HomeMy WebLinkAboutMiscellaneous - 18 WOODCREST DRIVE 4/30/2018Location
No.Date
�oRTh
TOWN OF NORTH ANDOVER
i
Certificate of Occupancy
$
��s',•a°' Eta
SgcMUs
Building/Frame Permit Fee
$—
Foundation Permit Fee
$
Other Permit Fee
$
TOTAL
$
Check #
/ ) , -J,9� -
14229 '-'` Building Inspe hof
SEC: I IUIN I- Si 1 E• IN FORMAI IUN 1
1.1 Property Ad c�, y
'TOWN OF NORTH ANDOVER
Number:
Parcel Numb
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
x.k
-mss. �.
� ."'CHtfi€,.'*. g„ x Y"€<.<:
, ./•?xxwa
BUILDING PERMIT NUMBER:
,•
DATE ISSUED:
Front Yard Side Yard
SECTION 3 - CONSTRUCTION SERVICES
SIGNATURE: AN44W
,X7
Building Commissioner/I for of Buildings Date
SEC: I IUIN I- Si 1 E• IN FORMAI IUN 1
1.1 Property Ad c�, y
1.2 Assessors Map and Parcel
Map Number
Number:
Parcel Numb
^Address for Service
1.3 Zoning Information:
Zoning District Proposed Use
1.4 Property Dimensions:
Lot Areas
Frontage ft
1.6 BUILDING SETBACKS ft
Si. ature Telephone
Front Yard Side Yard
SECTION 3 - CONSTRUCTION SERVICES
Rear Yard
Required Provide Required Provided
R
'red Provided
License Number
Expiration Date
3.2 Registered Home Improvement Contractor
1.7 Water Supply M.GL.60. 54) 1.5. Flood Zone Information:
Public ❑ Private ❑ Zone Outside Flood Zone ❑
1.8
Municipal
Sewerage Disposal System:
❑ On Site Disposal System ❑
SECTION 2 - PROPERTY OWNERSIDWAUTHORIZED AGENT
2.1 Owner of Record
Name n
^Address for Service
na re Telephone
.2 Owner of Record:
Name Print
Address for Service:
Si. ature 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 § 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed affidavit Attached Yes .......❑ No ....... ❑
SECTION 5 Description of Proposed Work check au applicable)
New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify'
Brief Deschtion of Proposed Work: /
I SECTION 6 - ESTIMATED CONSTRUCTION COSTS I
Item
Estimated Cost (Dollar) to be
Completed by pennit applicant
{? ,.yAl C
'.� „3,,, P-11,48, F
_ "T_.. !"
1. Building
(a) Building Permit Fee
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
3 Plumbing
Building Permit fee (a) x (b)
4 Mechanical HVAC
5 Fire Protection
6 Total 1+2+3+4+5
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, as Owner/Authorized Agent of subject property
Hereby authorize to act on
My behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED-AGENT DECLARATION
I, as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief
Print Name
Mature of Owner/A ent Date
lasom
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS 1 2 3
SPAN
DEVIENSIONS OF SILLS
DIMENSIONS OF POSTS
DMIENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SI7_.E OF FOOTING X
MATERIAL OF CHIMNEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
Date..................................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
,sSACHUS
.... )Ixt.l.
This certifies that ...... ..
.... .............. 4-v
/ . ... ... .................
has permission to pe2.4—'6L. <4'1' ..........
wiring in the building. of l -AY.. .....................
h Andover, Mass.
at../ . ... Noft
4�-a 14 'a
Fee...l.- ......... Lic. No. /?V? ........ . .........
ELEmicAL INSPECTOR
Check #
5571
R
_. _�___—.--_.-_.—_ V'Vf/fid/Vel PY iiMlodf v• dTf eiJJ�b1INJClLJ�/
I Permit No. lf�I)
Department of Fire Sere% s Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGI LAT IONS Pkev. 11/991 (leave blank)
APPLICATION FOR PERMIT ,® PERFORM ELECTRICAL WORK
Au weckto bs pada med in wcordwee with %44" ntus60 Fdecdial Code (Nec). 3 271 CAR 12.00
(PLEASE PMT IN 1NK OR TYPE ALL XFO ON} Date:----
Ca#y or Tower of: e� % �'a the 1 ecto ®f Wires:
BY this apglia ion the u i or her ir�ntion to perform tlxe clecuic3l work described below.
ikon (Stmt & Number) ti ,
telephone No.
owner or Teat �.
Owner's Address
60 con'nn with building permit" Yes No (Check Appropriate Boa)
fs the
ViItsDity Authorization No.
Purpose ofExi,W.----
ag Service � Amps Volts Overhead !� Undvd 7i
New. = Amps / Volts Overhead 7 Undgrd
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
No. of Meters
No. of deters
inlTnwinv able may ie waived by rhe Inspector o(Wims.
No. of Hecessed FixturrsIS^to. of Cell.-Susp. (Foggia) Fags 'transformers KVA
No. o€ Ligbting Outlets
No. of Hot Tubs Generators
tum
Na. ofL;tang Fixtures
ave-
Swimming Pool d.
l� „ted,
o. o ergency a g
Battery. Units
No of )iptaicle Outlets
No ;of Oil Burners .
