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HomeMy WebLinkAboutMiscellaneous - 122 MARBLEHEAD STREET 4/30/2018 122 MARBLEHEAD STREET 210/009.0-0017-0000.0 9 0 U 4 Date.6": �'.�. . . . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SSACNus� ;? : This certifies that �i?! . . . . .lff�;Jy. . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform (. .c. . . . . . . . plumbing in the buildings of . . C . . f.r-CL4 t EJ:r . . . at . . . . . . . . . ., North Andover, Mass. Fee .QJ .Lic. No.. . . . . . . PLUMBING INSPECTOR Check # A5 Z-- MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) F� AMA ,Mass. Date 20Permit# Building Location W� Owner's Name_�� �� (Z(`�, Owner Tel# Type of Occupancy New ❑ Renovation ❑ Replacement Plan Submitted: Yes ❑ No ❑ FIXTURES z z > o _ U W a a z a [aET�7 a w A d w A aG 04 0 a �y O d ¢ F U z F. F F v� O O 3 � o a S T BASEMENT IsT FLOOR 2ND FLOOR 3RD FLOOR 4T"FLOOR 5T"EMR x rH FLOOR 7`FLOOR a rH R DOR Installing Company Name jet f ( 0 �," Check one: Certificate Address /2 5,- ::r� ❑Corporation 1 ❑Partnership Business Telephone# r7l'Y;� ❑Firm/Co. Name of Licensed Plumber Mj f j f�afj INSURANCE COVERAGE: I have a curreniabili tyinsurance policy or its substantial equivalent which meets the requirements of MGL Ch 142. Yes,09 No ❑ If you have checked yews,please indicate the type coverage by checking the appropriate box. A liability insurance policy V 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. Check one: Owner ❑ Agent 11Signature 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 Plumbing Code and Chapter 142 of the Ge ner ws By Sirhat& Lice umbe Title Type of License:Master ❑ Journeyman City/Town APPROVED(OFFICE USE ONLY) License Number ACORD,M CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) 02/25/2011 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Matthews Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 182 Parker St HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. �. Lawrence, MA 01843 INSURERS AFFORDING COVERAGE NAIC# INSURED Michael Capeless INSURER A: Atlantic Casualty 105 Tyler St INSURER& Arbella Methuen MA 01844 INSURER C: INSURER 0: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD' POLICY EFFECTIVE POLICY EXPIRATION R POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE RENTED L143000684 08/07/2010 08/07/2011 PREMISES Ea occurence $ 100,000 CLAIMS MADE F�OCCUR MED EXP(Any one person) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 POLICY PRO CT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO HC357357 08/30/2010 08/30/2011 (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $ 300 000 SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ 300 000,. NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ 300,000 (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000 X1 OCCUR FICLAIMS MADE AGGREGATE $ 1 000,000 XL111463 02/22/2011 02/22/2012 $ DEDUCTIBLE $ RETENTION $ $ WC STATU- 0TH- X WORKERS COMPENSATION AND IMITS R EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE890911-0937696 11/17/2010 11/17/2011 E.L.EACH ACCIDENT $ 100,000 OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500000 OTHER DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Heating or combined heating and air conditioning systems or equpipment, installation, servicing or repair Plumbing 20 Little Rd North Andover, MA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION town of north andover DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN north andover, ma NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE 0-0811:18AT`Ie" ABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR EPRESENTATIVES. THORIZED REPRESENTATIVE ACORD 25(2001108) ©ACORD CORPORATION 1988 1N PLUMBERS AND GASFITTERS- LICENSED AS_A J-PIJ�R,NEYMAN PLUMB Ar3�' Y:L LGNtil + ) MICHAEL N CAPELESS a I 105 TYLER S7 M�ETHUEN MA 01844-1905 1787 Q510.1/12 7_70p08 E- 9.r „R +tYiL`t' AL .4d '.6Y#A.3w'7A4rE3 S A >f S---- -. IN PLUMBERS AND:GASFITTERS LICENSED AS A MASTER GASFITTER I 's0 ES Nr.AbCtJL t It S,N's 6,f MICHAEL N CAPELESS 105 TYLER ST . MEtHUEN MA 018`44--1005 52.b, 05410111.2 7-.7008.3 k_ 7701 Date.— . ...... .. HORTN of �' ° p� TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION � O t 9SSACHUSEt This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . ' has permission for gas installation . . . . . . in the buildings of . v Z 1'5-- ` t`Q �s o r. . . . . . . . . . . . at . . . . .` �:C,. �': .'.*. . . . . ., North Andover.,.Mass.. 20�Fee. Lic. No. : ? . . . . �..( GASINSPECTOR Check# Z. - MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) 6tm Amro A Mass. Date ` 20,/L Permit# Building Location/ &4fflaW Owner's Name{,05 ;kg Owner Tel# Type of Occupancy--7 Vi New ❑ Renovation ❑ Replacement A,- Plan Submitted: Yes ❑ No ❑ FIXTURES W °� o F O ¢ x ° CO W ¢ w x s > d CO w m w z d x ` w o SUB-BSMT BASEMENT 1ST FLOOR 2"D FLOOR 3RD FLOOR 4T"FLOOR r FLOOR CH FLOOR 7T"FLOOR i 87"FLOORT------=Lf±1 - - - - Installing Company Name In Check one: Certificate Address <7— ❑Corporation CM WR 42 l Oct '7" ❑Partnership Business Telephone/#T1�,-) -:3S) ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Uw � INSURANCE COVERAGE: I have a curre t liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes- No 13if you have c ed Yes,please indicate the type coverage by checking the appropriate box. A liability insurance policy A-1 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. Check one: 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 rtinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General La By Type of License: _ •-Plumber Sign re oTticensed Plumber or Gas Fitter Title -Y-las fitter A-master License Number&!�;L 6 City/Town •-Journeyman APPROVED(OFFICE USE ONLY) i ,. . _. . . r .. _ .. _ i Date. . ..... .. NORTH Of °� TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION �-ISS AC'HUS E�t This certifies that . . . _ . . . has permission for gas installation . . l:�'. . . . . . . . . . . . . . . . . . . . in the buildings of . .,l�?d1-��?ts� !F.;�T . . . . . . . . . . . . . . . . at 6. 'r. . . . . . . ..1, North Andover, Mass. Fee. U . . . . Lic. No.. .?� �� M z . . . . . . . . GAS INSPECTOR Check# 3 LLt' I" r MASSACHUSETTS UNIFORM APFUCATON FOR PERMPr TO DO GAS FTMNG (Type or print) Date S a-%�, S NORTH ANDOVER,MASSACHUSETTS Building Locations ° ` 0.0 Q zl_ Permit# _ Amount$ 3 p Owner's Name New Renovation El ® Plans Submitted El 'AIN 04 v; o o F w H o a O o Q WH 0 C a Uw; z G z O. c o Ww H 0 pz A U a U a A a H O SUB -BASEMENT BASEMENT ' 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or ty � N s��� � �� tec one: Cert i ate Installing Company nrp. Name Address '""� ❑ Partner. usmess a ep one ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check ne: I have a current liability lqslurance policy or it's substantial equivalent. Yes 0No❑ If you have checked yes,pl se indicate the type coverage by checking the appropriate box. 13Liability insurance policy Other type of indemnity 13Bond 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. Check one: Signature of Owner or Owner's Agent Owner ❑ 