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Home My WebLink AboutMiscellaneous - 129 BAY STATE ROAD 4/30/2018 129 BAY STATE ROAD _ 210!045.8-0037.0000.0 Date... RTN 00 TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING SS U us This certifies that ...... ......... C......... has permission to perform ........S�—x),',./ ......... ..... wiring in the building of... ....... ........... .North Andover,Mass. da ........... ..17 . Fee..... ........... Lic No. . I A INSPECTOR Check 1,35 5089 r 19 AP LIGATION FOR T uu WMKTD t$ CTRI VVORK cxus�rrs ZJCnWAL cont=CNt limn) PLEASE PRINT IN IN OR TYPE ALL INFORMATION Date: City or Town of To the Inspector of By this application the undersigned gives notice of his or her intention to perform the electrical al work described below.BY Location:(Street&Number)_ A4997 Owner or Tenant:-. /rOAV-4/yU' Owner's Address: Is this permit in conjunction with a Building Permit? Yes o -No�lCheck ( . Appropriate Box) Purpose ol'Building: Utliity Aut horizabon n2d Existing Service: /00 Amps (Volts Overhead Underground.D. #-Of Meters New Service:_Amps 00 f ''lv Volts Overhea L Underground.!] #of Meters: Number of Feeders and Ampacity: tocation and Nature of Proposed Electrical WoriclZ•l�i C No.of Recessed Fbmaes No.of CeiL.Susp.(Paddle)fabs ' No. orTransfomrers Total KVA No.Of Ughtlng CAsis No. of Hot Tubs t3ene rs KVA No. of Lighting Fixtures Swimming Poo* Abova ground a In Ground o #of Emergency Ugtding Battery Units No.of Receotecle Outlets No. of Og Somers' Fire Alarms #of 2ones No.of Switches #of Daftlim&to kft Devices No.of Gas Burners #of Sounding Devices: #of self Contained No.of Ranges No. of Air Conditioners TOTAL TONS: DetediofilSotandarg Davit= � 3 Local a, Mu I Connection o Other c No. of Waste D'vposats Heat Pump Totals: Number. TONS Security Systems. K No.of Devices or Equivalent No:of Dishwashers Space/Area Heating KW Data wiring,No.of Devices or Equivaient No.of Dryers -Heating Appliances KW Telecommunications Whirrs:No of GeYtces or Equivalent No. of Water Heaters KW No. of Signs: #of Balissls OTHiS� ;t of Hydro Message Tubs 'No. of Motors Tate!tip INSURANCE COVERAGE:Unless waived by the owner,no pomdt liar the perfohnshm of etegdeal work may issue unless the i'rc ansae Provides pmol of rramrny inshmrnca including'cortipleted oration'coverage of its sWuhralent, The undersigned rarifitm that such coverage is In force,and has wNbked proof of some to the pemdt Issuing office. CHECK ONE: INSURANCE k BOND a OTHER a Please sperdfy :.sttmated Value of Electrical work 5 A cno,Qty (when required by municipal policy) ' Work to Staa �3 lntperdions to be requested In accordance with MEC Rule 10,and upon comoletierr. I cerft,under the pains� ' and penalties of perjury,that the kdiDMation on ibis application is true and complete, Firm Name: T �"�'L -c.o Set2(/��( Ucerhsee: a.) UC.# Sign UG.; ((9� 7 Q-_ r� (if applicable,rrnrer"ex pt"it the lfrmnse num erfine) 1 Address Po v�'`P llGr7 S' �0 1� �(,VA r••� Bus.Tei.#ly° ��—�'t(l AIL Tel. OWNERS INSURANCE WAIVER.I am aware that the Licensee does not have the lability,msurance cove e waive this Mqurremerl. I am the(chest one) Owner o OR Avert o notrrhalfy �' BY my shghhature 6dow i n�reby� j-5 v Location No. Date NORTH TOWN OF NORTH ANDOVER f 3?O•,,`,D ,••hO O � 9 Certificate of Occupancy $ Building/Frame Permit Fee $ JACHUSE Foundation Permit Fee $ Other Permit Fee $ y L TOTAL $ Z-/? Check # �/ Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUELDING PERMIISSUED:T NUMBER. DATE ISS g x f Q �,. M SIGNATURE: Building Commissioner r o u1 dings Date - —a SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: J,Z? PAY .ST-ATF- Rv, as ^y p O VF— Map Number Parcel Number 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 Regaired Provide Required Provided Required Provided 1.7 Water Supply M.G.LC.46. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT m 2.1 Owner of Record RALP14 Sy i-1 S 1.9 9A Y 57,47-E RA Name(Print) Address for Service: Signature Telephone O 2.2,Owner of Record: Name Print Address for Service: z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 1 90 3.1 Licensed Construction Supervisor: Not Applicable 0 2AVp.)) CJ STRI C,DIVE REG, - SPG . Licensed Construction Supervisor: o o S GXTTa!� 97 b r �a dV9 P o VERJ License Number on Address J ' Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name O b s Regtstratton Number �• nA4JCZL9/ Expiration Date Signature Telephone 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 permit. ~ Si red affidavit Attached Yes.......0 No.......