HomeMy WebLinkAboutMiscellaneous - 15 MAGNOLIA DRIVE 4/30/2018 15 MAGNOLIA DRIVE
210/043.0-0037-0000.0
Date.... .....
of NORTH
TOWN OF NORTH ANDOVER
'01WRAW PERMIT FOR WIRING
This certifies that .........-7....C..'.'ff.../.:....... ...................
has permission to perform .......... .c..... ..............
..........
wiring in the building o44...... .....................................
at......... ............. North Andover,Mass.
Fee.�S. . ........ Lic.No./.?.7./J ............. ....
ELECTRICAL INSPECTOR
Check #
7432
Offrcia' Use Only
-- Permit No. 7// 32�
Department of Fire Services
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WOR
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL.INFORMATION) Date: > p
City or Town of: To the Inspect r of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number)
Owner or Tenant �ot �,�j, o s,r} Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ 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:
ea,d wllrt Ca ", -c,4_,
Completion of the following table may be waived by the Ins ector of Wires.
INONo.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tr Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
.aboveIn= o.o mergency Lighting
No.of Luminaires Swimming Pool rnd. ❑ rnd. BatteKy Units
No.of Receptacle Outlets 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. Tons Total 3,S No.of Alerting Devices
No.of Waste Disposers Heat Pump Number. Tons KW o. of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other
Connection .
Heating Appliances Security Systems:*
No.of Dryers g pp KW No.of Devices or Equivalent
No.of Water-- ,_. No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:No.of Devices or Equivalent
.+ r OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (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 permit issuing office.
CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:)
I certify,under the pans and penalties of perjury, that the information on this application is true and complete.
FIRM NAME: Ake— LIC.NO.:
Licensee: Signature LIC.NO.: I'171 f,2
(Ifapplicable,enter exempt".in the license number line.) Bus:'Tel:No 4>7k-372:%S5;;
Address: R�— SI S 41Y aJe s Imo. a)/f OJO7! Alt.Tel.No.: Ara 212f>23e,
*Security System Contractor License required for this work; if applicable,enter the license number here:
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/..bent
Signature Telephone No. FPERMIT FEE: $
gas
MASS APPROVAL .# GASFITTING
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO Do
.(Print orXT )
A) 4 , Mass. Date Permit 9
Building Location-
-- r K�(�� ( T Type of Occupancy I cu����
New p' Renovation rki Repucerfient 0 Plans Submitted: Yes[] No
n
o:
Y t G In
N W Q O V = F S
UA
e: C Cr
n UA r r a o z o ~ 'v' o M i
i W > u z. < C < < o o � o
c > o s V. o
SUB—BSMT.
BASEMENT I I
IST FLOOR I I I
2ND FLOOR I I I
3RD FLOOR I I
4TH FLOOR
STH FLOOR ' I
6TH FLOOR I
7TH FLOOR I
BTHFLOOR
Installing Company Name YANKEE GAS Check one: Certificate
Address 140 SOUTH MAIN STREET 2 Corporation 103C
MIDDLETON, MA 01949 r-1
«Rr�cinace�Tpfnnhnna
978-774 ' 2 760 rP 4--FTm/Co.
Date. . . . . . . . . .. .
s the requirements of MGL Ch. 142.
HpRTM ropriate bo)L
°p TOWN OF NORTH ANDOVER Bond 0
. PERMIT FOR GAS INSTALLATION
Insurance coverage required by
':plication waives this requirement.
sSACMUSE Check one: .
�.: r. ' `' Agent❑
This certifies that . . .. . . . . . . . . . . . . ..� -alt �
.� /r
has permission for gas installation, :J. . .. �
�— jaticn e We d accurate to the best ai my
in the buildings of -� E? L' . . . �. . . . . . 'I 1 be m c°mp' a°
at . .�,,—North Andov r, Mass.
';w moor or rtter
ee.u!�. . . . Lic. No... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GAS INSPECTOR 3785
C`eck#
4639 -
1 ___ � __,. o-�� - •f-j:.�r..✓Nt�`L �nr.y,;y ..--'Mrr.-• ..'.,.�.:4.,....u. � .. .-r.�+... ._ ..t`
Location -5 1j)40joL114
No. /G / Date �.
