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Miscellaneous - 178 WATER STREET 4/30/2018
MV �'V •� /i If Date y ......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .... ........ ...................................... has permission to perform ........ 0 1. L. -�... 41.1,5 ................ wiring in the building of ... Ij ..... .......................................... at .... �4.k ..... ��.) ........................ . North Andover, Mass. FeeD.0i. ......... Lic. No. . ......... Check # 7079 N Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit N°. 70 7s j Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] (leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFOR,�e_ MIATION) Date: J � I [0(, City or Town of: � N�r-- To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) J' -7g I aJ, +r � �� ��0 l 444 D le cr Owner or Tenant C(l /-i f Telephone No. 1_y'2g0 3%__:ga() Owner's Address SAr'Yle_ a, S /460V -e 1 Is this permit in conjunction with a building permit? Yes u No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / 'ZO / 9 q Volts Overhead a Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Naiure of Proposed Electrical Work: 01/ �U�NQ �,e dam l-AY1 t i Cmmnleiion nQe f lh,.,w,., z..IJ„ No. of Recessed Luminaires - No. of CeiL-Susp. (Paddle) Fans vcu' zrzz: /rza ectur ol vvlres. Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool oveE]n- ❑ rnd. rnd. o. o mergency Lighting Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o etection andinitiating Devices No. of Ranges 11 No. of Air Cond. Tota Tons No. of Alerting Devices No. of Waste Disposerseat mp Totals: um er ons " o. o e f- ontame Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal E] Other Connection No. of Dryers Heating Appliances KW ecurrty Systems:* No. of Devices or Equivalent No. o Water KW Heaters o. of o. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications irm : No. of Devices or Equivalent OTHER: CU40 bel o/a e�e (?o� Oe k l..ccr/ c�� ��t7 h� wAs n or asttacn additional detail iJ desired, or as required 5y the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: (a- (_0(0 Inspections to be requested in accordance with NEC 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 E2" BOND ❑ OTHER S eci I certify, under thepains andpena/ties ofperjury, that the i formation on t is application is true and complete. FIRM NAME:y/10� % U1Z4�� ( ,� G 10tl y4 LIC. NO.: 020/%O )4 Licensee: (t)4114Le 7 / � Signature �� LIC. NO.: /09131 S (If applicable, enter "exempt" in the license number line.) V Bus. Tel. No.: l- 7F— % i I� %� Address: (Q, l/,,¢_ Alt. Tel. No.: *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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 744 Date..*/I.0 ..... TOWN OF NORTH ANDOVER This certifies that .......t/�d-.�/h ....&,. .�. #r& .... has permission for gas installation �..l ?............... . in the buildings of ... IOaul . . at .�? .- . �. � ...... ..... , North Andov r, Mass F e'Se, :30.. -5 4. Lic. No./ jam.. p GAS INSPECTOR Check # � MASSACTITTSEMS UNIFORM APPLICATION FOR ERMIT TO DO GASFITI'ING % (1� Mass. Date / 20 lb Permit # ilding Location Owner's Name E�yl 77" WW'W A 1 � /MM of Occupancy /�Lcl/) Renovation Rerilacement ri Plans Submitted: Yes ❑ No ❑ C� Installing Address Name Business Telephone Name of Licensed Plumber or Gasfitter Check one: ET -Corporation ❑ Partnership ❑ Finn/Co. Certificate INSURANCE COVERAGE:. I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes e-0— No ❑ If you have: checked yes, please indica e the type of coverage by checking the appropriate box_ A liability insurance policy EOther 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 MGL, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent 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 the permit issued for this application will be in compliance with all pertinent provisions of th assachusetts State Gas Code and Chapter 142 of the General Laws. By Type of License:. Title a -Plumber a—Master Sigt4hilrVbf Licensed Pl(umber/Gsfitter City/Town ❑ Gasfitter ❑ Journeyman License Number %S % APPROVED OFFICE USE ONLY) • • ■■■■■■■■■■■■■■■■■■ Name Business Telephone Name of Licensed Plumber or Gasfitter Check one: ET -Corporation ❑ Partnership ❑ Finn/Co. Certificate INSURANCE COVERAGE:. I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes e-0— No ❑ If you have: checked yes, please indica e the type of coverage by checking the appropriate box_ A liability insurance policy EOther 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 MGL, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent 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 the permit issued for this application will be in compliance with all pertinent provisions of th assachusetts State Gas Code and Chapter 142 of the General Laws. By Type of License:. Title a -Plumber a—Master Sigt4hilrVbf Licensed Pl(umber/Gsfitter City/Town ❑ Gasfitter ❑ Journeyman License Number %S % APPROVED OFFICE USE ONLY) 8740 Date. TO N OF NORTH ANDOVER A 'ERMIT FOR PLUMBING This certifies that+ V� co .... .. ........................ has permission to perform ...... *0-? .............. . plumbing in the buildings of ...J.C✓A T ...................... . at ..., , . .... Wot...... North And vers X0 Fee . . Lic. No.. . � ....... . ................ PLUMBING INSPECTOR Check # .�,— PIYTI IRGC MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town: /"Q�LS�, MA. Date: �� Permit# Building Location: / ?6 WATOL Owners Name: Type of Occupancy: Commercial ❑ Educational ❑ industrial ❑ Institutional ❑ Residential New: ❑ Alteration: ❑ Renovation: ❑ Replacement: [� Plans Submitted: Yes ❑ No PIYTI IRGC INSURANCE COVERAGE: I have a current liabilitv insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes a- o ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy' Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: t am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Sianature of Owner or Owner's Agent 1 hereby certify that all of the details and information I have submitted (or entered) regarding this application are true_and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit Issuea Tor inls appucanon wm oe in compnance wim an Pertinent provision oT the Massacnuseus state riumoing woe ano %onapter- Tic or me venerarL-aws. By Title City/Town APPROVED (OFFICE USE Type of License: &U I/ � J Plumber Slg�r of Licens6d Plumber (�tZbster / ) ! 1 ❑Joumeyman License Number. � DEDICATED SYSTEMS � LU Z z H ; n Location/7,F- No. ocation/7,` 1No. �� ��_ Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ An Check # '"''--Building Inspector s CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 525 (2/8/06) Date: May 8. 