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HomeMy WebLinkAboutMiscellaneous - 165 MARBLEHEAD STREET 4/30/2018 (3) i 165 MARBLEHEAD STREET /�S 210/010.0-0053-0000.0 Date.....V........—/ .. .................. ,&ORTN TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ......Op./.......... .. ... • ...... ..... .... ...................... has permission to perform ........... 4, -Y......�yl. /-0?........ wiring in the building of 1�......./Iz ............................ 65— A# at............................................................................ North Andover,Mass. Lic.No.,3�, A40.............. . ..... . ........I...... Fee..................... . . . . .�.-�A44 ELEcrRIc;Z1*INSPECTOR Check # 007 Z 7 6 5.6 Commonwealth of Massachusetts Official Use Only Permit No. - = Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/051 (leave blank) —J APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code %IEC).527 C`�IR 12.00 (PLEASE PRINT IN 11VK OR Y E ALL : FORLIATION) Date: City or Town of: /IUlU� �d a OL-- To the Inspector of Wires: By this application the undersigned gives notice of his or her intention o perform the electrical work described below. Location (Street& Nu ber) �[ Owner or Tenant Telephone No� j Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility A thorization 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: ��rrLLAh t F �' /-y Sys Completion of the following table may be waived by the Inspector of 6Vires. 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 Above In- Emergency tg ting No. of Luminaires (Swimming Pool arnd. ❑ grnd. ❑ Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection ana Initiating Devices Total No. of Ranges INo. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pum Number Tons KW No. of Self-Contained ....................................................... P Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other J Connection No. of DrversHeating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No.of Devices cr E qui•alerit. r Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors Total HP No.of Devices or E uivalent OTHER: Attach additional detail if desired, or as required by the Inspector of 6Gires. 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 OVERAGE: 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,, tinder the pains mrd penalties of perjury, that the information on this application is true and cotnplete. FIRM NAME: ADT Security Services. Inc. LIC. NO.: 1533 C Licensee: ,'C G�� ,(� 1��5 { Signature LIC. NO.: :5WL4 L-� (If applicable, enter "exempt"in the license number line.) Bus. Tel. No.: ,-X94- �_ Address: 18 Clinton Drive Hollis N.H. 03049 Alt. Tel. No.: 603-594-5930 *Security System Contractor License required for this work; if applicable, enter the license number here: 00 111411 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hcrve the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. 1 am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE: $ Signature _ Telephone No. Location/f�— No. � Date �� - t �oRT� TOWN OF NORTH ANDOVER 3? •`' �. o f A s ; : Certificate of Occupancy $ Building/Frame Permit Fee $ s�CHUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ c Check #/� d 1 4 1 2 1 l Building InspIg/tor TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING �q M. ..s'z.W p .s`, ; �•.. �'"" ,....p,_, _ .. yc Swokm BUILDING PERMIT NUMBER: DATE ISSUED: X SIGNATURE: Buildin 6- ssio er din Date • Z SECTION 1-SITE INFORMATION o 1.1 Property Address: 1.2 Assessors Map and Parcel Number:. Map Number Parcel Number 1.3 Zoning Inform 1.4 Property Dimensions: AO Zoning Distrid Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 1.7 Water Supply M.G L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private_ 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSIEP/AUTHORIZED AGENT M 2.1 Owner of r�ecord Name(Print) Address for Service Signa a Telephone N 2.2 Owner of Record: Name Print Address for Service: O z M Signature Telephone M SECTION 3-CONSTRUCTION SERVICES 7� 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed'Construction Supervisor: License Number wn Address Expiration Date ic Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name M Registration Number Address OWNS 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. Signed affidavit Attached Yes.......