Loading...
HomeMy WebLinkAboutMiscellaneous - 14 NADINE LANE 4/30/2018 14 NADINE LANE J 210/025.0-0125-0000.0 7 r i i I I I r �" Safety Insurance Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall NORTH ANDOVER,MA 001845- NORTH ANDOVER, MA 001845- RE: Insured: ANN M WOOD Property Address: 14 NADINE LN,NORTH ANDOVER, MA Policy Number: HMA 0390577 Claim Number: BOS00045818 Date of Loss: 10/23/2014 Company: Safety Indemnity Insurance Company Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. -If any notice under Mass. Gen. Laws, Chapter 139, Section 313 is appropriate,please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim number. Gino Manzi Claim Examiner 10/27/2014 I Safety Insurance Company Homeowners Claims Unit P. 0. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3346 Fax: (800) 297-5212 Email: GinoManzi@Safetylnsurance.com n.�n:7k-v ..,..s.•t_'="...s.r'-.,."r.- -. -,.�.�..�-1"�'"�V.r'L�ier--^�;.�-...t-�..�'y�' �•;ice--��. iht L� cation D No `� Date /D- 5 N°RTN TOWN OF NORTH ANDOVER p , Certificate of Occupancy $ o Building/Frame Permit Fee $ Foundation Permit Fee $ s�C S Other Permit Fee $ =° Sewer Connection'Fee $ 1029, Water Connection Fee $ A p, TOTAL $ 7 uild' Ins or 16:06 �� 000 00 PAID .� Div. f3ubjWworks kLzt Location No. tJ Date tb 1 t NORTH TOWN OF NORTH ANDOVER M p Certificate of Occupancy $ Building/Frame Permit Fee $ _ sACMUs S� Foundation Permit Fee $ 00 !I° Other Permit Fee $ I Sewer Connection Fee $ Water Connection Fee $ '.. TOTAL $ 8�0 Building Inspector IV01/95 16:07 870.00 PAID 1 - 9310 Div. Public Works PEklfff ANO. 's�4S_ APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP -NO.fT� LOT NO. a 2 RECORD OF OWNERSHIP DATE BOOK 'PAGE ONE I SUB DIV. LOT NO. ygLOCATION,14 f PURPOSE OF BUILDING r, O gm- OWNER'S � OWNER'S NAME t NO. OF STORIES SIZE ?�.y O p '!OWNER'S ADDRESS 7 f y C�__ CnZ D' BASEMENT OR SLAB 4f 0-g � JV Iv +ARCHITECT'S NAME � \7�TL� 1�-�it �14Y7�J�bFG SIZE OF FLOOR TIMBERS IST 7xio 2ND 3RD its BUILDER'S NAMESPAN CONS Cwt Wig_— 1 DISTANCE.TO NEAREST BUILDING DIMENSIONS OF SILLS f I DISTANCE FROM STREET v POSTS L �` i / (.- W4, DISTANCE FROM LOT LINES-SIDES ¢ REAR "" GIRDERS ` AREA OF LOT j'"�o�)�f.,rFRONTAGE 7T- HEIGHT OF FOUNDATION �� �1 GTHICKNESS IS BUILDING NEW JJ (�t�/Y�ev^ SIZE OF FOOTING o ,F X '2 1 '- Xe, `, [V IS BUILDING ADDITION %� �� MATERIAL OF CHIMNEY ------ IS BUILDING ALTERATION Al6F • IS BUILDING ON SOLID OR FILLED LAND '® t WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER yel BOARD OF APPEALS ACTION. IF ANY ,0 %a��`/ IS BUILDING CONNECTED-TO TOWN SEWER 7'� �l/ IS BUILDING CONNECTED TO NATURAL GAS LINE - INSTRUCTIONS 3: '• PROPERTY INFORMATION LAND COST SEE BOTH SIDES PERMIT FOR FOUNDATION ONLY J-� REGULATED BY PARA. 114.8-S. B.C. EST. BLDG. COST 7[_ PAGE / FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. .j�-'E� PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM DATE 114 11 FEE PAID l )— SEPTIC PERMIT NO. O ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING a 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS t' .> PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED ocs- 30 17? / V SwIladflING II46PR 1 '5 • SIGNATURE OF OWNER OR AUTHO E.p AGE ` Lill3 OWNER TEL.# 21' FEE PERMIT GRANTED PERMIT FOR FRAME/BUILDING, CONTR.TEL.k DATE: ___._____FEE PAID CONTR.LIC.N H.I.C.N . PERMIT FE OCT 3 0 E LESS FISFEE-ft �, to L34- WE FRAME PERMIT$_ 1.310. �F?o- I 1 BUILDING RECORD L { 1 OCC U ANCY 12 - b SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA- APARTMENTS I RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. t CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH - CONCRETE _ d t 2 I3_ - CONCRETE BL'K. PINE _ BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL - - UNFIN. 3 BASEMENT I 1 . - ,t AREA FULL FIN. B'M'T' AREA - + '/, '/i '14 FIN. ATTIC AREA _ NO B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES _ EARTH ASPHALT SIDING HARDVJ'D _ ASBESTOS SIDING COMMCN VERT. SIDING ;SPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 1, FLOOR I_ 1 BRICK ON FRAME CONC. OR CINDER BLK. { STONE ON MASONRY WIRING STONE ON FRAME , SUPERIOR POOR - I ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE LoK 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 8& GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES 1 TILE FLOOR TILE DADO + 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. K TIMBER BMS. &COLS. STEAM STEEL BMS. 8• COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G _ ..,.