2007 THIS CERTIFIES THAT THE BUILDING LOCATED ON 178-180 Water St MAY BE OCCUPIED AS 3rd Unit Multi Dwelling 180 Rear Apt IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Lois Curtis 180 water Street North Andover MA 01845 .0��a. &.,� Building Inspector vl 0 6 4N ri fA ;5 LT 0 CD o 0 C.2 o ls� EQ CE UD CD 0 CL CD • C', -cc- �2 ..a 0 cn co 0 a 0 LT 0 p u �D 0 C/) 71 0 u C/) cf) I I U5 0 S 4.j CD 0 E CD O CD Z 0 . cm C3 Ag E 0 0 CD CD —ca 0 0 Cc 0 E:C2 CMCC ca Cc 23 C:L CD ca Z 0 CL. C.3 COD O cc "a ca LLI LU W W LU C9 uj w U) t 0 CD o 0 C.2 o EQ CE CD 0 CL CD • C', 0 p u �D 0 C/) 71 0 u C/) cf) I I U5 0 S 4.j CD 0 E CD O CD Z 0 . cm C3 Ag E 0 0 CD CD —ca 0 0 Cc 0 E:C2 CMCC ca Cc 23 C:L CD ca Z 0 CL. C.3 COD O cc "a ca LLI LU W W LU C9 uj w U) t 40 APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION Buildino Permit # :J ADDRESS/LOCATION OF PROPERTY: fD Map Parcel Lot Number SUBDIVISION DATE REQUESTED FILED/READY FOR INSPECTION 7 JL 07 CLOSING DATE ON PROPERTY: FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE- INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNED DPW - WATER METER SEWERIWATER CONNECTION NOTE ROUTING 7m] 0 � 5-i71o, Rol DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST r �, W DPW Signature File: OC form revised 2006 r Y U e C W C O 0 U o O 00 C U = C L z F �U N C °=ax c O o=15° t 5 3 a 30 C.7 Y : AU o c o U O O L y d 0 to _ U O _ 0 a x H ° � •o 0 C® C aw.. N C7 V Eo Q F r 0 0 N w N O � IrTl F V1 a F4 y W Q d o u Q L y y w •y 1Z � H 00 O O ie 00 O o a 0O0 on _ p O O �S C o C7 t0y ra a 4 A N N E a° y •O O �i •p y0 a1 O o � N U yon w 0cd > o o a � O y•0su �oo o = U N c o � r ami °? oro �o •3 ��o xQ why O d 1 M = 0 . 0 N 3 N E O 00 S y U V] � vcois V1 'C C q CJ �, vd�avc��iAci! v W r Y U e C W C O 0 U � c O C U = C L CL F �U V] Cp �., M p y 30. 0 3 C °=ax c o=15° t 5 3 a 30 C.7 Y : AU o c o U O O L y d 0 to _ U O _ 0 a x H ° � •o 0 C® C aw.. N C7 V Eo Q F r 0 0 N w N O � IrTl V1 U C W C O C CL �U C J to 0 0 N C® C O N C7 pORTM ^o4^ "SsAc US HEALTH DEPARTMENT Complaint/investigation Intake Report - Taken by: Date of Report: Category/Type of Cpxnplaint: Time: &VO de199- Address/Location of Incident: rName of Person Reporting: Phone Number: (H) or (W): W-91 Name of Alleged Violator: I Complaint Details: Phone Number: 'i (Cell): 6-6-y Phone Number of Alleged Violator: 1 1--ge:9 --<,?7 —, Recommended correctiye action to bp- taken: Je 35, - -" I T A—e— Immediate corrective action to be taken: I To be Investigated by: Title: Date Submitted for Data Entry: Az-� Date Scheduled for Investigation: Date Entered: N Date....... J.�...r.'.d TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that .0 V r �% ............................................................................................ has permission to perform7e �� ©�; 0z1' -44,l, � �S.�j� .............................................................................. wiring in the building of L ay 2?v at ........ I..ro 4t'.'.4A�. /r-- S>—............................ . North Andover, Mass. q JF Fee ....3.......s.. ........ Lic. No. � to 2 ELECTRICAL INSPECTOR Check # 7256 as V Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only \ Permit No. 2'a? 5�% Occupancy and Fee Checked [Rev. 1/071 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 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: 3 —r3 -0 i City or Town of: NORTH ANDOVER To the Inspector 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 40,5 C -� Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes [��No ❑ (Check Appropriate Box) Purpose of Building 127 i /y / 5 tc v -e Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity No. of Meters No. of Meters 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 No. of Luminaires Swimming Pool Above ❑In- E]o. rnd. rnd. o Emergency Lighting 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 and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pum Totals Number Tons KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal El Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent 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 ai and penalties of perjury, that the information o this application is true and complete. FIRM NAME: �, s )w trot-v✓�1-�%LIC. NO.: �^�, Licensee: visZI/t�/G Signatu e LIC. NO.: 1049g 7 (If applicable, enter "exempt" in the license number line.) Bus. Tel. N097����-[1rL Address: Alt. Tel. No.75ri -fflyy-7bB S *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. 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/Agent Signature Telephone No. PERMIT FEE: $ -r,4 ko-7 UE -R Pr-l?mt--.t F-com ju j 4ee �E3�; r'�'4f-e'co &'k 3- a 1,17 I� 4:!v -72. DEC 2'7DaMf.. .......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING CH 011 Thiscertifies that .......0 .................................................................. or has permission to perform ............ . .. . ...................................................... k wiring in the building of ..try........... . ................................................ X at .. mq .... 0'.. A 0, .......... (.—, .............. I North Andover, Mass. Fee ........... Lic. No�� . ....... I- ELECTRICAL INSPECTOR Check# -34 I 6660 M Commonwealth of Massachusetts Department.of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official) Use Only Permit No. �G0 Occupancy and Fee Checked [Rev. 11/991 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 MR .00 (PLEASE PRINT WINK OR TYPE AIiL INFO TON) Date: City or Town of: To the InspectAr of Wires: By this application the undersigned gives notice f his or her intention to perform the electrical work described below. Location (Street & Number) / Fb CA14 :�, Owner or Tenant 4,Q( -S v Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes [�r No ❑ (Check Appropriate Box) Purpose of Building J y�(I V 61e,0 2/J!�UUtility 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: 3 QMIJ y.. �/0- (hmnlatinn nftha fn' no inhly mmi hn u.niov t h,, rho 7--f— nlA7;. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets Z_ No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- rnd. rnd. o. o Emergency ig mg Battery Units No. of Receptacle Outlets % No. of Oil Burners IFIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. ol Detection an Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: ' Number Tons KW No. of Self -Contained . . Detection/Alerting Devices No. of Dishwashers Space/Area Heatin e** Local ❑ Municipal ❑ Other Connection No. of DryersHeating �. Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs . Ballasts Data Wiring• No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Auacn aaamonat aerate y aesirea, or as required by the Inspector of Wires. f 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 cove age is in force, and has exhibited proof of same to the a tit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of F4ectrical Work. / (When required by municipal policy.) Work to Start:L j (� Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the ains and penaId sof perjury, that a in ation on this application is true and complete - FIRM NAME: _J �3A i_ ,, k LIC. NO.: 3 Licensee: - � e� � :0--& 6A Signature LIC. NO.: (If applicable,end "exempt"}n the license nutnbe li e.) Bus. Tel. No. -.Q 2�3�'�3� -Address:l5 go1 �h�C��� re 6�►� Alt. Tel. No..• L - =OWNER'S INSURANCE WAIVER: am awatha 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/Agent ti' Signature Telephone No. PERMIT FEE.