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HomeMy WebLinkAboutMiscellaneous - 132 PLEASANT STREET 4/30/2018 (2) 132 PLEASANT STREET 210/070.0-0008-0000.0 M i i f Date �C21 J f NORTI{ " TOWN OF NORTH ANDOVER �c. PRIA WF PERMIT FOR WIRFNG �SSACNUS� This certifies that ... ........... vim" ........ 2 `115.......................f...................... ' has permission to perform ! e!4 ............ ,... . wiring in the building of. .. ...... ......................:.............. a,_. e� ............ �` 4 at k��.?"..2- � SC..................... .North Andover,Mass. �Fee...... :T�... Lic.Noq. 1.1.... ..... PL�al. ai� SPECfOR �Check o ' 10733 r . 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance with the provisions of M.G.L.c.143,§3L,the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been-accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§K. Permits shall-be limited as to the time ofongoing construction ac ivity„akd may be.deemed-by the Jnspector_of-Wires abandoned-and Juvalid_if_he—__. ._ or she has determined that the authorized work has not commer_ced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be.permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entitystated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chanter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-temp economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence”during the qualifying period beginning on August 15,2008 and extending"through August 15,2012. le 8—Permit/Date Closed: ***Note:Reapply for new perm' P 0 Permit Extension Act—Permit/Date Closed: N Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. Occupancy and Fee Checked r BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code MEC),527 CMR 12.00 1 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:-,2-/ axg rJ City or Town of: NORTH ANDOVER To the Inspector of Wires.- By ires:By this application the undersigned gives notice of his r her intention to perform the el ctrical work described below. Location(Street&Number) 3 ' Owner or Tenant leo2- Telephone No. Owner's Address Is this permit in conjunctionith a building permit? Yes 154-, No ❑ (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: ` Completion o the followingtable maybe waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- El o mergency -g mg rnd. rnd. Battery Units No.of Receptacle Outlets 7, - No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump Number. Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.o No.of Data Wiring: Heaters Si ns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eq uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electric Work: Q� (When required by municipal policy.) Work to Start- Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the pen-nit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) . I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: - - l: vc "0,--CA- r c a Y n C LIC.NO.: y 7 Licensee: Signature LIC.NO.: (Ifapplicable,enter in the license umber line.) Bus.Tel.No.; y 7rf���-� Address: 1(00 Ne-_o-5.a n,l Sit IU b-VIA-C1UP r Alt.Tel.No.: *Per M.G.L c. 147,s. 57-61,security work requires Department of Public Safety "S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 9347 Date A/4. . . . . °f;NO7M,tiO TOWN OF NORTH ANDOVER A or ; °w PERMIT FOR PLUMBING 40 �. SSACHUS This certifies that . . . .. . . . . . .e . has permission to perform plumbing in the buildings of at. . . . . .Q . . . . . . . . . . . . . . . . . .),)North Andover, Mass. Fee .