«-•..5?' a 3-! ............. •�I - - UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2rid _ ELECTRIC Vila �`�t��Ana-Is 1st 13rd I NO HEATING _ �Fivt; I •!�t NORTH T0VM of over ir I No. * 3k 19`1so L�]`8rt °' dower, Mass.,(1c"e-e- COcriic fit WICK � A0A'A-rE U "'P"k,�'C5 S BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...Ililla P.MWT................................................ ................ has permission to erect.... AIYI .. buildings on .1'4".... �.� 1 ....... `I�............. .• � Rough to be occupied as. ... T... 1. .'. D..Webkn.6......W ......LC.4 ....60404.0E....................... chimney in ever res ect conf6rm to the terms of thea lication on file inprovided that the person accepting thierm shall y p PP 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. PERMIT FOR FOUNDATION ONLY PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. REGULATED BY PARA. 114.8-S. B.C. Rough PERMIT EXP k6MOINW910�-Kk — FEEPAID Final UNLESS CON TRT R ELECTRICAL INSPECTOR Rough ' ........... Service BUILDING 1 ECTOR ' • Final ` Occupancy Permit Required to Occupy Building GAS INSR%CTOR { Rough s Place on the Premises — Do Not Remove Display in a Conspicuous �, 1-I f No Lathing or Dry Wall To Be Done ti�I N 'R PARTMENT Until Inspected and Approved by the Building Inspector. Q er r i - O� • Street No. 1' Smoke Det. ,.. ..._z.::_ . .. ,2 yvS gs;. 4„ _:;x�-i+ •Fr..r -..., e s .x�:.x. ..1�;_-:>.,>i, .- ... x ..._: K_ r":Y�r ,sk fix, .. _ -'. , LOT 20 LOT 6 LOT 7 F .s1 20 0' LOT 12 iu •moo =di011�t E� t9.6:r s-oe' LOT 8 44.00 --� OCT I 0 15.00' 21.33' 5.00 12' 4, SETBACK REQUIREMENTS: 18.00' FRONT = 20 FEET REAR = 15 .FEET . . SIDE = 5 FEET 2.17 r WETLANDS = 25 FEET SITE PLAN OF LAND LEGEND LOT 7 NADINE LANE OFFSETS FOR SETBACK REO. LOCAM IN PROPERTY UNE N. ANDOVER, . MASS. WITH.DIMENSION 75.94', /'R£PAAED fnq PROPERTY UNE OFFSET TO HOUSE CILLOW ' TREE DL LOPMEN SCALE 1- st 4L1' DATE SEPI 14 IM PROPOSED EDGE OF PAVEMENT m+ OCT x 1205 in EXISTING EDGE OF PAVEMENT ROADWAY CENTERLINE STATION 37 CHRISTIANSM&SE l f _ate . - -.'fA iYLQ 7R .IMfOS/.YL alm 7 mL ht7!-tylia OwdL NIL 0401AD7 FORM U - LOT REIZASE 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: JI 1IP10 t t � ) Phone _ 7� LOCATION: Assessor' s Map Number Parcel -- Subdivision _ /J "I'PiE Lots) Street IU f-(/LE St. Number _ 1 ************************Official Use Only************************ RECOMMENDATION OF VWN ENTS: At Date Approved Conservation Administr for Date Rejected Comments I �Q::, C 14 Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved S is Inspector-Health Date Rejected Comments Public Works - sewer/water connections /o-3o-1 5 •} d_ driveway permit Fire Department � f� u�. �r L Gf X� Received byBuilding Inspe for Date OCT 3 0 •i IWIw W 79.2, ' LOT 7 A=5000 S.F. �� /' ms's• P T.O.F. ^a �, 246.74 / Q 75.6' /. a FOUNDATION LOCATION PLAN /.CERTIFY THAT THE PRIMARY STRUCTURE SHOWN CONFORMS TO THE HORIZONTAL SETBACK REQUIREMENTS OFTHELOCAL APPLICABLE ZONING BY-LAWS IN EFFECT WHEN CONSTRUCTED. (THIS CERTIFICATION DOES NOT CONSIDER ANY OTHER RESTRICTIONS SUCH AS COVENANTS,WETLANDS,EASEMENTS, ORDERS OF CONDITION$ETC.) SCOTT CONSTR. CLIENT: THIS DRAWING SHALL NOT BE USED BY THE CLIENT FOR ANY THIS CERTIFICATION /S MADE AND LIMITED PURPOSE OTHER THAN THAT OUTLINED ABOVE,EXCEPr W17H THE WRITTEN PERMISSION OF CHRISTlANSEN & SERGI INa TO THE ABOVE CLIENT. FURTHERMORE THIS DRAWING IS THE COPYRIGHTED PROPERTY OF CHRISTIANSEN 8• SERGI INC. AND ANY UNAUTHORIZED USE IS PROHISITED.CHR/STIANSEN & SERGI TAKES NO RESPONSIBILITY FOR THE UNAUTHORIZED USE OF THIS DRAWING OR ANY INFOR- MATION CONTAINED HEREON. LOCATION: NADINE LN.N NO.ANDOVERNA. fl0,F q ml L G SCALE: 1"=20' DATE: 11/14/95 J REV. 11/20/95 u 1 PROFESSIONAL ENGINEERS •�`0'fAl �'` �✓`��� CHRISTIANSEN Q SERGI LAND SURVEYORS 160 SUMMER ST. HAVERHILL,MA. 01830 TEL 5OB-373-0310 ©1995 BY CHR/STIANSEN & SERGI INC. DWG.NO.:94015014 CERTIFICATE OF USE & OCCUPANCY Building Permit Number 545 (1995) Date APRIL 2911 996 THIS CERTIFIES THAT THE BUILDING LOCATED ON — 14 NADI EAL NE_(Lot 17) MAY BE OCCUPIED AS SINGLE FAMILY DWELLING W/1 CAR IN ACCORDANCE GARAGE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO Willow Tree Development 12 Rogers Rd. ADDRESS 1121,prhill MA— Building Inspector I i i 'i i OCT 30 — � (� 044 G� Oa � 4L3NJC� 4 D Oa NADINE LANE - LOT d' 7 North Andover EM -[Him Jim OEM - - - - - - - - - ---- oo 00 00 00 . � � . sari-i o2si SUNNI MENOMONIE a � MEIN IONIC -WES NEW -00010 / ftbO. - — __ ONE - _ - ■■■ __ ONES SOON SOMEONE! MEN SEES IONIC MENEM NOW DE NINE _ _ ONE on _ = _ ■■■ — _ _ on — _ OC 1 i LUL i rEd Date 2 R MARCH 1995 LJN k O RIGHT ELEVATION REAR EL EVATION zo r 1/8" = 1'0" 1/8" = 1b" j _I General Notes: O U 1. All dimensions are to be field verified by the Contractor and any LJJ Q adjustments made accordingly. Z Z .