HomeMy WebLinkAboutMiscellaneous - 203 GRANVILLE LANE 4/30/2018 (2)N
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Location
No. Date. ---
8794
OF NORTH ANDOVER
M Occupancy $
ame Permit Fee $
0it Fe
it Fee
Sewer Connection Fee
Water Connection Fee
TOTAL
$ LQ
$
$
Building Inspector
Div. Public Works
PERMIT NO. _
L
--
L
APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1
MAP d�0.
LOT NO.
2 RECORD OF OWNERSHIP IDATE
BOOK ;PAGE
ZONE
SUB DIV. LOT NO.I
F—
,,LOCATION + /� 1, 1 k
,t� /
POSE OF BUILDING � , J ��.�C
✓
OWNER'S NAME
NO. OF STORIES SIZE
OWNER'S ADDRESS
BASEMENT OR SLAB
ARCHITECT'S NAME -
SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME
SPAN
DISTANCE TO NEAREST BUILDING
--
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
BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
L BUILDING CONFORM TO REQUIREMENTS OF CODE I /
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
INSTRUCTIONS
SEE BOTH SIDES L.
PAGE I FILL OUT SECTIONS i - 3
PAGE 2 FILL OUT SECTIONS I - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND PPROVEEDD BBY' BUILDING INSPECTOR
✓/VDA�TE FILED J°r/F'///J 7 z�i. , ,
SIGNATURE OF OWNER OR &UTHORIZED AGENT
FEE rr/y% 1
PERMIT GRANTED
19�
3 PROPERTY INFORMATION
LAND COST
8T. BLDG. CoS JJ le/f
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
SUILDING INSPECTOR
OWNER TEL. #
/l
CONTR. TEL. # >
CONTR. LIC. #
H.I.C. #
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY
S-0 IES
MULTI. FAMILY
OFFICES
APARTMENTS
_
CONSTRUCTION
2 FOUNDATION
8 INTERIOR FINISH
CONCRETE
PINEHAR
B
2 13
CONCRETE BL K.
BRICK OR STONE
D
_
PIERS
PLASTER
6RY W
DRY WALL
—
—
—
_
UNFIN.
3 BASEMENT
AREA FULL
FIN. B'M'TAREA
_
V, 1/1 l/.
FIN. ATTIC AREA
_
NO EMT
FIRE PLACES
_
HEAD ROOM
MODERN KITCHEN
4 WALLS I
9 FLOORS
CLAPBOARDS
CONCRETE
EARTH
B
1
2
3
_
DROP SIDING
WOOD SHINGLES
ASPHALT SIDING
ASBESTOS SIDING
HARDW'D
COMMCN
ASPH. TILE
VERT. SIDING
_
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY
BRICK ON FRAME
_
ATTIC STRS. d FLOOR (-
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR I- I POOR _
ADEQUATE NONE
5 ROOF
10 PLUMBING
GABLE
HIP
BATH 13 FIX.)
_
GAMBREL
MANSARD
TOILET RM. (2 FIX.)
FLAT
SHED
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
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
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.
F .
OFFICES OF: L _ `^Town Of 120 Main"Stre'et 14
AppE.AIS - North Andover,
BUILDING NORTH ANDOVER
BI.tvtassachusettsotsas
�;e
CONSERVATION DIVISION OF
HEALTH
PLANNING PLANNING & COMMUNITY DEVELOPMENT
KARFaN H.P. NELSON, DIRECTOR
In accordance with t ro��isicrs of MGL c y0, S 51, a condition of Building Permit
Number _ e is that the debris resulting from this work shall be
disposed of in a prcpe ly ,ic; rased solid waste disposal facility as dcflncd by MGL c 111, S
156A-
The
56A
The debris will be disposed of in:
(Loction of Facility'
ICU
Signature of crmit Applicant
Date
NOTE: Demolition permit from the Town of :forth Andover must be obtained for
this project through the Office of the Building Inspector.
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Date....... ........ ........
flow
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ........... 4.....!.........�-........S.... ...... Y.� ........................
has permission to perform...............................................................................
Ling in the building of ......... M. Q.A. C 1:.......t ...........................................
a'4............ ..�, C) L/
C) ...... I ..... ... 4AL 1 orth Andover M
Fee....,7.3. Lic. No. Wk ............... .. . . .. .......
LECTR CAL INSPECTOR
Check #
Commonwealth of Massachusetts
Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
Official Use Only qq
Permit No. 1?0-3
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), 5 75 C R 12.00
(PLEASE PRINT IN INK OR TYP A INF RMA TIO Date: O( p2
City or Town of: To the Inspec or of Wires:
By this application the undersigne gives not4—Mf)V of his or her int tion to perform the electrical work described below.
Location (Street & Number) ,
Owner or Tenant I -Q r ,aa nt n 1 Telephone
Owner's Address /
Is this permit in conjunction with a building permit? Yes ❑ No 2 (Check Appropriate Box)
Purpose of Building
Existing Service
Amps / Volts
Utility Authorization No.
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: Installation of Security system
Completion of the followin table may be waived by the In ector of Wires.
No. of Recessed Fixtures
No. of Ceil: Susp. (Paddle) Fans
No. of Total
Transformers KVA
No. of Lighting Outlets
No. of Hot Tubs
Generators KVA
No. of Lighting Fixtures
g g
Swimming Pool Above ❑ In, ❑
g rnd. rnd.
o. o Emergency ig mg
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
o. of Detection and
Initiating Devices
No. of Ranges
g
No. of Air Cond. Total
Tons
No. of Alerting Devices
No. of Waste Disposers
p
Heat Pump
Totals:
Number
Tons
KW
No. of Self -Contained
Detection/Alerting Devices
No. of Dishwashers
S ace/Area Heating KW
p g
Local ❑ Municipal ❑ Other
Connection
No. of Dryers
Heating Appliances KW
SecurityNo. ofYsteDevices or Equivalent
No. of Water Kit
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 Eauivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
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:)
t) 1-7Lr. (Expiration Date)
Estimated Value Electrical Work: (When required by municipal policy.)
Work to Start: 2b Inspections to be requested in accordance with MEC Rule 10, and upon completion.
1 certify, under thdpains and penalties of perjury, that the information on this application is true and complete.
FIRM NAME: LIC. NO.: 153 1 -
Licensee: John S. Bassett Signature LIC. NO.: 1533C
(If applicable, enter "exempt" in the license number line) Bus. Tel. No.: 603 594 5928
Address: Alt. Tel. No.:
OWNER'S INSURANCE WAIVER: I am aware that the Li , see 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 i
Signature Telephone No. PERMIT FEE: $ 4