`." Lie. No. . . \. �J• • • • • . PLUMBING INVECTOR Check # -� •'tj MA55ACNUSf TTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK 1• -CITYl,/�/0 /9 At0(/e� I MA DATE]0 20 /�2 I PERMIT#1 JOBSITE ADDRESS /z:�- J7'kn s,d; S'j OWNER`S NAME SG 0 j)'- 6 tM�J p OWNERADDRI=SS I —S)o n le_ I TEL IFAXI I TYPE-bit OCCUPANCY TYPE COMMERCIAL ' EDUCATIONAL I RESIDENTIAL IS� PRINT 04EARLY NEW., I RENdVAT190:I I REPLACEMENT: „ PLANS SUBMITTED:YES I NOf I FIXTUEtES T FLOOR 13SM 1 2 3 4 5 B 7 8 9 10' 11 12 13 14 BATHTUB _i..._. .._ . . .. . . .. CROSS OONNECTION;DEVICE DEDICATED 8PECIAL WASTE tY$TEfvi _ ..... _ -- , ...._.._. __. .__I�... .... .,.....,.i ...... _ DEDICATED GASIO1USAND SYSTEM DEDICATED GREASE SYSTEM i_. .. ..:...... __. ._.. .:.. i DEDICATED GRAY WATER SYSTEM ;. _.�=1 •I _—- `_�� - . .� .....-. ........: ... __�.�. ...f .. .....I ......:.....; DEDICATED(NATER RECYCLE SYSTEM DISHWASHER :.. ... DRINKING FOUNTAIN FOOD DISPOSER FLOOR!AREA DRAIN INTERCEPTOR(INTERIOR) - KITCHEN SINK LAVATORY I - -•- .._ ..:, - . , ._... ROOF DRAIN SHOWER STALL SERAGE/MOP SIN{( TOILET I' URINAL MASHING MACHINE CONNECTION WATER.HEATER ALL TYPES WATER PIPING i - -- -— .OTHER .. INSURANCE COVERAGE: - — i have a ctirrQntliat_ �ility iiistuaifee policy.or its sufistantial equivalent vihich meets the requirements Sof MGI-Ch.142. YESML,NO I � IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY I BOND�• { OWNER'S INSURANCE:WAIVER:f ant aware that the licensee does not have the insurance coverage required by 0fiapte042 of the Massachusetts General Laws,and that my signature on this perWit applicaliotl`'+gives this requirement. — (HECKONEONLY:. OWNER AGENT.i I ;- SIGNATURE OF OWN kok AGENT I hereby certify Thal all of the details and irilonnalion I have submitted of enlered recgardinc�ahis application 'e true and accurate the best of my knovrledy'e and chat all plumbing work and Installations performed under the permit issued for this application till he' mpltance rrilh all erl Hent prevision oilhe Massadiuselts Stale'Plumbincd Code and Chapter 142 of the General Laws. j PLUMBER'S NAME JO$t-pIt be.SG�A-nye (LICENSE tI(/S'6-7b SIGNATUREV i MPS .1P1 CORPOF;ATION III123 3 jPARTNERS(ilPj 11Ej �LLC in COMPANY NAME--� JSG�qjs J'��ni ADDRESS I of S e U�,y sr j (STATE IM 16' 'I ZIP I 0 J f qy TEL( FAX I I CELL I I EMAIL { � ' 1 _lRO�J�7FJt P]L;1[Ti9�]37[1�1�][1�TS�C'7C'�9C][�DN'KOTIES: lmow ror'-D + Cr� usr" MAL NSP^CTgONlvOTES i Yes No THIS APPLVCATION'•SERVtzS AS T9 PERVIT ,[�* r7 FEE:: PEMIT PLAN i �1 i F F F t S ��' �'It��pjli�idl#[t►eii(llr p,�,�Y��i:��ir�1`tltr�fls l ;. ,b��i�it'ftu2it�o��'tttTitsC�ttrl Elcc(t�itfs fr' fllb�i{rslrlrr�foir.SYt�t'� �'` lvi(rtt►•ttrcrss:�pt%fr(rrt ' '�r� Tce>s ?C ritlit;tisrit�nicrtttsl�i_Fs�tt Af(itl`zt}rl� k3iI,kordG"oti€ett fo s ie C►isi�ciisl�' t tt e1+ t f�laIiettft€Iitfor+ltti�i6l \- _ _p7[ttsEt.t?iinf:X 1 �ittti[;X13+7;'utrB�fUi�Anii3tiontfttilitidual}���� ��;�! ��,�� •_--- 77 ' �i��dl[�it:etttitl�ti:�t•7Ct[ecTi Et[entiltint+rititeb[is: - • • �`�•�,F'�-bf 1[•o ecE•}t•�-itlEe"i; � ' ..fin . t ! 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X14................j 1I y ELE4R61 L INSPECTOR /J Check # t C.14'4— '8345 Commonwealth of Massachusetts Official Use Only :� -- -- _ Permit No. X'5 Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perlbi-mcd in ;accordance with Ilio Massachusetts FlccU-ic,al Code(MFC.),527 CMR 12.01) (PLEASE PRINT IN INK OR TYPE ALL INI,0104111]ON) Date: �N7 CL. 0 _13 City or Town of: NOR"I'H ANDOVER To the Irr,Vvelor• of Wires: By this application the undersigned ,-,ives notice of is or her intention o perfon the electrical work described below. Location (Street& Number) ` iy�j Owner or Tenant hJ g Telephone No. Owner's Address Is this permit in conjunction with-yaabbuiild• Ig permit'? Yes No ❑ (Check Appropriate Box) ®� Purpose of Building , r'1 IM Utility Authorization No. n�, `av Existing Service t 0 U Amps (Z•0/ Z(Pvolts Overhead4_ Undgrd ❑ No. of Meters New Service Qt's Amps G ?