-"$ /36— TOWN OF ANDOVER ELECTRICAL PERMIT FEES (Effective March 12, 2003) MINIMUM PERMIT FEES: RESIDENTIAL $25.00 COMMERCIAL $100.00 NO SE CABLE ON OUTSIDE OF BUILDING Air Conditioners: $40.00 each Alarm Systems Security: (for fire systems see smoke/heat detectors) Residential: $40.00 Commercial: up to 10 Devices $60.00 additional devices over 10- $1.00 each Carnival Equipment: $50.00 each Ceiling -Fans: $1.00 each Commercial New Construction or Alterations: - $100.00 per 1,000 Sq. Ft. of Construction Space Commercial Service Change/ Repair: Must have Utility Authorization Number $100 (first 100 amperes or fraction, one meter) a) each additional 100 amperes capacity or fraction. $30.00 b) each additional meter $25.00 Commercial Temporary Service: $100.00 Must have Utility Authorization Number Commercial Repair and/or Maintenance Permit: (Blanket Permit) up to 2 Electricians $150.00 per pair of Electricians over 2 $50.00 Data/Telecommunication: Residential: $1.00 per port Commercial: $30.00 up to 10 devices over 10 - $1.00 each Dishwashers & Disposals: $5.00 Each Dryers: $15.00 Each Emergency Lighting (Battery Units) $ 1.00 each unit Feeders or Sub -feeders: each 100 amp capacity of fraction thereof Residential: $5.00 each Commercial: $15.00 each Gas/Oil Burners: Residential: $20.00 each Commercial $20.00 each p®p s' -'y /-- a& /-4-tr Rtc, IL 3357- 5 Y Generators Residential & Commercial: a) including photovoltaic & generating Equip Per KVA $1.00 b) un -interruptible power systems, per KVA $1.00 c) batteries over 100 amp. hours, per cell $1.00 Heat Devices: $1.00 each Heat Pumps. $40.00 each Hydro -Massage Bathtubs/ Hot Tubs: $20.00 each Lighting Fixtures $1.00 each Lighting Outlets: $1.00 each Major Appliances: (not listed) $20 each Motors: (per hp or fractional part thereof) $2.00 Oil /Gas Burners: .Residential $20.00 each Commercial $20.00 each Office Furnishings: per circuit $10 (Relocatable Partitions/Cubicles) - Outlets & Fixture: $1.00 each Ovens Built in/Counter Top Units: $10.00 each Panel Change/Circuit Breaker: Residential: $20.00 Commercial: $25.00 .Phone Jacks: See data/telecommunications . Ranges $15.00 each Receptacle Outlets: $1.00 each Recessed Fixtures: $1.00 each Re -inspection Fee: $25.00 Repair to Service Residential: $20.00 Residential New Construction (Dwelling): $220.00 (with service up to 200 amps) Must have Utility Authorization Number for services over 200 amps see below a) for each 100 amps capacity or fraction add $20.00 b) each additional meter $10.00 c) each additional panel/sub panel $25.00 Residential Additions/Alterations: $220.00 maximum Residential Service Change or Underground Service: $40.00 Must have Utility Authorization Number a) one meter, up to 100 amp capacity $40.00 b) each additional 100 amp capacity or fraction $20.00 c each additional meter ..$10.00 Sewer Ejection Pump: $25.00 Signs: $25.00 each ballast Smoke & Heat Detectors & Initiating Devices: P Residential: $1.00 each . Commercial: $60.00 up to 10 devices over 10 - $1.0.0 each Space Heaters: area heating $1.00 each Sub -Panel: $25.00 Swimming Pools: Residential: Above Ground: $25.00 Inground: $50.00 Commercial Pool: $100.00 Switches: $1.00 each Temporary Service: Must have Utility Authorization Number Residential $25.00 Commercial $1.00.00. _ Transformers: a) capacitors, Per KVA .$1.00 b) ducts, conduit & conductors (Associated w/ Padmount Transformers) $25 c) each manhole $10.00 d) each handhold $5.00 e) per KVA $1.00 f) primary feeders, $25.00 each (over 600 volts, non-utility owned) r vaults and equip. $25.00 each' Washers: $15.00 each 's Waste Disposals: $5.00 each Water Heaters: $30.00 each J *For Multi -Family & Large Commercial Project see Wiring Inspector for pricing: Paul Kennedy (978) 623-8306 (Office Hours 8 am to 10 am), *Inspection Schedule: M' 1 ROUGH 1 FINAL 1 TRENCH (if applicable) ADDITIONAL INSPECTIONS x$25;00 (if applicable) V (rev+ cl -9�4) e 9d 6 � C=== eo m c L JC IL d � o ® v w t ' yLr t 0- •� V � L > ci C 7' LIJW a Z LLI oVO V 12 Im i-f a CM :Zz 0 0 0 1NoarM _ o �.. srr... Date. 7// ate.7// eel. . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING vs This certifies that . Rn° : 14. U s. t? .......... has permission to perform ... ................. plumbing in the buildings of ..0 .s, ..................... at ....%.`' North Andover, Mass. Fee.,5 . Lie. No..r f.1 �. . �,�,.. ......... ;. /`PLUMBING INOR Check # :69-U i:� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS (►� Date 7 Building Location ` �' j� 1(��� ) N Permit # S Owner Lel 1--,. C,\) 9� \ i� Amount Y7 New Renovation Replacement Plans Submitted'Yes n No 1 1 (Print or type)` 1) Check one: Certificate Installing Company Name���:'��� \ �&� ly� ❑ Corp. Address v` Partner. k%' �2 Business Te ep one Firm/Co. Name of Licensed Plumber: 3 -<AA I V,-)[ k���Q t{'1.V1 Q�k C Insurance Coverage: Indicate th type 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 D Agent 11 I hereby certify that all of the details and information I have sub o ntered) in above application are true and accurate to the best of my knowledge and that all plumbing work and install ons per u der Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus s Sta Code and Chapter 142 of the General Laws. BY igna ure o icense um er Type of Plumbing License Title City/Town icense MurnDer Master D Journeyman APPROVED (OFFICE USE ONLY I X, . — OORTH �Q104^YltD ygHO� Zoning Bylaw Denial p Town Of North Andover Building Department 27 Charles St. North Andover, MA. 01845 Phone 978-688-9545 Fax 978-688-9542 Street: / T - / . Map/Lot. nt. I /-je, //t Request: Date: Please be advised that after review of your Application and Plans that your Application is DENIED for the following; Zoning Bylaw reasons: Zoning _7� — 4/ q Item Notes Lot Area Item Notes F Frontage 1 Lot area Insufficient 1 Frontage Insufficient 2 Lot Area Preexisting y c S 2 Frontage Complies 3 Lot Area Complies 3 Preexisting frontage y s 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage 1 Allowed G Contiguous Building Area 7 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies 4 Special Permit Required cam/ e g 3 Preexisting CBA 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 Left Side Insufficient 3 Preexisting Height 4 Right Side Insufficient 4 Insufficient Information 5 Rear Insufficient i Building Coverage 6 Preexisting setback(s) y S F Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D Watershed _3 __Coverage Preexisting r��S 1 Not in Watershed S 4 Insufficient Information 2 In Watershed Sign 3 Lot prior to 10/24/941 Sign not allowed y 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking 1 In District review required 1 More Parking Required 2 Not in district es 2 Parking Complies 3 Insufficient Information 3 Insufficient Information 4 Pre-existin Parkin �5 Remedy for the above is checked below. Item # Special Permits Planning Board Item # Variance Site Plan Review Special Permit Setback Variance Access other than Frontage Special Permit Parkinq Variance Fronta a Exception Lot Special Permit Lot Area Variance Common Driveway Special Permit Hei ht Variance Con re ate Housing Special Permit Variance for S._n Continuing Care Retirement Special Permit special Permits Zoning Board Independent Elderly Housin S ecial Permit Large Estate Condo Special Permit S ecial Permit Non-ConformingUse ZBA Planned Development District Special Permit Earth Removal S ecial Permit ZBA Planned Residential Special Permit S ecial Permit Use not Listed but Similar R-6 DensitySpecial Permit i3 S ecial Permitor Sign_ - Special Permit Pocr a a� Tlfj-„ Watershed Special Permit - - (,. The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for DENIAL. Any inaccuracies, misleading information, or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided, at the discretign;of.the Building Department. The attached document titled "Plan Review Narrative" shall be attached hereto 001190t,.PotaWbrein by reference. The building department will retain all plans and documentation for the above file. You must file a new building permit application form and begin the permitting process. 1.