HomeMy WebLinkAboutMiscellaneous - 185 BOSTON STREET 4/30/2018N
Location
No.
Date !7-3-09
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee ?oo $ S
TOTAL
Check #
156x3
Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
71" Secdo6 for Offikid-Use Oil
j BUILDING PERMIT NUMBER:DATE ISSUED:
�7_ _ D
SIGNATURE: � � � Ca.e_c�
bUlIC[ln Comnussioner/I for of Buildings Date
SECTION ]-SITE IINFORMATION
1.1 Property Adclr°ss: 1.2 Assessors Map and Parcel Number:
_ l D L{ C(
GX� Map Number Parcel Number
1.3 Zoning Information: /, 1.4 Property Dimensions:
Zoning District Proposed Use Lot Areas Frontes ge fi)
1.6 BUILDING SETBACKS (ft)
Front Yard Side Yard Rear Yard
Required Provide Required Provided Required Provided
? Water Supply M.G.L.C.40. 34) 1.3. Flood Zone Information: 1.8 Sewerage Disposal System:
- blic 0 Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System
'ECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
.1 Owner of Record
.e
ame (Print)
Inatu
Owner of Record:
+ame Print
nature
ii CTION 3 - CONSTRUCTION SERVICES
Licensed Construction Supervisor:
used Construction Supervisor:
a
-ess
iture
Z�gistered Home Improvement Contractor
any Name
Ss
c / _
Address for Service
1 elephone
Address for Service:
Telephone
Telephone
ire T
Not Applicable ❑
License Number
Expiration Date
Not Applicable ❑
Registration Number
Expiration Date
�l
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 .......0 No ....... 0
SECTION 5 Description of Proposed Work check all a Iicable
New Construction ❑ Existing Building 0 Repair(s) 0 Alterations(s) 0 Addition 0
Accessory Bldg. ❑ Demolition ❑ Other 0 Specify R041 C 19 q a v e 6rluv "L
Brief Description of Proposed Work:
/7c/1 lt�jc'V-e
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollar) to be
{ j OFFICIAL USE UNLY .
b
Completed bypermita plicant
1. Building
(a) Building Permit Fee
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
3 Plumbing
Building Perniit 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
Q ` 94 /q�-14- e - /4,
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 OH17er
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
Date
1• ,as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief
Print Name
Signature of Owner/A en t Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS 1 ST 2 ND 3 RD
SPAN
DlIvIENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CFMvvINEY
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 all -necessary 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.
. ...................man .. OEM .............!!....■... now ............. mom .......■
APPLICANT J�7e_fiv �ar �iNNt U /ti/vin. PHONE 1'97f—."7
ASSESSORS MAP NUMBER LOT NUMBER
SUBDIVISION LOT NUMBER
STREET T ........ STREET NUMBER
OFFICIAL USE ONLY
...........................................................................
RECOMMENDATIONS OF TOWN AGENTS
..." .... ENO memo .. Moan ... mum ................. Ono ONE .............P■..0..Ono .■
1'41� �5__ '11�, DATE APPROVED 7
CONSERVATION ADMINISTRATE
TOWN PLANNER
CONINIENTS
FOOD INSPECTOR - HEALTH
SEPTIC INSPECTOR - HEALTH
COMMENTS
PUBLIC WORKS — SEWER / WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
COMMENTS
DATE REJECTED
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED
RECEIVED BY BUILDING INSPECTOR DATE
#,,3 5773,,,
0
R•�
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2�
� 42.88
DIS
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/P
_ ate' sr
I CERTIFY TO THE ANDOVER BANK AND ITS TITLE INSURER THAT THIS PLAN DEPICTS THE RESULTS
OF A CURRENT EXAMINATION OF THE PREMISES DESCRIBED IN RECORD BOOK E39-5 PAGE452- OF
THENo. Esscx REGISTRY OF DEEDS AND THAT THE PERMANENT BUILDINGS ARE LOCATED ON THE
GROUND APPROXIMA TEL YAS SHOWN HEREON.
