HomeMy WebLinkAboutMiscellaneous - 2050 TURNPIKE STREET 4/30/2018 (2)UA
Date ...... I/ . ......... ...... ..
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ..... 1,94.!;. ............................................ ..............................
has permission to perform . ..............................................
wiring in the building of ....... ...... .........................
at.- ..... <2, North Andovpr, ,as
L i c. No A,A—,3 ........ .... . . ...
LECT * I ALiNSPECTOR
rim0-1 >�
Check #
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THE COMMONWEALTH OF MASSACHUSETTS
DEPARTAflMOFPUBLICSAFETY
BOARDOFFIREPREVE MONREGUZA770NS527CNIR12:GU
Office Use on
Permit No.
F
Occupancy & Fees Checked
APPLICATTONFOR PERAIRT TO PERFORM °LECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECJ&AL CODE, 527 CMR 12:00 /
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date -5 0� ki b
Town of North Andover
The undersigned applies for a permit to perform the electrical work
Location (Street & Number) Q D S O 1 U,-
Owner
r
Owner or Tenant
To the Inspector of Wires:
Owner's Address
Is this permit in conjunction with a building permit: Yes 0 No ZF (Check Appropriate Box)
Purpose of Building 14C p dd p kn Utility Authorization No.
Existing Service QU U AmpsVolts Overhead Underground No. of Meters
New Service Amps Volts Overhead Underground No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work 4=C 1777t-77 O/ q, yyl ✓1 L;
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers
Total
KVA
No. of Lighting Fixtures
Swimming 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
No: of Ranges
No. of Air Cond.
Total
Tons
pZ
FIRE ALARMS
No. of Zones
No. of Disposals
No. of Heat
Total
Total
No. of Detection and
Pumps
Tons
KW
Initiating Devices
No. of Dishwashers
Space Area Heating
KW
Ng of Sounding Devices
Na';:,of Self Contained
Detection/Sounding Devices
No. of Dryers
Heating Devices
KW
Local Municipal
Other
Connections
No. of Water Heaters KW
No. of
No. of
Signs
Bailasis
No. Hydro Massage Tubs
No. of Motors
Total HP
S,
IOTHER-
SLanan=Cowrage Putstu totherequ r�ItsofMassaciniseitsGa a]Laws
Chave aauuertllab11tyh>stuanwFblicyinchx1IgComplete Opffalions Covetageoritssulslarvialeq valent YES NO
[hawstftniWdvandpmofofsametotheO>hce, YES u
� If}oubaeddodYES,plemindicaiedletWofcoverageby
lirckilgthe box
NSURANCE�
BOND r7 MIER F-1 (Please Specify)
. Dai
•'1 • Y.i 1 �/:•1 • 11.1" � i• .w�l:•
-L-1-Ma",
FsmnWd Va1ecfE1ect" Wolk $
Rough Final
Iic=No.
LicmseNo
BltsirmTel.No.
S6 JSl4� [� St La�t.rehC� /�//J A]tTUNo.
R'S INSURANCE WAIVER, I am awatethatdleLiosrwdoes nothave theinsurancemvetage orits su�al equivalent aslegtmeibyMassachuseits Cana] Laws
my signattue on this permit application waives this regtlnl✓r mt ou
check one) Owner® Agent ®
Telephone No. PERMIT FEE $
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
Boston, Mass. 02191
Workers' Compensation insurance Afdavit
Name Please Print
Name:
Location:
City Phone #
0 I am a homeowner performing all work myself.
I am a sole proprietor and have no one working in any capacity
17 1 am an employer providing workers' compensation for my employees working on this job.
Company name:
Address
City: Phone #:
Insurance. Co. Policv #
Company name:
Address '-
City: Phone #:
Insurance Co. Policv #
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,penaltiesln_theform -of -a.STOP WORK_ORDER..and_a fine -of _($100..OD)_a dayagainst.me. I
understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature Date
Print name Phone.#
Official use only do not write in this area to be completed by city or town official
City or Town Permit/Licensing
Building Dept
❑Check if immediate response is required p Licensing Board
p Selectman's Office
Contact persona Phone #. ❑ Health Department
o Other
uht Cramum fialth of uOUSIM P*rmk o. "" °n"
i9gmitntat of Public $ufttq Occupancy d Fee Ch clod
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 no peaty bianiq
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed In accordance with the Massacnusetts Electrical Code, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
Q* or Town of NORTH ANDOVER To the Inspector of Wires-'
The udersigned applies For permit to perform the electrical work described below.
aI
Location (Street & Number __ ( (� j °�'�?�� PI��P -W0
Owner or Tenant 1AA FQ AN k e4L(ty j I (JSt
Owner's Address S 7—
)-o [2�Y- 1,4 ��
Is this permit in conjunction with a building permit: Yes _ No l/r-� (Check Appropriate Box) G .
