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HomeMy WebLinkAboutMiscellaneous - 12 BERKELEY ROAD 4/30/2018 12 BERKELEY ROAD C 210/024-0-0055-0000.0 Location No. Date j :tea~ ",O oT TOWN OF NORTH ANDOVER # Certificate of Occupancy $ cNusEt� Building/Frame Permit Fee $ eps Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check /f ��✓�1���lo�� � y' 2466 7 Building Inspector X4.1 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Z Date Received Date Issued: - IMPO[RTANT:Applicant must complete all items on this page LOCATION J�� Print PROPERTY OWNER ��j r_ (ah�_ Unit# Print MAP NO: LZ�PARCEL: -:5-- Print DISTRICT: Historic District yes no Machine Shop Village yes no 100 year-old structure yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition Cyfwo or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial 9"Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other �Septixc 91W �®Floodp na l®tWtetlands �LL ® WaferslieDi'st ct ®Water/S_ewer� � - /7 DESCRIPTION OF Wax TO BE PERFORMED: /��iy►yv� =x�s72M D,ECk K rLA-CF :Z1 S1trIF locmrlZv�r (Identification Please Type or Print Clearly) OWNER: Name: J Ems` �2Li,GG�Uf Phone: 1 �D - 7 Address: CONTRACTOR Name s //>y�/Z�� � Phone: !�03 93Z-9S f Address: S A'9 cvz �l�'� q Supervisor's Construction License: � 769 1 Exp. Date: �C / Home Improvement License: 3� _ �j Exp. Date: S � ARCHITECT/ENGINEER Phone: it Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ 0� �U� FEE: $ od Check No.: e/0 .?q�,� 3�a! Receipt No.: (o NOTE Persons contracting with unreg&tered contractors do not have access to thegaranty fund r- Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. ;Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And/Or C.S.L. Licenses j ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition or Decks { a Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) I! ❑ Engineering Affidavits for Engineered products NO`'IE' : All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit I ew Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Ener Compliance Energy p Report ❑ Engineering Affidavits for Engineered products NOT dumpster permits require sign: All dn off from Fire Department g p ment prior to Issuance of Bldg .Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Doc.Building Permit Revised 2008mi 1 I F I ' t Dimension I � Number of Stories: Total square feet of floor area, based on Exterior dimensions. I Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine III NOTES and DATA— For department use I I I i I - i ! i ® Notified for pickup - Date I , Doc:.Building Permit Revised 2011 June/mi a., . ,:_ innatr�rc'nf,•iinr,+r....+ 'Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ .W1ell ❑ Tobacco Sales m Food Packaging/Sales/Sales ❑ ❑ ❑ g g IPrivate(septic tank,etc. Permanent Dumpster on Site ❑ 1 � THE FOLLOWING SECTIONS FOR OFFICE USE ONLY i I INTERDEPARTMENTAL SIGN OFF - U FORM 1 DATE REJECTED DATE APPROVED (PLANNING & DEVELOPMENT ❑ ❑ !!I CIOMMENTS (III NSERVATION Reviewed on S 11 � � Signature COMMENTS CP �Q w ('0b) !� P (I�I VIII HEALTH Reviewed on Signature COMMENTS Ang Board of A eals: Variance Petition No: Zoninpp g Decision/receipt submitted yes i i Canning Board Decision: Comments f!I Conservation Decision: Comments Water & S IIff SUV@T Con tleCttaon/Sig nature& Date Driveway Permit DPW Town Engineer: Signature: 1111 Located 384 Osgood Street FIfRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS NORTH To" of - ove0 .. No. - �,o lover, Mass., o Ap COCHICHEWICK S��RAYED P'PC� BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... ..