_+4volt Overhead.® Unndd'grd ❑ No.of eters Number of Feeders and Ampacity C � t E 1, JJ1/L - Location and Nature of Proposed Electrical Work: D _ e _ - � �1 r Complelion ofthe following/able rimy be waived by the hispector of lVires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle) Fans No. of "Total Transformers KVA No.of Luminaire Outlets No. of Ilot Tubs , Generators KVA No. of Luminaires Swimming Pool Above El El o EmergencyLighting rnd. rnd. Battery Units No. of Receptacle Outlets 4­6 No. of Oil Burners FIRE ALARMS No. of Zones No. of SwitchesNo. of Cas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. l ot`rl No. of Alerting Devices 'Tons g No.of Waste Disposers Heat Pump I Number Tons KW No. of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Healing KW Local❑ Municipal E:1 Other Connection } No. of Dryers Ileatin, Appliances I<W Security Systems:* No.of Devices or Equivalent y No. of Water KW No. of No. of Data Wiring: Heaters Si us Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total ITelecommunications Wiring:-111 No.of Devices or Equivalent OTH ER: Allach addiliunal derail if desired, or as required b.v the lnspeclor of lf'ires. Estimated Value of Electrical Work: O (When required by municipal policy.) Work to Start: I -12 Cr �- Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERACE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in lorce, and has exhibited proofofsame to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTI IER ❑ (Specil'y:) I cert/ft,under the pains and penalliec of perjury,that the inJurural/on on lhic appliculiun is/rue runt conrplefe. FIRM NAME: c LIC. NO.: ci Q Licensee: f A 61—ec.-LS Signature LIC. NO.: (//applicable, enter ext mpl"in the license cumber lime.) Bus.Tel. No.: -a-7, Address: I&,Q IP(ens,3l,r $]-. Nv 1411 L1 nda trey Alt.Tel. No.: _ *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safely "S" License: Lic. No. C — u OWNER'S INSURANCE WAIVER: I ani aware that the Licensee dues not huge the liability insurance coverts e-normally required by law. By nny signature below, I hereby waive this requirement. I am the(check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. FPERjT11TFEE. $ v S f � The Commonwealth of'Massachusettc —= T- Departutent of*Industritrl/Ic•cidents O.lice of'Investigations -- 7 600 111'ctshington Street Boston, J1111 02111 www.masti•.gov/dirt Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pluiiibei-s Applicant Information Please Print Legibly Name(BL[SIIleSs/Organization/Indivi(Iual):_ �, t� QyiLC_—l� ��t�1` ytt Cd -1 r f Address: ((o0 �I er,S'a w�-- Ake h 6 nd a UP,- cit&<./S City/State/Zip: tN-ILO r4h Rpt ,bluel 44- Phone #: 9' 7' &<f 7 'ZZ S3 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.�1 am a sole proprietor or partner- listed on the attached sheet. 7. VRemodeling ship and have no employees "(-hese sub-contractors have S. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised (heir 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that-checks box#1 must also Fill out the section bchlw showing their workers'compensation policy information. i.HOmI'OwnerS who submit this aff idavit indicating they are doing all work and Ihen hire oulsidc.contractors must submit a new allidavit indicating such_ TContractoi's that check(hisbox must attached an additional shccl showing the nal Ile.of the sub-l'onlraetol;9 and their workeis'comp.policy ill lixmation. I a»t cut employer that isl)r•ovidirtg rro►•kerv'conrpensutirut in.curunee fin•my entployee.v. Belo it,is the policy and job site information. Insurance Company Name:-� - ---- ---_---------------.._.�.__.___--__._-- Policy It or Self-ins. Lic.#: --_—_ -- _-- I_`xpiration Date: t Job Site Address: _ 'z ��-��-�.