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 Permit Issued for this application will be in compliance with ail pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. Signature of Lic lumber Gas ter By: Plumber Title Gas Fitter LicensC NumNri�` City/Town Master APPROVED(OFtCE USE ONLY) 0 Journeyman k c , A R• i Location . _ No. � Date NORTH TOWN OF NORTH ANDOVER 3? ' • OOt F 9 ' Certificate of Occupancy $ s' NUs Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ � ' Check # �l 1 8 5 ( 7 �.. - V 'd-wilding(ding Inspect61 40 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING qq 7777 BUILDING PERMIT NUMBER. ^� DATE ISSUED: (6/<>Q (0 1f) X SIGNATURE: -I Building Commissioner for of Buildings Date z SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 12.2 "ate r 9 (A.OAJ 4�17 0-0 q a 0 l I VAA JAA a® ©`\ Map Number Parcel Number t�► 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided ReqLtired Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information. 1.8 Sewerage Disposal System. Public ❑ Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No M 2.1 Owner of Record Name(Print) Address for Service tSignature Telephone 3 2.2 Owner of Record: Name Print Address for Service: Signature Telephone go SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable .r r �icensed Construction Supervisor: License Number 11 Address Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name M Registration Number r Address z Expiration Date Y Si nature Tele hone 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 rmit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Descri tion of Proposed Workcheck all a ticable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: el-IN �� SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be �' ,'' O [CLr�E� ,Y Completed by permit a vlicant 1. Building (a) Building Permit Fee J Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 PlumbingBuilding Permit fee(a) x 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 S — r/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit appl_ication. Si ature of Owner Date " SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject pioperty Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief P ' N Si ature of Owner/A ent Date g .:. d 4 NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS V SPAN 2 3 SPA DINIENSIONS OF SILLS DIINIENSIONS OF POSTS DM ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE t NORTH '9 Town of t Andover No. i6m2oo zg-a`- o 3� CO, A o over, Mass., COC MIC ME WICK AoRATE0 C2 `r BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....�'.. .�� �N.&4.......ofote... 'i<•N •r .... .... ................................................. Foundation has permission to erect..... �.�A fr...... build gs on .......�aa ,/..j'I�R�b�r� •..• Rough ............. Rea F"- 4- S & sgi�#r S PIA+` '� tobe occupied as...................................................................................... ........./t.....................A.......................... 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 re Ing to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 4?//07 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STAR S Rough �� &e I 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burnet Street No. SEE REVERSE SIDE Smoke Det. f, K9, 4. . 1�. O' i * + -'- + + -+ . -+ + + + -+--+ +- +- + + +-+_+ �_ + + + + + + + + + + + + 4 + + :� _+_.+ . + • i1 ill I ! 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I I I I +—+ t -+--+ +-+--+- -+ +—t + +- +—+ i---r 4--+ 1 + + • 1 � 1 I �'--1 � 1 1 I _} +_.+.