�...� —��. ..............�......(�................................................................................................... Foundation has permission to erect........................................ buildings on ... �.................................. Rough to be occupied as �C a ..........•. p ........................���.1 A.e;:.....;!L yt...(J�l. ..... �.l.l... .... `l�`- Chimney . . . . ......................... .. provided that the person accepting this permit shall in every aspect confor 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 EXPIRES IN 6 MONS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough ...................... ........... ... .. . ...................................................... Service BUILDING INSPECTOR 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 FIREDEPARTMENT'. Until Inspected and Approved ,by the Building Inspector-7 Burner - Street No. SEE REVERSE SIDE Smoke Det. eta Santosuosso & Sons Contract 5 Red Fern Circle Londonderry, NH 03053 DATE www.applewoodconstruction.net 8/29/2011 603-432-8599 Arleque 12& 14 Berkley Rd North Andover, MA DESCRIPTION TOTAL l.Remove existing upper deck,railing and stairs leaving existing rim joist. 7,030.00 2.Check deck for correct flashing. If it is not flashed correctly an additional $325.00 will be charged to supply and flash properly. 3.Supply materials and construct deck following same design and using existing footings. NOTE: If existing footings cannot be used or additional footings are required it will be an additional$275.00 per footing to dig, supply and pour concrete. 4.Supply materials and construct new stairs and landing following same design and using existing footings. NOTE: If existing footings cannot be used or additional footings are required it will be an additional$275.00 per footing to dig, supply and pour concrete. 5.Supply and install pressure treated decking nailed down. 6.Supply and install pressure treated railing with 2x4 on top and bottom with ballusts nailed to the 2x4's. Supply and install slate gray Azek decking as top rail. 7.Removal of all trash due to construction. TOTAL $7,030.00 ®1 /30/201.1 11:00 6034328599 SANTOSUOSSO AND SONS PAGE 03/03 K Saxatosuosso & Sons 5 Red Fern Circle Ong ract Londonderry, N1403053 DATE www.applewoodconstruction.,net 8/29!2011 ~ 603-432-$599 Ar1c9 ue 12& 1.4 Berkley Rd North Andover, MA, DESCRIPTION TOTAL T Tt ;above prices are hereby accepted. You are authorized to do the work as specified in he estima Payment will be made as outlined in attached payment schedule. 1 Sil ted: U c Dated- 7 -c U — 4c) AF ►roved by _ Ge :era.l Manag __ --TT0T1q L $7,03( .00 Page 2 �5f9j I C Gwoll 9tMA a4 i.cL ,Oki a oza 1 10_� ,r 1 313" YX,e 3"ja` C,11ice of('onamr Atiaors 8u$ PEC^ A y 44 7f- _ � qH ^4Y SF'R,,H,F� '1 f4�S" � �.����,` A'jy� 5.1`•R h 4.. _ Registration ' 6~3045 Expiration !013 LC.0 D SANT ONSTRUCTION s i xtQNRD SAN S r 7 5 Ri=D F�Rkbik ' — - i' t 4NDONDEftRY,N � �ti Ufldersecretary `� N1as�.icl:atictts- Depart+Hent ci�t.;B lard of Bailtfin :Construction Supervisor-License.