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Home My WebLink AboutMiscellaneous - 180 SUTTON HILL ROAD 4/30/2018 (2)Date, /.41.A I/ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... ..... A has permission to perform ................................ 'wiring in the building of ...... .................................................... ....... North Andover, Mass., at ...... / Li .......... ............... Andover, Fee ....... Lic. No.:V�q ....... . -3-( )--� ........... .. ....... ... a ....... Check # - IN >�6RICAL INSPE , �R -7/-�U / 715 6M, BOARD OF FIRE APPLICATIQN F, All work to be iterforur (Please Print in ink or type all information) Town of North Andover ;C'714, 657 ss uses 'ION REGULATIONS 527 CMR 12:00 Vllll;tcll VJC I Permit No. . OccupJ1 Fbe Che( R PERMIT TO PERFORM ELECTRICAL WORK in accordance with the Massachusetts Electrical Code 527 CMR 12:00 Date /-4. 70`/ To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. � f% Location (Street & Number IE -0 -, -S -1 A �,U a U 1 • Owner or T Gi,t,o + Owner's Address %kO Is this permit in conjunction with a building permit Yes 0 Purpose of Existing Service /OG Amps___j 0 Voits New Service —Amps___.--- Voits Number of Feeders and Ampacity Location and Nature of Proposed Electrical No lV"" (Check Appropriate Box) Utility Authorization No. OverheadUndgrnd D No. of Metl Overhead D Undgmd D No. of Met( 00/7 30 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 have cheesed YS please indicate the type of coverage by checking the appropriate box- INSURANCE ox.INS RANCE BOND = OTHER (Please Specify) Estimated Value of. Electrical Work$ G (Expiration Date) Work to Start 1-12 —e4 Inspection Date Resquested Rough Final Signed under the Penalties of perjury: FIRM NAME LIC. NO. _IC. NO,2-9L /? r' Licensee_ C /—am IT D V J�CJ i i) a Bus. Tel No. c9i S 0,19Cj % �j 0.2 It 2 o� Address �trt,tj(, /�.f� Alt Tel. No. OWNER'S INSURANCE W R: 1 am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Mass General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. (Signature of Owner or Agent) FEE $ Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above 0 In 0 No. of Lighting Fixtures Swimming Pool gmd 0 gmd 0 Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners 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. of Diposal No. Pumps Tons KW No. of Sounding Devices _ NoJ of Self Contained No. of Dishwashers SpacalArea Heating KW Detection/Sounding Devices _ 0 Municipal 0 Other No. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Bailases Wiring No. Hydro Massage 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 have cheesed YS please indicate the type of coverage by checking the appropriate box- INSURANCE ox.INS RANCE BOND = OTHER (Please Specify) Estimated Value of. Electrical Work$ G (Expiration Date) Work to Start 1-12 —e4 Inspection Date Resquested Rough Final Signed under the Penalties of perjury: FIRM NAME LIC. NO. _IC. NO,2-9L /? r' Licensee_ C /—am IT D V J�CJ i i) a Bus. Tel No. c9i S 0,19Cj % �j 0.2 It 2 o� Address �trt,tj(, /�.f� Alt Tel. No. OWNER'S INSURANCE W R: 1 am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Mass General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. (Signature of Owner or Agent) FEE $ Date ..... l..... .�.... �. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that '"/` 1 /li .....�......�..................................... :'2 %%f f3 :?V ` w .has permission to perform . :..f...Sr.....................................S....Y...�..�...t..t wiring in the building of .JC Ld k) W A 4 t2 t `e P j ............................................... tnn .................. at ...! ..�...... .....�N... � ....... l C � ..................... . North Andover, Mass. Fee.. .' Lic. No. Q 13'Cg ...`'1 =gy p Cc,(Q / . \.y ( - ......... ................ a� ELECTRICAL INsiEcrDR Check # 475j TBEC0[V H0NWF•ALTHOFMMSSACHUSET-fS Office Use only DEPARTAIEWOMMICSAFETY 75' Permit No. yl' BOARDOFFIREPREVEMONREGUTA77ONS527CMR12:010 r 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 Wire: The undersigned applies for a permit to perform the electrical work described below. Location (Street A Owner or Tenant uwner, s Aaaress Is this permit in conjunction with a building permit: Yes No ® (Check Appropriate Box) Za rpose o u11cling Existing Service /00 Amps/jILUVolts New Service 30 Amp / yjS�iVolts Number of Feeders and Ampacity Location and Nature of Proposed Ele Utility Authorization a Overhead ® Underground No. of Meters Overhead Underground ® No. of Meters INV. Vl LIglltlllg 1JUUU1S No. of Hot Tubs No. of Transformers Total No. of Lighting Fixtures Swimming Pool Above Below Generators KVA KVA round round No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Tota: Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained .� Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER�g"IS M6 L 7` (,,01 fl E !e h4gP- 2 !2FAJP iZ 14 / de fi -4 n 49f AL- — ('c E Fc20AA G7(AJ L pl(Ll1 Uc �� fZ U�c hunanceCoWrJge. RnuanttotheiagtutealnZdMassxhjs�t GaxT lLaws IhaveacaniatLiabilityhiAuarx:ePbhcyn>chldmgC Coageoritssubslarrialegtuvala,t YES ® NO Ihaves hA&dvandploofofsametothe0ffim YES if)mtnwd eclodYES>pkmi dcaethetypeofcovwdWby drddngthebox LLJJ��JJ LJ INSURANCE OTHER//0 BOND ER (PleaseSpty) %// DSL E1Date EslnramdvalueofE1ec" Wotk $ WoMoStatt v kq)xfimDateRoWested Rags, limat SiQnedundertTi -PF nai ieonfrrrnmr Signa M Liar=No �J, / Bus�ssTel. No. AV ' !�7/(�i!?i !� /Oil 6133/ A1tTUNo. r OWNE CS WSURANCEWAIVER IamawatethattheLioerrsedoesnothavetheit MMMOovsageoritssubstantialequivWentaswquiedbyMxsaduceUsCthe alLaws and thatmysignatuteon thispemritapplicahon waivesftregttuemeert (Please check one) Owner M Agent Telephone No. .PERMIT FEE � 0 t Signature o _ wner or Agent The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02911 Workers' Compensation Insurance Afdavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 0 1 am an employer providing workers' compensation for my employees working on this job. Company name: Address cibE. Phone #: Insurance. Co. Policy# - Company name: I— Address Ci : Phone #: Insurance Co Policy # Failure to secure coverage as required. under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to $1,500.00 and/or one years' imprisonment.as_weU_as.civil.penaltiesin-thelnun-fABTOP-WORK ORDFR�wd_afne_d.($J.0D D)_ aAay.agahWme. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. y I do hereby certify under Me pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name P_hone.# official use only do not write in this area to be completed by city or town officiar City or Town Permit/Licensina - Building Dept OCheck if immediate response is required Licensing Board E] Selectman's Officio Contact person: Phone #. E] Health Departmen El Other 1� THE COMMONWEALTH OF MASSACHUSETTS DEPAR7NIEVVT OFPUX 1CS4FE7Y BOARD OF FM PR EWIMON REG UI A77ONS 527 CYIR l2: 0 0 Office Use only Permit No. Occupancy & Fees Checked APPLICA77ONFOR 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 4�16'S Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street Owner or Tenant To the Inspector of Wire; Uwner's Address Is this permit in conjunction with a building permit: Yes M No M (Check Appropriate Box) ��p?No' Purpose of Building kZ'E(2 �A M P j 4) �� o Utility Authorizalio. O/ Existing Service � Amps /Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work A Overhead ® Underground Overhead Underground No. of Meters No. of Meters % No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total No. of Lighting Fixtures Swimming Pool Above Below Generators KVA 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 No. of Detection and No. of DisposalsNo. of Heat Total Totd Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW C No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER-7;-S7W11 7z --WA: S F/z 111e -of 10 'f."EA% ST%/VG R,ESoc 6101e -Z-ffS7W 0 10C X11%S1 ,e(/Vq frhS%/0A/ d F acv Gtr tl,,CE t inst==Covt�. Rust>atlttothem