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HomeMy WebLinkAboutMiscellaneous - 21 WILSON ROAD 4/30/2018Date. ........... °"I"o, V o a TOWN OF NORTH ANDOVER r• � PERMIT FOR GAS INSTALLATION This certifies that ../. .�.�9.!°.: - ........................ has permission for gas installation .. r< . ................... in the buildings of ..................... at .0 . !...(.-� ! . L. c. ....14, 1�-.... , North Andover, Mass. Fee.. s?.'". Lic. No. .... .. J-...! .-,....... GAS INSPECTOR Check # 2 1 , 5 I,. 7 8 ASSA �T� Ui�t1FaR1w1 AP�pt i�ATIM FOwP�' TO (3o- GA�F�TTi n I NG.. .� o 1U � 1�-1-�, 1-� I�Ct �•�-c� o�te Z -2.� z Permit 7 Ownec"s Nacho-= (� Gr wV Type of New Renwaum II _Ae0acernen PWWSi ted: YesO- Q_ Name of Llcensw.Pfwt , a,GU Flter "iNSUAANCE-LpVEpJ4 ac 1 have a . Yes equl &*.which: If Y No O . meets the.emer#s.a_1 Ch: i42- dxcosdaM�. Vie:�n the �_ �, A 11"Ity kwxz�. - Oumutypeckwemly Q 01EA'S WAN .T &w.swam �. 6an Cha _; Pta 142wt#he�Aass :Ge _� t:myaiQr e=o�. p � --#* oe.coverae r g *ement . AS 3his regt�etnerrt $�9natun ol�Ow�-+or=Owi�s Aunt:.. ��ne: o A9ent:Q i hereby cwy tWap of the detail and for+natian l.ha�ee . gothat all pkxt�bpp w,�c MW kutaM5O ° 'm above ap�ication ar+� }eve and ioauate.to.fhe best.ot visions of �e P�vm�ed u�ber the �� State Gas. Oode and1d2 win wRtr all MY By Fitle - - TPlumber�� tyiTowraMiAer - or er . Iourr,eyrt an U mse Number Ad t ■■■■ r: ac °. IL o: a - W .= Y a tie Cf - - Z Z _ N° 1 S"3 ! Date ... �v/..�M?, ,``° '• '"� TOWN OF NORTH ANDOVER PERMIT FOR WIRING �SACMUS� This certifies that �. �' ` ''� a 1 ........ ............ �............ 1111 1111. j, has permission to perform ........ ` . t �l G c t' - e'%I e _}._ f ............. .....116.1............... wiring in the building of .....•.!' ....,� <..... Pru ?.� ...................................... at ................. ..1...�'.:!...... '. `..................... /1111, North Andover, Mass. iFee ..................... Lic. No .............. ............................................................... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer No 2'1 6 Date... ........................... TOWN OF NORTH ANDOVER 'o PERMIT FOR WIRING r � ' This certifies that .......` ................................................................................ has permission to perform . l ..... `.�...................... ' . '"� �'^ �n ...... .............. ... wiring in the building of............................................................................. at .................................. /��'�................. . North Andover, Mass. Fee.,��................. Lic. N6........... .............................':................... ..... ....................... ELECTRICAL INSPECTOR 10/15/99 13:44 15.00 PAID ( WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 7-0 TIM COMMONWEA,LTHOFM4MCHUSEM Office Use only DEPARV EW0FAV1MC&4 ElY Permit No. a l I " BOARDOFFMP,REVE1MONREGUZA7YOAS527CjWR12.00 1, Occupancy & Fees Checked APPLICA TTONFOR PFJ1 b27T TO PERFFORMELE=(CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 �/ 1 �j cl (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date ` J Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. PARCEL Location (Street & Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead Underground No. of Meters New Service Amps / Volts Overhead Underground Q No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work alq (Jjo 5C f -t ff, l (- 0117,'l Ito. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixti Swimming Pool Above Below Generators KVA ground and Jo. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Bumcrs FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and r No. of Disposals jNo. of Heat Total Total 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 ; Location N8. `'� � Date �` a TOWN OF NORTH ANDOVER A Certificate of Occupancy $ Building/Frame Permit Fee $ •°��no �� �ss+cHusE< Foundation Permit Fee $ Other Permit Fee Sewer Connection Fee $ Water Connection Fee $ TOTAL $ { /41 -Ir-- C -,-/ 7 --Building Inspect' EM/26/99 12:27 130.00 ' nnrn Div. Public Works M N Cn Cn U z U i— lk z C z = o C� Q G C � z � -k -k M N Cn Cn U z U i— lk \LA V d Ni c J J z z = 77 \LA V d Ni c J J IPA t HOME IMPROVEMENT CONTRACTORS REGISTRATION ' 3 Board of Building .Regulations and Standards One Ashburton Place - Room 1'. Boston, MassachLAS-Ct11'. 