NR�N���
o,t«,o r.,w ®p4TOWN OF NORTH ANDOVER
Cer I
!.?•� Y��
w of Occupancy $
'Building/Frame Permit Fee $
f
Foundation Permit Fee $
sACMu
®r/ �tppr Permit Fee $ l� 0d
L Sewer Connection Fee $
Water Connection Fee $
TOTAL $
/z, ,
Building Inspector I
505 / Div. Public Works
PERMIT NO. (D l APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1
MAP $-4O. I LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE
ZPNE SUB 61W.-CO T NO. �)LOCATION
15 M A &irc C_
.Dle���' 7 PURPOSE OF BUILDING
OWNER'S NAME G ?A /LAnm`� NO. OF STORIES SIZE
OWNER'S ADDRESS I?� flA^ `r1 /K1 /SLI A ;\R BASEMENT OR SLAB
ARCHITECT'S NAME l T JJ SIZE OF FLOOR TIMBERS 1ST 2ND 3RD
} UILDER'S NAME L SPAN
4 DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS
DISTANCE FROM STREET POSTS
f DISTANCE FROM LOT LINES-SIDES CJl/S'T/%vG REAR GIRDERS
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW SIZE OF FOOTING X
jl9'S BUILDING ADDITION MATERIAL OF CHIMNEY
IS BUILDING ALTERATION - IS BUILDING ON SOLID OR FILLED LAND
L.-W'I—L BUILDING CONFORM TO REQUIREMENTS OF CODE S IS BUILDING CONNECTED TO TOWN WATER
1,i"6"15ARD OF APPEALS ACTION. IF ANY 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
PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT.
PAGE 2 FILL OUT SECTIONS i - 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
LA S MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
• DAT -Ep
��19Z
BOARD OF HEALTH
SIGNATURE OF OWNER ORA ORIZE ATENT
OWNER TEL.# 6
F E E O CONTR.TEL.#_
CONTR. LIC. #
PLANNING BOARD
PERMIT NTED �7
< 19�
BOARD OF SELECTMEN
APR - 6 ►�
BUILD INSPECTOR
s
BUILDING RECORD
1 OCCUPANCY 12 i
SINGLE FAMILY I_ 'rOR1E5 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
MULTI. FAMILY O—FFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA-
APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION
2 FOUNDATION 11 8 INTERIOR FINISH
CONCRETEL11d 1 2 I3
CONCRETE BL'K. PINE
BRICK OR STONE HA STE 0
PIERS PLASTER
DRY WALL
UNFIN.
3 BASEMENT 11
AREA FULL FIN. B M'TAREA _
'/, 1/2 14 FIN. ATTIC AREA _
NO BM'T FIRE PLACES _
HEAD ROOM _ MODERN KITCHEN
4 WALLS I 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH
ASPHALT SIDING HARDW'D
ASBESTOS SIDING _ COMMCN
VERT. SIDING ASPH. TILE _
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ONMASONRY ATTIC STRS. 8 FLOOR I_
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR Ij POOR
ADEQUATE NONE
5 ROOF 10 PLUMBING
GABLE HIP BATH Q FIX.) _
GAMBREL MANSARD TOILET RM. 12 FIX.) _
FLAT SHED WATER CLOSET _
ASPHALT SHINGLES LAVATORY
WOOD SHINGES KITCHEN SINK
i
SLATE NO PLUMBING
TAR 8 GRAVEL STALL SHOWER
ROLL ROOFING MODERN FIXTURES Ir
TILE FLOOR
TILE DADO
6 FRAMING I 11 HEATING
WOOD JOIST PIPELESS FURNACE
_ FORCED HOT AIR FURN.
