HomeMy WebLinkAboutMiscellaneous - 114 BLUEBERRY HILL LANE 4/30/2018 114 BLUEBERRY HILL LANE
/// 2101098.C-0093-0000.0
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!3? ..,„``_...•�,�o� TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
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This certifies that ............. /..u.............�- I �C.... ��..`.. .
has permission to perform
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wiring in the building of .
,. at... `1.:..;/.....I�.l.....:.. Z.... ,North Andover,M%
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Fee....�.:�..:�..... Lic.No1... � �1/ ..........1... ..:...........
Check #
ELECI'R16AL fgISPECfOR
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FOccupa
Official Use Only
/�LjePar[nlan[o�}iia �ervice�
BOARD OF FIRE PREVENTION REGULAT ONS nd Fee Checked
� ev. 11199] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to he performed in accordance with the Massachusetts Elcctricaf Cod (iIN1EC),527 CitIR 12.00
(PLE,ASE PRINT IN INK OR TYPE,ILL NI' AL 1170tV) Datc: vZ
City or Town of: J To the In )ector of!Wires:
By this application the undersigned gives notice of hA!"';
r intention to erform the electrical,work described below.
Location (Street & Number) /
Owner or Tenant p�
Owner's Address Telephone No.
Is this permit in con]unction with a building permit? Yes ❑ No
(Check Appropriate Bos)
Purpose of Buildingljylr;l,� Utility Authorization No.
ESIShIIg Service Amps / Volts Overhead ❑ Undgrd
❑ No.of ilIcters
Nely Service Amps / Volts Overhead❑ Undgrd 0
Number N
f Fe _1 tD. of letersa
L`. seders aIIII ARIpaClty
Location and Nature of Proposed Electrical Work: U 00
AW�J
Cunrnletion o(dre(oUuninQ table may be n•aived by the Ins ccro,•of jVires.
No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Falls No.of Total
Transformers KVA
No.of Lighting Outlets No. of Iiut Tubs Generators KNIA
No.of Lighting Fixtures Swimming Pool Above ❑ In- ❑ i o.o mergence lg lung
5 crud. end. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARII,IS No.of Zones
No. of Switches No.of Gas Burners No.of etection and
Initintin-Devices
No.of Ranges INo.of Air Cond. Total
Tons No.of Alertina Devices
Heat Puulp I `lumber_ Tons !K1V iVo.oCSetf-Contained
No.of Waste Disposers Totals: I I Detection/Alerting,Devices
No. of Dishwashers SpacciArea Heating XNV Local ❑ ttiiuuicipal
4 I Connection ❑ Other
No.of Dryers Heating Appliances h1V Security Systems:
No.of Devices or Equivalent
No. of Water I1Vo. of inn, of
K1V Data VJiriv--
IIeatcrs Sins
Ballasts No.of Deviccs or Equivalent
No.H)'droinassage Bathtubs No. of,llotors Total h1P Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:
Attach additional detail ifdesired, oras required by the Inspector of;Vires.
INSURAINCE COVERAGE: unless waived by the o%veer, no permit for the performance of electrical wort:may issue unless
the licensee provides proof of liability insurance including "completed operation"coverage or its substantial equivalent. 1'lle
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuin.office.
CHECK ONE: INSUYLANCE Z BOND ❑ O-I-HER ❑ (Snecify:) ?w�Giaout
Estimated Value of E! ctr al Work: �— (When required by municipal poli (Ex)<iration Date)
cy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
I certifj•, under tete pair and penalties of perjun•,tl:at the information all this application is trite and comple'te.
FIR,II NAVE: j;1 �t<�� 71Z�C' Cly 1 d_ LIC.\O. ,�S
Licensee: //I-/, D -./2 Si;filature �
(If applicable. enter -exempt"in the license numbline.) 4 -
/ X"',/��D�>dliz Ci/�5�f Bus.Tel.No. '
Address: Shy C/�ic'/�// /YG Ce D Alt.Tel.No.:
OWNERS INSURANCE N'AIVLR: I am aware that the Licensee does trot have the liability insurance coverage normally
required by lag. By Itiv si,_nautrc below, I hereby xvuive this requirement. I am the(check onc)❑ owner ❑ owner's aeent.