FIItE :i.Aiv15 No. of Z.oes
No..:of Stces
No: af`G'as Euraers '
° . 7oion ion '
Lritiatin Devrees
No. df Raag�s 3 :' -
No. of Air Cottd:..: -
°
Tons
No. of Alerting devices
:. ., �
No. of `'�'aste:Dis users
p
t p:
Totals
umber
az�s _ .
o .o - e - ontaane
detection/Alerting Devices
.
No. of Dishwashers
Space/ArtaHeating ICW
i Us u0p -Other
Local 0 Connection
of Dryers
IHeatine Appliances
KW
SecuriNo.
I Nof'Devices or E uivalent Sir
o. o ater 1Cy
Heaters
°. o
Signs
o. of
aia
]Data Wiring:
. ivant
No. H dromassa Bathtubs
y �
No. of Motors
Total RP "
elecorgrnurracataons rrstmg:
No. of Devices or l� ivaierrt
OTHER:
AMC* 44dJ nQMQi QOML r) ae 1-- ar as rwqu.ra.r X <,.....�,r.........� -... _.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of :lectriral work may issue unless
tttc licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The
undersiped certifies that such caverage is in forte, and has exhibited proof of same to the permit issuing office.
CHECK ONE: iNSLMANCE 91 BOND Q. OTH1:R ® (Specify:)
ton ate
Value of Electncal Work (When required by municipal police:)
Work to Start: ,f Z d e) Inspectiom to be requested in accordance Frith NE.0 Rule 10. and upon completion.
1.ewt!fy, u nd> r,thepains and pates ties of Perim ly, that the information on Arts app ° xien rs'rue and corapkae.
g..oiAr�caa Alarm&. Ca�ira3catiarur3r Inc. ` . LIC: NC?,. 12121.
chard L. $armnson__ Sagnature LIC P(O
app J Ie,, after "eampt" in die 6coa.rs numher_Isrre
ddress: T:- _ntral _St:reets krlington, i� 02476 Al,, Tea. _N0.:
"OWNER'S 05URAIN LE wAlvxx: r aM aware that the L1CCtrSee aces not Ve tnC . aaorut< u
MgtarTeti;bylaw. i3y mYagrtature below;.I hereby waive -this regturement.. I 3trt.the )check one)'
Owner/Agent : PES
Signature Telephone No.
FEL:.S
War's
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Town of North Andover
�� �•'� "`
Building Department
27 Charles Street
North Andover, MA. 01.845
��,°'•^''�'
S�cNuse
D. Robert Nicetta
Building Commissioner
(978) 688-9545
`(978) 688-9542 Fax
HOMEOWNER LICENSE EXEMPTION
Please print
DATE
JOB LOCATION
Number Street Address Map / lot
"HOMEOWNER vx/vw�s
Name
Home Phone
PRESENT MAILING ADDRESS /O ���0"!�) G� AV
zv /�r
City T
State
Work Phone
Zip Code
The current exemption for "homeowners" was extended to include owner -occupied dwellings
of two units or less and to allow such homeowners to engage an individual for hire who does
not possess a license, provided that the owner acts as supervisor. (State Building Code Section 108.3.5.1)
DEFINITION OF HOMEWOWNER:
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which
there is, or is intended to be, a one or two family dwelling, attached or detached structures ac-
cessory to such use and/or farm structures. A person who constructs more than one home in a
t two-year period shall not be considered a homeowner.
The undersigned "homeowner' assumes responsibility for compliance with the State Building Code and other
Applicable codes, by-laws, rules and regulations,
The undersigned "homeowner' certifies that he/she understands the Town of No. Andover
Building Department minimum inspection procedures and requirements and that he/she will
comply with said procedures and requirements. „ Z__�Z
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Location 6U00D1-1 RIE f D'l-
No. �/ Date e lU qc/
MaRTM TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $�
Building Inspector
13302
08/10/99 15:08
25.00 PAID Div. Public Works
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-FORM U - LOT RELEASE FORM
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 -Idwie's -+- S°A;�J R ROA),e y PHONE
LOCATION: Assessors Map Number C)3 PARCEL
SUBDIVISION
STREET JW fib
LOT (S)
ST. NUMBER
*****************************************OFFICIAL USE
REC-CMWENDATIONS OF T,QWN AGENTS: Co vt' a 7c V-4`( S ked—
CONSERVATION ADMINISTRATOR DATE APPROVED
DATE REJECTED
COMMENTS , / /,\A L!:�d R /D
COMMENTS
FOOD INSPECTOR -HEALTH
SEPTIC INSPECTOR -HEALTH
COMMENTS
V2 Lm
TE REJECTED
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING !NSPECTCR
Revised 9197 j
DATE
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Date .......
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ....... ......... ...........................
C
has permission to perform ......... A.. k.ck ...... 0.."A.i .. ...................
wiring in the building of .............a„ .a.M..'z .......................................... S-
at .....4z ...... 0LQQz.:f. ............... . North Andover, Mass.