m ii3%ofMasswxlMGaiaatLaws IbaveaamedLiabikykmanoeFbhcyiWhxhWGornplete m Covaageorr,absUtialopvalat YES NO Ihavewn iittedvandpo4ofsametothe011im YES 1youlimedledodYES, pkaseiri&&drtWofmvmgeby drdmngthebox 444��111 INSURANCE BOND MER [D (Please *dly) ILL Evirafioii.Ew �� 5 U Estirl>i VahreofE1&t i al Wolk $ WOMOSM VgeLfionDMRNirsted Rot# Final iinnPrittrrir�-t�wA�tiscnfrwriimr ._ FIlZMNANM ` -VAlJ Li x=No. 4f 13.508 y�/lll�y � /37IV Siglatute LLimwNo / 3 ,)Vy BusirmTel.No. 978' �V9 SyGQ 3 Alt Tel No. fi'kR -40 -QWO ONVINWSINSLRANd WAIVER IamawarethattheLmwdoesnothavetheinstm=oovetageoritsabsuitmlepvaleriasmgkedbyMa%adtusemCtnaWLaws and thatmysigoammonIbispenmtapplicationwnivesthistegtlito halt (Please check one) Owner Agent Telephone No. PERMIT FEE $i Signature o _ wner or Agent The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations �y Boston, Mass. 02911 Workers' Compensation Insurance Affidavit r Name Please Print Name: Location: C Phone # 1 am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity DI am an employer providing workers' compensation for my employees working on this job. Company name: Address Ci Phone # insurance. Co. Policv # Company name: — Address City Phone #: Insurance Co Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to $1,500.00 and/or one years' imprisonment.as well_as.civil.penaltiesiniheinrm-fA15TOP WORK ORDFRmd afine..of_($1D0.DD)-aAayAgainst.me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. / do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Pbone.# Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing El Building Dept OCheck d immediate response is regufred .0 Licensing Board p Selectman's Office Contact person: Phone #.• E] Health Department 0 Other Location No. FCF�� Date Fpp Of FORTH, TOW05 NONDOVER Certfof Occ4k y $ « Building/Fppr ,ermit Fee $ is'^^°'�c�' Foundation Perm(t✓°t,'t� $ s'4CMu5E Other Permit Fee $ ` Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector Div. Public Works PERMIT NO. 7 i 1 APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. & PAGE 1 M.4P KVO. LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK 'PAGE ZONE SUB DIV. LOT NO. -I LOCATION , PURPOSE OF BUILDING OWNER'S NAME NO. OF STORIES SIZE ry. OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAM DISTANCE TO NEAREST BUILDING SPAN DIMENSIONS OF SILLS DISTANCE FROM STREET " POSTS DISTANCE FROM LOT LINES - SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW - SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 f PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR / DATE FILED - k- / flJ1y SIGNATUB4 ON, OWNER jDR AUTHQRIZED AGENT F E E CONTR. TEL. #_____ ,+....._ CONTR. LIC. # PERMIT GRA T� �J? C/ 19 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN BUILDING RECORD 1 OCCUPANCY 12 _ SINGLE FAMILY STORIES MULTI. FAMILY OFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION _ 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL K. _ PINE BRICK OR STONE HARDW D PIERS PLASTER DRY WALL _ UNFIN. 3 BASEMENT AREA FULL 1/4 1/1 1/1 FIN. B'M'TAREA FIN. ATTIC AREA _ _ NO B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 �_ 3 _ DROP SIDING WOOD SHINGLES CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ HARDNIJ D COMMON ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME _ ATTIC STIRS. & FLOOR _ CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR I I POOR _ ADEQUATE NONE 5 RM 10 PLUMBING GABLE I HIP BATH (3 FIX.) GAMBFEL GgAMIIE]L FLAT M ANSARD SHED TOILET RM. 12 FIX.) WATER CLOSET _ _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ 10 - - 13rd I ELECTRIC NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. t, CQ w • 6i to ed 2 F - w CL rr 9 w w` ice o C9- o W z Z W W z z Q Z 0 Z 09 cc a o m < o u v m o m m t c .� rtut v t m m Y j E i0 � j i6 W j ` � O O L c O c O m C O c 3 E a: U ii ¢ U. ¢ co u. cr U. m 0 c O c O u �o. CL al 6a t O H E as a s 0 E w C O u d a V 40 a O 00 C CL O u u O C H d C6 w t CL •O m r� i CL c c •� O