� Ci(y/State/Zip:_ Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration(late). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition ofcriminal penalties of a tine up to$1,500.00 and/or one-year imprisonmen(,as well as civil penalties in the form of a STOP WORK ORDER and a tune of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify miler the pains and penaltie.v r , jury that the injorntation provided above is true and correct. Signature: Date: -/2 C Phone Official use only. Do not write in this arca, to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Ilealth 2. Building Depar(utent 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Gel 1na5 Structural �ngneerinq LLC Phone 978.465.6436 Daniel L. Gelinas, P.E. Fax Line : 978.465.5160 579A North End Blvd. Salisbury, MA 01952-1738 danlgelinas@comcast.net October 28, 2008 ( Jennifer & Scott Stein rg fax 132 Pleasant Street phone —NDAb, _.Andover, MA email Cell Copy: Ron Hebert fax/p 978.686.0786 RS Hebert Building & Remodeling cell 978.375.8224 102 Adams Ave North Andover MA 01844 a t Su bj ect: Structural Observations, Addition Mrs. .Steinberg / Ron: {' Ron Hebert requested Gelinas Structural Engineering LLC (GSE) walk thru the recently framed addition and comment. Our observations today indicate the framing, foundations, and LVL beams meet the requirements of the design drawings and the Massachusetts State Building Code 7th Edition One and Two Family-Dwellings'. f. Please call with any questions 114 O DANIEL L. Jp. GELINAS Very TrulyYours « STRtiCTURAL No. 3994 Daniel L. Gelinas, P.E. E Letter 10-28 framing per dwgs.doc Date. . . 14ORTry. `fig A 0p TOWN OF NO T NDOVER ' PERMIT FOR GAS INSTALLATION Y AC MUSE�ty This certifies that �._. . . . . . . . . . has permission for gas installation . c.47. ����::�. . . . . . ... . . in the buildings-of . . . . . . . . . . . . . . . . . . . at,!-3. . . .� . . . . . . . . . . . . . , North Andover, Mass. Fee-'�.... Lic. No�1�7�U�. . t���. � -�-! �... . . . . . . . . G' G S IN T, Check# 6582 MASSACHUSETTS UN DRM APPMATON FOR PERMIT TO DO GAS FITTIlVG (Type or print) Date NORTH ANDOVER, MASSACHUSETTS _L0 It _d Building Locations Cg `r Permit# O Owner's Name Amount$ New Renovation Replacement ❑ Plans Submitted a Z ; d � w o aa �° H e d a z z c F a W 4 p tyO� p z F W y Z U W Z F C C C W z F Z F Z x W W CW7 F w F" C o z Z a e A c °o �z, w o in x SU B -BASEMENT >' `� U > p a F p BASEM ENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . _FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . .FLOOR STH . FLOOR (Print or type) Name__ rbA,r Sfnrx. Check one: Certificate Installing Company Corp. Address LiK 44,.� Se �c !� iv 1 3 7 70 17 75 Partner. usmess Telephone Firm/Co. Name of Licensed Plumber'or Gas Fitter y FINSURANCECOVERAGEt liability Insurancepolicy or it's Substantial equivalent. Check one: cked es please indicate the a cove Yes � NoO typ rage by checking the appropriate box. nce policy ®� Other type of indemnity D Bond 13 Owner's Insurance Waiver: I,=aware that the licensee does not have the Insurance coverage required by Chapter 14:of Mass. General Laws,and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent Check one: Owner Agent 13 hereby certify that all of the details and information 1 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 willbe in .compliance with all pertinent provisions of the Massach a State Gas Code an hapter 142 of the General Laws. By: ..Signature of Licensed Plumber Or Gas Fitter Title lumber City/Town, Gas Fitter - U S ' _se ,.umber 0 Master _ APPROVED(OFFICE USE ONLY) 0-lourneyman Date. � . . S o' ti NaRT� TOWN OF NORTH ANDOVER ..•�,.� o PERMIT FOR PLUMBING 49 SSACMUSf This certifies that . . . . . . -- . . . .