< License: CS 57699 LEONARD SANTOSUOSSO ili 5 RED PER CIRCLE' , LOPIDOND8RAY, 1VF103053 ; I . Expiration: 9/2112x13: '1 t'ommisli�etcr' T 5548 SANTO-5 OP ID:JD ACORO" DATE(MMIDD)YYYY) �.,..._, CERTIFICATE OF LIABILITY INSURANCE 09130111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pol)cy(les)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCERCONTACT 603-890-6439 NAME: Planright Insurance-Salem6Q3-890-6521 P"°NEFAX 224 Main Street Suite 3C IC No E AIC No): Salem,NH 03079 E-MAIL : Jason M Mlocek INSURER($)AFFORDING COVERAGE NAIC I INSURERA:Peerless Insurance Company 24198 INSURED Apple Wood Construction,Inc INSURER B: dba Santosuosso 8r Sons Construction INSURER C: Leonard Santosuosso INSURER D: 5 Red Fern Circle Londonderry,NH 03053 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. INTS,RR TYPE OF INSURANCE POLICY NUMBER MMIAIJUL=1 DDIY MMIDDIYYYY CY EFF POLICY EXP LIMBS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CBP7025202 07124M1 07124/12 PREMISES Es occurrence $ 100,00 CLAIMS-MADEI OCCUR MED EXP(Any one person) $ 15,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 KEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,00 POLICY X jFCTPRO LOC $ ACOMBINED SINGLE LIMIT AUTOMOBILE LIABILITY SOO,OO Ea accident $ A ANY AUTO BA7025198 07/24/11 07/24/12 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS X AUTOS X NON-OWNED PROPERTentY DAMAGE X HIRED AUTOS $ AUTOS Per accid UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION x WCSTATU- OTH- AND EMPLOYERS'LIABILITY 'RYL"TS FY] I ER A ANY PROPRIETORIPARTNERIEXECUTIVE YIN NIA C7025199 04/27/11 04/27/12 E.L.EACH ACCIDENT $ 100,00 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,00 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) 3A-NH:Lenoard Santosuosso is excluded from coverage CERTIFICATE HOLDER CANCELLATION TOWNNAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover MA ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St North Andover, MA 01845 AUTHORIZED RE PRESENTATIVE O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts $ Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Mass. 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Mame(Business/Organization/individual):��-'` 1 �Cl_JC-��._�� 4 Address: City/State/Zip:l,o{1CfQ _d, Phone#: LA/ ) 6 -9�Nc Aou an employer?Check the appropriate box: Type of project(required): re1.`I am an employer with k _ 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part time).' have hired the sub-contractors 7. Remodeling 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp.insurance.$ 9. ❑Building addition required] 5.0 We are a corporation and its 10. ❑Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11. ❑Plumbing repairs or additions myself [No workers'comp. right of exemption perm MGL insurance required]t c. 152,§ 1(4),and we have no 12. ❑Roof repairs employees.[no workers' 13. ❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contactors that check this box must attach an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees.Below is the policy and job site information. Insurance CompanyName: q Policy#or Self-ins. Lic.#: `1��_ ��.,i���l� 1 Expiration Date: �{ ,��^ Job Site Address: \ ,- ,1� ..�� 0 City/State/Zip: _ fi 1 42- Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration(date). Failure to secure coverage as required under Section 25a of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of $250.00 a day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: r tl Print Name:`,_Q_Ocpp a 2>10 Phone#: � . SSCY�b Official use only Do not write in this area to be completed by city or town official City or Town: Permit/license#: Issuing Authority(circle one): I.Board of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#: Location 1.2 -��% ED 6C 'Z A? � No. 6 Date NORTp TOWN OF NORTH ANDOVER Ot �•o ,•'�q.0 G: • O� F - „ Certificate of Occupancy $ s ; Building/Frame Permit Fee $ ' • Foundation Permit Fee $ sAm PAO trrmit Fee $ / 00 RG ��EDS(ewer Connection Fee $IV � bMplor Connection Fee $ TOTAL No Andover Building Inspector Div. Public Works PEa'ltrr NO. 1-56 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. (, PAGE 1 Mn?P 4.40. LOT NO. 2 RECORD OF OWNERSHIP -'DATE (BOOK -'PAGE ZONE I SUB DIV. LOT NO. LOCATION PURPOSE OF BUILDING ?0QC\ Qe OWNER'S NAME NO. OF STORIES � SIZEBoo OWNER'S ADDRESS ^_ Aep _ _i� BASEMENT OR SLAB ARCHITECT'S NAME i SIZE OF FLOOR TIMBERS 1S19 y io ` 2NDa )( 3RD V O; BUILDER'S NAME aged ,r)C _I f SPAN ( o lc%LA - _'—p`— /` DISTANCE TO NEAREST BUILDING T , IV DIMENSIONS OFRSILLS DISTANCE FROM STREET �JCJ 1 ,L "" POSTS E77 1 DISTANCE FROM LOT LINES-SIDES.SS.I 4_ REAR /jC 1 "" "" GIRDERS AREA OF LOTfD,nm i-Cc f FRONTAGE••+ico 1 HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW No SIZE OF FOOTING X IS BUILDING ADDITION Ale) MATERIAL OF CHIMNEY OC IS BUILDING ALTERATION,�/ - e1 p�nr.I i n���,.Y.Q IS BUILDING ON SOLID OR FILLED LAND So / WILL BUILDING CONFORM TO REQUIREMENTS OF CODE F�.�.G IS BUILDING CONNECTED TO TOWN WATER ISS G yti 5 BOARD OF APPEALS ACTION. IF ANY �/� IS BUILDING CONNECTED TO TOWN SEWER NYES1't IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST Z QO © 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 DATE FILED _Z� ' BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED AGAT - - OWNER TEL.# F E E /©t, 0 0 CONTR.TEL.# _-Y,217 CONTR.LIC.# PLANNING BOARD PERMIT GR D - 19 BOARD OF SELECTMEN BUILDI i PECTOR Li BUILDING RECORD 1 J! OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUSTSHOW EXACT DIMENSIONSOFLOT 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 jifFOUNDATION 8 INTERIOR FINISH CONCRETE _ 3 1 2 13 CONCRETE BL _K. PINE BRICK OR STONE HARDW D PIERS 'II! PIASTER IIr _ DRY WALL III UNFIN. 3 It BASEMENT AREA F,UiLL FIN. B M AREA _ 'L '%i' '/. FIN. ATTIC AREA NO B Wj FIRE PLACES HEAD ROOM _ MODERN KITCHEN 'ff . 4 'IN WALLS 9 FLOORS CLAPBOARDS B 1 2 3 _ DROP-SIDING CONCRETE �_ W ASPHALT fDINES EARTH — ASPHALT SIDING HARDVJ'D ASBESTOS SIDING COMMCN VERT.:SIDING ASPH.TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK(ON MASONRY ATTIC STRS. & FLOOR _ BRICKION FRAME CONCI OR CINDER BLK. STONE ON MASONRY WIRING - STONE ON FRAME Of_ II' SUPERIOR POOR _ IIIf ADEQUATE I NONE 511 ROOF 10 PLUMBING GABLIE I HIP BATH (3 FIX.( — GAMBREL - MANSARD TOILET RM. (2 FIX.( FLAT, SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TARI,& GRAVEL STALL SHOWER - ROLL ROOFING MODERN FIXTURES _ qp TILE FLOOR 1II1 TILE DADO 6 FRAMING i l HEATING WOOD JOIST PIPELESS FURNACE 0I FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. &COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING ;H, RADIANT H'T'G T UNIT HEATERS `�7 NO. OF ROOMS DAL B`'M'T 2nd ELECTRIC iz lit 13rd I NO HEATING j f\ Dov � r • ��i :� �t,,, �,�\ice ' A- svll , s s 100 ) Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption (Please print) DATE /6 /F z JOB LOCATION__��Z- —/� /��/G✓i�-t_- Number Street' Address Section of town Nu� "HOMEOWNER" CrL/(,!'jq'j D Name Home Home Phone Work Phone PRESENT MAILING ADDRESS City Town State Zip code The current exemption for "homeowners" was extended to include owner occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license , provided that the owner acts as supervisor. (State Building Code, Section 109 . 1 . 