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HomeMy WebLinkAboutMiscellaneous - 1779 GREAT POND ROAD 4/30/2018O ,10 2233 Date.. 31.0 . .. ... TOWN OF NORTH ANDOVER 0 6-- PERMIT FOR WIRING r, - 7 - This certifies that ...... ....... �V.v ... ...... ............ has permission to perform....... 5x t,& ........ .............. wiring in the building of ......... at ......... ....... 7 North Andover, ?9 lvass-v, Fee .... Lic. No..'--. ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer J 77E 09AM0AWFAL7H0FMASS4C27USE77SOffice use my DEPARTMIDNTOFPIJBLIMFM j3 Permit No. BOARDOFFIREPREYE MONRBGUTATIOANR7ClKR12'QD Occupancy &Fees Checked APPLICATION FOR PERMIT TO PERFORM ELE(MICAL 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 12Y, Town of North Andover To the I Spector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes s� (Check Appropriate Box) Purpose of Building —144 6e Existing Service Amps —6/."Oolts New Service Amps Volts Number of Feeders and Ampacity Utility Authorization No. Overhead erground r7 No. of Meters --- I Overhead = Underground r—J No. of Meters `Location and Nature of Proposed Electrical Work 777,V No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground 0 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 Local Municipal Connections F7 Other No. of Dryers Heating Devices KW No. of Water Heaters KW No. of No. of igns Bailasis No. Hydro Massage Tubs I No. of Motors Total HP OTHER ..• n:• .�.. ••.rte. •i•ii •' .i► � i � • -•:. a• .� •�:' u►:"i /'••• .'• •:... ..i - i 2111 r 1 1-5 • 19• 104! Wa 02.4' iTrf sumiumanumpWratappoa Mqu1 r= (Please check one) Owner Agent Telephone No. PERMIT FEE $ . U v --�rvs --• �•• •d+err.nArrLJL..A1iun cu" t-rnrfril /v � Liu rs-a�rvsarr%+ • N _ (Print of Type) 1� NORTH ANDOVER, . Mass. [)ale BuildingB/ Permit # Z Location/ 7 7 Owner's Name— New Renovation p Replacement p Plans Submitted: Yes(3 FIXTURES........ M IXTURES.•..•••- Installing Company Address Business T Name of Licensed Plumber Check one: torp. ❑ Partnership ❑ firm/Co. INSURANCE COVERAGE: Chet I have a current liability Insurance policy or Its substantial equivalent. Yes No ❑ It you have checked ygl, please Indicate the type coverage by checking the appropriate box A Ilablily insurance policy E • ` Other type d indemnity 0 Bond ❑ Cadvicate 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 al Ovnef of OMmer a Agent Owner p Agent ❑ I hereby certify that all of the details and Information 1 have submitted W entered) In above appfkatlon are bus and accurate to the best of my Imowisdpe and that all plumbing work and Installations performed under the p nM Issued for this application wil be In compliance with aft pertinent provisions of the Massachusetts State Plumbing Code and Chaplet tj2 of ftGwWai 8y _ •u_I 99MIXG at U=mdum er i' Ucense Number 7 a Type of Plumbing lkanse: Master Journeym 0 �e9� Date. . ,.d �`k. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... ..��!.. V).'a -n 7.S . has permission to perform ....! plumbing in the b Ings of�/�!Y? G.r.-�.... , at .../. �.%—amu. C�' ft...iorth Andover, Mass.. Fee _? .... Lic. o.. 071 ........ ............... . PLUMBING INSPECTOR n-00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 3 U, 4c &MM0UWt# of maosg4uset 19pa'tmilent of Pubiit hnII to BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Only Permit No. i Occupancy & Fee Checked 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date `1- .30-97 Qtr or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical workdescribed below. Location (Street & Number) 7 75 Gl2ea_-I- �6 ,Z /t//W • Owner or Tenant" S� P2P Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No (Check Appropriate Box) Purpose of Building p�o—s I CL,— Utility Authorization No Existing Service Amps —J Volts Overhead ❑ Undgrnd ❑ New Service Amps Volts Overhead ❑ Undgrnd ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work a`3 q-sc �. No. of Meters No. of Meters No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures I Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners ` Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Total No. of Ranges No. of Air Cond. tons Initiating Devices No. of Sounding Devices No. of Self Contained No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices LocalMunicipal ❑ Other ❑ Connection 1 No. of Dryers Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: LL--) vi OI i)Et INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Comol d Operations Coverage or its substantial equivalent. YES 1✓ NO - I have submitted valid proof of same to the Office. YES _ NO If you have checked YES. please indicate the type of coverage by checking the appr hate box. INSURANCE BOND ` OTHER —_ (Please Specify) G ilP.2,-Q .