TIMBER BMS. &COLS. STEAM
STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR
WOOD RAFTERS _ AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS GAS
OIL
B'M'T 2nd _ ELECTRIC
1st 3rIrI NO HEATING t f >� p�
I
own ofFINAL
T40RTjj PINAL I
n4..� _ � over -
6
. No:
101
rG
xx ;
�F IVB V��� ��TRY PE RI' -
ri}a T �K r� er., Mass,P1
x
- 11
I * w BOARD OF HEALTH t
IT1110LD
'THISE � � i �
¢{<t �CERTIFISTH'AV-A„ ,, ” _
RA
.........
has permission to erect ........ ............ buildings onU4#-,,. . BUILDING INSPECTOR
• Rough
k'' to be occupied as. fcc....&7wo~. ej. 10t ............. Chimney'. .
`�•. Final
provided that the person accepting this permit shall in every respect conform to the terms of the application on file in ;
'-this - PLUMBING INSPECTOR
office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough :•.
•z-}Sk#ate
' Buildings in the Town of North Andover.
Final
fj $ 'VIOLATION of the Zoning or Building Regulations Voids thi mi r
xyt PERMIT EXPIRES N6 M NTHS ELECTRICAL INSPECTOR
UNLESS CON RUCT TAT Rough '
Service
a Final
••
'Y BUILDING ECIOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Final
µ ' Display in a Conspicuous Place on the Premises #
} " FIRE DEPT.
' Do Not Remove
Burner
No Lathing to Be Done Until 'Inspected and Approved b
Y Smoke Det.
Building Inspector
L.00atlon
No
Date `� 7 ,
pORtM rt TOWN OF NORTH ANDOVER ' k,
Certificate of Occupancy $
' �__.:.�..._, .,�•+ Building/Frame Permit Fee $
Foundation Permit Fee $
_ �.. Other Permit Fee $ h OD
r Sewer Connection Fee $
C Water Connection Fee $
r Y-
TOTAL $ /Q,
Building Inspector
-5Q87 A .it
i�
�i
c,
�¢ I
Date. ..
pORTH
i �tOya
TOWN OF NORTH ANDOVER
FO .� 9
• - PERMIT FOR GAS INSTALLATION
9SSACHUSEt
This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . .
JGti�
. has permission for gas installation . . . . . . . . . . . . . . . . .
z
in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
at . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., North Andover, Mass.
O �
Fee.�.p,. . . Lic. No. 3. . . . . ..�. .��ter.C. . . . . . . .
/►� / GAS INSPECTOR
Check# l/3
6002
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type) •
, Mass. Date �`�—�2 3 '7 Permit #
- Building Location �S� �� /4 ��` Owner's Name&�Ze;4
Type of Occupancy
New Ja Renovation ❑ �. Replacement ❑ Plans Submitted: Yes❑ No ❑
m
N W N
Y Z ¢ uj
N N V X 1•' 2
N Q N ¢ O O N S !-
W J in W O U 0] S n
Q
z a u a ¢ ¢ a a r
a m rn 1- +J W O a c as Q
cc N C7 W < _ = F- N O > W
V W N Q 2 D
W W Q = 2 2 W ¢ W F W F. H T
0 F- .Z 4 LU J H z W W O O > LL }- U J
O to =
4 W > cz < C y- Q Q 4 < O O W O W F'
L6 O O O J U > D a H O
SUB—aSMT,
BASEMENT
1 ST FLOOR
2ND FLOOR
OR I
3RD FLOOR _
4TH FLOOR I
5TH FLOOR
6TH FLOOR
". 7TH FLOOR
�d
CLIMATE DESIGN HEATING and AIR CONDITIONING, LLCC
+. heck one: Certificate
_
Installing 5 South Summer Street w1 610
Address Bradford,MA 01835 'ReCorporation ems'
978-372-9999(phone) _ = Partnership
978-372-0882 (fax)
Business Telephone t ic. Plumber: t,,,; HaPJ,- Au) - Firm/Co.
Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes X No ❑
If you have checked yes. ple
tase 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:
Owner❑ Agent ❑
Signature of Owner or Owners 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 perms sued for this ap licabo will be in compliance with all
pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of theFG neral s. f)
By. Tyke of License.
ti-
;Plumber nature of Licensed umMo�as Fitter
Title 0 Gasti r 1 3%0
c'Master License Number O
Gty/Town Journeyman
APPR(7VED (OFFICEUSE ONLY)