Purpose of Building _-Rt•S %rOtM-C-� - Utility Authorization No. '70,r 2 1�
Existing Service Amps _J Volts Overhead Undgrnd G40it No. of Meters _; •1
New Service Amps /2!2r-a-L(O`Volts Overhead Un
/ogrnoWo, of Meters
Number of Feeders and Ampacity c� `T Q t' d
Location and Nature of Proposed Electrical Work C"0AAPJ_M 64JIR!Z/L'z1 of Aj-e (,c/
a iV^�p " '-J- A w. f° is"e2v� c
No. Of Lighting OutletsI No. of Hot -.::s No. of Transformers Total
KVA
No. of Lighting Fixtures i Sw4mming P^ot AE)cve.-- in- r
grno. _ grno. I Generators KVA
No. of Recaotacle Outlets
No. of Oil corners
No. of Emergency LightingBattery Units
No. Of Switch Outlets I No. or Gas :crr.ers
FIRE ALARMS No. of Zones
No. of Ranges ( No. of Air C,:rc. oiai
No. of Detection and ,
'chs
Initiating Devices
No. of Disposals
I No of Heat To;ai 7oiai
?ur-cs
:ons '(W
No. of Sounding Devices
No. of Sed Contained
0election/Sounding Devices
No. of Oianwtianers
SoacerArea Heaiir.g KW
No. of Oryors I Heating Oevices KW
Local ; Municipal r—Other
._ Connection
No. of
Low Voltage i
No. of Water Heaters KW
( Signs °a las:s
Wiring
No. Hydro Massage Tubs ° I No. of Motcrs -otai HP
'i
OTHER:
i
INSURANCE COVERAGE: Pursuant to the reowrements „f massacnt sers ;enerat Laws
4
I have a current Liaodity Insurance Policy incluoing Ccmc:_etec Ccerations Coverage or
its substantial equivalent. YES = NO 1
have suomineo valid P f of same to the Office. YES = v0 = It you nave checked
Checking trio a ro ate pox.
YES, pipes* indicate the typW er • Oy
INSURANCE 0ONO = OTHER = (Please Scec:"O
:l
Estimated vete* of {*tint t Work S
{ pita ten Oates
Work G'L r
WW
to Start Insoecaon Date Aacces:ec: Rough
r Final
Signed under trio�PJen iii /�f p*qfqry-
FIRM NAME ` `� / eleLIC.
/'��3016 S
lidNO.c-�
Licensee L l 'P S,gca;/o/re
NO..��,,,
_
Address �ir�N�S I- e Z4? �
/ cI�
Ti.
Bus. 'N. No. L : 7 -3 %
p� /"
All. .el. No.
OWNER'S INSURANCE WAIVER: I am aware that the t_:censee toes not nave W heti ante coverage or its substantial
equivalent as re• ,
quireo by Massacnusects General Laws. and trial my signature on nis ; ermu application waives this reouirement. qwwwnnneeer Agent
(Please CneCK Oriel'
:eieonone No.
PERMIT FEES `
._ {Signature at Owner or Agsntl
x4"8.2
10 1 >
'NO Date..
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ...... j .... ..' ... ..... �1.1� ...................................
has permission to perform .............. 0 ....... ....... ....... ................................... ..
wiring in the building of ..... -: .................... . ..................
at ........ X . ....... ................... ....................... . North Andover, Mass.
FeeLic. No .............................................................................
ELECTRICAL INSPECTOR
04/30/98 13:12 200.00 PAI$
WHITE: Applicant CANARY: Building Dept. INK: Treasurer
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
Thiscertifies that ..`..... U•.............................................................................
has permission to perform ........!!i1... -c-...' .....................................
wiring in the building of ......'' "................................
at ...
��.�..../w..�-... ,North Andover, Mass.
Fee- . i .......... Lic. No/ ��/.................................................................