---}__ -+-- +- +-- +-i--+_ + - +. + -t + + +. -+-+ -_+ _'�-._} _.+- t +-.+_ +_-1 +- +- +- +- 'r-t -+- •' '+- 1- }_-t"-T +_�---r-*-_+' _+-.'}- -r i +-+ ' +-t-* + + + +-.}-} 1• i I +�- -+- ' 1 1 I 1 } I f +- + +-'+-+-+- t- + + r + + -+--t + -+-+ - + +- I -+ +-+ r-t +-+--t--•--t +-t-+- y' r r + +-r---i---t i -t--+ -• -+ -.+..+-r-.+.._t.. + +- t- +-..+-- t.... +. +-+- + + + t + + +- -t -t- r -+ -+ -+ + + +-t-+--+- +-+-� r + t--+----r--r ---. � I —+ I I r + -• -1' -a -+- { + + t t- , +. +. } r- + : > .+ .} i- ! + -+ 't + t t- r--•-t-+--+-Y--1_ -..-. «-. -- - - + 1I 1- + • - _ _+. t •.t- .+ +•+ -_ + + - -+ -+ -t -t - + + -+--: r-} •--r-T'-+__'1-"r-. +_-.._ - -+.� r 5th -77- F b ,e i3!''&M � I ,x22LJIV 5 tV I I gER x CWTIFY aro TM MW AMMR AND :PLOT PLAN THF.BARK IWr !7l$` DWW"G 19 LorATFD ori IN VON LOr AS SMWM"D THAs If-DOES CO NFORII' 07171T .�••. Ul�'a r .a, ea o✓ .� ZONING RFCULAUAXAFS .ve:/:) fiRa4)DjMV SVMWS FROM SMUTS & LOT L[NL'S:' I FURTRBR }' T IMS.D#1JVI.Wg IS NOT LOCAM JV FLOOD HAZMD AREA AS DRAW POR SX01PN ON PANEL Zsoo Fa oo o sc reF BTFP / AL3 ✓v�E`2oo' THIS PLOWFO F PURPf)SFS - NOT FdR J BC1MOY DL'TE`1WNArION. ,Atil AMMY INF RAUl oN .ERRIMACK FNCINFEl MO SERVICE'S MEN FROM ZHS7YNG RECORDS, B$ PARK STREET '1 582 AAMOVIR, "SACBMETTS 01810 Residential Property Record Card#1 of 1 'ARCEL ID: 210/009.0-0017-0000.0 MAP 0091.0 BLOCK 0017 LOT 0000.0 PARCEL ADDRESS: 122 MARBLEHEAD STRE as of:5/25/2C PARCEL INFORMATION Use-Code: 104 Sale Price: 1 Book: 05743 Tax Class: T Sale Date: 5/8/2000 Page: 0217 Tot Fin Area: 1793 Sale Type: P Cert/Doc: Tot Land Area: 0.22 Sale Valid: F Owner#1: CLARK,JAMES J Grantor: CLARK, GENEVIEVE Owner#2: JANE T ETHEREDGE Address#1: 122 MARBLEHEAD STREET Inspect Date: 6/23/2004 Road Type: T Exempt-B/L-%: I Address#2: Meas Date: 6/23/2004 Rd Condition: P Resid-B/L%: 100/100 NORTH ANDOVER MA 01845 Entrance: C Traffic: M Comm-B/L%: 0/0 Collect ID: RRC Water: Indust-B/L%: 0/0 Inspect Reas: R Sewer: Open Sp-B/L%: 0/0 RESIDENCE# 1 INFORMATION LAND INFORMATION , Style: CO Tot Rooms: 8 Main Fn Area: 865 Attic: NBHD CODE: 5 NBHD CLASS: 5 ZONE: R4 Seg Type Code Method Sq-Ft Acres Influ-1/2/3 Value Class Story Height: 1.75 Bedrooms: 3 Up Fn Area: 928 Bsmt Area: 855 Roof: G Full Baths: 2 Add Fn Area: Fn Bsmt Area: 1 P 104 S 9500 0.22 100/ 148236 Ext Wall: AB Half Baths: Unfin Area: Bsmt Grade: Masonry Trim: Ext Bath Fix: Tot Fin Area: 1793 Foundation: ST Bath Qual: T RCNLD: 138230 Kitch Qual: T Eff Yr Built: 1962 Mkt Adj: Heat Type: HW Ext Kitch: Year Built: 1920 Sound Value: Fuel Type: O Grade: A Cost Bldg: 138200 Fireplace: Bsmt Gar Cap: Condition: A Att Str Val 1: DETACHED STRUCTURE INFORMATION Central AC: N Bsmt Gar SF: Pct Complete: Att Str Val2: Str Unit Msr-1 Msr-2 E-YR=Blt Grade Cond %Good P/F/E/R Cost Class Att Gar SF: %Good P/F/E/R: /100//76 G1 S 364 1988 A A 50///50 5600 PorchType Porch Area Porch Grade Factor E 339 W 192 VALUATION INFORMATION SKETCH Current Total: 292000 Bldg: 143800 Land: 148200 MktLnd: 148200 W Prior Tot: 261000. Bldg: 119700 Land: 141300 MktLnd: 141300 192 Sq.Ft. PHOTO E/O 6 108 Sq.Ft. 6 14 18 FU/Beye D Sq.F � r . 7 FU/FM/Busi , �''tt 6 855 Sq.Ft. k ai 12 is 26 g 00 660 Sq.Ft. 6 122 MARBLEHEAD STREET , 1-FbYff 1 10 10 Sq Vit. NORTH TOWN OF NORTH ANDOVERs;no BUILDING DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER MA 01845 978-688-9545 978-688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE L — IS— O� JOB LOCATION (-2:1 Number Street Address M lLot HOMEP- OWNER C D L �A �_(E—�_7b -� (p O Name Home( Phone� Work Phone PRESENT MAILING ADDRESS 1 ( � �Qy L LQ_ "-c,, Q` J l/A-LA, City/Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of two 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 108.3.5.1.) 