1 ) DEFINITION OF HOMEOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside , on which there is , or is intended to be, a one to six family dwell- ing , attached or detached structures accessory to such use and/or farm structures . A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit . to the Building Official , on a form acceptable to the Bulding Official , . .that he/she shall be responsible for all such work performed under the building permit . (Section 109 . 1 . 1 ) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes , by-laws , rules and regulations . The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements . HOMEOWNER' S SIGNATUREX 0( APPROVAL OF BUILDING OFFICIA Note : Three family dwellings 35 ,000 cubic feet , or 1 r , will be required to comply with State Building Code Section 127 .0 , Construction Control : -J _ I r i Location /.2—IV No. 1-5 b Date S NORTh TOWN OF NORTH ANDOVER p Certificate of Occupancy $. Bulldin /Frame Permit Fee $ _ 9 �'��'�^•'''t�' foundation Permit Fee $ ss�cMust Other Permit Fee $ /0, 00 Sewer Connection Fee $ Water Connection Fee TOTAL Bull Ing Inspector 5161 Div. Public Works ;. Y SE ERI �� ®�_HWAL PLANV4INC uV AL CONSF,R Y ATiFINAL Town of ndover No. 5 6 tIVEWAY ENTRY PERMIT r MaIC ss 10? A C ME \ 0SSOR PERM . IT pP BOARD OF HEALTH THIS CERTIFIES THAT. .. ... ........... ..... ....... .. ...A ... .. . ... . .... ... ........... . • AWk BUILDING INSPECTOR has permission to erect ......................... buildings on�...��..A.W. ......� Rough Chimney . iobe occupied as.......... -1 '�........101re.K.......................................... Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Pjwnft PERMIT EXPIRES 16 N T H S ELECTRICAL INSPECTOR Rough UNLESS CONST UT Service Final . .. ........... ...... .. BUILDING INSPECTO GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector Date.... Tot TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .......tom..77-5 has permission to perform ..............................7x .................................. wiring in the building of................5.....r..q..... ............................. at..... A. ............ r, IC51,4�Y .................. .North,Andover,Mass. Fee.4'��. ... Lic.No....., ................. ........... ........ . ......... ELECTRICAL INSPECTOR Check # 7219 Commonwealth of Massachusetts Official Use Only .Permit No. _ 7 2 Department' of Fire' Sere ces Occupancy and Fee Checked y� BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/OSJ leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 12.00 All work to be performed in accordance with the Massachusetts Electrical Code(MEC 27 C MMP (PLEASE PRINT IN INK OR:TYPE ALL INFORMATION) Date: 0 7 City or. To,.:yn of:. Ndt?P h To the,Inspector of Wires: of�hi-s1or her intention to perform the electrical work described below. By this application the undersigned gives notice Location (Street& Number) . Telephone No. j�) „ Owner or Tenant JJ Owner's Address _ Is tills permit'in conjunction with a building permit? Yes ❑ No Z (Check Appropriate Box) i purpose of Building Ut!ilty Autho_rizntlon No. _ Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Mcters New Service Amps / Volts Overhead❑ •Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security and or Fire alarm systems , Com letion o the ollowin table ma be waived 6 the inspector of-,Wires. .. No.of . , Total No. of 1Zeccssed Luminaires No. of Ceil::Susp..(Paddle)Fans Transformers KVA No of Lumuiai're Outlets ., No. of Hot Tubs Generators 'VA Above o o mergencY .!g: ing �. iYo 'o;ft,wninaires Swimming Pool rnd: "� rnd: � ,Batter Units A No. of Oil Burners FIRE ALARMS^ No.,of Zo^es No. of Receptacle Outlets No. of Detection and No. ol'Switches No. of Gas Burners.: InitiatingDevices _ Total No. of Alerting Devices No. of Manges No. of Air Cond. Tons Heat Pump num"der Tons KW No. of Self-CoMained "" " --"� Detection/Alerting Devices w No. of'Wnste Disposers — Totals: -- Municipal (- Ottier S ace/Area Heating KW Local 0.Cot•lnecaoli --1 1 Foo Dishwashers p j O ,• Security Spterns", f,7ryers :�Ieating rHpptidr�ce5No.of Devices or ; uivaleiNo. of ,,� No.of Data.Wiring: f Water KW Ballasts No.of Devices or Equivalent Heaters Signs Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors Total HP ' No.of Devices or B uivalent OTHER: I1 �' Attach additional derail ijdesired, or•as required by til¢lnspecror o, iVires. Estimated Vnfue of Electrical Work: L q � "'(When required by municipal policy.) n/� Inspections to be requested in accordance with MEC Rule'l0, arid upon completion. Work to Start: A-SI l permit for the erformance of electrical,work may issue unless INSURANCE COVERAGE: Unless waived by the owner,rio p p •the licensee rov_ides proof liability insurance including"completed operation".coverage or ifssubstantla,.equivalent. The P_.... . undersigned certifies that such,coverage is'in force, and�has exhibited proof of same to the permit lssuiltb office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) ' Tccrtify, tnuler the pains and pe/ialties of perjury, that the information oivthis apphcatia: is true and complete. , _ LIC. NO.: 15»- C FIRM NAME: ADT Security Services, Inc. LIC.N0.: 5966D Licensee: Kenny Wong J Signature �-_� - -- (if applicable, enter "exempt" in the license number line.) Bus.Tel. No.:,. 603-494-5900_ Alt.Tel. No--_93_-5-9A-59-1Q-- ---------- Address 18 Clinton Drive Hollis N.H. 03049 *Security System Cantractor License required for this work;if applicable, enter the license number here: SS CC 001975 1'-bi!ity insurance coverage normally OWNER'S INSURANCE WAIVER: I am aware that the Licensee dads not hove the t� � r `aaent. � „�P hoinw 1 i erebv waive this requirement. .I am the(check one) r t w„er ❑ owner's .----- - 7 '-i A (( ,:A: :L't i-ti'r, i: •'kali - '1. .. ^� J' •:tom 1 C.1.: - moi'._^•': _ r 1 04 COMMONVVEALl'H OF A4,�SS/;:.h[�:iETTS + 'OF ELECTRICIANS ' REGISTERED SYSTEM , TECHNICIAN .! <, ISSUES THIS LICENSE TO KENNY Q WONG f' t < ' 22 PIELD51"DN�. DRIVE I { I .tr t` BURLTNGr N MA• 01803-421.3 -#_::;:..•,,,Tta +!+'{!�rt•rr'�,4 fiY, 5966 D 07!31/.07 99176'1. Y. Fold,Then DOach A+ong Alf Perforations :,r•�' .r �:• :.Jar•• -s.:: a::. �.. — t T" .L ,r ! t - 3-. ss= -0ji u .� -: -•. ...,._.. e„ .._.,-._7^'....,.. ..:...• _..,,r,.. a._.�. C• �Ir 1. `••,..:1...'C:a.': tt I > 4 / t 1 «r �. .. ..., .. .. f .!.t... Tf. Wit. ,N +!. .•_ �•..-�.r - '.i:.i:c - - - ••v.:::' .•a..•': .t. -L r• :t- .1 _.ih-• q� } r rae•_ C+' . a' ..�. •'!( ';,b J..,.'i.Tf�T F,,..u�.N.:: .,aCt-:`r. '%:"'.- .CY[;'!" ••Y• +\'-..i: .. .L.!5if1 r-. ,,.!+s,. .If.. T'ta.�•:. .,r i .:�:•�e:,J. - rS,.' lf�:.: i-ti.:!'`•,i��: �a`••' Wit: a.. .. .. .. .L,.:,...,r,5:: ,.M„,•.,a-..: _ ..q •:n,�..4`:.-,v*"="„(i�F-�i>..yy.. =•,.a'::- -ter r . .. .. .. .: !R: ; ;._:1?c�•e'e?{aTT}F.F.:e�a�!:Ir 07. o�irnnonaeal!/i o�../EbaauQek� •': 'T, s • i DEPARTMENT OF PUBLIC SAFETY 4' 1 Licensef; : SEC SYS CERT.CLEARANCE' t . 1' Number: .;`,. h,. '::• t ._ SS CC 001975 :.:. .'rlY•j"t•� i Birthdate �.� . 10/09/1969 10/ 007 Expire 09/2 Tr.no: 110.0 „ Restricted: 00 _'•"�t `' KENNY :aJf•! r t�: WONG ,• 22 FIELDSTONE OR '�''•'JB ';• BURLINGTON, MA-01803 C /f' .} 's -COMMISSI er - 1 .Y. � t I •tt� a .. :•}.•.ir.. .J P 1 - •'ri. f .J r