❑ No.......0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: A F x. .,Jx SECTION 6-ESTIMATED CONSTRUCTION COSTS .. Item Estimated Cost(Dollar)to be �3C1€ .1TONr' y Com leted by ILermit ap2licant 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 AOWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT w; 4, I, as Owner/Authorized Agent of subject property Hereby authorize to act on '?} My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I,��/�//j/ms 4�/x ,as Owner/Authorized Agent of 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 N e Si ature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINIBERS IST 2ND 3RD SPAN DIN ENSIONS OF SILLS DDVIENSIONS OF POSTS DD,4ENSIONS 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 NORTH Town , of _ 4Andover CO, o '� dover, Mass., 4a COC MI CME W ICK �q ADRATE D PPa\�,�5 S BOARD OF HEALTH PERMIT D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ......................... ............... ........ ............. ............................................... .................... Foundation 5has permission to ere ................ ...... buildings on . ......... Rough to be occupied a ................................................................... chimney . . .. .... . . . .. . . . . provided that the person acc this per shall in every respect conform to the terms of the application on file in Final this office, and to the provisi s of the Cod 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 " Final UNLESS CONSTRUCTIONS 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. turner r- Street No. SEE REVERSE SIDE smoke Det. ` 0 NOR7k 1 Town of North Andover ?.� :."o Building Department sop 27 Charles Street North Andover, MA. 01845 �,S•,Te '�.g D. Robert Nicetta S"`""5e Building Commissioner (978) 688-9545 :(978) 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print G DATE JOB LOCATION Number r Street Address Map/lot "HOMEOWNER 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 not possess a license, provided that the owner acts as supervisor. (State Building Cade Section 108.3.5.1) DEFINITION OF HOMEWOWNER: 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 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, f 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 Location Nod Date NaRT� TOWN OF NORTH ANDOVER Ofst��o 1ti % Certificate of Occupancy $41 _ ' Building/Frame Permit Fee $ S Foundation Permit Fee $ s�cMusE Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ I ,s TOTAL C� rT 361V Building Inspector ,� 49/02/98 09:22 /188-50 PAID Div. Public Works r r `,Location ( ' No! -%� �'� Date j �f "OPT q TOWN OF NORTH ANDOVER o?O•,t`,o -0 p Certificate of Occupancy $ + Building/Frame Permit Fee $ Z Foundation Permit Fee $ s�cMust Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee TOTAL J k " , Building Inspector ' Div. Public Works PERMIT NO. 370 APPLICATION FOR PERMIT TO BUILD********NORT11 ANDOVER, MA i!► LUi.NO. Z. RLcoRI)Ol oW11'4ERSIIIP DATE BOOK PAGE AI\P NO• v ZJ)hE SUB DIV. LO'F NO. / 1.O(-A110N PI1RK)SE(X:IjUI1DING ) e-it. tk OWNER'S NAt.IL' NO.<)F ST(1F21ES SIZE 1)WNI R`S ADDRESS ���� � /'��, BASEMENT OR SLA[3 Rn ARl'I II1 ECI'S NA).tE SIZE OF FLCKNt TIMBERS I 2 Hn 3 Bt III DER'S NAME SPAN DIST ANC E TO NEAREST BUILDING 2`1 DIMENSIONS OF SILLS DIS FANCE FROM STREET' C—Ad t �J DIMENSIONS OF POST S DISTANCE FROM LOT LINES-SIDES Q1)I REAR 161 DIMENSIONS OF GIRDERS AREA OF LOT .S oaq ( ��FRR NJI ACE ' t I IEIGI f OF F(x1NDAll(N! THICKNESS SIZEOF F(K)IINC. X IS BUILDING NEW IS BUILDINGADDITIONMATERIAL.OF CIIIAINEY IS BUILDING ALTERATION y�S U-01 IS BUILDINGON SOLID OR FII LED LAND wil1.BUILDING CONFORM TOREQ111REMENISOFCODE Y ISBIIII.DINGCONNECTED'IOTOWNWAIER s '!,i0-ARD OF APPEALS ACTION, IF ANY IS BUILDING CCNNNECI ED TO TOWN SEWER �, S IS BUII.DING CONNECT ED TO NA I'URAI.GAS LINE Y LANDC'C)ST IP{Sl'll("LYONS 3. PROPE117Y INFORNIATION q ES f. BI.IXi.COST 1 PAGE I FILL Ot I F SECTIONS 1-3 ES 1. BLL)G.COS f PER S)2. FT. EST. B1 DG. COS I PER R(K)M ELECTRIC METERS MUST BE ON(x1TSIDE OF BI11IF)INO; SE19IC PERMI F NO. AnACIIEDGARAGES MUST CONFORM TOSFATE FIRE REGULATIONS 4. APPROVED PLANS MUST BE FII.ED AND APPROVED BY BUILDING INSPECi(X2 BUILDING INSPECTOR DAIS FII ED 3� Z j 0 OWNERS'FIiLN D0 COOI RAELH � C(N,f1 R.l.1C'N S16NAIURF.Of OWNER OR At)IIK)RI"ZI:DAGENT � b PERMIT GRANIED 47It 19 t4ORT Town of over No. 3 Z A dover, Mass., 19 * � 0 -T S LAKE � '9 COCHICHEWICK i'�• •9 4�q,4 E D PP`s •�� is BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System `v`� � BUILDING INSPECTOR r '1 THIS CERTIFIES THAT................ .... ................ .e. �l Foundation ........ has permission to erect...' l.t- t�..... bw dings on T.......... . IM kkl.��4'ce �..t..... Rough ........ .... ............. II / to be occupied as .'-V.%-c�.bf.. F.S�l AA& .�. a�'Yj. /.04 Chimney provided that the person acceptiNg this permit shall in ev ry 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 Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TARTW Rough ...................... . ............... ......... ................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner •� Street No. v �/ Smoke Det. MORTGAGE INSPECTION CYR ENGINEERING SERVICES, INC. 234 ESSEX STREET LAWRENCE, MASSACHUSETTS MORTGAGOR. '�/� ADDRESS OF PRINCIPLE BUILDING l`/:QTI+' /-AIV-0V52, f1-45S. 1 I� DEED REFERENCE: BKii=%;LPG. Z(o v' Lor - PLAN REFERENCE: 02-d7 K 5,�9 SF DATE OF INSPECTION: aA- 2. 19-58 l � I I g' NOTE This Mortgage inspection was prepared spe. ;JT �• I not to be , srY. l U J relieedd u ly for as artsurve .Cyr ses and Engineering Services, �n survey.��9• ng uc.Fe $ Inc.accepts no responsibility for damages result- ing from said reliance by anyone other than the and its assigns n connection with its proposed mortgagee mortgage financingi to said mortgagor. CERTIFICATION TO: i y This Mortgage inspection was prepared in accordance �GNdru uuC Fei,�s with the Technical Standards for Mortgage Loan Inspections as adopted by the Massachusetts Associa 1\14 tion of Land Surveyors and Civil Engineers.Inc. W J I FURTHER STATE THAT IN MY PROFESSIONAL „^ OPINION the principle struct re/s and accessoq� I'V�11 outbuildings, !�li" (� with the setback requirements of the local zoning or- 1`\�/ dinances,and that there are no encroachments of majors either way across property lines ex as os . s J. e ALSO: �rc:r � rhos.- ;✓,o,✓,c 2,c-r� Silt ■ 1.Property is not in a Flood Hazard Area ❑ 2.Property is in a Flood Hazard Ansa. ❑ 3. Information is insufficient to determine Flood Hazard. Scab: Doe of Plan: 1� ;_/ Flood Hazard determined from latest Federal Flood Insurance Rate Map. r Town of North Andover ' BUILDING DEPARTMENT ! Homeowner License Exemption Wlease print) DATE JOB LOCATION Number Street Address Section of town "HOMEOWNER" �'�'e.r �Or.�o� ro$)-40664c3�9 { Name Home PhoneWork Phone PRESENT MAILING ADDRESS 01 Fq,5 . 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 I 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 Lo 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 , !.hat he/she shall be responsible for all such work performed under the building permit . (Section 109. 1 . 1) The undersigned "homeowner" assumes responsibiiit for compliance Y p ce with the Mate Building Code and other applicable codes , by-laws , rules and <�gulations . !e undersigned "homeowner" certifies that he/she understands the Town of ­ Lh Andover Building Department minimum inspection procedures and ._ .:quirements and that he/she will comply with said procedures .and i.-equirements . 'OflEOWNER' S SIGNATURE �•,� i PROVAL OF BUILDING OFFICIAL i jte : . Three family dwellings 35, 000 cubic feet , or larger, will be required to comply with State Building Code Section 127 .0, Construction Control . TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units...or to structures which are adjacent to such residence or building" be done by registered contractors, with certain exception, along with other requirements. Type of Work: � - Est. Cost C 6W Address of Work Owner Name: cS —' Date of Permit Application:) 1 hereby certify that: Registration is not required for the following reason(s): For office Use Only Work excluded by law Pemit No. 3Z� Job under $1,000 Date !/72 Building not owner-occupied Owner pulling own permit Other (specify) Notice is hereby given that: CONTRACTORS OWNERS PULLING THEIR OWN IMPROT 0 VEMENT T WORKK DO NOTITH HAVE ACCESS TODTHEE ARBITRATION FOR APPLICABLE HOME PROGRAM OR GUARANTY FIND LINER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Da Owner Name 08/14/1998 10:47 19786826270 MARTHA BRIGGS DESIGN PAGE .02 1 NPWAW , xEeryn�►� J� .... 41 ,c'•t �� 17 08/14/1998 10:47 19786826270 MARTHA BRIGGS DESIGN PAGE 03 yv I 4-4 V N to a A- J i i vv/1`}/177v 1e�.4r 17tGOOLOL(Cl MAKIHA bRIUGS DESIGN PAGE 04 i1 �t ► x 4:5�ln"Zol �w IN t t�lls ev f + � d Bra -f?:7 ^ "sem t rTI•�- 0V �T7 �1 �'"�fl r^r�"�['[/t d ,-A AjO � ,: .� s s.r;ice---, ,::,: _,a- ,a.-r-; r�•��raca }�Llk' 08f14f1998 10:47 19786826270 MARTHA BRIGGS DESIGN PAGE 05 nv p ` +�f�ox •. V;�-t�F ��- tit���.�►IoN� w t`�-- �►L�S 6•N ��L '� 3,4vIt� l� TYP1l h Ll �Kier,00-Y w fi � E , u ' 1� IL PLO , - . _ C .. .. :___...._ ' 08/14/1998 10:47 19786826270 MARTHA BRIGGS DESIGN PAGE 06 rn C= CD N rf+ O co � a w N is ra � a m ❑ �D ❑ � C� � tV t�j �T i N /�-�E co CY I................ oe v as D,.S9 D�gn: morin erMof t sof llY fffi TME "muff FAIRFIELD SCBM:m®ronum wwwvwissM++en natear+leeeeaaca�laa%+�+s EATMERIOND „ppb HOME DEPOT �twhftaeanpWarjoa 186MMBLEMEADST D na ANDOVER MA01IMS RGONA y �- Date. •5• 3820 e ,,ORT►, TOOF O`S�.■c ��1ti0 TOWN N #b� ;. M PERMIT FOR PLUM IN a ss,cmus � NORTH AMOVER a EASURER-COtLECT05 This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . .. . . . . . . . . plumbing in the buildings of . . . . . . . North Andover, Mass. Lic. N/0�0. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR a 1 - 16:12 50.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer + MASSACHUSETTS UNIFORM APPLICATION FOR PER IT TO DO PLUMBING V (Type or print) 12-1 Q's NORTH ANDOVER,MAASSACfPETT$ ^ ` Date Building Locations USS �'+0-bbk�eQ/ �(' Permit # 13c�2611 Amount 00 Owner's Name &X-4 New Renovation Replacement ❑ Plans Submitted n FIXTURES rA � w w a F � w a a x A a d w d A SZSBM BjL4T'INT ISE RDM 2 I Z%D FLaR 3M RIM 4M l[Jaa 5M RIM 6M FWM 7MRJXR gIH FWM (Print or type) Check one: Certificate c Installing Company Name e-epl tekirlc Corp. � ., )Opt ' I S Partner. � Address ` , S �1 �� .2 wt M Business Telephone (o ' ❑ Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate theXe 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 insurance signature Owner ❑ Agent lib s terasAsasl•+��aeons l laC==:i1jmiW 'c cmc ac af�c bat 0fmy jmaMeage and that all phmmtimg work and pabrvxd far iais appiL� be m m Code yfhaker 142 of the General Laws. compliance with all pertinent provisions of the Massachusetts to P g Cod t By: tgna re otLicensea riumoer Type of Plumbing Liewse Title 91D City/Town umuer Master El/ Journeyman 4 APPROVED(OFFICE USE ONLY r N° 2 J J J Date..�.p...�� .:.. O NORTH ft •�"� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ^cMusf This certifies that ... ...:'t4... - ...............a................................. has permission to perform . ,..�t ,-�.r - .^........................................ wiring in the building of... ... ...--...................................... at./.4W..... ; ........... ,North Andover,Mass. } Fee?4...6"'�..... Lic.Nol-�;-./. S!A............................................................... ELECTRicAL MpECTOR 09/15/98 15.37 40.00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer L\ Office Use Oniy Permit NcL Ov 9 71-75 Occupanel 8 Fee Checked0`" BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:0//0 (Please Print in ink or type all informadon) Oate To the Inspector of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number ! S 0. Owner or Tenant ^ ( I Owner's Address ^/G-S 1 v\.0'A�Q. en-I IS Is this permit in conjunction with a building permit Yes ❑ No ❑ (Check Appropriate Bax) Purpose of Building_ )•Q- C Utility Authcr¢ation No. Existing Service Vy Amps 2 3 t? volts Overhead ❑ Undgmd ❑ No.of Meters New Service Amps Vcits Overhead ❑ Undgmd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed E'.e=cal Work t.D levo Total No.of LjqmtSnq Outlets to No.of Hot fuse No.of Transformers KVA r Above C In C No.of Ugntinq Fixtures Swimming Pool gmd C qmd C Generators KVA No.of Emergency L<gnbng No.of Receomc!es Outlets No.of Oil Burners Bartery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone t Total No.of Detection and No.of�Ranoes No of Air Conti Tans Initiating Oevices Heat Total Total f No.of Oiocsal No. Pumos Tons KW No.of Sounding Devices I r No.l of Self Contained No.of Oishwasners SoaceiArea Hestina KW OetectioniSounding Devices C Muniupal C Other No.of Owers Heating Oevices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Badases I Winng No.HWro Massage Tuds No.of Motors Total HP OTHER INSURANCE COVERAGE. Pursuant to the regwremen6t3 of Massachusetts General Laws I have a current Uabdity Insurance Polic/including Completed Operations Coverage or its substantial equivalent YES= NO = ha m, valid proof of same to the Office YES= NO = I youhave ch YES please indicate theet/ype cp`raye b checking the appropriate box I SURANCe = BOND = OTHER = (Please Soeafy)' (Expiration Date) Estimated Value of Electrical Work$ t9++ Work to Start Inspection Date Resquested Rough Final Signed under the Pen sof ury: C FIRM NAME c UC.NO. Q Ugjnsee 15i Signet LIC.N0. 1/ � 4 0 t1\ y ��1( —�'7`- eus.Tel o. Addrasa Aft Tel.No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachuse[ts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE 5------ - (Signature of Owner or Agent) Date....... .. . . . . . . . .. . . pf Mp oT/y q'1. o� �` TOWN OF NORTH ANDOVER t ~ P PERMIT FOR GAS INSTALLATION h �-ISS ACHUSEtS This certifies that . . . ' ' . .� /? �. . . �. . :!:'. . . . . . . . . . . . . �P has permission for gas installation . . . . . . . . . . . . . . . . . . . . . . . . . in the buildings of . . . . .`. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at North Andover, Mass. Fee. . . .'. . .'. Lic. No.. . . . . :.'. . . i... . . . . . . . . . . .. GAS INSPECTOR Check# 1 4 , 62 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) k baye (L . Mass. Date 4- 6.2 Permit # Building Location__ IL 5 GE yEA/1 Owner's Name 6A2,q I/ y" .. Type of Occupancy VeS ic/Px c�,/ v New ❑ Renovation ❑ Replacement Maris Submitted: Yes[] No ❑ tn OC Y N N V Z rL N W W tic O U ' h F' J N Wm S A Z O W h 4 CC Z 0 O h W 4 O M M cc W O a c si h N a N tl a W S Z r' N O. W J Z x a H A ac t' G h s N it tl H Z J ! Z p. W W O > u. �W. U J W z a u, 4 a h a. H m z o z a o 4 x Q W > a W = z. 4 X 4 oc .= O tl 7C U. a 3 G tl � V c > a a F- O SUB—BSMT. BASEMlEMT _ !ST FLOOR 2ND FLOOR 3RD FLOOR a 4TH FLOOR `i STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name BAY STATE GAS COMPANY Check one: Certificate # Address 55 MARSTON STREET X7 Corporation 1862 LAWRENCE, MA 01840 ❑ Partnership Business Telephone .687-1105 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Francis X. Corkery - INSURANCE COVERAGE: I have acu renntt liability Insurancepolicy or its substantial equivalent which meets the requirements of MGL Ch. 142. if you have checked Vis, please indicate the type coverage by checking the appropriate box. A liability insurance y , dY policy 18( 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 El hereby certify that all of the details and information I have submitted(or entered)in abo plication are true and accrue to the best of my knowledge and that all plumbing work and installations performed under the permit Iss f r this application will n mpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene S. . T of License: Plumber Signature of censed Plumber or Gas Title Gaslitter Master License Number City/Town 9Journeyman APPR0VEUT0TF1c—EUs—r-0—N—LW— BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO, APPLICATION FOR PERMIT TO ADO GASFITTING NAME TYPE OF 13UILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED DATE .79 GA3 INSPECTOR 1 -. Location No. e) Date NORTy TOWN OF NORTH ANDOVER 1O _ O� 9 Certificate of Occupancy $ Building/Frame Permit Fee $ s�CHU Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 1655i � - ��Buftng Inspecto TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING DATE ISSUED:� BUILDING PERMIT NUMBER. M SIGNATURE: Building Commissioner/IEEeedtor of Buildings Date SECTION 1-SITE INFORMATION 0 1.1 Property Address: 1.2 Assessors Map and Parcel Number: I I,, A t o Z 3 bl e- ryC7'� 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 Required Provide. Required Provided R red Provided I Flood ood Zone Information: 1.8 Sewerage Disposal S 1.7 Water SupplyM.G.I..C.40. 54) System: Public 0 Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSH[P/AUTHORIZED AGENT Historic District: Yes___No M 2.1 Owner of Record .i' .1,S-v,- I b 5 it//(4 r<-C'� ��� — )ref Name }(Print) Address fo S vice .1.[kjil U� 'All U Signature Telephone 2.2 Owner of Record: f Name Print Address for Service: O Z Signature Telephone Mrn SECTION 3-CONSTRUCTION SERVICES go 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: 0 � License Number Address Expiration Date ic Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 Company Name Registration Number r Address _r Expiration Date z Sr nature 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. -Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check allapplicable) New Construction Existing Building ❑ Repair(s) ❑ —Fe—rations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: �J SECTION 6-ESTIMATED CONSTRUCTION COSTS 3 tJFFICiA L USE{}NLY Item Estimated Cost(Dollar)to be— Completed eCom leted by permit applicant , 1. Building i �Q) (a) Butldmg Petmit Fee Multi lier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee tel x(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1'+,1--A+5 " Check Number ' SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on 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, as Owner/Authorized Agent of 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 r S, ature of Owner/Agent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS 1sr 2ND RD 3 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 NORTH 4 ovm Ofover O No. Q y _ z Op AD � dover, Mass.,Wo DRATE BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System M.*41.5.51) BUILDING INSPECTOR THIS CERTIFIES THAT....... ............ ..' .............................. . . .............................. Foundation has permission to erect...�C?...� .. ..�........ uildings on .......16."V.../y1�.Ip6�iG ,f 1 r� .....�° Rough ���� �. Chimney to be occupied as.... ................ ........................................................................................... .................................... y 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 an By-Laws r;Vj ' g to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. �p/5�� a wowPLUMBING INSPECTOR VIOLATION of the. Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final �r�YI�'��• UNLESS CONSTRUCTION STe.A.0.40� 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. SEE REVERSE SIDE Smoke Det. ty r TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED: 1 D 3 -� X SIGNATURE: Building Commissioner/I for of Buildings Date z SECTION i-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: �eAd 10 Z3 J S- �(1;�AVhl� 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 Required Provide Reqwred Provided R aired Provided 1.7 Water Supply M.G.I-C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District:Y@S..�0 M 2.1 Owner of Record Name(Print) Address f Service 461 kili 24U Ll 9 7� YIQ �(IL6 Signatur Telephone 2.2 Owner of Record: Name Print Address for Service: O Z m Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ r Licensed Construction Supervisor: O License Number 11 Address Expiration Date r Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name M Registration Number r Address r Z Expiration Date /) Signature Telephone �l/ { 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. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check aIIapplicable) New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: i�1 Lin Ci 1� V SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be 0MV'CIAL USE ONLY 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+J+4,+5)11 44A _ 8' I Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ,as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of 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 Signature of Owner/A ent Date NO. OF STORIES SIZE ^ BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 3 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 i I 1A -�d�S gig, S•zs - _ .. r„nl T ryv" a r NORTH ToVVn of Andover :. 0% No. © q _: O� OCL w� dover, Mass., DRATED PP��.(5 S H E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT.......1......,lt.l .S 8............ ��.. .................................... ...................................... Foundation has permission to erect...49..�. .. ..�........ uildings on .......® ...��� 6. ..,�1.1r Rough Ica rk ���� N �r do /' .Chimney to be occupied as.... ................ . ..........................................................................................��. 't A$........................ y 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 anc,By-laws relat' g to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. /a_3 jej -go- PLUMBING INSPECTOR VIOLATION of the. Zoning or Building Regulations Voids this Permit. Rough rem S PERMIT EXPIRES IN 6 MONTHS Final �lir�►YI UNLESS CONSTRUCTION STARS ELECTRICAL INSPECTOR Rough .4goo .................. ................................... 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. SEE REVERSE SIDE Smoke Det.