- 2. All work shall be completed in compliance with all applicable Q Q n Building, Plumbing, Electrical codes. Any other local, state and/or J = federal codes that may apply to this project shall be considered as 10 part of the construction documents. ry CO 3. All waste materials and debris shall be removed and disposed of properly W N z 4. Numbers set within [ ] reference that section of the Massachusetts Z X State Building Code for additional information. .5. These drawings were repared per guidelines set forth n the � Mass. State Bulding CodeSection [4 ] for 1 & 2 family dwellings. Q N ® 6. Win ,ow' dglazing shall be considered hazardous when used in doors z within 5'0" of a doorway or closer than 18" to the floor. Windows used for emergency egress shall have a minimum opening size of 20" x 24" Job No. in either direction and shall not be more than 44" above the finished 1 0058 ® floor. [ 3401 . 7 . 2 & 3401 . 10 . 3 ] Dwg No. ` 7. All-walls next to stairways shall have fire stopping installed adjacent to and parallel with the stringers per [ Fig. 3401 — 1 ] . A 2 " Y LEFT ELEVATION 8. Masonry chimneys constructed to section [ 3408 . 2 & 3408 . 3 ] �1/8" = 100" of the Massachusetts State Building Code SH 2 OF 9 ._ _..� -..�..�__ .....,.w ��. _...�... �...- �.�.... w n .� �.,�..... -..-�, w... ....._. 25 3yz" 4'10',4" r 130101/4 800" 10'7/4" 6/81/4" 2'0" 2'10/4" 30 Me 2'10" 3'5" / N 6'0" SLIDING I 2 6 X 3'5N -------- � � -ow- ------: 0 GARAGE FINISH All wood constructed walls and Q celing to have 5/8" type 'X' fire DINING ROOM KITCHEN o ,6 LAV rated Wallboard installed LOo f x CV = GARAGE CV cC' � j� N O C 2 — 2'6" 0 N C L. (V = N O d- cv 410" 8'0" o 00 FOYER N C-4 SD aoO o = o 04 � L-CC:4 9'0" x 7'0" Overhead door LIVING ROOM ,� PORCH 2'10" X 55" 2"10" X 5'5" 596" 7'0" 506" 616" 21991219" 710" BION 18'0" 12'0'114'0" 212" 441011 FLOOR PLAN GENERAL NOTES: 1. Smoke detector systems shall be Type I I I in conformance with 3. Light and ventiation:All habitable rooms shall be provided with [ 3401 .14 . 1 1 ] .Detectors shall be located as follows: aggregate glazing area of not less than eight (8) per cent of the A mininum of one per floor and basement,one per each 1200 sq.ft floor area of such rooms.One—half(1/2) of the required area of or part thereof.One shall be located outside of each separate glazing shall be openable. ' sleeping area and/or near the base of,but not within,each stairway. 4. Hall and stairway widths shall be a minimum of-3 feet clear. 13401 .14 .2 ) Handrails may project no more than 3 1/2" into,the required width. FIRST FLOOR pLA N 2. Ventalition: Kitchens and bathrooms shall have mechanical venting [ 3401 .10 .4 .2 .3401 .10 .8 ] . , systems that provide 20 cfm/occupant Bathrooms with a window which 5. Window rough opening sizes shown are for RlVCO Window units. 1/4" = 1'0" opens directly to outside air,no mechanical ventilation shat be necessary [-Table 3401-2 ,3401 .5 .2 .1 ]. - - 410291 3 18'51/4" 216" 9'21/" 6141/4" 716" 810" 10'5,4 5'4'4" 3,101/4" r 5'9ki" X 4'5" 2'10" X 3'5" O BEDROOM #2 z BATH WALK—IN _ w o CLOSET M BATH CD O M = st `n O = 0 cV ," U v a = N U CN! 2,4" 2,t r tp M N CLOSET N X a it N it 2 — 3'0" 2'6" `V e D N L 8'0" 7'10'/4" 490" 'O^ f Y J • ] O r yy r CN N M BEDROOM 1 # BEDROOM 3 R 5'9�i" X 4'S" N 2'10" X 4'5" # o 7 2'10" X 4'5" 2'10" X 4'9" 5'6" 7'0" 5'6" 610" 610" 700" 7'0" 18'0" 12'0" 1410" 44'0" SECOND FLOOR PL 1/4" = 1'0" • . 10291 4-9 dig 30'0" 14'0" 810" 150" 7'0" Bulkhead size & location by builder r ----------------------------------------------------------- ---- ---- ----------- -------------------------------------- -1 I loon I ----------------t P ---------------------- ► 1 2'10" X 3'5" : '► GARAGE FINISH '► FOUNDATION ; All wood constructed walls and ., „ ; ceiling to have 5/8" type 'X' fire10 Concrete Wall / 40 Pour 1 '► 1 rated Wallboard installed 1 '► ' 10" Dp x 1'8" W Cont,FootingSD x , 1 �- 1 ► j j ► N 3 — 2 x 12 Center Beam 1 a ' , 1 1 1 I I n n n ► n I n 1 O1 1SO 60 60 76'0 60 60 ► . 