�. � . . . . . . . . . . has permission to perform-0r . . . . . . . . . . . . . . . . plumbing inA`66 buildings of. . . . e. . . . . . . . . . . . . . . . . . . at . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . ., North Andover, Mass. . Fee=-`,�,. . . .Lic. No`-��`'1�f� . PLUMBING INSPECTOR Check # f y� 789 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Building mg Location Q �Owners Name Date 16 O Permit# j / c-d Type of Occupancy Amount New ri Renovation Replacement 1:3 Plans Submitted Yes No FIXTURES j O U Oton U U W x W v� O D0 U as q Ca Q � ]�4SH1VII�' MFLOCtZ (+ I 14-1 87WHaR 51H ffiOaZ (Print or type) Check one: Certificate Installing Company Name Arl S (-� � ® Corp. tAddress R Partner usmess I elephone ❑ Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ Insurance Waiver. I, the undersigned,have been made aware that the licensee of this application does not have any one of the above three ' ur ce ignature 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 installationserformed under P Permit Issued for this application will be in compliance with all pertinent provisions of thei2= Plumb' ode and Chapter 142 of the General Laws. By: 1gnature o ice se um er Title Type of Plumbing License `3� Q' City/Town �f©icenseum er Master APPROVED(OFFICE USE ONLY Journeyman Location A 3 z 1-L�A-�AA-7/ `ST No. -3 Date S//-5 l9/ Z NORTH TOWN OF NORTH ANDOVER .•,�O0 F _ „ Certificate of Occupancy $ Building/Frame Permit Fee $ cMuSE` FaVndation Permit Fee $ ^ Other Permit Fee $ 1 e °ever Connection Fee $ (Ci°11 ater Connection Fee $ N°•end°Ve TOTAL $ /.5 0"c7_ ( t/ BuIIa(n9 P _Ins ectorc-� } Div. Public Works �Rlfff NO. 17,;,; APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. r PAGE 1 `MAP dJO. I LOT NO. &9A 2 RECORD OF OWNERSHIP I®A�.TE 8 Y[ BOOK 9��IPAGE (9 / ZONE SUB DIV. LOT NO. 7 L 46 LOCATION PURPOSE OF BUILDING c. Q�+G ic(e / OWNER'S NAME iM I j-- 0-el P®Li�2.®'t-; NO. OF STORIES ; SIZE is "�+ OWNER'S ADDRESS A4\6 A 1!L D RA ]M/1/1,/ BASEMENT OR SLAB s® ARCHITECT'S NAME I 'fl/�1 1� 7�, SJ NC�lil� SIZE OF FLOOR TIMBERS 1ST X F 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET X POSTS DISTANCE FROM LOT LINES-SIDES I��r REAR 1p�0G1 1 1i' �Q GIRDERS AREA OF LOT i 01 (o F FRONTAGE l� HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW g:5 r SIZE OF FOOTING X IS BUILDING ADDITION Af MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND S' WILL BUILDING CONFORM TO REQUIREMENTS OF CODE {�C IS BUILDING CONNECTED TO TOWN WATER •J BOARD OF APPEALS ACTION. IF ANY 7, J 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 ® 00 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. 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 BOARD OF HEALTH 1 NATURE OF/OWNER AUTHORIZED AGENT r FEE OA PLANNING BOARD PERMIT GR� '7 ! S 19vel Z BOARD OF 8ELECTA'EN BUILDING IN OF 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 RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. x CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE _ B 1 2 13 CONCRETE BIL K. PINE - BRICK OR STONE HARDWD PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B M TAREA _ 114 1/1 FIN. ATTIC AREA _ N_O 8 M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 7 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARDVVD _ ASBESTOS SIDING COMMON VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I--] POOR - - ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE 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 - TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO `- 6 FRAMING I 11 HEATING WOOD JOIST PIPE LESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 8 COLS. STEAM - STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING r A f 1 1 t 