcvl in accordance with the Massachuww.rl,timit-it CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date City or Town of - N 40e� l,• tl,r. Inc(,rrtnr of Wit-- The undersigned avplies for a permit to pt+rfoon rho electrical work dt,scribed below. ,I Lowlier (Street R Ntutthert Owner or Tenant �i8 fJ Yt/9►s7� T — J Owner's Address Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building 11tility Aotltrui7atinn No. Existing Service _Amps / Volts Ovethr•ad 0 Undgrd ❑ No. of Meter, New Service Amp- ► Vo!ts th•erl:r.,rl ❑ Undgrd ❑ No. of Meters Number of Feeder, and Ampacity Location and Nature of Proposed Electrical Work (()TAI. No.of Lighting Outlet, No. of I•lot Tubs No. of Transformers KVA Above In- No.of Lighting Fixtures Swimming Pool grnd. ❑ grnd. c;-Ilf•ratort K\'A _ of Emergency Lt�!huny. No.of Receptacle Outlets No. of Oil Burners li.wcrV Units No.of Switch Outlets No. of Gas Burners FINE ALARMS Nn of 7om- lot'' No of Detection and No.of Ranges No. of Air Conditioners Tons Initiating Devices Heat Total lol.11 N,,. of Sounding Devi(— No. e:a—No.of Disposals No. of Punifis Tons K\V N„ of Self Contain,-d — 1 virction/Sounding 0i vo,•. No.of Dishwashers S rtcel/\rea I Ivatin KW Mv;,Irit,.4 ((''�� - local❑• Connection L_ (Mier No. of Dryers Heating Devices K\v No. ot No. ol 1,,,•: Voltage No.of Water Heaters KW Signs Ballasts \Firing No Hydro Massage Tubs No of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Mnssachosttes Genera! Laws have a current Liahility Insurance Policy including Completed Operation,Coverage or its cuh,tanti.,l ,•,Ini,nlrmt. YES C: NO) ' ! h.,,,••.uhrnittwl v.,!id pr—,. of same.to this office. YES U NO O If you have check(vl YES, please Indicate the type of coverage by checking the appropriate ho\. INSURANCE ® BOND ❑ OTHER❑ (Please Specify) ^ r�� ' (Expiration Dat,) Estimated Value of Electrical Work$ Work to SWR Inspection Date Requested: Rough Final Signed under the penalti%flfIpRrjfy l�'agller�afif FIRM NAME IFN+ LIC. NO. Ucensee Sox 633 23 Mair St, Signal LIC. NO. l Address Atkinson, N.H. 03812 Bus. Tel. No:6:2 / ( Alt. Tel. No. .OWNER'S INSURANCE WAIVER:I am aware that the Licensee.does not have the insurance rovr,.wn or it<.oho;intial Pryuivalent as rrgtiired by Masrac'hu�rm .General Laws,and that my signature on this permit application waives this requirement. O)-%nvr \I: nt (Please check one) /) Telephone No. PERMIT rFr Sd•cu - (Signature of(honer or AgenU Date.....��`�/.�.... .. 2703 t HORT1�1 e - '" TOWN OF NORTH ANDOVER PERMIT FOR WIRING SSAC14US� This certifies that ..... ..?..'...i.`.!'. .:./)(( ,lf�[a�?..t............................ has permission to perform �'h'e....1..........,l f wiring in the building of........�` . .c � ......`1�. ....�� . ........................ at...... ....... ... ........................................ .North Andover,Mass. s Fee..-5' .)... Lic.No.1:7.Y#............................................................... c ELECTRICAL INSPECTOR 7"/95 11:24 50.00 PAID H WHITE: Applicant CANARY:Building Dept. PINK:Treasurer GOLD: File