1 1 1 if C*4 I ; I I ; I 1 � I I I I , t ►' 1 O 1 ' 1 '---� - '---�--- '---F- I I I I iL--� -- i ►► �o -0 i ►► i 31/2" Dia.Lally Columns I I I I I ; >► "� ►' With 2'6' Sq.x 1'0" Dp. Footing (4 req'd) 1 o U a 1 ' , 1 ►, 1 = p 1 '► 1 I 1 N - - - - - - ---------------1 '►► 1 1 '' 1 ► r----------------------------- - I ' 1 1 ►' -----------— — — — — , ►► 1 , 11 1 1 ,► • • 1 2'10' X 3'5' 2'10" X 3'5" ' ' FL--------------------------- ----- • ' ----- 1 ------------------------------------- -+- - -----------------------------� > ► _O 1 • • o A N I • • • ------- !J ------ ---------------__- --------- ------------------------------ ---# - - 5'6" - 7'0" - 516" - 212111- 918" 2'2" FOUNDATION GENERAL NOTES: 18'0" 12'0" 14'0" y 1. Concrete slabs on grade shall have contraction joints with a depth Limits: 10" Raised Foundation of at least 1/4 the slab thickness.These shall be spaced not more 6. Lally column spacing is determined by [ Table 3405-6 pg.34-76 than 30 feet in each direction.Contraction joints shall be placed where offsets are more than 10 feet. 7. Wall pockets:Ends of wood girders entering masonry or concrete walls Contraction joints are not required where 6 x 6--6/6 welded wire fabric shall be provided with 1/2" air space on top,sides and end,unless approved or equivalent is placed at mid—depth of the slab.[3405 .3 .1 .1 ] durable or treated wood is used.[3402 . 8 .6 ] . 2. The ultimate compressive strength of concrete foundations at 28 days 8. Studs in framed kneewalls shall be 14" minimum,in length and when the ' shall be not less than 2p00 lbs/sq. ft.[ 3402 .2 .1 ] kneewall is greater than 4'0' in height,R shall be of the size required for an additional story.Kneewalls shall be thoroughly and effectively j 3. Foundation walls shall extend at least 8" above finish grade. [ 3402 .3 . 1 ] cross—braced.[ 3402 .7 & 3402 .7 .1 ] FOUNDATION PLAN 4. The bottom of any point of a foundation shall be a minimum of 4'0" 9, Foundation anchor bolts shall be a minimum of 1/2" in diameter. below finish grade. [ 3402 .3 .4 ] They shall have a mhinum embed of 8" in poureb concrete. 1/4" = 1'0" a 5. The exterior surfaces of masonry foundations enclosing basements shall There shall be a minimum of two anchors per section of sil plate.' 1091 5-9 be dampproofed. [ 3402 .6 ] Maximum space shall be 8'0" on center.[1704 .8 ] Continuous Baffled Ridge Vent Continuous Baffled Ridge Vent 2 x 10 Ridge Board 2 x 10 Ridge Board 12 " --- ROOFING 12 i 8 2 x 6 Collar Ties ® 40 OC. --- Composite Roofing Buid'ng Paper 8 x 6 Collar Ties ® 4'0" O.C. 1/2 Plywood 2x8 ® 16" OC. r CEILING CEILING 2x6016" OC. 2x6 ® 16" OC. 10" Overhanging Soffit R30 Fiberglass Insulation R30 Fiberglass Insulation z with Venting Vapor Barrier Vapor Barrier 00"' 1/2" Wallboard 1/2" Wallboard. r\ FLOOR FLOOR 3/4" Plywood 3/4" Plywood 2X8016" OC. 2X8016" OC. 00 - x WALL Sheathing Sid'ng,A'r Barrier 2 x 6 0 16" O.C. '") Sheathing,2 x 4 ® 16" O.C. Insulation,Vapor Barrier -- 00 1/2" Wallboard F_ FLOOR FLOOR 3/4" Sheathing 3 - 2 x 8 Beam 3/4" Sheathing 2X10016" OC. 2X10016" OC. _ Porch post SILL. 3 - 2 x 12 Center Beam 3 -2 x 12 Center Beam 1 - 2x6KD1 - 2x6PT i", Continuous SA Gasket 1/2" Dia.x 12" L i Anchor Bolts 31/2" Dia.Lally Columns 31/2" Dia.Lally Columns ' ® 8'0" OC.(max With 2'6" Sq x 10" Dp Footing With " Sq x 10" Dp Footing r` (see foundation plan for locations) (see foundation plan for locations) FOUNDATION -e e 10" Concrete Wall/ 4'0" Pour _ e - 10" Dp x 1T W Cont Footing 4" Concrete Slab a 4" Concrete Slab - - i SECTION r - - SECTION - FOYER 1/4" = 1'0" 1/4" = 1'0" .. . 10291 6-9 n Continuous Baffled Ridge Vent SECTION GENERAL NOTES: 2 x 14 Ridge Board 1. Floor design live loads are based on 1st Ar ® 40#/sq.ft, ROOFING 2nd Fir.® 30#/sq.ft and nonusable attics ® 20,#/sq. ft. As halt Fber ass Roofing Roof design loads are 30#/sq.ft live load and 7#/sq.ft dead load. -- g [ 3405 .1 & Table 3406-6 ] Building Paper 2 x 6 Collar Ties ® 4b" OAC. 1/2" Plywood 2 Minimum ceing height for habitable rooms is 7'3".In a room with a 2 x 8 ® 16" O.C. sloping ceiling the prescribed ceiling height is required in only one half of the area of the room.No portion of the room measuring less than 5 feet finished shall be included in calculating minimum area [ 3401 .6 .1 ] . 3. Stairway Headroom: Stars between 1st & 2nd firs,and 2nd & usable attics shall have a minimum headroom of 6'8* measured vertical from star nosing CEILING Basement staffs shall have a minimum headroom of 6' 6*. 2 x 8 ® 16" O C. [3401 .10 .8 ,Fig.3401-1 & 816 .2 .2 ] R30 Fberglass Insulation 10" Overhanging Soffit w/vents 4. Frestopping shall be provided to cutoff all concealed draft openings Vapor Barrier (both vertical and horizontal) and form an effective fire barrier between 1/2" Wallboard. stories,and between a top story and the roof space [ 3403 .2 .7 ] . 5. Insulation minimum total R value requirements for FLOOR �—WALL Exterior walls is 125,Floor over unheated space is 20D,Roof/celiig 3/4" Sheathing Siding,Air Barrier assemblies is R30,and Fnished basements walls is R125.[ Table 3423-1 ] . 2 X 8 ® 16" O.C. Sheathing,2 x 4 ® 16" O.C. 6. A vapor barrier of 1D perm or less shall be installed on the winter warm R19 Insulation Insulation, Vapor Barrier side of walls,ceings ad floors enclosing a conditioned space [3422 .1 ] 1/2" Wallboard 7. When eave vents are installed,adequate baffling shall be provided GARAGE FINISH to deflect the incoming ail above the surface of the insulation with All wood constructed walls and a 2 inch minimum clearance under the roof deck [ 3421 .1 .3 ] . ceiling to have 5/8" type 'X' fre rated Wallboard installed j 00 SILL 1 — 2 x 6 P.Tj — 2 x 6 KD. Continuous Sil Gasket 1/2" Dia.x 12" L .Anchor Bolts 4" Concrete Slab e ® 8'0" OL.(max 0 a a e FOUNDATION •- - 10" Concrete Wall 18" Dp x 1'8" W-Cont Footing SECTION M BEDRO IMI /PARAGE 1/4" = 1'0" 10291 7-9 MAXIMUM ALLOWABLE SPANS FOR HEADER SUPPORTING WOOD FRAME WALLS AL Spon of Headers i Sae of Wood Sappor ft One Story Two Stories In Garages or In Wdis Header Roof Above Above not mfforum Floors or roofs 2-2X4 4' 6' 2-2X6 4'to6' 4` 6'to8' 2-2X8 6'toe 4'to6' 4' etow 2-2X10 8'to10' 6'to8' 4'to6' 10,to 12, 2-2x12 10'to12' Stow 6'to8' &tow MEN FRAMING GENERAL NOTES: 1. All structural materials stall be void of any defects that may diminish they capacity to function in an adequate manner.All members are 2 x 10 ® 16" O.C.(UNA) Structural Engineering or any other professional services that All members are 2 x 8 ® 16" OA (UNA) FIRST FLOOR FRAMING may be reWhW Fall be provided by others. SECOND FLOOR FRAMING `i 2. Frcming lumber.Spruce—Pine—Fr,No.2 or better,with a Design . 1/8" = 1'0" Value in Bending"Fb" of 1000 for normal duration.[Table 3403-31)] 1/8"= 1'0" 3. Mininum bearing for joist shall be 11/2".[3405.2.4] 4. Use built—up 2 x 4 posts under all beams(4 minimum). 5. Double up floor joist under partition walls above. MAXIMUM ALLOWABLE SPANS FOR JOISTS/RAFTERS 12' 13' 14' V FRST 2x10%16 2 x 10/16 2 x 10/16 2 x"0/' 2 x 12/16 SECOND 2 x 8/16 2 x 8/12 2 x 10/16 2 x 10/16 2 x 10/12 2 x 10 R' a Board ArrseuruEeoo6 2 x 10/16 2 x 12/16 x 10 Ridge Boar ATS R00115 2 x 6/16 2 x 6/6; 2 x 8/16 2 x 8/16 2 x 8/16 NO VUCUB oe LEN z 6/16 2 x 6/16 2 x 6/16 2 x 6/16 2 x 8%16 `o �Frre i i s% 2 x 8/16 z x 802 12 2 x 10/16 2 x 10/16 m iLLLHILLLUCATHEDRAL 2 x 8/16 2x16%18 2 x 10/16 2 x 10/16 2 x 122%16 0 X JOISTS/RAFTER SPAN NOTES: N 1. Spm Tables for First%or joist[3405--2] Second floor& useable ®ttic joist3405-1 ] Attic(no future rooms)[3406-1 f AU members are 2 x 8® 16" OZ.(UNA) All members are 2 x 8 O 18" OA.(UNA) Cape attic floor jo%6-16 34a tics2 R00F FRAMINCRoofs over at ATTIC A—OnD MAMIN Cathedral Roof Rafters[3406-3] 1/80= 1,0• 2. Maxmum spm for 2 x"8 ceiling joist for. _ cape-attics is 19' 11" [3406-2 .�O]. • . 91 ......... ..... 3/4" Plywood Continuous Baffled or Joist Ridge Board e Vent RidgA Roof Sheathing 1-2x6 P.T, 1-2x6 K.D. Continuous Sill Gasket 1/2" Dia. x 12" L Anchor Bolts 2X Fire Blocking a 8'0" D.C. (max Ridge 3 — 2 x 12 Center Beam Roof Rafters m,Air Space FIRE BLOCKING 1/2" = ,lots OB RIDGE VENT 1/2" 11011 1/2"Plywood I Gasket aintain 2" (min) Air space or Caulk 12 � /4" plywood 1 — 2 x 4 Bottom Plate 8 Alum. Dip Edge 2 x 8 Rim Joist x 8 Fascia with Gutters 2 — 2 x 4 Top Plate L2 x 8 0 16" D.C. 2 x 3 Nailer Floor Joists "--Soffit w/vents INTERM. FLOOR 1/2 11010 SOFFIT 'I, 1/2's 100" 4" Concrete Slab Gasket or Caulk 1 — 2 x 4 Bottom Plate with Sill Gasket or Caulk FOUNDATION 3/4" Plywood 3/4" plywood 2 x 10 @ 16" D.C. 10" Concrete Wall / 8'0" Pour F 10" Dp x 1'8" W Cont. Footing 7 ---'---l-2x6 P.T., 1-24 K.D. 2 x 8 @ 16" D.C. Continuous Sill Gasket 1/2" Did x 12" L Anchor Bolts 2 — 2 x 8 Rim Joist @ 8'0" D.C. (max 2 — 2 x 4 Top Plate Conc. Fdn E S�iLL. is its 3/2" 1,0" 10" CONC. FDN. 1/211 100"10291' 9-9 .. 