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***************** APPLICANT: U CA4 ��f,12�p Phone (o�J LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) I Street I,�,O`� e(X,5OLn St. Number ************************Official Use Only************************ RECO DATIONS OF TOWN AGENTS: ` Date Approved 1 Conse ati /on Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Health Agent Date Rejected Comments Public Worcs - sewer/water connections - driveway permit \, Fire Department Received by Building Inspector Date - r•ra- iAp Pi 'yk+Tf +,n •< {t ,at�s"r} S tea `' ' s g4 d Jy 9 a i � y 'r. 9w 4 Ari' i t P.M �.7G}�A,is�g a,'y r �e� �.� P.-_ a�$r Y^ u: ��•� � �� s; r e.aya. � - p&TrR aa On K wt,v ^"�� gn.+ �' w`:;:q'i PUBLIC 40' STREET a� -; -J. t It'P* .. _ .' i,. $1 fl '. Yr .mai p. g �(. I' ) ��� 1586.15 �7 ..... 44 existing dvjrel I 199. " _ bort �, N/F L F A R N.I N G C E N za5 AS SO C I,AT ES T': A LOT x 'f7",a JJ i .„ L• * ! - 8f.1 5 r N/r-- W!L'L! S NORTH A f as #' , s . • M 111 � s+ IL eA a t 7..v+�'t .,.f•,�+,t t `,' t .#a �',� 'rst° tJ„'A` ^` � »• '� �.��� y.. , '•'?�., a ax y.sG -'�.i � �ss.y,. •;+S'e' a b ` ;..'^"`� raj ts;�ta�y N g"`a ,?rYx*? di4j,4'L' Kiw ' .. + F ;ra.:- I..• v �;,..' ' "�ryt F . •.:This t{'a�� .�.�.{ d y that 1 haus ewpw frm dete�o''irEY sio day's Mad _- evrttpp�figts Of all 07 A-ilzt Oe ATE OF .1LING APPROVED., NORTH AND { }PLATE OF HEARING `��— !i` a' i BOARD OF:.A P.PEALS DATE' OF 'APPROVAL a t yv� A� CHAIRMAN f0 ij 4 Boor yhgvNw', Y . a r � ATE"D � TftN3 : i i Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption (Please print) DATE (! 14 191? a JOB LOCATION / 3 a `1 eaSa¢'1l SA Number Street Address Section of town :'HOMEOWNER" tY�i CkaP f lou zzo� r � Name Home Phone Work Phone PRESENT MAILING ADDRESS � �,0— UT YY_1\ i�s 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 minimu inspection procedures and requirements and that he/she will comp with said procedures and requirements . (� HOMEOWNER' S SIGNATURE C2 12 4:�' "Q APPROVAL OF BUILDING OFFICIAL Note : Three family dwellings 35 ,000 cubic feet , or larger , will be required to comply with State Building Code Section 127 . 0 , Construction Control . Location No. 3 Date S Z Pot TOWN OF NORTH ANDOVER Certificate of Occupancy $ s Building/Frame Permit Fee $ SscNustt Foundation Permit Fee $ _ Other Permit Fee $ A-57 jLt9 Sewer Connection Fee $ Water Connection Fe $ TOTAL $ 67 co O BOdin Inspector 5182 Div. Public Works r T WSLRVAT�10W -----JINAL SEW[-:R/ ' INAL FINAL - Town of ndover No. 173 DRIVEWAY ENTRY PERMIT - � �K� � r Mass 144Z A C HEWICK e , a , 0,1? QR` SSS 4 BOARD OF HEALTH PERMIT T LD THIS CERTIFIES THAT X. A0 .l..d . 07r.1 3 BUILDING INSPECTOR has permission to erect . ...... buildings•on 1 .�... ...�.� .•............�� Rough . . � 0 � Chimney to be occupied as...........,Z...�..�y......... . . .. . . ...... ........ . . .. . . . .. . ,. 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 Permit. PERMIT EXPIRES MONTHS ELECTRICAL INSPECTOR Rough UNLESS CONS UAR Service Final BUILDING INSPECT GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough e.... 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 a Date...`3—.........................s.. �'' °`, °;•�'"° TOWN OF NORTH ANDOVER 3: .t.r -� .-• of PERMIT FOR WIRING r �S3CHUS f This certifies that .....!!..�hhw .. .1`t�...:... ��.v.F.�.` ..�................. .. .. ,\U (CIP C�t�i has permission to perform ......cJ...`Q.............................. J. ...`....................... wiring in the building of.................... h9 . .. .......................................................... �.�3 Qt`s�S aN :!�" .................... .North, dover,Mass. Fee... ....... Lie.No � ....PSI.. lulu. . . �...... 