0;-'10£t HOME IMPROVEMENT CONTRACTOR Registration 102467 Expiration 07/02/00 Type -- PRIVATE CORPORATION NEW ENGLAND CUSTOM DESIGN, INC. Val Lan: a 226 LOWELL ST. WILMINGTON MA 01887 DEPARTMENT Of PHLIC SAfrIY CONSTRUCTION SUPERVISOR I.;CENSE Number: Expires: Birthdate: CS 008828 0420/2000 O4f2O/1951 Restricted To: 00 VAL J LAMA 34 BIXBY ST REVERE, NA 02151 a i O NC O 01 e Q N to =: m 0 m C O Nmac Z �. H CD fNi, o' -* m _a =rd = C .0 co —40 CO) o m C n O m �. p CO2 ^ O C• A m CD Z y m CCD O 'C r C1j a .. to o . CL r m O H: d c �o-c : um : O l l c -p N a CD CA d: c >(o -0 I 'C C7 m0 y /^ < C v v J CCDo i m CD o CL f0 ea m -c _ CD5 CD Cn �-r -� FW N p '� O� Cl) D CD O CD O o .. mz c�: w w O C.0 CD cop) CD CA v2CD 77 WM �F CD CD I = m ;w co) coo CD CD 05r� p =r : C) d O _ 'O CD n = C-) c, C W� CD M: c o n m -n Mn y -a 2 'v o z G ^ ray M O aq cn G N �77p S. 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C � 03 03 O ° rte^^ VJ F CAl -W 9 J O CT7 n(a O e�P v CD c CD 0 o cn Im CD cCD o O ON C CD n v Co vs �- z � O CD v) o zCD q rl■ 0 O CD Z: • Q C CD �+ . � y 1' 0 Z O_ m O O CM O C O m CD m c O O N C 0 a N N m —CA 4c m N y 5=mom m n ca CD O O1 d y C •-► m -n m a =r m '-1 O O N O y 3E 2 O O N 2 O N n O O CL O CD m N 1 C m CL 1 :/ m3 :. N 3 � N Q. O C C a r- CD gym: m m D m oCD 0 no: go N O !� O� CD zi- d zoiln y " o C OQ O a �? 7 m o �' r . 7 o C o Z C c C O ?� O a o ° � IE m v 0 C� )mq 0 0 c MCIELIM EN T A a L., N Anc-over MA 011a, OFFICES OF: APPEALS BUILDING CONSERVATION HEALTH PLANNING VWRpf, Town of a NORTH ANDOVER ;1 •O••:.e :F� S9 @s�CHU DIVISION OF PLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON, DIRECTOR 120 Main.Street North Andover, Massachusetts 01845 In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number !Va R is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S 150A. The debris will be disposed of in: (Location of Facility) r Signature of Ternlit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. / - Date ............. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that t F ha. permission to perform ..... �� �:.I..!. A. .............. n .... �................ wiring in the building of ..... �/...Ql..!... r rel'. �..: �.t ........................................ { r at .........r.....�.... �...:....... ,.�:.�...................................... North Andover, Mass. Fee.�...1�..... Lic. NQl.✓..�� ............... ! f..,:....:......./ ......� /� LE CAL INSPECTOR Check # / �� '/ The Commonwealth of Massachusetts FOR OFFICE USE ONLY �j� c Permit No.FA Department of Public Safety Occupancy dr Fee Checked ip(l OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 (leave blank) ` APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work willbe performed in accordance with the Massachusetts General Code. 527 CMR 12:00 / (PLEASE PRINT IN INK OR TYPE LL INFORMATION) Date 6 Citv or Town of D D V- To the inspector of Wires: The undersigned applies for a permit to perform the � �eel%%ectrical work described below: Location (Street and Number) _/ a-),; / S G �,7 �\ rib • Map: Lot: Owner or Tenant lUte --2 / omq s, Zone: Owner's Address S� Is this permit in conjunction with a building permit? Yes ❑ No IV (Check Appropriate Box) Purpose of Building 4 Utility Authorization No. Existing Service Amps / Voits Overhead ❑ Underground ❑ No. of Meters NelService Amps i_ Volts Overhead ❑ Underground 13 No. of Meters i Number of Feeders and Ampacity �/ Location and Nature of Proposed Electrical Work � �� ;F�I H21 d /Y --eV /957` No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above gmd. ❑ In-grnd. ❑ Generators KVA No. of Receptacle Outlets I No. of Oil Burners No. of Emerg. Lighting Battery Units No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection'and Initiating Devices No. of Sounding Devices No. of Self -Contained Detection/Sounding Devices V:f of Ranges i No. of Air Cond. Total Tons No. of Disposals No. of Total Total Heat Pumps Tons KW — No. of Dishwashers Space/Area Heating KW No. of Dryers ( Heating Devices KW No. of Water Heaters KW No. of Signs No. of Ballasts I Local ❑ Muncipal Connection ❑ Other No. of Hydro Massage Tubs No. of Motors Total HP I Low Voltage Wiring OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including C,op?