,0.C.S1 ..
Fee'' 1.. Lic. No. ..................................................
ELECTRICAL Nsnc-rOR
c� �- L �-3 -7
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
rwg 07
ao-4.a.c 4 ;64rz, 5-64 i
BOARD OF FIRE PREVENTION REGULATIO
Office Use Only
Permit Na_ �, v
Occupancy & Fee Checked
527 CMR 12:00
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Cade 527 CMR/12:00V
%
�S
(Please Print in ink or type all information) Date
To the Insp4ctor,6f Wires:
Town of North Andover
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number,
Owner or
4?d24�-S?r
Owners Address ��'/101
Is this permit in conjunction wwiitch, as building permit Yes,tf No ❑ (Check Appropriate Box)
Purpose of Building l/ e � Utility Authorization No.
Existing Service Amps Volts Overhead ❑ Undgmd ❑ No. of Meters
New Service Amps Volts Overhead ❑ Undgmd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed E'.ectncal Workl� G1 I 7/ �7 -A
-res- 0 e-�J1 5 / C.
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 Work$
Work to Start Inspection Date Resqussted Rough Final
Signed underthe Penattles of perjury:
�. FIRM NAME LIC. NO.
Ucensee Signature LIC. NO.
Bus. Tel No.
Address 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
General Laws. that my sf re on this permit appilcadon waives this requirement. Owner Agent (Please Check one) ,
/�/ � ��
6'.r� Telephone No. f ^ ��� PERMIT FEE $! -o d
Total
No. of Light8riq Outlets
No. of Hot fuse
No. of Transformers KVA
Above ❑
In ❑
No. of Ugntinq Fixtures
Swimming Pool gmd ❑
gmd ❑
Generators KVA
No. of Receptacles Outlets
No. of Oil Burners
No. of Emergency Ugnang
Battery Units
No. of Switch Outlets
No of Gas Burners
FIRE ALARMS No. of Zone
No. of Detection and
Total
No. of Ranges
No of Air Cond
Tons
Initiating Devices
Heat Total Total
No. at Dioosal
No. Pumos
Tons
KW
No. of Sounding Devices
No./ of Self Contained
No. of Dishwashers
Soace/Area Heating
KW
DetectiontSounding Devices
❑ Municipal ❑ Other
e
No. of Dryers
Heating Devices
KW
Local Connection
No. of
No. of
Low Voltage
No of Water Heaters KW
Si ns
Sadases
Wiring
No. Hvdro Massace Tuds
No. of Motors
Total HP
OTHER:
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO =
have submitted valid proof of same to the Office YES = NO = if you hive checked YES please indicate the type of coverage by checking the appropriate box
INSURANCE = BOND = OTHER = (Please Specify)
(Expiration Date)
Estimated Value of Electrical Work$
Work to Start Inspection Date Resqussted Rough Final
Signed underthe Penattles of perjury:
�. FIRM NAME LIC. NO.
Ucensee Signature LIC. NO.
Bus. Tel No.
Address 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
General Laws. that my sf re on this permit appilcadon waives this requirement. Owner Agent (Please Check one) ,
/�/ � ��
6'.r� Telephone No. f ^ ��� PERMIT FEE $! -o d
Location
16
No. Date
MaRTN
TOWN OF NORTH ANDOVER
o -
p
Certificate of Occupancy
$
` i •
,
Building/Frame Permit Fee
$
'I'�s'•••° 't�
s�CHU
Foundation Permit Fee
$
n
Other Permit Fee
$
Sewer Connection Fee
$
Water Connection Fee
$
TOTAL
$
T2702
Building Inspector
Div. Public Works
Location _
No.
Z1 Date
t
TOWN OF NORTH ANDOVER
Certificate of Occupancy
Building/Frame Permit Fee
$
$
Foundation Permit Fee
$
Other Permit Fee
$
Sewer Connection Fee
$
Water Connection Fee
$
TOTAL
$
Building Inspector
Div. Public Works
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Town of North Andover
, BUILDING DEPARTMENT
Homeowner License Exemption
!Please print)
,1'E
JOB LOCATION / Wo od c re _%
/ Number Street Address Section of town
iOMEOWNER" VA�1ms's. �/JIt✓C
Name
!'RESENT MAILING ADDRESS i
/Va 14Ni?o4,r2.
City Town
�$ ? -39 _S
Home Phone
WaC>DcRC's> Ort
State
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ork Phone
,ip code
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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 HOMEOWNER:
Person(s) who owns a parcel of land on which he/she resides or intends to
reside, on which there is, or is intended to be, a one to six family dwell-
ing, attached or detached structures accessory -to such use and/or farm
structures. A person who constructs more than one home in a two-year
period shall not be considered a humeowner. Such "homeowner" shall submit
to the Building Official, on a form acceptable to the Bulding 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
North Andover Building Department minimum inspection procedures and
requirements and that he/she will comply with said procedures and
requirements. 11 _
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Note: Three family dwellings 35,000 cubic feet, or larger, will be
required to comply with State Building Code Section 127.0, Construction
-ontrol.
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