�rGfi C uilding Departme Officia Signature Application Received 6`//—O,;t, Application Denied Denial Sent : If Faxed Phone Number/Date: Plan Review Narrative The following narrative is provided to further explain the reasons for denial for the application/ permit for the property indicated on the reverse side: Referred To: Fire Police Conservation Planning Other Health Zoning Board Department of Public Works Historical Commission BUILDING DEPT ► TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ci�Yvgpg �. ta, � ♦ �i i 9 BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/I for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: r76 A 80 4-:2 ST' 1.2 Assessors Map and Parcel Number: 69, ,�D. Map Number Parcel Number e � �t (Mi 4�ov� R MA, o (84 S 1.3 Zoning Information: Zoning Diaiic—t Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.GL.CAWO. 54) 1.5. Flood Zone Information: Public ❑ Private ❑ 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 5T, Name (Print) Address for Service: 180 w47-zE-fz i X, 4,0, ct7,5-FJ7-3oza Signature �/ � �Tel_ephone 2.2 O ner of Record: JV 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 -M M Z O SECTION 4 - WORKERS COMPENSATION (MLG.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 .......0 No ....... 0 SECTION 5 Descri tion of Proposed Work check a!1 a llcable New Construction ❑ Existing Building 0 Repair(s) ❑ Alterations(s) ❑ " Addition 0 Accessory Bldg. ❑ Demolition ❑ Other 0 Specify Brief Description of Proposed Work: Y &A15 -TRU -0- 17 OAIZL 2L:bRoo/+1 A -OT IN 12FA& aC 100 I SFC'TION 6 - FSTIMATF.D CONSTRUCTION COSTS I Item Estimated Cost (Dollar) to be Completed by permit applicant 1. Building 3J`�GCt� (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 Qas 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 Sienature of Owner/Anent Date LXrst� `�Rkrtirc QMr'�t �rM�rr,p Gm vo Location � No. 5 3 `� Date (' (3 L-1 NORTiy TOWN OF NORTH ANDOVER Of .ao ;•'�y0 • ` • OL 109 Certificate of Occupancy $ sCMus <� Building/Frame Permit Fee $ -30 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 3 0 Check #30 ©� 16886 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REM RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED:03 SIGNATURE: (/ Building Comnuissioner/InEeEtor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 18© L/QST Historic District: Yes No 1.2 Assessors Map and Parcel 69 Number: Parcel umber Name (Print) Address for Service: 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Name Print Address for Service: Front Yard Side Yard Si naeure Telephone Rear Yard Required Provide° ReqWred Provided Reqmred Provided Not Applicable ❑ Licensed Construction Supervisor: 1.7 Water Supply M.G.L.C.40. 54) Public ❑ Private ❑ Zone 1.5. Flood Zone Information: Outside Flood Zane ❑ 1.8 Municipal . Sewerage Disposal System: ❑ On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSH P/AUTHORIZED AGENT Historic District: Yes No 2.1 Owner of Record ' Name (Print) Address for Service: iS g3' -3020 Signature Telepho e 2.2 Owner ofRecord: Name Print Address for Service: Si naeure Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed 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 M M X ic Mpp�qqq fr'N,� W d z M 90 on ic r M r G) 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 it. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) Y Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: 0P05c J (�_C-A-1&l ; WAS (_ 7-6 CZ-AiK G-R6UNh C-LL-AM&C< AVOID \AMIzDZ /�aitPCDliTton! � t�A(5 /-/vim I NS t:5C 1 h�1 /l� 4Cz (e'l (WING OFF G SAD t- SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item 1. Building Estimated Cost (Dollar) to be Com leted b unit a licant �jX6CV .0 IWO �� WIN (a) Building Permit Fee Multiplier {NL04 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 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 Owrier/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 NO. OF STORIES Date SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 3 SPAN DMIENSIONS OF SILLS DIMENSIONS OF POSTS DINIENSIONS 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 FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used. to verify that allnecessary approval/ permits from Boards and Departments having Jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. I■asa■anow Nos aa.WON a.a.aac.■a■aa■ man Was •■aaNam a..aaana.-a.aa■ass aaMan aa■a■sa-a■■ APPLICANT �U47C, r-rs JAZ PHONE gZoo -8_�7-3(ozc) ASSESSORS MAP NUMBER LOT NUMBER SUBDIVISION LOT NUMBER. STREET 1(gd VV&i t,]L STREET NUMBER ° " i 8Q 1.■a0..raaar.aaaa-aa0aa0Wm0■.00a WE a a a a.aaa.aaa..aa a 0 a a a a... a. a a.. a a. a a. a a a a a a a a a■ OFFICIAL USE ONLY �aaaaa...>.•sa.a.........a.■..r.aa.aaa-a.■.aaraaa■...•.aaa...aaa,..Nam a0a0aama RECONEVENDATIONS OF TOWN AGENTS ra.a.a.....a--.....■aaa.a.a.a.......MEN .Oman .......a.............:..asaaaSOME .aaa:aaa.ao a a 0 DATE APPROVED CONSERVATION ADMINISTRATOR DATE REJECTED CONEVIENfS .. DATE APPROVED TOWN PLANNER DATE REJECTED _ --- - COMMENTS 0 FOOD INSPECTOR - HEALTH SEPTIC INSPECTOR - HEALTH CON VIENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERNU FIRE DEPARTMENT DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE Tel: 978-688-9545 Town of North Andover Building Department 27 Charles Street North Andover MA 01845 HOMEOWNER LICENSE EXEMPTION Please print. DATE .66Y, 12 JOB LOCATION I S' /I // Number 7 Street Address Section of Town "HOMEOWNER i�LLjS �, �2�TIS 2 78 ^ 7 -?6Z cD, 7 Number 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 1 or 2 units 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 of two there is, or is intended to be, a one family dwelling, attached or detached structures accessory to such use and 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, a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 108.3.5.1) 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 /�r�c3'�L'_ri�� � �` 9" APPROVAL OF BUILDING OFFI Note: Three family dwelling 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0 Construction Control. Revised 4.30.03 Home owner Exemptions Form 4 ri P s'; ups 64�%i4? 0 -- APKHORS _ s=XeS'jdi�L i'Loes l 14OLLI-S WATml Sr� -- --- --i-go �,c�►- vjALL.--a Rvaiy s 6 PRCFOS-Z:D CEMKI, r C:R�A-IE C�RaUNT3 CLC-AM/VCE- AND WATT Tt i,W<Acaf- ANP tn4sec-i -Dhm6 E %off ---- --------- Ir 1 W rA co LLJ co o O o �oc O y L O03 --- -._"- -U- - - - _ -W - - -p ---- W . - IO OC.3 C.J O � COD C F-4 _"W O CD w z, 0 a • -A z -- 0-4 04 -J z -W a v c a o z v o v o o x G Cd v Cd_ W w cn w w U w rz° w w�' cn w w cn Cl) LLJ Z O W a4 co o O o �oc O y L O03 O CL IO OC.3 C.J O � COD C 14 p, C O CD Ca • m C 1 '� m m E a a CD co cft :fir = *46 CDd s. y E O om Cl H �m ♦: C +'cc ; CDca c. Q E J 'fl m �: CO CD y cl Vy CA CD m Z r y C C ■ C � O CC ca O O • � y R O nC% v y m ® : t C m � CD C cm C • ; m p •y m C1 O i ts o •� co cm c Q m C2 i m C • = m :m-3 O. O NC r y m a� m COD o ev •y 16•0 o F- CC •m L- C_.+ c 'y mi Z C.3 CA p m C co _ d m O 'O a h •� O H' ypr c• *- �. Z O W a4 co O O L O03 O CL O � COD C O CD Ca '� m m 0 CD co CDd O m Cl H �m O C +'cc VCc J 'fl C CD u cl Vy CL. ® !O C C ■ C ■y Location Irla_1SO (.(.9AlCIZ S-� No. 15 3 QL7 Date � NORTH TOWN OF NORTH ANDOVER � s + ; Certificate of Occupancy $ ; �'�a °•�° s Mus t Building/Frame Permit Fee $ 1/© Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ) l D " Check # -3� 8s 16361 04 ICot— Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/I-or of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: W/PL=f3�� r \ 1.2 Assessors Map and Parcel Number: 6P C/ Map Number Parcel Number J� 1.3 Zoning Information: Zoning Diaiict Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) Public ❑ Private ❑ -Zone 1.5. Flood Zone Information: Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT ' 2.1 Owner of Record � / f-ta" c s �1., C Rr Name (Print) r i s Address forger -vice -83 = 302_c:1 Signature T ephone 2.2 Owner of Record: Name Print Address for Service: Signature Tele hone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: c 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 ou M z O O Z M 90 O Wn ic r v M r r z ^ VI -i SECTION 4 - WORKERS COMPENSATION (M.G.