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,one or two family dwelling,attached or detached structures 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. 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. HOMEWOWNER'S SIGNATURE APROVAL OF BUILDING OFFICIAL 5925 Date... ..... ............... NORTH TOWN OF NORTH ANDOVER 00 PERMIT FOR WIRING CHUS ■ Thiscertifies that-Inl: ................................................................................. has permission to perform,—.,4,A-,-.�... ... ..........I wiring in the building of. ................................................. ............. ............................................. .North Andover,Mass. Fee. .. ............... Lic. ......) ELECTRICAL INSPE� R- Check 4 ���p�DEA�+I/1p�Ty+11�g1�VP�O�MBtDES�AF'ETY7�� ��p /� � Fees Checked APPLICATIONFOR PERAffTO PERFORM,,LL0P.'c.rcmuP1mNc0y CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRMR 12:00 /. PLEA SE PRINT IN INK OR TYPE ALL INFORMATION) Date of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) t a,� M og 6l f h e%}A S Owner or Tenant 6 U S P- o ncAt2 Owner's Address / 4 M— Q Q l fe he R Is this permit in conjunction with a building permit: Yes No �: (Check Appropriate Box) Purpose of Building c;) Fan fr \/ f 4o L)SQ Utility Authorization No.3� Existing Service tQ.. 0 .Amps f,b a�olts Overhead ® Underground No.of Meters New Service O 4 Amps��a Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work n t QJ S•e Q C-e 7e Vr e i1 fi C., OLA STe, No.of Lighting Outlets No.of Hat Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool* Above Below Oenersfars KVA ground and No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of an Horrors ;N-o.of Ranga No.of Air Cond. Total FIRE ALARMS No.of Zones Toro No.of Disposals No.of Haat Total Total No.of Detection and. Pumps Toro KW Inidating Device No.of Dishwasher Space Area Heating Kw No.of Sounding Devices No.of Self Contained DetectiordSounding Devices No.of Dryer Heating Devices KW Lord Municipal O-! Connections No.of Water Heaters Kw No.of No.of Signs Bdlasis No.Hydro Massage Tubs No.of Motor Total HP OTHER- :. Aasuertbdle atlVla®d>�aGalamlIawa IrmtaaneCoraaga Iha eaanaltlia6Jtyb&==Fbicyircludr8t7arr or svbta�ielaq�ivale�t YES 0G NO 1tzw ftri ladvaidpwdcfswwlD he0ffi=YES r)uuha%edrd edMp1..i d - de afomwwly gde �{� /�..1 VQ-e4Z-42,0 Ph i 1 1ZL RANGE BO OMM U51A41 FYI fr#c26'6 t✓� t,V cul Edn1edvakrcfEkc"Wade$ La00 WbikioStart DaRegiewd R * Fire) SVwdurda RnmM fpq*.. RRMNAME LiotstseNa see Ielvo 363 D t BusilessTdNa ? -I dt AIL TdNo. 17 OWMCSMJRANCEWANfRlatnaa+a tgdieL+csn dpmnot lheit»vano anwpariismbgmrialqivalaltastapWbyMmadll MG=W am arddmtmysigrlaamondispemzxvimdm%aivesmmp*muI (Please check one) Owner 1:3 Agent Te, lephone No. PERMIT FEE S signalure or Owner or Agent Dlh;'4A M©VPOFAIBf1C34MY LPernnmdtNo. s" ��BOARDOFFIREEPRLVFMVREGUlA527aglZ'WFa Checked APPLICATTONFOR PERMITTO PERFORM ET,ECTRIC,AL WORK WORK ALL W TO BE PERFORMED IN ACCORDANCE WTTR THE MASSACHussTs ELECTRICAL CODE,527 CMA 12:00 PRINT IN INK OR TYPE ALL INFORMATION) Da (PLEASEI � Town of North Andover To the Inspector of Wires: 'Ilse undersigned applies for a permit to perform the electrical work described below. Location(Street tit Number) Owner or Tenant Jr^U S P n c, '2 Owner's Address Q ts i -e h-Qof d S t Is this permit in conjunction with a building permit: Yes a No ® (Check Appropriate Box) f Building Fa vn r"/ 14o a S� Utility Authorization No.3 Purpose o g �/ ty �.� Existing Service !a C Am Ids / d`i 'Volts Overhead Underground No.of Meters ��. l� New Service -;1004 � Amps 1k 1 a Volts Overhead M Underground C3No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work e QUi r-ee Vile o fi CLVLA d LA S,d e No.of lighting Outlets No.of Hot Tubs No.of Trandoane s TOW KVA No.of Lighting Fixtwa Swimming Pool' Above Below CWwatom KVA around No.of Receptacle Outlets No.of OB Burners No.of Ernerpocy Lighting Battery Units No.of Switch Outlets No.of Oas BOrnms No.of Ranges No.of Air Cord. TOW FIRE ALARMS No.of Zones Toto No.of Disposals No.Of Heat Total Total No.of Detection and. Puny@ Tons Kw Initiating Davit= No.of Dishwashers Space Ata Heating KW No.of Sounding Devices No.of Self Contained DetectiordSounding Devices No.of Dryers Heating Devices KW Local Municipal a Other connection No.of Water Heater KW No.of No.of Siam Ballads No.Hydro Massage Tubs No.of Motors Total HP OTHER- lratt UCovaagi At�atbdeta�iamo�afMa�eda�aelttGm®1Lawe IhateacwerYLie6�'iyhgmtxRi�.yirdtdtBClon� o*ita�>bela}ivaist Y>34 �G Np Iharesub niadviidpiodefsartiDbOffim Y$41:2 if)autMd�od�dmpkmirdcnin afaomWby ds�gdie hoc. 444���--��� •QQ2�-ec22 e� i'h,40A IIVS[JRAIKE BOND a �61Ai 1� Vh 1eiQ6 C. t VxUV21 Cu,1 E�dVar>cof�l Wale s La 0 0 WadcbStaR IrapaciiortDeRec�reBod RaoRd *nedurtder P�bofpecjiay. fBtMNAME Uz=Na t i.Sjke J e-n &Z ELr L i S*0W Uffilem 3(o3 D 1 (� BtidnmamNo. 37s-373-moi! -77' Adim a ;-` V Lcf—�. AkTdNa 9 7SH?&jf- Dd)9 7 OWr,WSMJRAN EWA1VQt;IamawaeQiettheLit wdd= otn ltrttelheirsualoecmu*oftatsWalegtivaiUastepWbyMmdmmCandIm atddtetmysi�ia<aeontlispettritappitafrawaiKst�iareq�rat � . (Please check one) Owner Q Agent Telephone No. PERMf FEB S Nignum OT UW=r or Agent '+ Date. . ...... .. r + NpRTM '-1- TOWN ttTOWN OF NrTH ANDER • - PERMIT FOR IN ALLATION �9SSACMUSESIC F This certifies that . . .: f . . . ! j�'�.!�'`. `° . . . .. .�� . . . . . has permission for gas installation . in the buildings of . . . . . . . . . . IE. . . a!. .. . . . . . . . . . . . . . . . . . . . at . . . . �� . . .u`1 �4/t. �► . .. . .. . . :rNorth Andover, Mass. _ Fee. �5"'w . . Lic. No.. 3.6 . . . . . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR Check# / 9 "E- 6028 MASSACHUSETTS UNIFORM APPUCATON FOR PERMPT TO DO GAS FITTING (Type or print) Date NORTH ANDOVER,MASSACHUSETTS Building Locations Permit# G o Z k Amount$ L�� Owner's Name New D Renovation Replacement Plans Submitted id FAMII-� w a� F 0 c S g z w Gw � � zz Q�; '� F a� O a w f3�Fi 0 Zi W - 9 F d �i %� Fw+ V Z 9 SUB-BASEMENT B A S E M ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH . FLOOR 5TH . FLOOR �y 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) (( c C k one: Certificate Installing Company Name V t J✓ 4 �� � �d— -15-11 Corp. Address � � x r-d rz-1 liLvL .d�( d CJ�1 ,/�_ Partner. business I elephone 9 k _ �irm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes Ey No13 If you have checked les,please indicate the type coverage by checking the appropriate box. Liability insurance policy 13— Other type of indemnity 13 Bond 13 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. Check one: Signature of Owner or Owner's Agent OwnerAgent 13 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 apd installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Mass=ode and hapter 142 f theG eral Laws. 113y: Signature of Licensed umber Or Gas Fitter Title 13—I lumber City/Town [3Gas Fitter License Number aster APPROVED(OFFICE USE ONLY) Journeyman