3...to pv.... .................................... ......... .............. j ELECTRICAL INSPECTOR Check # 313D 5645 1 t!C(.VLYlLY1VLv YrC.fiL.![I Vr�r t,nv.usi i� �•��- �•� J DEPAR731E T61F Permit No. BOARDOFFIREPREVF1VI7ON ONSS27Q1�12A0 Occupancy&Fees Checked APPLICA77ONFOR PELT T PERFOPEEC ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDAN E WITH MASSACHUSSTTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATI N) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electric work described below. Location(Street&Number) 1 a. YS P, .l Owner or Tenant -Ii n I Fa—z— `�Cl�i'I Sf1�T7 �r Owner's Address �1'�Y 1,6 Is this permit in conjunction with a building permit: Yes F] No (Check Appropriate Box) Purpose of Building r Utility Authorization No, Existing Service Amps / / qo-xOlts Overhead r I Tnderground No.of Meters New Service �6_") Amps►�/�olts Overhead nderground =1 No.of Meters Number of Feeders and Ampacity (� Location and Nature of Proposed Electrical Work L, C No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA round ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps . TO KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.-of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local M Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER; 2dZ!✓� �'1 t ZC��� �!z Leh 2Cc�1 i S 1'Zsntt1Dft eytmarla>ts dmsMCmaa1 aws h iNeaa Liah* Fblicyirtc!u&gCorrVkV etn2`o�ageorilsstlt�r>balec}rivalaR YES NO Iha�eaattrt3lt htuaatce 1haNe&ftniWdva6dpm4ofsa=10d 0ffm YES rT ffywhawdrdodYESpbmirdcaiefttAxofa aaWby drddrigtheqp7ftINSURANCE L.J—b0°` BONDa oRF»~x ( )=sE7( F�tirnDa� Estim*dVatleofEbcftWW k$ WakloSralt 3 �?^� D IrnpecfimDAeRegpesWd Roth FvW sigr>adutda& 0f1 NY F7lZNINAME � I CybyA Lim=NoL Sigrnane Lioa>seNo BusamTelNo. 976 600 5qq ALTdNa 9 8 OWNER'S INSU KRATMWANER;Iamawwdmtd eLio wdoesnotharethema =we aageorilsa1b61anGaleglri mbtastegxWbyM=d>t MGalaallava a�dtha[mysignahaeon tlnsparritapp)icaOialvvai�esdlislagtmenlat (Please check one) Owner Agent Telephone No. PERMIT FEE S signature of Owner or gen L t1C 1LU1V11V1U1V VVrAMR.1 n Ur 1ntU3 arxt,nv.lasi i L3 ••-� •, DF.PAR739MOFPUBIKSAFEIY Permit No. BOARDOFFIREPREVFIINITONRIX UTAT ONS517C RI2.Bfl Occupancy&Fees Checked APPLICAHON FOR PERMITTO PERFORM ELECTRICAL WORK fl ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 © (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) Owner or Tenant (j,— 1 Owner's Address Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box)' Purpose of Building t (iUtility Authorization No. Existing Service Amps ! / W-Nolts Overhead r --t-Jnderground a No.of Meters New Service Amps)W-) -Irr—N olts Overhead nderground =1 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work G C. No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swims-dng Pool Above Below rJ Generators KVA ground itround No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons Coo.of Disposals No.of Heat Total Total No.of Detection and Pumps . Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local � Municipal � Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis o.Hydro Massage Tubs No.of Motors Total HP tz 2C.c.t— Aas>att b die teglritarlais of tiseaa Galeal Laws aanaYLiAtylmaar=POEtymciu tngCmFk!le a'itssub alaluiydbt YES NO a> miWdvafidpmdofsvw10 eOfm YES '/' T lfyouh MdMd®dYFS,plra9eindial fttA eofoo�aWby �' BOND p Oyu p ftm**) 6�s� Ab5 aio� Estinta�d Vale afF]acmcal Wodc$ IDSUVt hp�WmD*RNp,,Wd Rot* Furl urs �pmNY NALice=Na ME 2 �IL-�i-�r c' �.c.� sae , © Signaaae O Liom>9eNoG t9 Bu*=TdNcL 97A 603;75q-11 �` al AkTdNa I ;�l 69S' 0 'SINSURANMWANER;Ianawmdmtdieliaa>sedtxsmtharetheirmramwmWcrics al*valmtasmgiiedby GalaalLam mysgnamonlhispmritffhatmwavesdmmpoTnt e check one) Owner Agent Telephone No, PERMIT FEE Signature of Owner Of Agent