ELECTRICAL INSPECTOR
07I31t93 09:c8 3�.^� PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
�::..e Pse P.ty
p- n
Pie Commonwealth of AlossachusetLS
e..relt ¢n. V
Deparimcnt of Public Safety
OccuP.lne) S he checked
BOARD OF FIRE PREVENTION REGULATIONS S27 CIAR 1200 7/90 ti,, a blink)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All *vrk to be performed In accordance with the Maesachusctu Electrical Code. 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL
�I INFORMATION) Date ' ' %'—.2 7'- 9B
City or Town of Neeny 6NDd�E2 To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number) .2056 TUe_AA00/ItE" .S7.J96,Er
Otrer or Tenant SANDY /_IAI
Owner's Address SAME 978) 7.-s- GSSt„i _
Is this permit in conjunction with a building permit: Yes ❑ No (Check Appropriate Box)
Purpose of Building Utility Authorization 110.
Existing Service Amps / Volts Overhead ❑ Undgrdi _� No. of Meters _
New Service Amps / Volts Overhead ❑ Undgrd ❑ Ito. of Meters
N=ber of Feeders and Ampacity
Location and Nature of Proposed Electrical Work Installation of Alarm System
No. of Lighting Outlets
No. of Hot Tubs '
No. of Transformers Total
KVA
No. of Lighting Fixtures
No.
Above ❑ In -
Swimming Pool grnd. grnd. ❑
Generators KVA
No. of Receptacle Outlets
No. of Oil Burners I
No. of Emergency Lighting
Batter Units
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS No. of Zones
No. of Detection and
Initiating Devices
No. of Sounding Devices
.
Noof Self Contained
Detection/Sounding Devices
Local ❑ Municipal ❑Other
Connection
No. of Ranges
No. of Air Cond. Total
tons
No. of Disposals
No. of HeatsTotal Total
PumpTons KW
No. of Dishwashers
Space/Area Heating
No. of Dryers
Heating Devices KW
No. of Water Heaters KW
No. of
Signs Ballasts
ernw o ag A Q(44�
No. Hydro Massage Tubs
No. of Motors Total HP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
I have a current LiabilityInsurance Policy including Completed Operations Coverage or its substantial
equivalent. YES ❑ NOC] I have submitted valid proof of same to this office. YES ❑ NO
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE ❑ BOND ❑ OTHER ❑ (Please Soecifv)
Estimated Value of Electrical Work $ a4<f 00
Work to Start 7 a 9- 98 Inspection Date Requested:
Signed under the penalties of perjury:
FIRM NAME A.D.T. SECURITY .SVSTEMS NORTHEAST INC.
Rough
Expiration ate
Final x'3'98
LIC. N0. 12 31 C
Licensee DONALD A BROOKS Signatu;"e'— N0. 1231C
Address 60 William Street, Wellesley, 8 s. "el. No. 413-739-4400
Alt. Tel. No. (781) 431-5831
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or is sub-
stantial equivalent as required by Massachusetts 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
042
PERMIT FEE S 3S
MASSACHUSETTS UNIFORM APPLICATIO .,F011 PERMIT 0 -*00-'-p
(Type or Print) •.
NORTH ANDOVER ,Mass �� �:, te:' •
. DaaVlow
�SC
Building Location _L05'Q :4 % CA 1?W folk Permit S: �
Own.ers Name OW 7
New Ey---Renovation j] ' Replacement [] Plans SVbmitted
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3RD FLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
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BTM FLOOR tH+ I`iIT 1-1 F1
(Print or Type)
Installing Company Name A13N&UOS7 UP -r-
Address
Address / f (�u b%/ Rts
N /9-S /4Lk t9 N • el • Q 3 6 C3
Business Telephone /a • $ $ 6 d F 4
Name of Licensed Plumber:
Check one: Certificate
��rP • ...
M Partner.
Ejj Firm/Co.
Insurance Coverage: Indicate the type of insurance coverage by checking the
appropriate box:
Liability insurance policy ED---O-cher type of indemnity E] 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 coverages.,,
•Signature of owner/agent of property Owner Agents%
I bemby certify gist all of the details and infotnalion 1 lave subinitted (ot entacdI in shone application lite list 4:ate to IM btN M of
.... k"wkdge and that all plumbing work and installations toctfafmcd under Permit issued fat this appticatioit trill be ill costysliattoa Milk try 10"M PW'A
vision of Ws Massadiuseus State Plumbiad Code and Chapter 142 0( the General t.swL ,w
By
Title•
City/Town:
Signature of"Licensed Plumber
Type of Plumbing License
9i.5 3
7" 3627
,aOR71i
Date. .'� . d . �
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
4S comw
�..�k.�� U 17Thicertifies
This that: Y. ................... G`---
has permission to perform .... T . ..... ................. .
plumbing in the b,of ......... .