1/2 1 INTERM. FLOOR 21L r7 Andover , No. 4 Nortlh-„Amdover, Mass.,(4� 3k 191-LT IT � BOARD OF HEALTH Im ` Food/Kitchen Septic System ILD BUILDING INSPECTOR PEI MTHIS CERTIFIES THAT...� : . ..................................... . ............... Il�+ _ buildings .,...... {' .......�d.............. `Z� SRoughhas permission to erect ....fi?�lYl °.. g - +,.. 40.4}.... . . W himn r c to be occupied as ..... . . .�1G,..�GnCI.��Q4RMG... C � eY ::A..;,provided that the person accepting this perm' shall in ev arm to the terms of the application on file in Final 'thleoffice, and to the provisions of the Codes and By-La:. Inspection, Alteration and Construction of Buildings in the Town of North Andover. PERMIT FOR FOUNDATION ONLY PLUMBING INSPECTOR REGULATED BY PAR,. 114.8-S. B.C. o VIOLATION of the Zoning or Building Regulations Voids :. lt/II7 E,� PIS ,_ D ATE 10�� i�FEE PAID L� %a ELECTRICAL . ZXR f /r 1►/ r 1 / r i PER F FRAMEIBUILDING /a �` / Se v . .�..........................r° .. 76 , BUILDING INSPECTOR / DATE: FEE PAtD- OCC )a .Cy Pc771 i l l RC-c”, GAS IN PECTOR Display in a Conspicuous Place c . .,y rises — Do Not Remove p _ BeDone No Lathing or I.. FIRED PARTMENT z � Until--Inspected Jand Apprwilding Insp6,ctor• Burner_ ` Street No. � Smoke Det. 19Pe' � o'la La 1 1 Location No. ' Date -- t NORTH TOWN OF NORTH ANDOVER 0 • Os 9 + �o • ; Certificate of Occupancy $ CM�SE`t' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # M / `� � 0 Mpp Building Inspecto� .y TOWN OF NORTH ANDOVER BUILDING DEPARTMENT 'APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING 3 BUILDING PERMIT NUMBER: DATE ISSUED: 3-- a -C), 0 o / SIGNATURE: CCs -- Building Commissioner/l-for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: i y N�}o�ti� Lac-7 M Number Parcel Number tuber 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sf) Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Require Provide Required Provided Required Provided 1.5. FI Zone Information: 1. Sew a sal 1.7 Water Supply M.G.L.C.40. 54) �sP° System: Public ❑ Private p Zone Outside Flood Zone p Municipal On Site Disposal System p SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record �ivv n'1 ltJo 6/J ltJlJ otic Lv[� Name(Print) Address for Service Signature Telephone o 2.2 Owner of Record: Qo Ab Name Print Address for Service: M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ i t JLicensed Construction Supervisor: License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone SECTION 4-WORKERS COMPENSATION(NVLG.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. Signed affidavit Attached Yes.......11 No.......❑ SECTION 5 Description of Proposed Work check au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ' ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: -��— SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICLAI.USE f?l!iLY Completed b ermit applicant ;,,. ; - 1. Building r (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 1, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf.in all matters relative to work authorized by this building perniit application. " Si iawre of Owner Date SECTION 7b OWN//E��R///AUTHORIZED AGENT DECLARATION I, d4lz �x UV�� as Owner/A,&� ^.+.4^f subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Si attire of Owner/Agent Date NO. OF STORIES SIZE r BASEMENT OR SLAB SIZE OF FLOOR T NMERS 1s 2 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DI[v1ENSIONS 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 %4wRrk Town of North Andover °xs., w °0 Building Department ° 27 Charles Street # _� a9 tocxxvv<. 1� �' North Andover, MA. 01845 s D. Robert Nicetta Ac►ause Building Commissioner (978)688-9545 (978) 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print. DATE Z'I JOB LOCATION Number Street Address Map/lot "HOMEOWNER A?Nil//Y) GyDDD }7 og [ V 45770 �� / Name 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 two units or less and to allow such homeowners to engage an individual for hire who does r not possess a licens8,i provided that the owner acts as supervisor. (State Building Code Section 108.3.5.1) DEFINITION OF HOMEWOWNER: Person(s)who owns a parcel of land orr which he/she resides or intends to reside,on which there i h r s oris intended to be a one or two family dwelling,attached or detached structures ac- cessory 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 No.Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL I 3 was r FURNA t dryer STORAGE U) 3 O , N ; 2668 ` 6 ,-t26$� I rvl t f O i - O(D f O FA11A A. !-Y' sink M refdg �0 0 - N TV S`c° 21035 LIVING AREA 609 sq ft i Date.-//:. N2 4781 oftiwORT + TOWN OF NORTH ANDOVER 0 0 0 PERMIT FOR PLUMBING SAC14US This certifies that e--.1 . . . . . . . has permission to perform . . . . . . . . . . . . . plumbing in the buildings of : . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at. . . . . . . . . . . . . . ., North Andover, Mass. Fee. . ... .Lic. N . . . . . . . . . PLUIVIBINGINECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Date. . . . ..©.... . . ... . HORTM pf ao 10 F� °p TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION h �9SS^CNUSEtt This certifies that has permission for gas installation,. in the buildings of . . . . . . . . ` . :. . . . . . . . . . . . . . . . . . . . . . . . . . at . �`� . �? ` �` '. . . . . . . . . .. North Andover, Mass. Fee. 15. . . . . . Lic. No../Y. 7. . . ` GAS INSPECTOR' Check# 3612 159 i 1VIASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING V—W, IType or print) Date-1-7f , �r 2 19 a� NORTH ANDOVER, MASSACHUSETTS Building Locations Cr' Permit 9 261 2, Amount S Owner's Name �2 New❑ Renovation Replacement Plans Submitted n - n Ilu Z J Z z Z y Z = Z _ suaSE .vfETF - B ,kSE .vt ENT iTr. FLOOR 2N D . FLO U R 3 R D . F L O U R 1T II . FLOG It 3T If . FLooR 6T II . F L 0 0 R 7T If . FLoo It S T Ir . F L O O R Name—(Print or type) � � � Check one: Certificate Installing Company 11'.21 Address L� Parmer. Business Telephone Firm/Co. Name of Licensed Plumber or Gas Firter INSURANCE COVERAGE Check one: I have a cu�'ent liability Insurance policy or it's substantial equivalent. Yes Zr No If you have checked ves. please indicate the type coverer=e by checking the appropriate box. Liability insurance policyM Other type of indemnity 71 Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter [42 of the Mass. General Laws,and that my signature on this permit application waives this requirement. Check one: S]enature of Owner or Owner's Agent Owner ❑ Agent I hereby certify that all of the details and intbi-mmion I have submitted for 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 all pertinent provisions of the Massachusetts as Co and Ch p r I-f'' the General Laws. Bv: Sienature of Licensed Plumber Or Gas Fitter Title Plumber 7 Cl City/Town Q Gas Fitter (cense ;Numoer 'faster PPRU�"ED It>rrlc:=usF �Ni.vl Journeyman MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Z�( Building Location � �/A'-- rA/4 Owners Name 11/lYC, Permit# - I Amounts Type of Occupancy <!C, New Renovation Replacement Er Pla s Submitted Yes No El FIXTURES z PLO z H a � w � a H d � H SIRBM MTILOCIR 20 1LOCIR 3M l--OCIR 4M Him s�x>�oaz Date.U �. z '4732 ;heck one: Certificate 10RTIy ❑ Corp. °� ,�'° •'" TOWN OF NORTH ANDOVER G j PERMIT FOR PLUMBING artner. , ,SSACHUS� This certifies that ..,. r e box: has permission to perform . . <-r—.�-� . .c.�, Bond plumbing in the buildings of at. . 1.�y. , , . , plication does not have any one of the above . . , -t r_.� ,..?- . . .-�---. . . . . . . . . . , North Andover, Mass. � Fee./.S .r . . .Lic. No..'?'/,?�F . . . . . . . PLUMBING�jINS , rent GPE/?,ECTOR )ove application are true and accurate to the Check # �� Jl mit Issued for this application will be in t er -42 of the General Laws. WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Title G' Z City/Town License TNumoer, Master Journeyman APPROVED(OFFICE USE ONLY I � i i Town of North Andover I t%ORT o Rt, ® A ® Building Department ® c 27 Charles Street North Andover, Massachusetts O1845 (978) 688-9545 Fax (978) 688-9542 sSAenu§���y DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of. Building permit# / R the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in/at: I� � Ilzhfjj�-IL 5Tft7(;S-J4 e�5_6 Facility location ` Signature of Applicant yh)- / Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project.through the Office of the Building Inspector. i TkORTH Town . of over , 0 LA ori dover, Mass., O� COC MICKE WICK V ADRATED S H BOARD OF HEALTH PERMIT T Food/Kitchen Septic System THIS CERTIFIES THAT........ BUILDING INSPECTOR . ........... .........&.Pob...................................................................... Foundation has permission to owt.... .......... buildings on W.�gLAM.7!!k.............. Rough to be occupied as...Foo ..Jy.....R.00oft1.11i ..VK.1O.V*............................. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of � �'$. rias pta � Buildings in the Town of North Andover. 7 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU=O Rough ........... .......................................... Service ... . ......... ..... ..... ...... .. . BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. f MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS j Date G Building Location / /1�C�lG� Owners NameLPermit# 417 P • � Amount Type of Occupancy . New ® Renovation Replacement F1 Plans Submitted Yes No FIXTURES z zCn w a >4 a� o wa z a �" U zE. p, d SOMM BSS / r M>�O(MR MFLOOR 3t FLOCR 41H FLOOR 5]H FIDQt 61H Kit 71H Hit 9IH Hfm (Print or type) /-- / Check one: Certificate Installing Company Named/ ��� 1:1 Corp. Address L �y` Partner. Business Telephone Firm/Co. Dame of.Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: I�iability insurance policy Other type of indemnity BondL.1dr El ❑ Insurance Waiver. I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature 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 all pertinent provisions of the Mas sac to u b' C apter 142 of the General Laws. By: signature or Licenseaum er Type of Plumbing License Title K�2 City/Town 7icense NumSer Master Journeyman APPROVED(OFFICE USE ONLY 2 ;' 4 6 Dater .:....! : f NORTH'1 :;t.. ��'�."°O� TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING ,ISACMUS� This certifies that ....................:. .........................'. .............................. has permission to perform .... ..............:.... ........................................ �a wiring in the building of................. ' ' .. ......:......................................................... i t.....:L......::.... <-.��- _ ��North Andover,Mass. Fee.... .....:...... Lic.No./.....:.. ......... ' I.......a................................... ELECTRICAL INSPEC MR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer -_� v_ �;,•—.......a va �i.�..w-�7,a..t.a.,..,�,1..� ..sc only DEPARTME7VT0FPUBLICS4My � BOARDOFMEPREYE W0NRWUMT10ANR7CMR12�00 P ermit &Fees Checked APPLICATIONFOR PERMIT TO PERFORMaECTRICAL WORK 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 m��� 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 N�J ►}� I�VD 06 Owner's Address Is this permit in conjunction with a building permit: Yes® No ® (Check Appropriate Box) Purpose of Building R S l n Utility Authorization No. Existing Service Amps� Volts Overhead ❑ Underground ❑ No.of Meters New Service Amps / Volts Overhead ❑ Underground ❑ ---••� ,"X No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work IQ E=NO V A7 BSS t—M EkrT— No.of Lighting outlets No.of Hot Tubs No.of Transformers Total No.of Lighting Fixtures KVA 8h g 1� Swimming Pool Above Below Generators KVA / and ound No.of Receptacle Outlets / No.of Oil Burners No.of Emergency Lighting Battery Units i No.of Switch Outlets to r 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 P s Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained No.of Dryers. ' Heating Devices Detection/Sounding Devices KW Local ❑ Municipal Other No.of Water Heaters KWa Connections No.of No.of Si Rns Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER Jia Tr�u'moeCaraage tithe1eq�a»�ofMa�dis�l�GataalLaws Ihawaa>aaitIiabildyhum=Pck-Yr kdMCanpkk CmeaWcrdsWxt Wec�tivarai y� ❑ NO E3rrrMestditnitmavatirlpoofofsarneatheo�YES ❑ rfjcuhmeIdxdmdYES pkmeitdic*thetypeofoovaawbydmckiigthe box NWWICE ❑ BOND ❑ OTHER ❑ ftwespe y) Eyialim Dole Estin&dVahtedMmftical Wait S Wodc�Slatt . � IrnpaCtionIJa�Regt>S6ed Rao FEWsigned underlie Penalties cfpajuay: FIRM NAME Sigra°e LioaseNo Busies Tel.Na A � Alt TeL Na OWNER'S W5[IRANCEWAIVER,Iama6v=t9theL=wdomnut 'xm%rd=aMBWOrISR*WrtWcWnelotastcLmadlyCnffaILaws andthattnysg�traernt!>is pe�applirabatwai�esthis tec�ertag (Please check one) Owner a Agent ❑ 6y Telephone No. 1�7WI 7 PERMIT FEE$ i