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HomeMy WebLinkAboutMiscellaneous - 168 WATER STREET 4/30/2018 (2)N2 2204 Date ........ TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING This certifies that ........ R,C, � C"t J R q vo e— k C If C, ... ................................................................. has permission to perform ...... .................................................. wiring in the building of ....... ....................................................... at ......... W.4q�j+�e ..5r .......................... Z-2, North Andover, ;Mass. Fed-..'/ .00... Lic. No. ........ ELEcmc;ZINSPECTOR*-'***'*'... I WHITE: Applicant CANARY: Building Dept. PINK: Treasurer �2 ThEC0AM0NWE4LTH0FA14SS4Ch7MM Office Use only q G� �, DFPARTME TOFPIIBLICS4FM Permit No. BOARD OFMEPREPUW0NREGUL4T1011 V7CMR1200 Occupancy & Fees Checked APPLICATION FOR PF�ZMIT TO PERFORM ELECTRICAL 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 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) la�g W Q -71-2o(/- S 7— Owner Owner or TenantI, qiA DL Sa--S a vl 57-4'g-rtS Owner's Address Is this permit in conjunction with a building permit: Yes [:D No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead Underground a No. of Meters New Service Amps / Volts Overhead Underground No. of Meters Nurp,ber of Feeders and Ampacity Location and Nature of Proposed Electrical Work zxi rr it1 0`%h a .4= IZ alage / j � � Nol of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Locala Municipal Other No. of Dryers Heating Devices KW Connections a No. &f Water Heaters KW No. of No. of Signs Bailasis No. hydro Massage Tubs No. of Motors Total HP 4 m -Pr,� H 7' lig // /"ePl C <1 -L rr/ f LA/ htArarroeCo Piasuatmthetatltatarta� Gara�alLaws Itmeaom tLmbtkyhnxmmPcbcyetclsrdingCanpkte �gdval Cov=Wcrits�iaiaat YES NO a Ihaaeakmimadvalidptoofofsaar otheOffm YES F-1 If}outs` drdWYES,plrasenba*th NxofwmaWbydniongthe INSURANCE d BOND F-1 OTHER r7 ft=Spm y) Expi WcnDar Btim&dVakredUecttical Wait $ WorkbStat 3_ �- d hspamarDuieRaWested Rargh FbW Signed urdcr& of f FIRM NAME /l I C-ne /P �a f E' C � lee e %/' 1'e- /a Al � Lioa>.seNc. BtsmessTd.Na q7 �3 A"=-VLa./ AkTdNa Cl %Fs�� OWNER'S NSURANCEWAMT41anawatethattheLimmdo not thert>straroecr a�sui�rtialagtrivalmtasr�edby Gates andd4nysig cnthspwniappk3bmv4ai%esditstaqAmrnent. ^ (Please check one) Owner a Agent jv\ Telephone No. PERMIT FEE New Hampshire RICHARD HAMEL Massachusetts Fes,, !:Ansed Electrician Licensed Electrician #9169 Electrician #1889JR 11.1 CEDAR SREET, AdVIFSBURY, MA 01913 e,ving treater Lawrence, Haverhill and Surrounding C,mmunities Business Tel/Fax�978-388-3383 Hume Tel: 978-388-4483 Customer NameC�t1 7 �'�! 1 ��' '_S Job Location Address,��' �� S��'' ieer ALL BILLS PAYABLE 1MN1FD!ATELY 'JPCN REMPT OF STATEMENT A LA'Z'E PAYMF.NT CHARCE OF 11.5% F'ER x IONTH WILL RE ADDED TO A!." ACCOUNTS OVER 30 DAYS, T4ANK YOU? Tel, ` 50 Terms Date --2 - ©6 Quantity Price Amount �Qescrip?Fon /� c;2 r eta -1 61.es .-1� Q n � /-7,(-/— ® p e7 Ff 41 ALL BILLS PAYABLE 1MN1FD!ATELY 'JPCN REMPT OF STATEMENT A LA'Z'E PAYMF.NT CHARCE OF 11.5% F'ER x IONTH WILL RE ADDED TO A!." ACCOUNTS OVER 30 DAYS, T4ANK YOU? Date'.- .. %% .lq? 434 �',� �' -•1�o TOWN OF NORTH ANDOVER MOW PERMIT FOR PLUMBING This certifies that ....... .............. has permission to perform ---c'71.9— .......................' plumbing in the buildings of . A....... r.... ..': .�� at .�� r<Jc_:� . .............. , North Andover, Mass. Fee/(6. .. Lic. NoA �7 ................ ........ ............ PLUMBi G61 SPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS r i's. z000 A _ Dat Building Loion t y i� �i� C. Owners Name i SPA (�' � P cat Amount Type of Occu an ^ New Renovation Replacement 1:1 Plans Submitt es E No 10 MTtTRES (Print or type) ,,qq j Check on -Certificate Installing Company Name lyir-- LW�M Corp. . i riPartner. Firm/Co. Name of Licensed Plumber. P % d ,u ck - . Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate boic 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 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 Massach tate hun ' ode and 142 of the General Laws. By: TlIffa o icens um er Type of Plumbing License Title City/Town License �� Master Journeyman rl APPROVED (OFFICE USE ONLY Location � t "4 No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ •, sACMUS t� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ %tel Check # C'Wo 14124 - Building M66 ector Cc ` TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING .N-- BUILDING PERMIT NUMBER: r DATE ISS D: =� SIGNATURE: Building Commissioner/12VEtor of Buildings Date — �1 SECTION 1- SITE INFORMATION 1.1 Property Address: W 11 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area (sf) Frontage ft 1.6 BUILDING SETBACKS 00 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: Public 0 Private ❑ Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Name Print) Address fol Service Sig tore Telephone 2.2 Owner of Record: Name Print Address for Service: z Signature - Telephone SECTI6N 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone SECTION 4 - WORKERS COMPENSATION (MG.L. C 152 & 2506) 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 rmit. Sinned affidavit Attached Yes .......0 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: SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item I. Building Estimated Cost (Dollar) to be Completed by permit a licant S►{+Ngl� 3'_ !31 .ri3 {� M()[C�I, ... .....W,, (a) Building Permit Fee Multiplier USS ,<}�,y3' 2 Electrical © (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical HVAC Ci 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 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, wh as Owner/Authorized Agent of subject pr ert) 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- ture of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TD/MERS I ST 2 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHNINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Town of North Andover Building Department 27 Charles Street North Andover, MA. 01845 ��s�'..o•e'�i; D. Robert Nicetta Building Commissioner (978) 688-9545 (978) 688-9542 Fax Please print DATE JOB LOCA Number HOMEOWNER LICENSE EXEMPTION ST Street Address / lot f "HOMEOWNER Rvow � av\rsko S��P.fi9�S �^I�'Iea I 'Bo0g tAA —woe 3 19 h\w Name Home Phone Work Phone PRESENT MAILING ADDRESS Wo \oJ �XCR Sr P4QRA. mon 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 Code 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, 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 cv) A r �i Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax(978)688 -9542 DEBRIS DISPOSAL FORM NORTW '9 O �S4ED �6 M O '° L '9_ COCKKWwK• In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in /at: sGk o ele-,L C.0011"A,`rJEa Sery, r, c - A)ee 41 MtJJ 17,9 Facility location 9+� a0 Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. s 'p rA W tv av 0 � ° w° a a cn 0 A ,� a ° 'O z w° ..0 � v C U w o � co n� a .0 o a G w a w U r.� w l a°' v V) `° w O az `� 0 .0 a°' `° w z A w W y a oq ° z cn Q v o cn z CL COO W U. I... W L.3 H H C3 03 H to � 3 G3 0 0 �L CLCL cn < c tv o J .0 O Z 43 CL C4 C 0 U) U) w W W (/)