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 permit. Signed affidavit Attached Yes .......0 No ....... 0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building B' Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposied> Work: L.l�a�� j � r`+TGffr'`/J �C3leu�TS >P�P.ni4Tti: �LL L C'�u t='P'S i� G,�DL �f1 T�� I �Ct/✓iI3 to rG 'ORAW t e4Cc aj-T SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be C m leted by permit applicant 1. Building 00 _ _ � OIC ICDk' R (a) Building Permit Fee Multiplier E (DNLY 2 Electrical GYJ (b) Estimated Total Cost of Construction o� _ 41�>Q 3 PlumbingJ coo Building Permit fee (e) X (n) j / o t / / 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 v �as 30wner)/uthorized Agent of subject property ereby authorize a /yt 2-,i o u.5 to act on My behalf, i all matters r lati to work authorized by this building permit application. y Si nature of Owner Date SECTION OWNER/AUTHORIZED AGENT DECLARATION ��7b 1,1 l`o L LAS �.� tz7� S rz 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 / &"�4-��s tz�ts Jaz Print "Name - Si ature Owner/A ent Date ' 2,11 MUM _1 NO. OF STORIES SIZE BASEMENT OR SLAB ' SIZE OF FLOOR TIMBERS I 2ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DEV1ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERL4L OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 0 North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number - is that.the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S.150 A. The debris will be disposed of in: (Location of Facility) Signature of Pe it Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through. the Office of the Building Inspector Tel: 978-688=9545 Town of North Andover Building Department 27 Charles Street North Andover MA 01845 HOMEOWNER LICENSE EXEMPTION Please print. DATE Nom ' 20C>3 JOB LOCATION- -� �G `/�ic}TL (� Si- IYQRTKiDdCr� . ] •V4R�'KK• Number Street Address Section of Town "HOMEOWNER /go V AEf Qj a. 9 ZS �- 93 rI - 342,q Number Home Phone Work Phone PRESENT MAILING ADDRESS 1 NO rz 711 &Ay15oY� 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 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 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 to six family dwelling, attached or detached structures ac- cessory to such use and 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, a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) 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. ,�L-�J HOMEOWNER'S SIGNATURE /,_4,6 i1. APPROVAL OF BUILDING OFFICIAL Note: Three family dwelling 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0 Construction Control. 1� O z Q a x w uv o a ° P-4 z a a °�° U co it o W z ' d �n a A4 z w W °�° cn �n w x O U : w w z x w w z cn cn . o : CD o C H ' � C Cc O C3 .Q•'C p• C ev ev m C O ` G2 N � :mac s :tom :oaCD0 : fa �+ Z c fti 1 : o_ = Q E :m ir' cm m N A •= C N N O % C m cp A c o Q N ®or o ®.0 c Q oCD o •o COD ui I -- cc CD •N aZ W C O 2 ® ED _ o o COD CL ®� ®:8 _ cz cc ca J=*- a . � R O CO) Q3 L t .r c Q CO) O V .CL H c 0 .0 _cc �. CO2 r—1 L s CD Q. CA 0 U) Cn W w crw Date .��.....:..�J.... .......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .................................... ..........: ................... ................................ ,has permission to perform J�. .................................................................... wiring in the building of`..........--��............................................ � �: Jl J ... North Andover, Mass. at ............................ ...................:.ti ................... Fee.-. �.............. Lic. No o?/ 9%.�. �_ �ELECTRICALINSPECTOR Check # �'�l�7 4492 THECOMMOARFALTHOFAMSACHUSEM Office Use only DEPAMMEWOFPUBIICSAFETY Permit No. BOARDOFFMEPREVEVHONREGUTAIIONS527CNIR12 Q0 Occupancy & Fees Checked APPLICATTONFOR PERMIT 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) «Q A44 71 —L- K S -r- Owner or Tenant ac gL,t S A, Cu t2T'Ls JFZ, Owner's Address -3 4 -/yl i,^ Is this permit in conjunction with a building permit: Yes = No (Check Appropriate Box) Purpose of Building RZs t 'p cg -,/q T1 I Utility Authorization No. Existing Service � Amps / Volts Overhead � Underground �_ No. of Meters Ne, Mi cc C= Amps / Volts Overhead Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 1P0 Atli &7 RIEnLOVi4IT-t 16 No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total _y KVA No. of Lighting FixturesSwimming 3 Pool Above Below Generators KVA round 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 1JA rr27 W t (z a No. of Detection and 1.:X1 S %/1rc No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices t7 No. of Dishwashers "Space Area Heating KW No. Self Contained ®N Detection/Sounding ction/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW E3 Connections N% of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER- histrra=Coraage Piasirant�therogritanaYscfMassadi> IsGer�alLaws Iba�eaamaYLiablidyhmuxto Fbhc;yrrkxiugC rlp�e Co�a�aitsst legtliv�tlat YES M NO r IbaNestllniUBdvaidpmdcfsa riDtheOffim YES IfjouharedteclkclYFS,pleas uka1e1hetype0fCDWrageby dheddTftINSURANCE F -1a box BOND r --J GIBER ( y) EqirafionDale { - inlrr� � EsfiruakdValtleofF7x"Wolk $ Ge . WolktoStart re= h>SpectiorrDateRffpested Rough`` /000 Final ;5-<)o SigiadurderEPataltiesofperjuiy Y-, Gw ,> I, ! 1s5gyA nl�py R Licer�s.No � � q 70 FIRMNAME � A -Y /_17 � S S t /'rl d /1l L� AddtT"Zq At Tei No. OWNER'SINSURANCEWAIVER;Iamawaret AdrLio wdoesnothavetheirrs war,cecowrageoritsstllUMegLnvalattaswWredbyMassadnisarsGmcralLaws and thatmysigiatuteon thispelrriitappkation waives disiegttlirariait (Please c eck one) 01.yqer Agent F-1 Telephone No. PERMIT FEE $ Signature ot Uwner or gen The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print Name: Location: © W,+�-R T 416 RTi4 4/vbxsV e -(L , 1""T A, I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity - 8 3 7-302o I am an employer providing workers' compensation for my employees working on this job. Company name: City Phone #: 'J Insurance. Co. Policv # Company name: Address City: Phone # Failure to secure coverage as required. under Section 25A or MGL 452 can lead to the imposition's(cximi w penalties of,a fine up to $1.50D.00 ancVor one years' impmornvmAas -we[Las-cmd,penakms-wAbe%un-da_STC)P V OW -C RDERand-afine-f_($1DOm)a day -against ore I understand that a copy of this statement may be forwarded to the Office of t ors.,of the DiA for coverage verification. / do hereby certify under the pains and pens ies ofperjury that the information provided above is true and oared: Signature_ Print name v�,�i� �uiz�iS JctZ, Pbone# �� ''`�37-SOZ-0 Official use only do not write in this area to be completed by city or town dfic" City or Town Pem>it/Lic Mnq El Building Dept E]Check if immediate response is requires/ .0 Licensing Board Ej Selectman's Office Contact person: Phone A- ❑ Health Department ri Other .! '" Town of North Andover Town Clerk Time Stamp Community Development and Services Division