�� 6� �� �` /a?' 3 f -f'7 (Expiration Date) Estimated Value of Electrical Work $ Work to Start Inspection Date Requested: Signed under the Penalties of perjury: n FIRM NAME VtS$Ol 1Pa i+ Lr�k (Ta�ac �20- Licensee Joe ✓ A e co Signature Rough Final LIC. NO. A 1112-2- 2 LIC. NO. 3 9.3 7 SG` Bus. Tel. No. Z -S/-039 3 Address '-'/ e 71,11 • D/G/a-c-u7 1—ria• Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) X-6565 4 �w q - .30 ..... . - - � - Date ............. .... e`tao'•e�e �oTOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies the has permission t wiring in the building of .............%.�,�-a.,.�,.a................... j-,,,/ at .......� ..:' .:...... �,r' ... c.►'.,.... , North Andover, Mass. ...................... ...... ...... ........ ....:........... / ELECTRICALINSPECTOR 4/30/971i':21 15.0o PAID WHITE: Applicant CANARY: Buil ing Dept. PINK: Treasurer A 7 Location 140.Date' NORTol TOWN OF NORTH ANDOVER Certificate of Occupancy $ ',S'"•°' Eta Building/Frame Permit Fee $ s�cMus Foundation Permit Fee $ Other Permit Fee $ errJ TOTAL $� Check # 16184 rBuilding Inspect - TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING :�,`,: ,Y'. 'Y"s? y�'"'�'..��vY`kr'(�s3 Se'�fd#t"�.,�;�� .R1 ._��$iva ..3as �'➢'��' z.. '�ix� "` -mac', BUILDING PERMIT NUMBER:n O DATE ISSUED: a _) D _a 00 3 SIGNATURE: A Building Commissioner/IEECEtor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 3 Map Number Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS 00 Front Yard Side Yard Rear Yard Required Provide R red Provided R red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private ❑ ) `7 Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record �67�60AA14.5 b ame`1 (Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 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 (M.G.L C 152 4 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 permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check allapplicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ ;q '` .' i',. — '�.. x — `_o tt t irk Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: 'c IC eem N Am. 1pev'r% od C er A roa 'I and SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be (1FFICIALgUSE�0 Y Completed bypennit applicant 1. Building (a) Building Permit Fee L(� 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 O BE COMP ETED WHEN OWNERS AGENT OR CONTRACTOR APPIIES FOR BVILDING PERMIT j� ' � / �Oer/thorized I, / CAl a:5 >" ►'CE J 1 Agent of subject property ereby authorize 1 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 re of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TRABERS 1 2 3 SPAN DRvIENSIONS OF SILLS DIMENSIONS OF POSTS DUAENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CFUMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Ft /%y7 5 �� V�. +4 c FORM U LOT RELEASE FORM - d oo 3 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 or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT PHONE C� W LOCATION: Assessor's Map Number PARCEL-3-9- SUBDIVISION ARCEL-3-9SUBDIVISION (� LOT (S) y� STREET �'e�� c�� c� (K ST. NUMBER ************************************OFFICIAL USE ONLY*********************************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR COMMENTS TOWN PLANNER COM OD INSPECTOR -HEALTH _� (\,A3 U_(5,r.J I -R SEPTIC INSPECTOR -HEALTH COMMENTS ��S"Ie�.._ Zey�C Z:,1� e`C0 5�-�-h►�t�% DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED I b 0� 4,63t-,.1 PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 Jim c-6 E _ C 0 A* A 4b J ,J N N N N N N A A A N � co coo N (n N S SS mmm mmm -4 -q --i to N V) O z INS T.; w O �Q u� 18 o z c� z O C -0v m e T = C4 a a� pCD N C4 a uF+i W C4 v.Qd cn w x O w a z CD w z W d w m m cn v p o CML0 C� Mc MM EQ D c •mom < s �. o c o= (^ o m�E CN N m N�. C O I co CIO: a :t�MN m �J C O :ECD r'y�m cc Q... .O c ;mor m co N O b - W > Z O • C a 0 C Q V� m m e o = m a� pCD N H C C C cn W...�_ CD 10 CD 'D ♦. m m O -r- O N d=_ C Z W Ev�vN O V m 0 0= C o�c ILI) coo m -5 O _ "F. cn = 0 O H O �J= CI mom 6 O C� O C� A O O V O - Z d O D H C C C cn ®'v CD — .co)FE m m O O CD CD �M 'O o � ; CD m CL O CL Q cn i o�c M CC CJ —J _ "F. cn O V zCD 0 CL V H C CI _� ®.cnis Lli0 LLI CcW w ccW LLJ CO Date4 .......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thjs certifies that .......................7...................... .............................. hai permission to perform . .................................... ........................................ wiringin the building of ............................................................ ....... North Andover, Mass. at ... Z. /'.p Fee. ....... i .......... Lic. No. �t � ~'ELECTRICAL INSPECTOR Check # 4542 C.ominonweatth of MaJJacAIII Official Use Only e ar ment -'0" `> %5 L-1-2-1 BOARD - � /� t` s¢rvices Perrnit No: BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev. 1 1 mi PLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perflornied in accordance with the Massachusetts Electrical Code (MEC), 527 ChIR 12.00 (PLE11SE PRINT LV INK OR TYPE: ALL hYL'01WATION) Date: City or 1'o�vn of: Norte �pt�( (,'2 By this application the undersigned gives notice f hi or her intention to performs he elhisectrical o work described below. Location (Street & Nuniber)_ Owner or Tenant -L4"1' ha OI r r Telephone No. Owner's Address - S Is this permit in conjunction with a building permit? Yes N0. p ❑ (Check Appropriate Box) 1'ur[tosc of Building I��Yfr7UC ) D (} - >� �}'� G Utility Authorization No. Existing Sel- ice Anips ! Volts Overhead ❑ Uud rd g ❑ No. or Meters' . New. Service . Anips / Volts Overhead ❑ Undgrd ❑ No. of Meters, Number of Feeders and Ampacity Location and Nature.of Proposed Electrical Woe 4771, C, 777 No. of Recessed Fixtures Conr Lebon a%tlre ollowin table nta be ivaived bv y the htacGto, of IVires. 1 No. of Ceil: Susp. (Paddle) Fans NO °f Total Transformers No. of Lighting Outlets KVA No. of blot Tubs Generators KVA No. of Lighting Futures 1 Sirimnriug Pool.. Above ❑Irl' o. o mergency rg r ng rud. rnd• Batte 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 No. of Ranges Initiating Devices No. of Air Cold. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump s umber lTons K�V_ No. of e (:Contained Tota•Is:-~-' - �-' �. Detection/Alerting Devices No. of Dislr�vaslters Space/Ar•ea Heating K`Y Local ❑ Municipal Connection El Other No. of Dryers Heating Appliances KW ecurity Systems: No. of NaterNo. K1V of Devices or Equivalent of No. No. o! - Heaters Data Wiring. Sins Ballasts Devices i No. Hydromassage BathtubsNo. No. of or Equivalent of Motors Total IiP Telecommuuicatrons ti irrng: .,- • OTHER: No. of Devices or E uivalent Attach additional detail if desired, or as required by the Inspector of fVir•es. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical�vork ntay 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:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I.certify, under the Irn is and penalties of perjury, that the information on this application iS true and complete. 11-110I NAME: 15111 LIC. NO.: Licensee:��-1 i 9 �1 Aia ©' Signature (f !p LIC. NO.: 1 a r livable, cuter "crempt " in the licence nun er line.)III qA Address: ,,' tq Bus. Tel., y 23- 283a -F OIVNER.'S IN"si-i R: I am aware that he Licensee sloes not have the liability insu insurance coverage normally al�� � required by lawlow, I hereby waive thisrequirement. I am tate (check one) owner ❑owner's agent. ;SignatureTelephone \`a 78 69� 57-D*F FP—j,-Rj11JT FEE: $ ROUGH FINAL Date ,&--. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .................. ................ has permission to perform I/_/.. . ............................ plumbing in the buildings of .................................... at ... 7.7 '7 4North Andover, Mass. ............ Fee c. o. LiN/. ECT*o Check # 5?11111_� 5760 MASSACHUSETTS UNIFORM APPLICA (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location 222 i�Z ft j /,9 Owners Name of RMIT TO DO PLUMBING Date 110 -.o 0 Permit #-- =15' (10 Amount _�� D New Renovation Replacement Plans Submitted Yes No ►' 1 ' / • MR arm, mmmm---.-�-�.®- W4110 At MN„M-M--.----WM.M-----OM -- ' MM ®,'MMMMMMMOMMMM®MM®M®=MMMMMM M;ilivggo-ommmmmmmmmmmmmmmmmommmmMMMM (Prinkr type) Check one: qCertificate Installing Company Name ,_j/_ Aj 13olp_ Address �'/�/�il�'1%�f�c'1' S% Partner. Business Te ep one p Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking theappropriate box: Liability insurance policy LSd' Other type of indemnity E3 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 ignature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my -knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuset e Plumbin d Chapt 142 of the General Laws. By: signature 01 LICenSeaPlumDer Title Type of Plumbing License City/Town icense Numoer Master M/Journeyman ❑ APPROVED (OFFICE USE ONLY L _I