NOTES:
1. THIS PLAN WAS PREPARED FROM COMPILED INFORMATION
AND WAS NOT MADE FROM AN INSTRUMENT SURVEY. IT
IS NOT FOR RECORDING PURPOSES. THE PLAN SHOWS THE
CONDITIONS EXISTING AS OF THE DATE SHOWN HEREON.
CERTIFICATION IS FOR MORTGAGE PURPOSES ONLY.
PROPERTY LINES AS SHOWN ARE APPARENT ONLY.
2. THE PREMISES DO NOT FALL WITHIN A FLOOD HAZARD ZONE,
PER FEMA MAP 25098 ��.�c�L isz3 r�rD�/�s/s3
ZONE: C-
3.
3. THE PREMISES DID CONFORM WITH LOCAL ZONING
SETBACK REQUIREMENTS AT THE TIME OF CONSTRUCTION.
MORTGAGE CERTIFICATION
SKETCH FOR
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18 S 30 -STC/\/ ST/:Z,EFT
NORT/--( .�/�11�0�/�i2, MA.
SCALE: I =50' DATE: 3 A7=1TZ S> -2 -
PREPARED BY: )(�n�
KING ASSOCIATES
17 WILLIAM ST.
ANDOVER, MA.
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Date.. 7121 �. .....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that .... ........... C--.. Lv.-Cle C.....' ..............
... ... ... .
has permission to perform ........ I ........ ..........................
I ti
wiring in the building of ....... 1�9 .................... 7 .................................................
.... .................... rth Andover
at ..... ......... p.
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Fee ...'.�q�.�k Lic.No. ..........
K' P OR
LE RI
Check # 3 >�
DEPARTMFJVTOFPUBLICSAFE7Y Permit No.
BOARD 0FFIREPREVEM0NRWUTATT0NS527C1✓fR 12.00
Occupancy & Fees Checked
APPLICATIONFOR PERIL fTO 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 _ 7- / �0 0
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) I�S Q� S ►�
Owner or Tenant -e ,v A,-1
Owner's Address / ?
Is this permit in conjunction with)a building permit: Yes No (Check Appropriate Box)
Purpose of Building ?d U L j} h aV t C j'Ui/X4 Utility Authorization No.
Existing Service Amps / Volts Overhead M Underground No. of Meters
New Service Amps Volts Overhead r-7 Underground No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No. of Lighting Outlets
No. of.Lighting Fixtures
No. of Receptacle Outlets
No. ofSwitch Outlets ' 1
No. of Ranges
No. of Disposals
No. of Dishwashers
No. of Dryers
No. of Hot Tubs No. of Transformers Total
KVA
Swimming Pool Above ri7relow r' I Generators KVA
No. of Oil Burners No. of Emergency Lighting Battery
No. of Gas Bumers
No. of Air Cond. Total FIRE ALARMS
Tons
No. of Heat Total
Pumps Tons
Space Area Heating
Heating Devices
No. of Water Heaters KW I No. of
No. Hydro Massage Tubs
OTHER
No.
No. of Motors Total
Total No, of Detection and
KW Gtitiating Devices
KW No. of Sounding Devices
No. of Self Contained
Detection/Sounding Devices
No. of Zones
KW Local Municipal a Other
Connections
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Telephone No. / 76�~ y -0'07f' PERMIT FEES y
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COMMpNWEALTH OF MASSACHUSETTS
i
OF ELECTRICIANS
REGISTERED MASTER ELECTRICIAN
ISSUES THIS LICENSE TO
CURLEY ELECTRIC
BRIAN L CURLEY
31 ORIOLE RD
WINDHAM NH 03087-1615
10633 A 07/31/04 397066
OF � (CC16Sc-
N/ �)uc-Sr,�„� s pccws(f c�c<
31 Oriole Road, Windham, N.H. 03087
1-(603) 432-6816