(pleted Operations Coverage or its substantial equivalent. YES D NO 111 have submitted valid proof of same to this office. YES U NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ld BOND ❑ OTHER ❑ (Please Specify) (Expiration Date) Estimated Value of Electrical Wor $ Work to Start 6 // / d -)- Inspection Date Requested: Rough Final -OI� d Signed under the penalties of perjury: FIRM NAME 4�bCP-5 E --EC / - � ��LIC. NO. �7 �9/�- Licensee IZ/V(Y'' Xq' LAW'bef5 Signature -O- `-LIC NO. 14 -g/-L Address /&LrD 6 5 6 6z 6 S -r, ya• b01/nf°,�7,4 B / pyy Bus. Tel. No. 9 7.0- t; g (� - -3 $� Alt. TeL No. OWNER'S INSURANCE WAIVER I am aware that the Licensee DOES NOT HAVE the insurance coverage or its substantial 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. PERMIT FEE $ . r 14 Location 1/ / S ""'' ? C/ No. Date 0 y U TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ 3� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ s v Check # vZ13 7686 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: (C&( -t -,— Building Commissionell._ntEtor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Nu Parcel Ndmbej 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS 00 Front Yard Side Yard Rear Yard Recored Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.Q. 54) 1.5. Flood Zone Information: Public ❑ Private ❑ Zone outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2- PROPERTY OWNERSHW/AUTHORIZEDAGENT _f'61.,0rr{7' District: Yes NO 2..1 Ownerof Record Name (Print) Address for Service: e rn�l`?�ff�3 Signature Telephone 2T Owner of Record: r I sine Print Address for Service: Signature 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 a Not Applicable Company Name 1 Registration Number Address Expiration Date Signature Telephone 00 M M z O 0 L M 0 ic se r M r r ai z 0 P °'r SECTION 4 - WORKERS COMPENSATION (M. G-1. r 152 s 25rr61 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 Descri tion of Proposed Work check au a Hcable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit a licant OFFICIAL USE ONLY ' 1. Building 945> or- s / / a Building Permit Fee Multiplier 2 Electrical U (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical HVAC (' 5 Fire Protection O 6 Total 1+2+3+4+5 3 708 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Herebv authorize_!' My behalf, in all matters r G.. T� Signature of Owner SECTION 7b OWNER/ to rHORIZED AGENT as Owner/Authorized Agent of subject property to act on by this building permit application.����/� Date 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 Na Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS l y 2' 3 RD SPAN DIMENSIONS OF SILLS DMNSIONS OF POSTS DUv1ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING _ X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND _ IS BUILDING CONNECTED TO NATURAL GAS LINE FA Town of North Andover Building Department 27 Charles Street North Andover, MA. 01845 �1SsAcmuSE% D. Robert Nicetta Building Commissioner (978) 688-9545 (978)_688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print. DATE ©� JOB LOCATION 2 / 4V I�4 ! v 6�74-1)/ N, flvDo V6� Number Street Address Map / lot 2,-1- ..HOMEOWNER Name Home Phone Work Phone PRESENT MAILING ADDRESS c�/1� RO,4 P W GU-,�)Oye5 k AIA City Town State Zip Code The current exemption for "homedwners" 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 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. HOMEOWNER'S SIGNA APPROVAL OF BUILDING OFFIC The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # F1I am a homeowner perforating all work myself. F-1 I am a sole proprietor and have no one working in any capacity I 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 welLas_civil.penaltiesjnlhefnrinda..STOP WORK_ORDER.and_a.fine of ($100.00)-aday against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 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/Licensina ❑ Building Dept []Check if immediate response is required Licensing Board ❑ Selectman's Office Contact person: Phone #: ❑ Health Department ❑ Other W C h C'. C ev m C v! i a a mC ECe S 0 0 CD �mc N N mm 0�3 CD m `� zco Co A N E� m o o�C O -cc O0Cc •viz e CL Q o m=3 _ CL I- o O H m ... 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