IRECEIVED .; Office of the Zoning Board of Appeals 8RADS19AW 'JJACHus'` 400 Osgood Street North Andover, Massachusetts 01845 D. Robert Nicetta Telephone (978) 688-9541 MAY 2b P 4: Building Commissioner Fax (978) 688-9542 This is to certify that twenty (2f,t) clays have elapsed from date of decrs!:;n, filed without filing of an�ppl. 0 Any appeal shall be filed within Notice of Decision Date ��%%A 7� (20) days after the date of filing Year 2005 Joyce A. SnWsha f of this notice in the office of the Town Clerk Town Clerk, per Mass. Gen. L. ch. 40A, § 17. Pro at: 178-180 Water Street NAME: Hollis A. Curtis, Jr. HEARING(S): May 12, 2005 ADDRESS: 178 -186 -Water Street PETITION: 2005-011 North Andover, MA 01845 TYPING DATE: May 23, 2005 The North Andover Board of Appeals held a public hearing at its regular meeting in the Town Hall top floor meeting room, 120 Main Street, North Andover, MA on Tuesday, May 12, 2005 at 7:30 PM upon the application of Hollis A. Curtis, Jr., 180 Water Street, North Andover requesting a dimensional Variance from Section 7, & Table 2 of the Zoning Bylaw for premises at: 178-180 Water Street for relief of lot area, street frontage, the front setback on the existing dwelling and the left & rear setbacks on the detached garage. Said premises affected is property with frontage on the North side of Water Street within the R-4 zoning district. The legal notice was mailed to all abutters and published in the Eagle -Tribune on April 25 & May 2, 2005. The following members were present: John M. Pallone, Ellen P. McIntyre, Joseph D. LaGrasse, Richard J. Byers, and Albert P. Manzi, III. The following non-voting members were present: Thomas D. Ippolito, Richard M. Vainancourt, and David R- Webster. Upon a motion by Richard J. Byers and 2rd by John M Pallone, the Board voted to GRANT a Variance from Section 7, Paragraph 7.3 & Table 2 of the Zoning Bylaw for relief of 11' from the left side setback and rear side setback of 13' for the existing garage in order to allow a third dwelling unit to be constructed within the footprint of the existing dwelling structure per Certified Plot Plan, location, 178-180 Water Street, North Andover, MA, prepared for Curtis, Jr. & Lois J. Curtis, Date: August 3, 2004, Revisions: February 10, 2005 [by] Frank S. Giles, II, P.L.S. #41713, Scott L. Giles, Frank S. Giles Surveying, 50 Deermeadow Road, No. Andover, MA 01845 and Floor Plan, 18OR Water Street, drawn by H. A. Curtis Jr. With the following condition: 1. The third unit granted by Special Permit 2005-006 on 4-12-05 shall be within the existing footprint and roof elevations of 178-180 Water Street. Voting in favor: John M. Pallone, Ellen P. McIntyre, Joseph D. LaGrasse, Richard J. Byers, and Albert P. Manzi, III. The Board finds that 178-180 Water Street is a corner lot in R-4 and that the dwelling front setback is within the average of Water Street front setbacks within 250', per Footnote 8 of the Zoning Bylaw. The Board finds that the applicant has satisfied the four conditions of Special Permit 2005-006 and the provisions of Section 10, paragraph 10.4 of the Zoning Bylaw in that the granting of this Variance will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw because the Variances granted are on the existing structure setbacks. ATTEST: Pagel of 2 A True Copy Town Clerk Board of Appeals 978- 688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535 J Town of North Andover Office of the Zoning Board of Appeals Community Development and Services Division 400 Osgood Street North Andover, Massachusetts 01845 D. Robert Nicetta Building Commissioner Telephone (978) 688-9541 Fax (978)688-9542 Furthermore, if the rights authorized by the Variance are not exercised within one (1) year of the date of the grant, it shall lapse, and may be re-established only after notice, and a new hearing. Furthermore, if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two (2) year period from the date on which the Special Permit was granted unless substantial use or construction has commenced, it shall lapse and may be re-established only after notice, and a new hearing. Town of North Andover Board of Appeals, Ellen P. McIntyre, Chair Decision 2005-011. M69P40. Page 2 of 2 Board of Appeals 978- 688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535 `!y�"`�u+�a93�;G`ioS.�c-��-+v...+ext9[-�:►�`v"�,..'.'I`yiJ�*f'.. �.., � --�.. ..o...,_�...-r .+:,,.....,{ _+�- .. ,�..'� Location No. Date ZZ M°RT" TOWN OF NORTH ANDOVER o+o.,��ao 0 3? • " 0 p Certificate of Occupancy $ * Building/Frame Permit Fee $ .o At 14 sE� Foundation Permit Fee Other Permit Fee $Ln Sewer Connection Fe $ Water Connection Fee $ TOTAL $ Building Inspector p pa Div. Public Works .. P4 a W Q a Y 0 0 m W F - Q MM IL (n M W z 0 u Z LL a 0 _J a :)_W Ir m k. rc O O WW N 0CL O C N d Z 0 z 0 J 0 a Q 0 z 0 J m D N { z 0 W Q 0 0 O z N r N m K W m f F C 0 0 J 4 4 O W N_ N N W O m H W _z J r 0 J f 0 m LL W u z a r N N 0 W z x u s r z 0 r a 0 z 0 U. 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N C a'E c CD ey t I� o " z is 0 $ 0 m z z Q J Qm .c H A m m m d O m 'Cd O C O N m a� m � m ) CD m �= a +' 'd m c o ...� ; m O C-1 N O m G �C = m o N �..� H m y m ea = m w W O 'O + 'd a r G C .� C C, W V m C,. m C Off•COOD a R o CD a C, H .0.. is :E m i 1� �a o J z E LL c L O O v � Z Q O � y � Z O O COO Gj _ •O (r M 'E O m CD LU U) z � O CD ~ ice..• CD O.Q O co � CD 0CD O Q� �Q C C= = cc C� CJ J 5.O Z � Z C LL COD cc C ey CL <n z is z z Q J s= ' OFFICES OF: Town of APPEALS , ;, : NORTH ANDOVER BUILDING CONSERVATION Dtt'IStON OF HEALTH 1'1--\NNING PLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON, DIRECTOR y" , 01 120 main street North Andover, Massachusetts o 1845 In accordance with the provisions of LJGL c -10, S 54, a condition of Building Permit Number _ ZC*1 is that the debris resulting from this work shall be disposed of in a properly lic- ased solid waste disrosaI facility as defined by MGL c 111, S 156A. The debris will be disposed of in: CqQ (1,ocation of raciiity) e Sienature of PUMIL Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. 22Date.... N009 TOWN OF NORTH ANDOVER PERMIT FOR WIRING — 0 This certifies that ....... ......... .................................. has permission to perform ......... ......... C. e ................. wiring in the building of ......... ...... ................................. at .... 5� . ........ ZkUiA ...... /2r ... W'—� .......................... ,North Andover, Mass' Fee. ()')... Lic. No. ELECTRICAL I . i;SPECTOR C << /o�y WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Office Use Only g Permit No C f %*u£ 4z'%+p %%J!.>¢5.514�r1�SGl%%S Occupancy & Fee Checs(ed BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be oerforrned in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Town of North Andover The undersigned applies for a permit to perform the electrical wort( described below. Location (Street & Number owner or Tenant --do / r` Owners Address I C61D ) � S Date / 997 To the Inspector of Wires: Is this permit in conjunction with a building permit Yes O No K (beck Appropriate Box) Purpose of Building � ��' WC Utility Authorization No E_,6sting ServiceAmps vats Overhead O Undgmd C] t!