Owner/Agent
Signature 'I•c!ephon,e No. [P1_-R_1_r1T FLE•: S /J
3
Location
No. Date
'AO TOWN OF NORTH ANDOVER
AGAI&iviu
p Certificate of Occupancy $
: Building/Frame Permit Fee $
fur
ESQ' Foundation Permit Fee $
s�CMus
F
Other Permit Fee
k Sewer Connection Fee $
is Water Connection Fee $
TOTAL $ 3�—
I`
Building Inspector
€. �� 7830 Div. Public Works
PERMIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1
MAP 4d0. LOT NO. 2 RECORD OF OWNERSHIP IDATE (BOOK :PAGE
ZONE I SUB DIV. LOT NO. (
OCATION PURPOSE OF BUILDING !� 0-440
.�WNER'S NAME NO. OF STORIES 'CAS' SIZE
gWNER'S ADDRESS Com' ��p BASEMENT OR SLAB
ARCHITECT'S NAME y� �►/ SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME n L,®� n��,�Bf 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. BLDG. COST
PAGE 1 FILL OUT SECTIONS 1 - 3
EST. BLDG. COST PER SQ. Fr.
PAGE 2 FILL OUT SECTIONS i - 12 EST. BLDG. COST PER ROOM (f P!)
46
SEPTIC PERMIT NO.
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
c
PLANS MUST BE FILEDAND APPROVED BY BUILDING INSPECTOR
DATE FILED i,/ 4 o
&Z
—1 -�^�/ RU ILDI NO INSPECTOR
-SIGNATURE OF OWNER ORVITHORIIIED AGENT
r L,l
E E � ' Z OWNER TEL.#
PERMIT GRANTED CONTR.TEL.N
CONTR.LIC./1 7
H.I.C.b �l� 3 3
BUILDING RECORD
1 OCCUPANCY 12 a
SINGLE FAMILY I I 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 I I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION
2 FOUNDATION —I 8 INTERIOR FINISH
CONCRETE d 1 2 13
CONCRETE BL'K. PINE
BRICK OR STONE HARDWD
PIERS PLASTER _
_ DRY WALL _
UNFIN.
3 BASEMENT
AREA FULL FIN. B M'TAREA _
'/. 1/1 1/. FIN. ATTIC AREA _
NO BMT 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. & FLOOR _
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR I� POOR
ADE.UA% NONE
5 ROOF 10 PLUMBING
GABLE HIP BATH (3 FIX.) _
GAMBREL MANSARD TOILET RM. (2 FIX.) _
FLAT I SHED WATER CLOSET _
ASPHALT SHINGLES LAVATORY
WOOD SHINGES KITCHEN SINK _
SLATE NO PLUMBING _
TAR & GRAVEL STALL SHOWER _
ROLL ROOFING MODERN FIXTURES
T11 E FLOOR
TILE DADO
6 FRAMING II 11 HEATING -
WOOD JOIST PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. &COLS. STEAM
STEEL BMS. & COLS. HOT W T OR VAPOR
WOOD RAFTERS _ AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS GAS
OIL
B'M'T 2nd _ ELECTRIC
7;,—1 3,d INO HEATING
"" A'd0 oprover
No' 600
Tylpndover, Mass.,� m 191
Q J' LAKE
COC LAKeJICOF,A.r.Es
BUILD
BOARD OF HEALTH
Food/Kitchen
PERMIT TO Septic System
�oxA� �Qu 11 �T BUILDING INSPECTOR
THISCERTIFIES THAT...............................................`............................................................................................................... Foundation
has permission to erect...Act*&. ................... buildings on ...11!' ..IL•u660-R2c1...�,�,� Q-�..................... Rough
to be occupied as..9.4VA ..l.I.. .4-14...... . QfJ 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
Final
PERMIT EXPIRE IN_�. 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONS U N ; T� Rough
...................... Service
BUILDING SPECTOR
Final
Occupancy Permit Required to Occupy BLcildirlg GAS INSPECTOR
t Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT
Burner
PLANNING FINAL CONSERVATION FINAL Street No.
Smoke Det.
SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT
�783d