❑ SECTION 5 Description of Proposed Work(check all applicable) New Construction.❑ Existing Building Repair(s) ❑ Alterations(s) ❑tAddition 0 Accessory Bldg. ❑ -Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: < '�a' s-rk g k R o aI= SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost Dollar to beet q " Completed by permit a licant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total.Cost of Construction 3 Plumbing Building Permit fee(a)x (b) 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 A 1, as Owner/Authorized Agent of subject property Hereby authorize to act on J My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, DAVID C A,5 TX 1 C,e`)nl,E as Owner uthorized Agen f subject property Herebv declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief p V C Printe _ Al2 Si ature of Owner/Agent Date F NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 ST2TqD3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS 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 . �� Building Department 5..; d o 27 Charles Street • North Andover, Massachusetts 01845 (978) 688-9545 Fax(978) 688-9542 DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and.a condition of Building permit-# the debris resulting from the work shall.be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl I, sI50a: The debris will be disposed of in/at: L,L, + S Facility locatio Signature ofA,pplicant 25 Date y NOTE.- A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. _ t i f. Board of Building Regulations and staiidaId, "Licence or regi.:rahiin vapid for.irdividul,u5o►1y HOME IMPROVEMENT CONTRACTOR before the expiration date. Iffound return to: Registration:.1,04568 Board i�tEaiLlingRegulations and St:nda.-ds El,.t raaon ;/14/02 One Ashbt rton Place Rr►] Tyre: Pk'1VATE CORPORATION Boston; 1[a.O 1Flfi P-AVID CASTPICONE'nOOFINu,:? au4cone r 7 HilW ae Road ca, <L Boxfotil MA-.0 Admin 9trator t r No►v:.li4 1Wi+hou►Signa±tr NORTH Town of E Andover 0 No. IC2 6) o�A�oCL � �y dower, Mass., RATED P' 5 9S H BOARD OF HEALTH PER IT T DFood/Kitchen Septic System BUILDING INSPEC'T'OR THISCERTIFIES THAT......... .... ......... ... ............... .......................................... .............................. Foundation has permission to erect,_,-#... ...... .. ............. buildings on / ...l........... .,�!. Rough to be occupied as Chimney provided that the person acceptinglhfs�ip��eftshallin 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 Fina' UNLESS CONSTRUCTION S ELECTRICAL INSPECTOR 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE Date.. . . . . .. . .. ...... To 3r �` TOWN OF NORTH ANDOVER Vw PERMIT FOR GAS INSTALLATION 9 . 9 y�SS4CNU5EtS This certifies that . . . ......, . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation in the buildings�s''of . -t -f-a-�' . . . . . . . . . . . . . . . . . . . . at 1. North Andover, Mass. Fee='. Lic. No.. ..... .. .. . . . 'GAS INSPECTOR Check# 4 �- 5b MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFI17ING30 (Print or Type) rn //Yl1yUV&1r . Mass. Date. Ie ,(5�Zgou Permit# U �� Building Location a s G Owner's Nam /,s l S d Type of Occupancy I�^ F 17t•N Ti rl New ❑ Renovation p Replacement Plans Submitted: Yes[] No❑ t � N .. YW.r y< Z�. N N9) C V 41 �1 W 0 C O 0z CW N 0N F- W W O C W ! H H 4 N b W Z Z O W W W 0 W z Z Z CC W $- W F' _ J W r7 > U. r•- v J N Y dc W J 4 C ~ f' �' to m z O z o N S W > 4: W = 2 4 t O O W O W F- J SUB—BSMT. BASEMENT 1STFLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name r;Ae LZ T A . �AM MAT A eQ Check one: Certificate Address 3L ❑ Corporation M E T H U E tJ 01 A U l k p Partnership Business Telephone "7 f L9--lfi rrn/Co. Name of licensed Plumber or Gas Fitter -f (-)aEP-T A• jAMM►9 1 r4 C� INSURANCE COVERAGE: I have a current I• bility insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142.. Yes No ❑ If you have checked Les, please Indicate the type coverage by checking the appropriate box A liability insurance , policy� 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: Signature of Owner or Owner's Agent Owner[] Agent O 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 pFthol foron • be in compliance with all pertinent provtstom of the Massachusetts State Gas Code and Chapter 142 ofLaws. By T of Ucense: C� Plumber hAturb of Elcensed Pluryftror fitter Title tier ert Ucense Number U31) City/TownAPPIFIDAD 0 IC Journeyman BELOW FOR OFFICE USE ONLY f FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO, APPLICATION FOR PERMIT TO DO GASFITTING I NAME S TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED DATE GASINSPECTOR