� Volts 0�� Undgmd O New Service a0b Amps a . No. of Meters No. of Meters 1, mber of Feeders and Ampacrty �/ G AO '" Lo=on and Nature of Proposed Electrical Work c"- -,V-c SEP J1 �C f QOM �D� #/2�b No. Of Lighting Fixtures No of ReceptaG Is Outlets No. of Switch 0 idets No of Ranges ° NO of DIDO-I No. of Dishwashers `v NO of Dryers No, Of Water Heaters KW u� H�.nm KA;%-&aae Tuds iia tlzl,y — :r✓ & No. of Hot fuse Above ❑ in ❑ Swimmina Pool Qmd ❑ qMd ❑ No. of Oil Burners No of Gas Bumers No of Air Cond No. Space/Area Hea Heating Devices No. Of Signs No. of Motors Total Tons Heat Total Pumps Tons Total KW KW INV No. of Total of T Generators KVA No. of Emergency Lighting Battery Units FIRE ALARMS No. of Zone No. of Detection and Initiating Devices No. of Sounding Devices No./ of Self Contained Detection/Sounding Devices O Municipal ❑ Other Low Win OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO have submitted valid proof of same to the Office YES = NO = If you hive checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE = BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Works Slit) 'o0 Final (� -? Work to Start �' Inspection Date Resquested i �� _ Rough Signed under the Penattles o p jury: LIC. NO. FIRM NAME L /� 3a Licensee �F F'-� ``�Signature C"—LIC. NO. �! [' Bus. Tel No. .-5 Address ./� J `D Alt 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 Massachusetts application waives this requirement. Owner Agent (Please Check one) General Laws. And that my signature on this permit app Telephone No. PERMIT FEES U (Signature of Owner or Agent) Zoning Bylaw Denial ' Town Of North Andover Building Department . :. 400 Osgood St. North Andover, MA 45 018 . ,��. ,:• . Phone 87644-8545 Fax 878.688-41542 Street: I �� —_ /fid i Mao/Lot 25 Applicant: HO //1 s -� -j � Request - Date: Application is Please be advised that after review of your Application and Plans that your AppyK DENIED for the following Zoning Bylaw reasons: zoningNotes i� A Lot Area 1 Lot area Insufficient Notes F 1 Item Frontage Frontage Insufficient Access other than Frontage Special Permit 2 3 Lot Area Preexisting Lot Area Complies S 2 3 Frontage Complies Preexlsti e 5 4 Insufficient Information Special Permits Zoning Board 4 Insufficient Information Large Estate Condo Special Permit B Use SpwW Permit Use not Listed but Similar . 5 No access over Frontage R-6 Density Special Permit - 1 Allowed G Contiguous Building Area 2 Not Allowed 1 Insufficient Area 3 4 Use Preexisting Special Permit Required —77---S 2 3 Complies Preexisting CBA 5 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient 5� G 5 2 Complies 3 Left Side Insufficient amp Ltf 5 _ 3 Preexisting Height y 5 4 Right Side Insufficient 4 Insufficient Information 5 Rear Insufficient ( 6rsM HCS i Building Coverage 6 Preexisting setbacks 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D Watershed 3 Coverage Preexisting 5 1 Not in Watershed fd e- 4 Insufficient Information 2 In Watershed J Sign 3 Lot prior to 10/24/94 1 S" n not allowed 4 Zone to be Determined 2 Sign Complies -5 Insufficient Information 3 Insufficient Information E Historic District K Parking 1 In District review required -- 1 More Parking Required 2 Not in district-' 2 Parking Com 3 Insufficient Information 13 Insufficient Inforrmation 4 1 Pre-existing Parking Rernedv for the shave in checked below Item a Special Permits Planning Bored Item d Variance Site Plan Review Special Permit C =Z Setback Variance Access other than Frontage Special Permit Parking Varian Frontage Exception Lot Special Permit Lot Area Variance Common DrNeway Special Permit Height Varian Congregate Housing Special Permit Variance for Sign Continuing Care Retirement Special Permit Special Permits Zoning Board In dentEWedy Housing Permit SpwW Permit Non -Conforming Use ZBA Large Estate Condo Special Permit Earth Removal Special Permit ZBA Planned 2TTqTLM District Specivil Permit SpwW Permit Use not Listed but Similar . Planned Residential SpedW Permit Speciail Permit for Sign R-6 Density Special Permit - specmd Permit prewdstingnonoonformin Watershed Special Permit The above review and attached m<pirrat-1 of such is based an the plans and Infanneft submitted. No definitive review and or advice shall be basad on verbd m;1- 119 , by the applicant nor ahai such verbal mpleneft s by the appicrrt varve to provide deraiidve amm tithe abere reaeons for DENIAL. Any iu=aade , nte0- di 9 9MorineW , or ofhw subasquwd dwiges to the Mbru tion submitted by the Wpicent shall be grounds for #ft review b be voided at the diecraion of the Building Department" The atfactred docurnant Mad 14m Refto Narrative dO be abactod hereto and incorporated heroin by Mwence. The buil ft deprtnsnt will retain d piano and docmentabon for the aba a tie. You mast fie a now building Parrot applicabon torn and begin the p- dM proo�as d13L Building Department Official Signature Apopi Ap Denied f1..oe:..l n --a, . 16 nu--- Al,.e..la�>fiisaln• Plan Review Nafradve The following narrative is provided to further explain the reasons for denial for the application/ permit for the property indicated on the reverse side: lIM� j Police va f� 14V,(.e 14r )C"42 eV S � � h,9 � l� p,v 4A Con ger S e %.4cle av Planning d ,e /,? 2,4 Other s C , r7 � -t4- � 6Z Izi-4i-17-111- Fire Health Police Zoning Board Con Deperbmit of Public Works Planning Historical Commission Other BUILDING DEPT AL ... Fire Protection by Computer Design Xcel Fire Protection 11A Industrial Way Salem, NH 03079 800-537-3331 OF 9G,y LAWR V. u R FIRE PR (770r4 c N . J1 q� Q STEA s%OIVALE�G\�� Job Name : Building 178 - 180 WATER STREET Location 178 - 180 WATER STREET System 1 OF 1 Contract Data File WATER ST.WX1 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 f Xcel Fire Protection Page 1 Date HYDRAULIC DESIGN INFORMATION SHEET Name - WATER STREET APARTMENTS Date - 10/03/05 Location - 178 - 180 WATER STREET Building - 178 - 180 WATER STREET System No. - 1 OF 1 Contractor - XCEL FIRE PROTECTION Contract No. - Calculated By - XCEL FIRE PROTECTION Drawing No. - 1 OF 1 Construction: (X) Combustible ( ) Non -Combustible Ceiling Height VARIES OCCUPANCY - APARTMENT BUILDING S Y S T E M D E S I G N Type of Calculation: ( )NFPA 13 Residential ( )NFPA 13R (X)NFPA 13D Number of Sprinklers Flowing: ( )1 ( )2 ( )4 ( ) ( ) Other ( )Specific Ruling Made by Date Listed Flow at Start Point - 12 Listed Pres. at Start Point - 8.2 MAXIMUM LISTED SPACING 12 x 12 Domestic Flow Added - 0 Additional Flow Added - 0 Elevation at Highest Outlet - 20 Note: 0'-0" Gpm System Type Psi (X) Wet ( ) Dry ( ) Deluge ( ) PreAction Gpm Sprinkler or Nozzle Gpm Make TYCO Model LFII Feet Size 1/2" K -Factor 4.2 Temperature Rating 155 Calculation Gpm Required 24.247 Psi Required 73.104 At Test Summary C -Factor Used: Overhead 150 Underground 150 W Water Flow Test: A Date of Test - T Time of Test - E Static (Psi) - 110 R Residual (Psi) - 50 Flow (Gpm) - 450 S Elevation - 0'-0" P Location: P L Source of Information: Y Pump Data: Tank or Reservoir: Rated Cap. Cap. @ Psi Elev. Elev. Other Well Proof Flow Gpm Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 m `O Z U o Q0 CL o =3 d U) (D L � U- � -5 X 04 r- NO COONO O ti M N N .. .. .. .. .. .... N -p 7 O N N N 0�^�C U °EEU`oE� un iamQ)1�SC N �Qp m >,vv w cn U) cn ) 1 cn y cNN O OM N �ppp22pcA E N p O O 0 M LO cq r O < O Z M _ 0 J U- C) N O O CDN O lO � LO 'I N cn N 3 LO U,o con LL f0`6a CL O o o - aa LO (O—NN �UUU ), o U) O 't o M O N o .– O O O O O O O O O O Cl e O M � (0 U) 't M N U a w cA U) : w co co O Cl) O Q Cl) 2 Z E w s a C: a 0 U C (`) cu al � 0 q N CO N (0— CO r N S , t� ,It O It O R co Cl LO � 0 co h co N N(ON O N Ln N O tf)M M tb � � O O � M � N M N lt) N — rn C I1 O O � c -CCN) � I -- co CO —CO co r.