......... ....... -�!� .. , North Andover, Mass.
Feer`?l'c7?.... Lic. No..%�.5:� .. ............................. .
A21
PLUMBING INSPECTOR
02/27/98 12:05 202.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
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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 local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
APPLICANT: 1 .y Phone n'
LOCATION: Assessor's Map Number '��"'� Parcel
Subdivision Lot(s)
Street �"�� St. Number GUT
************************Official Use Only************************
NDATIONS,OF TOWN AGENTS:
Date Approved l� 1
Conservation Admi istrator Date Rejected
Comments
I
Date Approved C'
ToWh Planner Date Rejected
Date Approved
Food Inspector -Health Date Rejected
Date Approved 7 a
e c Inspector -Health Date Rejected
Comments
Public Works - sewer/water connections _-� -7/2,' %
- driveway ermit l� j 7 _2z
.Fire Department
%6( V%4
Received by Building Inspector Date
NAV � ig97
i
Growth Management Bylaw Exemption Statement
Town of North Andover Building Department
This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the
Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information
as requested below.
Name of Applicant on Buildi g Permit (below) Addres of Propee for rmit (below)
Map and Parcel : "",.Purpose Qf Application (check below)
Ph -one Nu�tm,bber of A licant: J_ Single Family _ Two Family
I the undersigned applicant for the above property attest that the attached building permit for which this
form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth
Management Bylaw. I also understand providing this form does not absolve me or any party to this permit
from the requirements of obtaining 9ther permits required prior to the issuance of the Building Permit.
Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building
Department and is only officially accepted when the Building Permit is issued.
Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the
above lot, in the building permit application and associated attachments, complies with one or more of the
following sections as indicated by a check mark.
This is an application for a building permit for the enlargement, restoration, or reconstruction of a dwelling in
existence as of the effective date of this by-law, provided that no additional residential unit is created.
g The lot(s) were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning
Bylaw.
This application is for dwelling units for low and/or moderate income families or individuals, where all of the
conditions of 8.7.6.c are met and/or represents Dwelling units for senior residents, where occupancy of the units is
restricted to senior persons through a properly executed and recorded deed restriction running with the land. For
purposes of this Section "senior" shall mean persons over the age of 55.
This application is a part of a development project which voluntarily agreed to a minimum 40% permanent
reduction in density, (buildable lots), below the density, (buildable lots), permitted under zoning and feasible given the
environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently
designated as open space and/or farmland. The land to be preserved shall be protected from development by an
Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism
approved by the Planning Board that will ensure its protection.
This application represents a tract of land existing and not held by a Developer in common ownership with an
adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth
Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the
parcel.
This application represents a lot which is ready for building permits,(i.e. all other permits from all other boards and
commissions have been received and the project is in compliance with those permits), and the Development Schedule
does not accommodate issuing a building permit in that Year, one building permit will be issued per Year per
Development until such time as the Development Schedule accommodates issuing building permits. Applicant must
supply approved form U with this EXEMPTION.
Please provide any and all information that would assist the Building Department in making a determination
that your application is allowed one or more of the above EXEMPTIONS.
By signing below I attest to the accuracy of the information provided and that the attached building permit is
allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or
inaccurate information, or the checking off of an above item which does not comply, whether done to my
knowledge or not, is grounds for refusal by the Building Department to issue a Building Permit.
Signature of Owner or Authorized Agent who signed the Attached Building Permit Date
This form must be attached to the Building Permit upon application for such permit.
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y CERTIFICATE OF USE & OCCUPANCY
Town of North Andover
Building Permit Number568
THIS CERTIFIES THAT
Date Juiy 9 , 1998
THE BUILDING LOCATED ON2050 Turnpike Street
MAY BE OCCUPIED AS Single Family Dwelling IN ACCORDANCE
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND
SUCH OTHER REGULATIONS AS MAY AP
MOII T►
CERTIFICATE ISSUED TO Mark Ruggles
8 Victory oad Bill ca HP. 01821
Z.
ADDRESS
Building ector
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