- h N N tD r- (D 3 O O LL N In r LOC O N cn I�rOOVcc m to to O J MOM -O tll X IL t0 N to N to O m tU N7N tU m O C �I NCl) NLL Pressure / Flow Summary - STANDARD Xcel�Fire Protection Page 4 Date Node Elevation K -Fact Pt Pn Flow Density Area Press No. Actual Actual Req. 101 20.0 4.2 8.2 na 12.03 0.05 100 8.2 102 20.0 4.2 8.47 na 12.22 0.05 100 8.2 103 20.0 10.57 na 104 10.0 16.24 na 105 10.0 18.14 na 106 10.0 18.61 na 107 10.0 19.06 na 108 0.0 24.13 na TOR 0.0 25.73 na BOR 0.0 26.41 na UND 0.0 33.73 na TEST 0.0 73.1 na The maximum velocity is 16.08 and it occurs in the pipe between nodes UND and TEST Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 FinbIl'Calculations - Hazen -Williams r Xcel Fire Protection Page 5 Date Hyd. Qa Dia. Fitting Pipe Pt Pt Ref. "C" or Ftng's Pe Pv *'' **" * Notes Point Qt Pf/Ft Eqv. Ln. Total. Pf Pn 101 12.03 1.101 0.0 10.000 8.200 K Factor = 4.20 to to 150 0.0 0.0 0.0 3.825 102 12.03 0.0266 0.0 10.000 0.266 Vel = 4.05 102 12.22 1.101 1 E 3.825 17.792 8.466 K Factor = 4.20 to 10.000 150 0.0 3.825 0.0 150 103 24.25 0.0971 0.0 21.617 2.100 Vel = 8.17 103 0.0 1.101 1 E 3.825 10.000 10.566 107 to 1.265 150 0.0 3.825 4.331 104 24.25 0.0971 0.0 13.825 1.343 Vel = 8.17 104 0.0 1.101 1T 9.563 10.000 16.240 14.935 to Vel = 6.19 150 0.0 9.562 0.0 4.967 105 24.25 0.0972 0.0 19.562 1.901 Vel = 8.17 105 0.0 1.101 1 E 3.825 1.000 18.141 to 150 0.0 3.825 0.0 106 24.25 0.0972 0.0 4.825 0.469 Vel = 8.17 106 0.0 1.394 1 E 4.762 10.000 18.610 to 150 0.0 4.761 0.0 107 24.25 0.0308 0.0 14.761 0.454 Vel = 5.10 107 0.0 1.265 1T 5.935 9.000 19.064 to 150 0.0 5.935 4.331 108 24.25 0.0494 0.0 14.935 0.738 Vel = 6.19 108 0.0 1.265 2E 4.967 26.292 24.133 to 150 0.0 5.935 0.0 TOR 24.25 0.0494 0.0 32.227 1.592 Vel = 6.19 TOR 0.0 1.265 1 E 2.967 8.000 25.725 to 150 1Z 2.967 5.934 0.0 BOR 24.25 0.0494 0.0 13.934 0.689 Vel = 6.19 BOR 0.0 1.025 1 E 2.7 0.083 26.414 to 150 1T 6.75 9.450 6.000 " Fixed loss = 6 UND 24.25 0.1376 1Zwa 0.0 9.533 1.312 Vel = 9.43 UND 0.0 0.785 1T 4.773 40.000 33.726 to 150 5E 11.933 18.217 10.000 ' Fixed loss = 10 TEST 24.25 0.5046 1 Eql 1.193 58.217 29.378 Vel = 16.08 0.0 24.25 73.104 K Factor = 2.84 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 x���������of��s 381 Common Street Lawrencg, Massachusetty O184O #12 4 -R T PL 5O.0O DOC 25098 C. P. 2100 R. D. 5.00 # 125 Rec: Type NDTC 5LOO DOC. 25O99 C. P. 20.00 � D. MO ' # 126 Re(:: T -y- e !,-.!OTC 1510,00 DOC. 251C)0 2cD.O0 R. D. 5OO Total 225.00 #127PapentChalk 22& OO ' ' ` ` ' THANK YOU! Thomas J. Birk.- -9694 16-9-10 Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .......... 4......... has permission to perform...... G ....... wiring in the building of ....4�i ........................................ at ... l.y -..� �.. t tP% /G:.... ?'.......................... North Andover, Mass. 1 . L..�.� ' Fee ... �..-�'�..:-..':'.. Lic. No. Via? 4. D ................... �.... ....... ELECTRICAL INSPECTOR Check # 107 M o m w p N • U q N� h O H CFJ tq p O � m h• 'm O a A .i❑y ,� •O G ,y N Ed q •�„ � C�y. o v .p., .a _ ca .cp ca ' 43 3a •ti rn O ca qb 0 o �% ❑ dJ qpO N C ] ,Qy�' q 'O gr�L N t31 O c+��0, N 3 '� C7 ' nom+ p y �, q Ir' .'�•'p, 'p q m .o ';j v q C- .0 w .. •ci •cs a� C::, •q q := a� Mme' p vOi 8 Cpi U' c�dy OOH+ off N y� �4N5. L' -r ❑ Vi Cpl A A M .Li �-'' p� • O H O.is qcm 'b ai:-' Vim• U o ci ❑p- ',1,2 o w� cv a,a, t00 *.{ bA U ti b ,pN p w .� A q A O. O bO U N 24 q o ,p o yiwj�a A N •N � 4-1 •tl by .4+ q p UP O d 9) H O q O O O p ttt q � .bU� or o 42 asof -2 a� q oq d �� ❑ � �ppA�ob�.� y. ppb W��H 11 �-a � � � 'Li � U •U � � U q � U O � PI P. O N O U H !�' N .O `is P, q W O N H H '+�' ¢. �' % ' +�:''�' �-� ll+lUllMlX6iYtlpP/F/1C8898,6U Q8t! I19®69S�s&6aB&G�t�66� ��� Permit No. -- Depar, tment ®f Fire �������� Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/071 (leaveblank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (NEC), 5277CNa 12. 00 (PLEASE PRINT IN1NK OR TYPE ALL INFORMATION) Date: /0 — 9-1P City or Town oh NORTHANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) /7?— /fO G✓A Y ✓ r � „ , � , Telephone No. % % �"' .� o Owner or Tenant j v y' I er g r 7? Owner's Address S� Is this permit in conjunction with a building permit? Purpose of Building Existing Service/!� a Amps 2 Za Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work:' Yes ❑ No (Check Appropriate Box) Utility Authorization No. Overhead Undgrd ❑ No. of Meters 3 Overhead ❑ Undgrd ❑ No. of Meters Completion of the following table may be waived by the Inspector of Wires- , F.T. I ires.Total No. of No. of Recessed Luminaires (Paddle) Faris Transformers RVA Generators KVA Above In o. o mergency ig ing rnd. rnd. ❑ Batter Units FIRE ALARMS No. of Zones No. of Ceil.-Susp. No. of Luminaire Outlets No. of Hot Tubs No. of Luminaires Swimming P 0 No. of Receptacle Outlets S No. of Oil Burner No. of Switches Burne No. of Gas Burn No. of Ranges No. of Air Cond. No. of Waste Disposers Heat Pump Totals: Nn No. of Dishwashers Space/Area Heat No. of Dryers Heating Applian No. of Water Heaters KW No. of Si ns No. Hydromassage Bathtubs No. of Motors OTHER: j� e t✓� ff `� <4 f ( Initiatin Devices Total No. of Alerting Devices Tons tuber Tons KW ,. „ No. of Self Contained '" ' .. Detection/AlertingDevices Municipal Other ing KW Local ❑ Connection ces Key Security Systems:* No. of Devices or E uivalent No. of Data Wiring: Ballasts No. of Devices or E uivalent Total HP Telecommunications Wiring: No. of Devices or Equivalent • .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:) X certify, under the pains and penalties ofperjury, that the information on this application is true and ®lete. FIRM NAME": Licensee: LPo yi to %rI/ � f Signatur ,� LIC. NO.:���� y' a r% (If applicable, enter "exempt" in the license number line) Bus. Tel. No. - Alt. Tel. No.: Address: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lie. No. 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 EI owner's Owner/Agent Telephone No. PERMIT FEE: $ Signature The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 �„ s<•' www.mass.gov/dia Workers' Compensation Insurance .Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ' Please Print Legibly Name (Business/Organization/Individual): �4 i2 ti -11V� / I Address: City/State/Zip: /7;'A o/,p4,5 Phone #: 9 / d Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).' have hired the sub -contractors listed on the attached sheet. # 2. ❑ I am a sole proprietor or partner- These sub -contractors have ship and have no employees working for me in any capacity. workers' comp. insurance. o workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their required.] 3. 0 I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no employees. [No workers' insurance required.] comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions 11.❑ Plumbvng repairs or additions 12.❑ Roof repairs 13. ❑ Other, *Any applicant that checks box 41 must also fill out the section below showing their workers' compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 1Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company N, Policy # or Self -ins. Lic. #: It T - 'k Site Address• Expiration Date: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DTA for insurance coverage verification. I do hereby certifder the pains and vvenalties oer�ury that the information provided /jabove isj/tt roue and correct. Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town CIerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone