Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 2177 TURNPIKE STREET 4/30/2018 (3)
-4 1t� Town of North Andover NORTp Building Department O �T to o , a q•0 400 Osgood Street North Andover Ma 01845 O (978) 688-9545 Fax (978) 688-9542 7,9 0RAren SSACHUSE APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS LOT NUMBER SUBDIVISION DATE REQUEST FILED'' DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF. THE STRVOTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE ROUTING D.P.W. — WATER METER f'54 DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR THE /INSECTION REQUEST DATE. ViAf SIGNATURE /TTPXA0THORIZATION Date. `Y � X41 <4 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING C :. This certifies that ..,Q 1.. ��'�.... !...1+ ................ . has permission to perform ... ..... C... . ?.................... . plumbing in the buildings of ... e:el�. �5.�. y .................. at ..oZ. ! ! !� TV 1 N /�s k,e ,North A ,over, Mass. O�vGFee. .. Lie. No. �J? ..... ......... Z2 / Mc .. -r 1 / PLUMBING IN " TOR Check # 6147 reo' MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Pr t or Type) Date Receipt# -Permitx 41 - V, Building Location .Q.vner'sNarne Map: Lot: Zone: Type of Occupancy Newt Renovation ❑ Replacem-eht ❑ Plans Submitted: Yes No ❑ FIX URES Installing Company Name �w �� Checkone: Certificate Address_ 7(_, �, G3 03 ❑ Corporation EstimateValueofWork: ❑ Partnership .BusinessTelephone_ 6 O-3 x'3,302 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter A` -'r �GG� INSURANCE COVERAGE: I have a curreJnt 1 ability insurance policy cr its substantial equivalent which meets the requirements of MGL Ch. 142. YesJ� No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. ?,. I A liability insurance policy,e Other type of indemnity ❑ Bond ❑ OVINER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this application wa-ives this requirement. Checkone: Owner AgentO Signature of Owner or Owners Agent I hereby cer'ufy that all of the details and information I have submitted (or entered) in above app!ica"'on are t'ue and accurate to the bestof my knowledge and Gnat all plumbing work and installations performed u r the p,rr,;it' ed for Geis application will be in compliance with all pertinent provisions of the Massachuse-tts State Plumbing Cod Ch^ 'e cf :e _neral Laws. By Sign tore of Licensed Plumber Title Type of License: h'as:2r/0" Journey^an ❑ � �� City/Town �� APPROVED OFFICE USE ONLY) License Number (5� / v R,,.,td. czcz r Date .... Q..1 �. . . � Of NORTH TOWN OF NORTH ANDOVER o PERMIT FOR GAS INSTALLATION This certifies that ...".A t . Q. �t .... .. . has permission for gas installation .. �N?...1 .`� ... . in the buildings of .... Q-A 4� -�-. �f ......................... at .-!�I.`7 17...7u P!. t�t. 5 . , North Andover, Mass. /i / ' Fee.. ... Lic. No.l-�(?4(0.. `�'.7f d27.! ( .r GAS INSPECT Check # / R � : s MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING _ (Print or T pe) I.('d .fti1A Date % Receipt • Perm. h# Building Location sName flap: Lot Zone of Occupancygn New J\ Renovation ElReplacement ❑ Plans Submitted: Yes ❑ No ❑ Installing Company Name a GWS..— A-6xl Checkone: Certificate Address oZ �t//(�Dy'G�,z� ❑ Corporation EstimateValueof Work: • ❑ Partnership BusinessTelephone_ (� �� ��` 7j,JoZ ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes,$ No ❑ If you have checked yes—please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Checkone: Owner AgentO Signature of Owner or Owners Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are Lve and accurate to the bestof my knowledge and that all plumbing work and installations performed under the permitissued,for this application will be in compliancewith a!I pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene Laws. j: 3y Type of License: lumber Signature of censed Plumber or Gas Fitter Title Gasfitter Jb aster License Number City/TownJourneyman APPROVED (OFFICE USE ONLY) s =seueii��a�e��9e�ee Installing Company Name a GWS..— A-6xl Checkone: Certificate Address oZ �t//(�Dy'G�,z� ❑ Corporation EstimateValueof Work: • ❑ Partnership BusinessTelephone_ (� �� ��` 7j,JoZ ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes,$ No ❑ If you have checked yes—please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Checkone: Owner AgentO Signature of Owner or Owners Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are Lve and accurate to the bestof my knowledge and that all plumbing work and installations performed under the permitissued,for this application will be in compliancewith a!I pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene Laws. j: 3y Type of License: lumber Signature of censed Plumber or Gas Fitter Title Gasfitter Jb aster License Number City/TownJourneyman APPROVED (OFFICE USE ONLY) s � t' I III Location cam2 I r) 0 TO ✓`/� A l K e S� J� e No. % & � _.__ Date '1h,310 NORTh TOWN OF NORTH ANDOVER OL Certificate of Occupancy $ �� s'�•°E��' Building/Frame Permit Fee $ �cMus Foundation Permit Fee $ Other Permit Fee TOTAL Check #oto 1 1744 lo M `f Building Inspector 4 --Ai&° r'l/ t5/0 3 V11-3 `f 8 j?b0m a 1-4 03 >4 a Sfa I ( u "Okv r o �( �9 o 0 8 Cl) w i1 I CERTIFY THAT THE OFFSETS SHOWN COMPLY WITH THE ZONING !i BYLAWS OF NORTH ANDOVER CERTIFIED PLOT PLAN Scott L. Giles R.P.L.S. LOCATED IN NORTH ANDOVER, MASS. Frank. S. Giles R. P. L. S. SCALE. -I"=50' DATE: 7/7/2004 50 Deer Meadow Road North Andover, Mass. TURNPIKE S 4704445" E 47.56' S 47°07'28" E M.H.B. STREET 148.42' LOT I -C o PLAN #12164 N.E. R. D. 56,771 S.F. EXIST. HSE FND. to tA4 IA -5 WETLANDS f A-6 A-7 A-7 N 4704445" W 181.57' OFFSETS SHOWN ARE FOR THE USE OF THE BUILDING INSPECTOR ONLY AND SUCH USE IS FOR THE DETERMINATION OF ZONING CONFORMITY OR NON -CONFORMITY WHEN CONSTRUCTED. N N N Nv to co S h 13972 0 s �FCISTER�� a Location c;2//)() yurA) ke S-� No. Date a- b TOWN OF NORTH ANDOVER 50-- ,15— D 17117 Building Inspector F ` � a Certificate Occupancy of $ �'�s'•"°'t<� JACHUS Building/Frame Permit Fee $ Foundation Permit Fee $ - Other Permit Fee.-A,,,.rM�� $ TOTAL $ .r Check # 50-- ,15— D 17117 Building Inspector m o °- V 2 o Iw Cc) Q NQ: W c = V C° LL 0 ao aw 0 I O: y;: a y-, o Lo Ln aj O - vJ• OC L QW • u m C . 4 ~ a �!� C Q1 3 f° 3 N oaj ��•�O o m u0 Ln y ; .° E c -0 -0 T �J o £ n. ° o c �.U-1 � o r.• o c E00 n u 0) aj z a m c O O d ` c a W C V C. O O` O O�0 0) m AX =oma '0 � E W a` oa U O OOG N li n Ln m ` a - .ta� o ui.....p _ ?� o 141- . c C� OZ o" Q 4 v • rot., x ~ m o °- V 2 o Iw Cc) Q NQ: W c = V C° LL 0 ao aw 0 I O: y;: a y-, o Lo Ln aj O - vJ• OC L QW • u m C . 4 ~ a �!� C Q1 3 f° 3 N oaj ��•�O o m u0 Ln y ; .° E c -0 -0 T �J o £ n. ° o c �.U-1 � o r.• o c E00 n u 0) aj z a m c O O d ` c a W C V C. O O` O O�0 0) m AX =oma '0 � E W a` oa U O OOG N li n Ln m ` a - .ta� o ui.....p _ ?� o 141- . c o o" Z a u ~ O ` D O z IA .-. 'r�`.a.9a5-�ar't17�'�,: mid• °0"1,.F.�.... ��'��e'^ti�,'�sl�' . -..r.�..b. �� 'KSf�` _. _ ..._ _ .,_ ._ .. w....... _ ..453 °i'4 - - I"q, Location a i 9 h DIU r AJn 1 �� S4 Flo. i 8 f Date - /16 -1013 "ORT" TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ /00 Other Permit Fee q TOTAL d }Check # bq 16711 A4 ,Q ` (-.,— '� Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMrOLISH A ONE OR TWO DWELLING dFAMILY fi1rW�0 BUILDING PERMIT NUMBER: O DATE ISSUED: SIGNATURE: Building Commissioner/In for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 6 r r... Lf6rA A Map Number "' ' "*Parcel Number 1.3 Zoning Information: zy 11"+� f Zoning District Pr osed se / 1.4 Property Dimensions: _s(;, t/ 1 1 Lotsea Fronta e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required ppProvided 30 I �� ' 1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private V Zone Outside Flood Zone Ur 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System @000 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner.of Record �'+� ,., " ' . 6,5��A ` . L.Asa i � r� �) L / �v�a Name (P Address for Service Y Signature Telephone 2.2 weer of Record: Name Pr ut Address for Service: t Signature "' Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: d r..,;aPA �'. Q ��'`, Licens onstruction Supervisor: g§ �^F QI � `�L SF 1 Ojbb.ml A_c�n ` �"� Signature Tel phone Not Applicable ❑ License Number —� Expiration Date 3.2 egistered Home Improvement Contractor r Not Applicable Company ]•'Jame Registration Number Address Expiration Date Signature Telephone T M z O 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 buil ng permit. Signed affidavit Attached Yes ....... V No ....... ❑ SECTION 5 Descri on of Proposed Work check all licable New Construction Rf Existing Building ❑ Repair(s) ,` ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description (off f Proposed Work: t (24sr1wa �`Z L 47 P-Alt�'R&'VA< C;1-' 18'� -L-a' \AM0T T— � SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OffICIA USE fI iLY 1. Building Z z"8224 (a) Building Permit Fee Multiplier 1 s S ¢' ' 8. - P` UK - +�-SCo P 2 Electrical ✓f7i 540 (b) Estimated Total Cost of Construction Q O / 3 Plumbing Building Permit fee (a) x (b) S•- �� SS. - 4 Mechanical HVAC ;l 5 5 Fire Protection 6 Total 1+2+3+4+5 'ZZ. 3 C'5-0 — Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 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 Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I,)(jg, L 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 N Si ature of O er/Ag&t Date O. OF STORIES pig tai go p3eM1FPVIZE Zb BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 p 3 RD SPAN l DEv ENSIONS OF SILLS ja DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS FE-HEOF FOUNDATION THICKNESS 'Z Q SIZE OF FOOTING ra '3' X MATERIAL OF CHIMNEY z4 -Ja IS BUILDING ON SOLID OR FILLED LAND ISO L IS BUILDING CONNECTED TO NATURAL GAS LINE lip J tir BOARD OF BUILDING REGULATIONS ' License: CONSTRUCTION SUPERVISOR Number: CS 002429 Birthdate: 04/07/1947 - Expires: 04/07/2004 Tr. no: 19982 Restricted: 00 JOSEPH P CASEY 65 FEDERAL ST WILMINGTON, MA 01887 Administrator 00 - 35,000 cf enclosed space ;MGL C.112 S.60L) 1A - Masonry only 1G - 1 8 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DIG SAFE CALL CENTER: (888) 344-7233 FORM U - LOT RELEASE FORM BfRC1 ) 03 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 or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT�� L{# 601 PHONE -()� LOCATION: Assessor's Map Number Mae PARCEL SUBDIVISION LOT (S) STREET��)RAJP%/_!I�^Pl�� ST. NUMBER Zl� ************************************OFFICIAL USE ONLY*********************************** RE99MMENDATIONS OF TOWN AGENTS: C NSERVATION ADMINIST ATOR DATE APPROVED I DATE REJECTED COMMENTS_ aga-IQ Jr.S —Ti-0---c,e"Ar o. int ;°, • ��Id a A �v l_ RECER ER DATE APPROVED DATE REJECTED D r,SEE, M g003 COMMENTS H ANDOVER • PLANNIl11DEE'Ai TNIENT FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SE IC INSPECTOR -HEALTH DATE APPROVED 0 0 0 DATE REJECTED (]� COMMENTS_ ftjL1ej tC 5-- -tv C 0 C- � G� PUBLIC WORKS -SEWER/WATER CONNECTIONS _9-27-0 A _ DRIVE Y PERMIT „FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTO Revised 9\97 jm P DATE 9-Z7-os MA`r-15-2003 02:41 PM GILES, P.L.S. 979 653 2645 P.01 PPOPOSED PLOT PLAN Scott L. ON®s R.P.L.S. LOCATED IN NORTH ANDOVER, MASS. Frvnk. S. Offes R.P.L. S. SCALE. f "m50' DA TS.1&1 2003 50 Dow Moadow Road N,00 Andover, Mass, TURNPIKE STREET S 47944`45" E N 47"44'45"W 181.57' f CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE THE OFFSETS OF' THE BUILDING INSPECTOR ONLY SHOWN COMPLY AND SUCH USE IS FOR THE WITH THE ZONING DETERMINATION OF ZONING BYLAWS OF CONFORMITY OR NON -CONFORMITY NORTH ANDOVER WHEN CONSTRUCTED. 771c Canunonwealth ofMassachui-ettc Department of lrrdustrial Accidenis OMce o//MsligaGvns 600 Washing, ton Street Boston, Mass 02111 Workers' Compensation InsuranceAff(davit IWM � �f•t[1c1GR7�iT�t �, o ., I am a sole propnuor, general contractor, or homeowner (circle one) and have h>rcd the contractors listed below who have -- the following worlccrs' compensation polices_ tom an • name: �� ���• t ir'if, r � 2 d d cess: ti/ f city: - - ohon� q insu"nce co. - f�_levna�r. Company n]mc- address: h nc K: injurancc co �??'riAfr��4onn����Vs�' olick q Facture to secure eoveiabc as rcgatred under Section 25A of MCL 152 can Iead to the tmposicion of e-riminal�< aaJties of a tint up to 51,500.00 and/or one r<ars' imprisonmeal as wdl as civil penalties in the form of a STOP \YORK ORDER and s fine ofS100.60 a day arainst me. I understand Ihars_ copy of this statrmeot mar be for..-ardcd to the 0Ir.cc of lnvcsticarinns of the DIA for covcra.•r vcrifcation. do hertbr « �rnn i%i ndcr c ninj pact !/ire n ! / ! er/u!1• that !hr in/nrraniton prorided ahorr is mut and correct. \t,�n:. f 1' tat name - -- -- - �1 h �1 `ase- ---- ---- - --�- -------- - - 1'Itpnc = (may "(,i(s�•J • ofcial use only du not w-ritc in this arc2 to cc cool, l.lctcd l.y ci(y.or town , ofrici2l <i(• or town: permi(Aiccnsc il flllaildinx Dcrartntrut O check if immedimr resiwnsc is required 0Lse<"nl: lloard _ CISciccim<n's 0frcc CONTROL BUILDING ASSOCIATES SUBCONTRACTOR INSURANCE ROSTER 2177 TURNPIKE STREET NORTH ANDOVER, MASSACHUSETTS PAGE 2 CIAMPA MASONRY 1087 SHAWSHEEN ST TEWKS. LEGION INSURANCE CO 978-858-0713 WC20121597 CHRIS COVIELLO, INC 30R PINE ST STONEHAM THE TRAVLERS 781-438-7766 IVOUB8031)474798 DIFLUMERI CERAMIC INC 439 PROCTOR AV REVERE THE TRAVLERS 617-387-8754 1 HUB341Y348297 NEW ENGLAND PLASTERING 12 WRIGHT ST STONEHAM LEGION INSURANCE CO 617-828-7642 WCJ67191 .ARCHITECTURAL FRPLS 8 MARBLEHEAD ST NO ANDOVER NATIONAL GRNG. BPT 66960 978-975-4409 LIBERTY MUTUAL WC1-312-475822 LAFONTAINE FINISH 271 HIGH RIDGE - LONDENDERRY NATIONAL GRG MPT64752 603-425-6869 NH EMPLOYERS OFWAUSAU 151600093725 EDWARD J MC DEVITT III 8 HILLSIDE RD KINGSTON NH THE TRAVLERS 603-642-4767 83HUB905KO62598 CITY PAINTING 220 CARLETON ST LAWRENCE PREFERRED MUTUAL 978-685-5388 CPP0110514850 LEGION INSURANCE CO WC4-0282892 GRANITE STATE KITCHENS 341 RT 101 BEDFORD NH ACADIA INS CO 603-472-4080 WCA003725811 SCENIC DESIGN, INC. P.O. BOX 85 NO. READING, MA WORCESTER CB827332 978-664-2535 " " " WC812419 I do herby certify under thft pains and penalties of perjury that the information provided aboveAtni ani cprrect to the best of my knowledge. ------ ` . www Date ------- ------------------------- P. Casey d/b/a Control Building Associates Tel 978-988-0001 MA CS#2429 SUBCONTRACTOR INSURANCE ROSTER BUILDER: JOSEPH P. CASEY D/B/A CONTROL BUILDING ASSOCIATES MAILING ADDRESS: POST OFFICE BOX 428, WILMINGTON, MA 01887 TELEPHONE: 978-988-0001 JOSEPH P. CASEY MA LICENSED CONSTRUCTION SUPERVISOR #2429 BUILDER'S W.C. POLICY # A.I.M. MUTUAL VWC 6003170012003 'PROJECT: 2177 TURNPIKE STREET NORTH ANDOVER, MA DATE: AUGUST 28, 2003 IN COMPLIANCE WITH MGL 152 SECTION 25A; AND PURSUANT TO THE W.C. INSURANCE AFFIDAVIT THE FOLLOWING ARE CONTEMPLATED SUBCONTRACTORS FOR THE ABOVE DESCRIBED PROJECT. THIS . LIST WILL BE UPDATED TO REFLECT ANY SUBSEQUENT CHANGES AND/OR ADDITIONS. CONTRACTOR VIKING TREE, INC. P.O. BOX 272 NO READING MA WAELTY CONSTRUCTION 61 OLD ANDOVER NO READING 978-664-2126 K & M FOUNDATIONS 42 BUTTERS ROW WILM 978-658-4226 KEVIN JARNAGIN 16 WILDWOOD TEWKSBURY 978-851-975 ELAD CONTRACTORS 58 CALL ST BILLERICA 978-667-6066 ENVER CAUSEVIC CAGNINA MASONRY ANTONIO COGNATO FAIELLA PLUMBING 383 REVERE BCH BLVD REVERE 52 NASHUA ST WOBURN 781-933-2436 70 MEADE ST TEWKSBURY 978-851-3985 27 ESCUMBUIT RD DERRY, NH 603-893-8332 POLICY # WORCESTER INS. CO WC810395 GRAPHICS ARTS MUTUAL CPP2158982 UTICA MUTUAL 2983240 WORCESTER CB817399 TRAVLERS 7PUB404X830098 EASTERN CASUALTY WCV3000335 MARYLND CFP27292078 CIGNA C80117577 LEGION WC40116672 GUARD INS CO CAWC911915 PREFERED MUTUAL CPP 0110515139 LEGION WC1 026011 TRAVELERS 680657K6814 LIBERTYWC 1311247942018 QUALITY INSULATION 15 PITTSBURGH AV NASHUA NH ROYAL INS OF AMERICA 800-258-1002 PT0444906 GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT TOWN OF NORTH ANDOVERBUILDING DEPARTMENT This form shall be used to assist the Building Department in their determination of exemption under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The applicant shall provide all of the necessary information as requested below. 6NSCEYZ0% j`_`�'r Vii^'" ,L6C - Permit Applicant Property address Map / Parcel Applicant's Phone Number SinCe 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 Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other 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 bylaw, provided that no additional residential unit is created. The lot(s) was / were created prior to May 6, 1996 and are exempt from the provisions of 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 are met and or represents dwelling units for senior residents, where occupancy of the units is restricted to senior citizens 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 part of a development project which voluntarily agreed to a minimum 40 % permanent reduction in density (buildable lots) below the density 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 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 bythe 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 and shall receive a onetime exemption from the Planned Growth Rate and Development Scheduling provisions for thepurpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for a building permit ( 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 submit an approved FORM U with this EXEMPTION. PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A DETERMINATION THAT THIS APPLICATION IS ALLOWED UNDER 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 OR INACCURATE INFORMATION OR THE CHECKIN F OF A ABOVE EXEMPTION WHICH DOES NOT COMPLY, WHETHER DONE TO MY KNOWLEDGE OR NOT IS q&OUNDS F REFUSAL BY THE BUILDING DEPARTMENT TO ISSUE A BUILDING PERMIT. PLICANT SIGNA DATE TkUS FORM 0 BE ATTACHED TO THE BUILDING PERMIT APPLICATION North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A.. The debris will be disposed of in: Z -,I, 5 AA (Location gVacility) Signature of Permit Applicant -03 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector ..... , . , J06 CA S L Y ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE RESIDENTIAL NES✓ CONSTRUCTION and ADDITIONS 780 CMR Appendix J Applicant Name: Applicant Address: Site Address: City/Town: Lip, ANi:)ovt2j2_ Use Group: Applicant Phone: Date of Application: Applicant Signature: Compliance Path (check one): �i Prescriptive Package (Limited to 1- or 2 -family wood frame buildings heated with fossil fuels only) Package (A through KK from Table J5.2.1 b): Heating Decree Days (HDD„) from Table 15.2.1 a. (For items d. through i., fill in all values that apply from Table J5.2 lb:) a. Gross Wall Area A--2.2 —&sq.ft f. Wall R -value R- J 9 b. Glazing Area' ___A 7sq.ft. g. f :oor R -value R- 19 c. Glazing%(100xb,a)--V.iT0 h. Basement wall R- 19 d. Glazing U -value U- .�3 t• Slsb Perimeter R_ — e. Ceiling R -value L--2-0— j. Heating AFUE 8, oda Component Performance: "Manual Trade -Off' (Limited to wood or metal framed buildings only Climate Zone (from Figure J6.2.2) g ❑ Zone 12 �' Zone 13 ED Zone 14 Attach Trade -Off Worksheet from Appendix J, (and HVAC Trade -Off Worksheet, if applicable) ❑ MAScheck Software Attach Compliance Report and Inspection Checklist printouts ❑ Home Energy Rating System Evaluation Attach Home Energy Rating Certificate (HERS rating ;:core must b- 83 or higher) ❑.Systems Analysis OR ❑ Renewable Energy Sot-rces Attach Mass Registered Architect or Engineer Analysis ALTERNATIVE FOR ADD1TI1rjNS ONLY: a. Gross Wall + Ceiling Area ._sq.ft. b. Glazing Area'_�_sq.ft. c. Glazing % (100 x b - a) ❑ ADDITION with Glazing % (r.) up to 40% may.use 780 C IR Table 11.1.2.3.1 below: PArea U-value MINIMI _ — R -Values Ceilin Wall Floor�R-10 :ent 1Vall Slab Perimeter De th R-37 R-13 R-19 I Glazie either Rough Opening or Unit dimensions. R-10 4 ft z Based on NFRC listing. Applies either to every unit, or to area -weighted average of all units. 3 R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R -value over the entire ceiling a- a (i.e.- not compressed over exterior 'A -alts, and including any access open,ngs.) ❑ "SUNROOM” addition (greater than 40% glazing -to -wall at.d ceiling gross area) Attach "Consumer Information Foran" from 780 CMR ,appendix B. Official's Name: Official's Si1;rnature: Application Approved ❑ Denied❑ -- Datc of Appr:val/Denial: Reason(s) for Denial: (provide additional details as seeded on baci: side) •780 CMR Appcndix J Manual Trade -Off Worksheet Builder Name Date Builder Address Site Address Zone []12 J413 E)14 Submitted By Phone PROPOSED _Ceilings Skylights and Floors Over Outside Air Required U -Value UA (fable J6.2.2) x Area = UA 42 ,035 1200 �2 Insulation x Net nocrrinflnn R -Value U. -Value Area Ceilingft2 (TableJ6.2.2a) 3� .035 12�� Floor Over Outside Air (fable J6.2.2a) Space J6.2.2e) ft Windows Basement Wall (Table ft2 (NFRC or Table J1.5 -3a) fTs ft Total Area Za0 ft Walls Windows, and Doors Insulation x Net r-) a 'intinn R -Value U -Value Area Walls 19 0� 0 427(, (Table J6.2.2b,c,d) Space J6.2.2e) i Windows Basement Wall (Table 475.E (NFRC or Table J1.5 -3a) fTs J6.2.2f) Doors — 28 89 ft= (NFRC or Table J1.5.3b) Sliding Glass Doors— 29 9 D U ft, (NFRC or Table J1.5.3a) , Heated Slab ft (Table J6.2.2) ft Vide read s� 1'9 " JOE easEy Per mit # Checked By Date Floors and Foundations Insulation Insulation x Area or nacrrinrinn Deoth R -Value U -Value Perimeter = UA Floor Over Unconditioned (Table 9 �� X27 SM Space J6.2.2e) i Basement Wall (Table fTs J6.2.2f) Unheated Slab ft (Table J6.2.2) in. Heated Slab ft (Table J6.2.2) in. ft ft Total Proposed UA must be I Total Required U -Value x Area = UA ,8t� 3& 3to8.o Required U -Value x Area = UA 047 12 71 59,7 ,640 612 310,7 mus a ess Total than or equal to Total Required UA Proposed UA 96•� ~� Required UA 91°•� Statement of Compliance: The proposed building design represented in these documents is consistent with the building plans, specifi tions. anp other calculatio s submitted with the permit application. i ArRCH 1YE C -r to -17- -03 Builde /Desig"ner Company Name Date DRAFT (for training purposes) 53 /z _2: 0 Aspf f AIh oua r 15 FQ1� _ ��; x R.30 2 A I 0 j&%S INSuL,• �acdar� 4L 4Ltr,) CZA 'PLV, i' Sub 19LOO& o' PJaTd . .:Frawwy (u .o�•-b`,�,,,.:� 2 �Od.-PSI , Co' ns4. G rad ¢ 2xL$�fl•�;tad, ,, l ...ftl:�la . STY&AROAM kV JOSEPH A + ?0 4') L A YID o*,/ SAIA, JR. '. Er- C -�-' _d u ' READING cn !u Off o. ..'.. ?.fit �_-:.;Jl:`.' 0,�. , - 6r�da• ,: ,'��;. R -{I l�l�lec�c,. �arfs�lDns111XIV Q �... , x $��, roc �yCo or half•C6 at,�_._...- � •.•.. � � , �rad� 'f o ooh s . of1. ;••41 ,�. �1I_I� ,, l ...ftl:�la . STY&AROAM kV JOSEPH A + ?0 4') L A YID o*,/ SAIA, JR. '. Er- C -�-' _d u ' READING cn !u Off o. ' � '• ., ..,.gip:.'••�,v...•�-_ '--'- / prs S NAND �-� 12 A I L I2�S70P AT STAR$ CIZlLING_ s t �TRiNC,CR Wr� 3�4uCDX L , _i'_Ly wooer CON TI N 0 0 0 S 911 • }%11 h , v z I I - 1 TA I �y 4p � ����'•�Jd51`ryl I ,� `L SAID, N0. 3838 I N0. FtDING �S± �O C� jk of 9k/ f� 0 p V) W Q v u � Crl:o V ER * mLL flq s� �u W o� a pro CLai iD V c LLJ cu o �-• a. m v Ad -v a a�C cca �C d O u c 0 a� cc ° gy� a� l�m. u �� c �� a`i O Q,� c a c 0 O�� m c al U� o W O cv t Of ro y 40 O ac 0 F" 3 C .0 c LLJ x V o o 4) •c N u- a,. a t a�� t .0 ouj LA .0 .� ® C Z`cuu 0 al UI Z H m uni v y a 0 Q n a 0 CQ m o ' N a _ rL o a CL. ea C: �v c m c s �••� • L 1 •H 0 cin •E G w° p°G U a Q ro a W °�° C cm m t x ma�yy. m L n ci v cn o cn uni O O v R., 2 Irs CD C cm ca La O O �E m CD 0 CD CD L cc 0 0. CMQ ca C C_.+ C ev .c as Z ts as cicc y C C� _c Q. C* D 0 U) uj Cn irw w W U) C1•�Z O n 2: c m o ' N C _ rL o CL. ea C: �v c m c s �••� • L 1 •H 0 E a D •E A• �: L c Q Z co Q.: o a �. 9J: E c Q y'v CL Qo: c 0 C cm m t CD C N !O ma�yy. m L n ci F� c V ; c o •' -mom f c co N �' / A O 4mo c 9� acs m go cm H •j m v N O O O v R., 2 Irs CD C cm ca La O O �E m CD 0 CD CD L cc 0 0. CMQ ca C C_.+ C ev .c as Z ts as cicc y C C� _c Q. C* D 0 U) uj Cn irw w W U) C1•�Z O n H• a m o y C mL 3 C _ rL o W c ea'�... t s �••� •H � IV � � ac •E dt C � CO2 •h Z co LLIcm Q y'v CL m� o = Le C = H m t S d4- O O v R., 2 Irs CD C cm ca La O O �E m CD 0 CD CD L cc 0 0. CMQ ca C C_.+ C ev .c as Z ts as cicc y C C� _c Q. C* D 0 U) uj Cn irw w W U) Date....:`.' fix.... opo• TOWN OF NORTH ANDOVER F P • - PERMIT FOR GAS INSTALLATION �9SSACMUSEt F -r This certifies that .................... �'-......... . has permission for gas installation ... .:.. ........... �n the buildings of.,........ ... ......................... at. > �%`..��r �-� ..... , North Andover, Mass. FeL �� . Lic. No.. .... '.. r ...... . GAS_INSPE0TO Check # j i i MASSACHUSETTS UND-ORM, (Type or print) NORTH ANDOVER, MASSACHUSE Building Locations 2177 Turnpike S TON FOR PERMIT TO DO GAS FITTING Joe Casey Owner's Name New Renovation ❑ Replacement ❑ Date 12/30/04 978 258 8442 Plans Submitted ❑ Permit # _ Al 9s Amount $ 30 S $30.50 W W ]ST. FLOOR 2ND. a° 3RD. a W 4TH. a &d N FLOOR as un er ro 1i 7TH. 8TH. c N 0 a z c w p e o b rs st waa x Eli a a w H z � <�' ¢ x � w a� a N ' ° w z o a SUB-BASEM E BASEMENT ]ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. 8TH. FLOOR FLOOR Name or type) Eastern Propane Gas Check one: Certificate Installing Company Corp. Address 131 Water S t . ❑ Partner. TQa n-Nre-r�-, MA nl QP 4 Business Telephone 1 800 3pp _ „ 7 _ ❑ /Firm/Co. Name of Licensed Plumber or Gas Fitter �% % INSURANCE COVERAGE Check oLk I have a current liability Insurance policy or it's substantial equivalent. Yes M No ❑ Ifyou have checked M please indicate the type coverage by checking the appropriate box Liability insurance policy F Other type of indemnity ❑ Bond ❑ IOwner's Insurance Waiver I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I `hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this a lication will be in -. - -compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapte 2 th La s [APPROVED (OFFICE USE ONLY) I Signature of Licensed Plumber Or Gas Fitter Plumber i sF Gas Fitter License um er ❑ Master ❑ Journeyman Date................... ............. ikORTH 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING, This certifies that ......... has permission to perfoj wiring in the building ol atc->W;77��4 Fee.V-5�..l ...... Lic. I �Check # 565.8 �4 \_ MRA O h rb 4' CD 0 CD CC rS O 0 I y O M E a� CD C O CD 0 _cc ca 0 C cc O c _cc 0. y 0 ts y C _o () 1) crw w ``w^ vJ F a L ri :A •� x V 7��• • C � C y�y O Qi : Z • v V CN'L O CL �: me • C 1 Cf) o CD 04 C/ O O' a�cc 2 3 © cm fti pq `n � u G'Q b ,� C ►•a �„� � � ,� � v COSco = �+^V w cgi C / y A D f. two w w U w Of .o c CD 0 CD CC rS O 0 I y O M E a� CD C O CD 0 _cc ca 0 C cc O c _cc 0. y 0 ts y C _o () 1) crw w ``w^ vJ F a L :A •� O V 7��• • C � C y�y O Qi : Z • v V CN'L O CL �: me • C 1 Cf) o CD U C/ O O' a�cc 2 3 © cm fti CD c W; E COSco = �+^V y C / y A D f. two O :limo Of .o c 0 C3 hZ O co = o C:, c a m"— m c c HO C 4 yr y m w N O Nd p 'COD z w r .y O C C.t W .E .y Z o V m p m C COD "Co CL cc a y= O i �=4-a�m� CD 0 CD CC rS O 0 I y O M E a� CD C O CD 0 _cc ca 0 C cc O c _cc 0. y 0 ts y C _o () 1) crw w ``w^ vJ F a L :A •� V O Z O v J • Cf) WO U C/ CD 0 CD CC rS O 0 I y O M E a� CD C O CD 0 _cc ca 0 C cc O c _cc 0. y 0 ts y C _o () 1) crw w ``w^ vJ TH COMMONWEALTHOFMASS'ACHU.SMS Office Use only DF.PAR73ZWOFPUBIK'SAFMY Permit No. BOAROOFFIREPREVF. VHONR a AT OMM7(&12'ID 3' Occupancy & Fees Checked O APPLICA77ONFOR PERAIZT TO P ORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSAC SST" ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 9-13 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work d bed below. Location Street & Number t t S Owner or Tenant Cgsev `• •„ f r Owner's Address Sbe Is this permit in conjunction with a building permit: Yes No a (Check Appropriate Box) Purpose of Building IJ&Lo CAhs �rvt, 4�aa Utility Authorization No. Existing Service Amps�Volts Overhead Underground No. of Meters New Service 9a�� Amps)16 Volts Overhead Underground C -14o.. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work .fir% '-1 - . 1 ly '4� No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA round uund. 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 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 Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP rffJX law nrs�zouetegtuHrBacalvit iate[dtlaws aa>aeYLiabil►Yhis�'arlcePokYirri�dngCarnple� ai�subAarrialegt>ivaiat y)� NO sirrivadvWpmafafsMWk) rOffi a YES rXI rV ffyuuhmdrckWYEpbmmdcwdrMxofby lheappto�box, BOND � MEM tusratt `I' �J I kspac mDftReWeslBd Rall Fstirr�Eidvatreaf)~7a:�ical Wade $ NAME RrW Penabesofpe�try: �gnpv�' fly Lioa>,seNa r Sew Liomm1% BusiI=TdNa 9-;a; 831 31TS �— Alt. Tel. Na �JWI0R'SINSURANCEWANT~R lainmwdvtt rLio wdoesmtfti mraloeoDverWcritsatsmnf iagivaiatast g*!dbyMasmdmsftG alLaws arddrtnrysignaltaeonthispearitWpkabmwaivesdiste# mat (Please check one) Owner 0 Agent Telephone No. PERMIT FEE $ signature o caner r gen �J^ C�Er�s O EO C OM11wnwfaid, o/ lrla!lacliulells Official Esc nl cc�� cc�7 Permit No. ,...;•5 6 �((� ..Utparinranl oJ.}ira �irvic ! OBOARD OF FIRE PREVENTION R GULATIONS Occupancy and Fee Checked Rev. l I/99j rt��.,� �{-••h•� APPLICATION FOR PEffTA2'�IERFORM ELECTRICAL WORK All work to he perl'ormcd in actor Me wi i theclwsctts Electrical CM (�1CC�, 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE.*ILL INI- R, , tTION Date: u-• � �^ D rj' City or Town of: To the lltspeclor of -I- il•es; By this application* the undersigned gives notice of if or her intention to perfor the electrical i�ort; iiescl{tied belb,iv: �,� Location (Street & Number) I ' Owner or.Tcnant �O E G'► `w s Owner's Address C' G t!✓M 0 ` Telephone No._, Is this permit ill conjunction with a buiidinb permit' Yes ❑ No (Check Appropriate Box) Purpose of Building_A/ y-rK ";+0 M,�oP_ -;70 5 ilii} Authorization No. Exis(ing' Service'= Amps l"; volts 0yerhead Uqdrd ,.of Meters g ❑ New Service Amps ! Volts O,•cnccad❑ . Underd ElNo. ofilleters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Cunt letiva eiidief jullurvui ! b/ i'ar Attach additional detail if desired; or as repaired by the hisp.ctor of 1Vires. INSM-kNCE COVEILWE: 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. 111e undersigned certifies that such cove ge is in force, and has exhibited proof of sante to the permit issuing office. CHECK ONE: INSURANCE BOND ❑. OT IER C]e (Skcify:) ' ii'/i T t �n � , ! Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Datc) Work to Start: A4x,0 Inspections to be requested in accordance with NIEC Rule 10, and upon completion. crrtif}}•, ranter Ihr tits acrd prrralI es of erjurr, Iltilt Are inforniation oil this application is lrttr and rotrrplcvr.' FMN1 NAAIL:--C• r �(��%l t C'_C7LI C.N0.• /4 Ito Licensee: Q �l„/ rr Signator e LIG NO.: 156 (If applicable• enter ••ex: rnpl" in tilt, lice to rrutttber line.) Bus. Tel. No.• " Address: ?ai L�„f�-'� 1' �Y` �t��G21 MA�l�`1(�� Alt. Tel.itio.• OWNER'S 1 NSURANCE WWI VE'R: I am aware that the Licensee dons not have Ilk liability insurance coverage normally required bylaw. Uv :try signaunr below, i hereby wai\,c this requirement. I am the (check one) ❑ owner ❑owner's agent. ¢ u e )"a'? aarced br rbc lnsncrtor of ii'ires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans • 1 0.0 s Total Transformers KVA No. of Lighting Outlets No. of Hot Tums Generators KVA of Lighting Fixtures A Swin{ing Pool ❑ rnd. ru.❑ - n rgecy g t nigNo. Battery Units No. of Receptacle Outlets No, of Oil Burners FIRE ALARt1•IS No. of Zottes No. of Switches No. of Cas Burners No. of election an Initiating Devices No, of Ranges No. of Air Conti. Tons No. of Alerting Devices No, of Waste Disposers cat uwu p i mber Totals: Tons •, ••_ __ h 0.0 c ontatne DetectiotdAlertina Devices No. of Dishwashers Space/Area Heating KW Local unicipa ,�• f ❑ >, Connection ther I No. of Dryers Heating Appliances Secunty ystems: No. of Devices or Equivalent No. o stet KW Heaters o. 9 r o. o Sins Ballasts Data R arta : \o. of e-rIccs or E ulvalctit No. Hydromassage Bathtubs No. of REotors Total UP a econintuuications irutg: No. of lle�ices or E uivalent OTHER: Attach additional detail if desired; or as repaired by the hisp.ctor of 1Vires. INSM-kNCE COVEILWE: 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. 111e undersigned certifies that such cove ge is in force, and has exhibited proof of sante to the permit issuing office. CHECK ONE: INSURANCE BOND ❑. OT IER C]e (Skcify:) ' ii'/i T t �n � , ! Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Datc) Work to Start: A4x,0 Inspections to be requested in accordance with NIEC Rule 10, and upon completion. crrtif}}•, ranter Ihr tits acrd prrralI es of erjurr, Iltilt Are inforniation oil this application is lrttr and rotrrplcvr.' FMN1 NAAIL:--C• r �(��%l t C'_C7LI C.N0.• /4 Ito Licensee: Q �l„/ rr Signator e LIG NO.: 156 (If applicable• enter ••ex: rnpl" in tilt, lice to rrutttber line.) Bus. Tel. No.• " Address: ?ai L�„f�-'� 1' �Y` �t��G21 MA�l�`1(�� Alt. Tel.itio.• OWNER'S 1 NSURANCE WWI VE'R: I am aware that the Licensee dons not have Ilk liability insurance coverage normally required bylaw. Uv :try signaunr below, i hereby wai\,c this requirement. I am the (check one) ❑ owner ❑owner's agent. / olV6 k,oRk, ew zrw /V0�- Dfc- Flkc- 1-14- CK 0' - a 4i -O S- U S, 9 i ® .Nlera2 N l.ommonwaal�i o� //(assac%usells Official Use nl cc�� cc''�j Permit No. `..,. 2eparinwn! of - irer _3arvic s Occupancy and Fee Checked 76 BOARD OF FIRE PREVENTION R GULATIONS Rev. 11/991 (leave blank) APPLICATION FOR PEI MIT 0 PERFORIN ELECTRICAL WORK All ��-ork to be pert'urmed ba accord ncc wi +the Massachusetts f'lectrical Code (�1.0.527 cNirz 12.00 (PLEASE PRINT LV INK OR TYPIs . tLL !tVl�Qli', , t770N) Date: q-1(_05 City 01"I'01vil of: To the hishectoi of 1+71•es: By this application the undersigned gives aoticc of a or her intention to perfor the electrical work described below, Location (Street S Number) CJ Owner or l.enant CA !S Telephone No. 0wtter's Address _ " U''L Is fats permit in conjunction with a building permit:' Yes ❑ No (Clteck.Apprnpriate Box) 1'urluse of 13uildiug �}�G(1rYh S.� �? ility Authorization tato.. Exis'11itg Service Amps 1 Volts Overhead Undgrd ❑ No. of'Meters New'Service, Amps ! Volts Ovcnccnd ❑ Undgrd ❑ No. of Meters Nuinber of Feeders and Ampacit} Location and Nature of Proposed Electrical Work: J A Completion ofthe followin. table rant/ be xnired by lire hrsnertor• of Wires. No of Recessed f=ixtures No. oiCcil_-Susp. (Paddle) Fairs ! o. o ota Transforniers K dRRcn auuruur+ur urruu r� rrr�uca, ur uo rcqurrea a}'are rnspcctor u1 r. a v�. INSUIt kNCE 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 certiftes that such cove ge is in force, and has exhibited proof of same to the permit issuing of cc. CHLCK ONE: li'SUR.,\NCI. (BOND ❑. 01'IILR ❑ (Soccify:) (Expir2tion Daic) Csuiiaaled Value of Electrical Work:' (Wben required by municipal policy) Work, to Start: Inspections to be requested in accordance with NiLC Rule 10, and upon completion. I ccrrtifj, rrurfer�t-l1Nr` Iris acrd /rcrtalldes uft►�rrjrrrrr ltrp irrfornrarion nrr this application ix rrrrr and cauplcrlNd' L•\i NAAIL: 1 -ie F1 • ��rt t rE' LIC. NO.: FIL Licensee: OpttJi; (�� Q o i•% S� S,gnatur C LIC. NO.: (lJnpplicuGlr, elttcr ".:r. utpl "lit t!� !icer ¢ ce rtnatber line.) �� Bus. Tel. No•• Address:'�^�kb&t&,f:�_k�j -M-Alt. Tel No.: �( OWNER' IiVSUh:�`iCE �V:�IVI;lt: l am aware that the Licensee docs not have th liability insurance coverage normally required by.la\ . 13\ my signature bclo\t', I hereby wai\•c this requirement. I ant the (check one) C1 owncr ❑ owner -s au -cut. YA No. of Lighting Outlets No. o(ltot Tums Generators KVA No. of Lighting Fixtures Above n- Swimming Pool rnd. ❑ rud. ❑ o. o mergence Lighting Battery Units No. of Receptacle Outlets No, of flit Burners FIRE ALAiLMS ND. of Zoites No. of Switches No. of Cas Burners id j o. o eters Devices evi•iccs No. of Ranges Total No. of Air Cond.Tons No. of Alerting Devices cat O11p !-.umber' .ens _ __� i o. oc- ontainc \o..of Waste Disposers F 'Totals: _ Detection/Alertina Devices No of Dishwashers Space/Area Heating K%V Local ❑Gonne cion 17 Otlrer. ` ! No. of Dryers Heating Appliances KW Security Systems: No. of Devices or E uivatent t o. of Water . K,V I•Icatcrs o. o n alo. o Sim+ts Ballasts Data.Wiriug: No. of Devices or Equivalent No. Hvdromassage Bathtubs No. of Alotors Total UP c ecommunications . Wring: No. of Devices or E uI.•afent OTHER: dRRcn auuruur+ur urruu r� rrr�uca, ur uo rcqurrea a}'are rnspcctor u1 r. a v�. INSUIt kNCE 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 certiftes that such cove ge is in force, and has exhibited proof of same to the permit issuing of cc. CHLCK ONE: li'SUR.,\NCI. (BOND ❑. 01'IILR ❑ (Soccify:) (Expir2tion Daic) Csuiiaaled Value of Electrical Work:' (Wben required by municipal policy) Work, to Start: Inspections to be requested in accordance with NiLC Rule 10, and upon completion. I ccrrtifj, rrurfer�t-l1Nr` Iris acrd /rcrtalldes uft►�rrjrrrrr ltrp irrfornrarion nrr this application ix rrrrr and cauplcrlNd' L•\i NAAIL: 1 -ie F1 • ��rt t rE' LIC. NO.: FIL Licensee: OpttJi; (�� Q o i•% S� S,gnatur C LIC. NO.: (lJnpplicuGlr, elttcr ".:r. utpl "lit t!� !icer ¢ ce rtnatber line.) �� Bus. Tel. No•• Address:'�^�kb&t&,f:�_k�j -M-Alt. Tel No.: �( OWNER' IiVSUh:�`iCE �V:�IVI;lt: l am aware that the Licensee docs not have th liability insurance coverage normally required by.la\ . 13\ my signature bclo\t', I hereby wai\•c this requirement. I ant the (check one) C1 owncr ❑ owner -s au -cut. Location No. S-3 Date Check # j TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ 0? 4,N ttittil Other Permit Fee wAfl I $ TOTAL $ 17861 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPA15 RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: ^ SIGNATURE: Building Commissioner/12Td6or ofBuildings Date SECTION 1- SITE INFORMATION 1/.1ff Property Address: 1 P 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: ILI vFron Zoning District Proposed Use Lot Area (sf) e ft 1.6 BUILDING SETBACKS (ft)- Front Yard Side Yard Rear Yard Required Provide R red Provided Reqwred Provided 1.7 Rater Supply M.G.L.C.40. 1.5. Flood Zone Information:1.8 / Zone Outside Sewerage Disposal System: Public ❑ Private g� Flood Zone C Municipal ❑ On Site Disposal System SECTION 2 - PROPERTY OWNERSHMAUTHORIZED AGENT istoric District: Yes NO > 2.10 er f Record ! , 1 Name>wAadress for Service Si store Telephone 2.2 Own of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 LiSpyWConstruction Supe icor: Not Applicable ❑ Lice n ed Construction Supervisor: 0530 zj�'4' , License Number Address �14- coo Expiration Date SigCure Idiephone 3.2 R%gistered Home Improvement Contractor Not Applicable ❑ Compa4y Name Registration Number Address Expiration Date Si nature Telephone 00 M z O Uj z M 0 M ro e• 0 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 ....... El No ....... ❑ SECTION 5 Descri ti of Proposed Work check au applicable) New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: S 1_ At 0 SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be OFFICIAL USE O�IIy V� 4 Com leted b permit a licant 1. j , (a) Building Permit Fee ��� Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x - (b) v 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 I, 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 Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, a wne Authorized Agent of subject property Hereby declare that the statements and informa ion on the foregoing application are true and accurate, to the best of my knowledge and belief Print Naine pp Si ature QN3e ent "q •' Date •.,• NO. OF STORIES"-' SIZE BASEMENT OR SLAB y SIZE OF FLOOR TINMERS 1 ST2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS 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 'i 'a, f +_. X00 35,000 Cf enclosed space (MGL C.112 S.60L) 1A - Masonry only j,1G - 1 8, 2 Family Homes ! Pailure to possess a Current edition of the j ,oassachusetts State Building Code I Is Cause for revoCation of this license. tj F ©�i G SAFE CALL CENTER: (88ti) 344-7233 BOARD OF BUILDING REGULATIONS: icense: CONSTRUCTION SUPERVISOR Number: CS 002429 Birthdate: 04/07/1947 i Expires: 04/07/2006 Tr. no: 20380 'Restricted: 00 JOSEPH P CASEY 65 FEDERAL ST WILMINGTON, MA 01887 Acting Cc mis oner _�-- `=j l ; I c Callln,on ll.cafth oJMnssac/rusc/!.� 1 = — �° r�cpartnrerr! of lirdrtslrial Accidents �� _� 0/%o//nvesligalions t — i 600 Washing Ion Strcet Boston, Mass- 02111 Workcrs' Compcn5a(ion Insurance Affidavit A A �N CA, 1 am a homcowncr performing all wort; mysclr. h nc .qt 1 am a sole propl ictor and have no one working in any capacity t am an employer providing wor 17S' compcn.sation for my employees working off this job. com '2n n- me address: c, R•: in It ncc c -- — ----- o l ICY 19 1 am a sole proprietor, general cc Lt"cfOr. or homeowner (c rc•It one) and have hired the contractors listed Wow viiia II��N the following workers' compertsatior, l'0lic<s- comp2ny name' L AT`.'J+i.121 address: r" ----- - —.--._ -- Dhonc P- sui�2ncc co. 2 in,juf]n<c (;p Ootu — —GuJ7 F's iturc to secure covcrsrc ■s « Quircd under SccGon 25A of MGL 152 eta kad to the imposition ofcnmivt ca2Jties of n fine up to 51,500.00 /od/or one re2rs' imprisonmeat •s eoerl as civil hcnaltic-s in the form of a STOP WORK ORDER and . fine ofSt00_tH! a a copy of this sta(c.ncnl maY be for.cardcd to the On CC of l c<daY rainzt mc. ! undertt2nd th,r +li . It` 1)tA for CO'crs-c .-cri5c2tion. / do hcr, c, i`i ndcr r 'nine and 1,i--1rinc n_/ I,; ryur)• that Ii,r intnrntntion /,rntddrd ahn,r is trite and rort-cri. e, f -m �- orGcial u>c o..lr du not ..-rile to lta,. —c ,lir Gc coml.l Ct<d Ac ri/r nr tn.. n oriici�l A j N,F _ l --------- 1•cr neit/liee nig q - < -- —._.D i)<,il4inr D<rr�ftnrrnc j O Ci-(Ck if ima.cdastc response is rcquircC OLiccnsirr ➢lea; d '_I"` lc CI m< "'s t7 Cr �: WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE Associated Industries of Massachusetts Mutual Insurance Company Burlington, Massachusetts (800) 876-2765 NCCI NO 26158 POLICY NO. VWC 6003170012004 ITEM PRIOR NO. I VWC 6003170012003 1. The Insured Joseph P Casey dba Control Building Associates Mailing Address: 200 Jefferson Rd Wilmington Ma 01887 (No. Street Town or City County State Zip Code ® Individual ❑ Partnership ❑ Corporation ❑ Other FEIN 02-6368222 Other workplaces not shown above: 2. The policy period is from 10104/2004 to 10/04/2005 12:01 a.m. standard 's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Le at aw of the states li ted here; MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ 500,000 policylimit Bodily Injury by Disease $ 100, 000 each employee C. Other States Insurance: See Endorsement WC 20 03 06 A D. This policy includes these endorsements and schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating plans. All information required below is subject to verification and change by audit. Classifications INTRA 420608 Premium Basis Rates Per$100EstimatedTotal :.deLE"iedmat Mnal of Mnual Remuneration Remuneration Premium SEE EXJNSION OF INFORMATION PAGE Minimum premium $ 500.00 Total Estimated Annual Premium $ 659.00 As indicated, interim adjustments of premium shall be made: El SemiAnnually ❑ Quarter) Deposit Premium $ 678.00 ® Annually Y El MA Assessment Chg. $394.00 x 4.9000% $19.00 This policy, including all endorsements, is hereby countersigned by 09/28/2004 GOV GOV KIND PLACING CLAIM NAME WGROUP Authorized Signature Date STATE CLASS AUDIT OFFICE OFFICE CHECK MA 5645 2 605 Byette Insurance Agency Inc 853 Main Street WC 00 00 01 A (11-88) Tewksbury, MA 01876 Includes copyrighted material of the National Council on Compensation Insurance, used with its permission. W7 CONTROL BUILDING ASSOCIATES CBA CONSTRUCTORS WILMINGTON, MASSACHUSETTS 01887 JOB SHEET NO. OF _ CALCULATED BY �/ ' �� DATE /1I CHECKED BY_1 / n DATE✓�T _ SCALE 1 (9-0 C PRODUCT 207 f�Y C PRODUCT 207 HOW TO USE THESE DESIGN CHARTS TO USE THE GRAVITY WALL CHARTS: 1. Choose unit. 2. Choose near vertical or 1" setback. This will put you on one of the tables. 3. Choose appropriate soil type on vertical axis. 4. Choose appropriate backslope on horizontal axis. 5. Intersection will indicate maximum allowable height. 6. If maximum allowable height is shorter than desired height, consider another gravity wall option or use the reinforced wall charts. 7. Repeat for each cross-section of wall. TO USE THE REINFORCED WALL CHARTS: 1. Choose desired unit. This will eliminate half of the reinforced wall charts. 2. Choose near vertical or 1" setback option. This will eliminate half of the remaining charts. 3. Choose the appropriate soil type. This will determine the appropriate page. 4. Choose Case 1, 2 or 3. 5. Choose the wall height of the cross-section you are working with. 6. Repeat this procedure for each cross-section of wall. These design charts should be used carefully. Please read the cover page of this section for further information. r. GRAVITY WALL CHARTS the information contained herein has been compiled by Keystone® Retaining Wall Systems, Inc. and to the best of our knowledge, accurately represents the Keystone product use in the applications which are illustrated. Final determination of the suit- ability for the use contemplated and its manner of use are the sole responsibility of the. user. Structural design and analysis shall be performed by a qualified engineer. PAGE: 1 of 2 KEYSTONE" Retaining Wall Systems • 4444 West 78th St. • Minneapolis, MN 55435 • (612)89;-1040 • (800)747-8971 • Fax(612)897-3858 STANDARD UNITS ONE INCH (25mm) SETBACK WALL (1" (25mm) min. setback per unit) STANDARD UNITS C®MPAC UNITS ]m) for all soil types. Assumed tb angles for earth pressure calculations )an Clay=261. Non critical structures with SF>1.5. No surcharge loadings vill reduce maximum wall heights. Sliding calculations assume a 6" (150mm) aterial. The information provided is for preliminary design use only. accepts no liability for the improper use of these tables. GRAVITY WALL CHARTS The information contained herein has been compiled by keystone® Retaining Fall Systems, Inc. and to the best of our knowledge, accurately represents the Keystone product use in the appitt trions which are illustrated. Final determination of the suit- ability for the use contemplated and its manner of use are the sole responsibility of the user. Structural design and analysis shall be performed by a qualified engineer. PAGE: 1 of 1 KEYSTONE® Retaining Wall Systems • 4444 West 78th St. • Minneapolis, MN 55435 • (612)897-1040 • (800)747.8971 • Fax(612)897-3858 KEYSTONE RETAINING WALL COMPONENTS Keystone Units Setback/Batter Wall Height Embedment Leveling Pad Finichar1 C,mrip Backslope or Surcharge Low Permeability Soil Retained Soil Zone Unit Core Fill Limit of Excavation Drainage Collection Pipe (if required) KEYSTONE GRAVITY WALL NOTES: • Wall Height (H) is the total height from top to bottom. • Minimum wall embedment is 6" (150mm) or Height/20. -Subsurface soils must be capable of supporting wall system. • Unit core fill is 3/4" (20mm) clean crushed stone. • Leveling pad is crushed stone base material. • All backfill materials are compacted to 95% max. density. • Finished grade must provide positive drainage. J" KEYSTONE. Designed for inner strength and outer beauty. With KEYSTONE, distinctive looks start at ground level. Graceful curves. Classic lines. Shadows and textures. Geometric patterns. No matter what the application, KEYSTONE Retaining Wall Systems is the preferred choice among architects, engineers, developers and contractors. You'll discover that the real beauty of KEYSTONE is its inner strength. KEYSTONE's patented interlocking design gives your walls rock -solid stability and per- formance. Its strong concrete rnodules and fiberglass pins cre- ate maintenance -free walls. KF1510NE protects the environ- ment by using non -corrosive, envi- ronrnentally safe materials. Installing a KEYSTONE Retaining Wall Svstem is fast and easy. Not to mention the economic benefits and cost-effective advantages of KEYSTONE. Add up the benefits. The beauty of natural stone, the durability of granite. easy installation... it's ail yours v,fth KEYSTONE. KEYSTONE Retaining Systems. The choice for: • Civil engineering • 'Vchi ecture I_anri-,rAninn • R�. • Compressive strength_ 3.1000 psi minimum General Information • Absorption r ate ...... .. 8%.; ,r!axirnum • Composition ............... Higt strength, high-density, zero -slump concrete Wall — - — -- -.-._ • Weight* ................... 9`5 lbs. ( 75 kg) Standard.Unit • Size* (Hx1NxD;! .... I...... 8"x IS',° x. ?i (.2032 x .4572 x 5461 m ) • Exposed face area ....... i sq. f . - 8"x i8' (.093 sq. ri - 2032 x .4572 m ) i 0 h Ri u J- am •® c CD r: :oma C.3v 'ate •: a= A O O C O L a E a " w a cpi CL (A E c w° c�4° v U w a a°' w w W 'C00 a°G u w WCL O CbO a°' w a � cA o z cn -0 cn u J- am O w a cm CD O •— m Q� di O .CO2RCD Q CD CD m m a ~� demo 3 � as e_�vo a CL Ca Co o c cc .ca as c Z CL C.3 y O c c cc COD Q 0 N W W cc W U) •® c CD r: :oma C.3v 'ate •: a= A O O C O L E a CL (A E c CD Ko E *74 WCL O 0 vs _ ! R3 O M ; c�O •� _m s y = caa _ W � N m _O a�� Co : ) cc co 0�oa :mof m • ca;;0 �:W�Z �. o coo cm '� a m WCL :gym= IS S CC W Cg, Z m ILIC W E C�C4 o C.3 a m��A.g = w .0 ` O H z a aMm F. O w a cm CD O •— m Q� di O .CO2RCD Q CD CD m m a ~� demo 3 � as e_�vo a CL Ca Co o c cc .ca as c Z CL C.3 y O c c cc COD Q 0 N W W cc W U) Date ......-..........d TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that ... ..... ..... . .................................................................... has permission to perform .................................................. ............................... ....... ........... wiring in the building of ........ . ........ at I . . . .... North Andover, M s. Fee. ................... Lic. No ....................... .. . .. 4. ...................... ELECTRICAL INSPECTOR Check # 1-1,f �?/e P 5460 THFCOAMMONWFALTHOFMASSACHUSETTS Office Use only DEPAR7A1 VTOFPUBUCSAFM Permit No. BOARDOFFMPREVEMONRBGUlAHONS5raM I20 Occupancy & Fees Checked APPLICAHONFOR PERMIT TO P"'OELE=CALWORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACVqAbed &SSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 9-13 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work below. Location (Street & Number) a Owner or Tenant :l'c,E Cgsey Owner's Address Sb�e Is this permit in conjunction with a building permit: Yes No a (Check Appropriate Box) Purpose of Building IVew G4h$4rVtA%, ', Utility Authorization No. Existing Service AmpsVolts Overhead Underground 1:3 No. of Meters New Serviceao� AmpsI1/ate olts Overhead Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Com" P ti,r, h , Oi urw S,nS /e P"M, ly No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA round around 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 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 Connections a No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER• hlalm=Cowrage Pll "1othemqukrrf9ofMmwhu sGalaalIaws Ifxmmbr i*dvafidpoofofSWWlDdXOlfiX YES I CdVddTdrEM BOND o MER o ViaudcroShatt `�''r3 I htspac�onDa�Rec�d FIRMNAMEE PMW p� flet dpwft YES ® NO U If)mha%edx kedYES,pleaseindicatedleM acfcay Fby F-ViralimD* Bstir %*dValeofEkcft talWade $ Final LimmNo. Lic acre � ,�• v Signe LioatseNo Busir=Td1%. 97ir 851 31-1gS Alt Tel No. X78 99y G�aa OWNER'SP4SURANCEWAIVER;IamawaethattheLio wdotsnothavetheirmaaoacDNw,WorZalbsUtalegtrvW tasIegtluedbyNlassodx>MGaxralLaws andtha nysiglomcnduspemt*plicMmwanesdlisOW'K rxst (Please check one) Owner 1:3 Agent M Telephone No. PERMIT FEE $ signature of Owner or Agent i1 h !" 1 '7 E_- . � _ �' f Date . /7— 1-5-- 0 7 ... .............................. f NOR7p , 3r��'�`�� •"! "°oma TOWN OF NORTH ANDOVER PERMIT FOR WIRING • i r This certifies that . t C% P` 4 b ` K' N............. ..................................... .............. has permission to perform .......... � �?..� u �.. ............................. . .............................. wiring in the building of �� S ... . ................................................................................ 1, f`N �' 'C .......... North Andbver Mass. ............. ............... t t Fee.:A57. Lic. No.............. .................... ELECTRICALINSPEGCOR Check # q 8 5342 THE COMMONWEALTHOFMASSACHUSETIS Office Use ordy,� DEPARTNIENTOFPUBLICS4MY ^ Permit No. BOARDOFFIREPREVE M ONREGUTA7YONS527CM12W Occupancy &Fees Checked ' APPLICATTONFOR PERMIT TO PERFORM E }' =CAL 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 ;�11-5- 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) 6,,�/77 Owner or Tenant Owner's Address W ��i�J�'✓ �� J J2)e7 C9S Is this permit in conjunction with a building permit: / Yes � No � (Check Appropriate Box) Purpose of Building /04–w Utility Authorization No. Existing Service Amps / Volts Overhead Underground No. of Meters New Service Z60 Amps /Zo /ZP�D Volts Overhead ® Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs _ LiariseNo No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators 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 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 Connections No. of Water Heaters KW No. of No. of Si ns Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER• i hmrtat`�Coverage. Ptusttanttothetagtmetrtetrts�Galaaltaws IhawawnMl nb&ykmancePbhcyin hxk gComplefeCoNe ageoritssubstai eaq riv� YES NO IbawWmmtedvWidproofofsaumtotheOffioe. YES ( lfyvuhawchododYES, plea9eit the WofcDwrageby dleddngtheafbox. INSURANCE BOND r7 OTHER (Pease Spedy) WodctoStatt h>SpectionDaleRetd MMNAME P PgJ�Y1�5'06141^ jio�Signature — 17v Uw1NhKJ1N6UKAANL:CwAtvmiamawaretr ineL=w(JOPSmynai and L my sigttalute ort this permit appheation waives this tegtmuricitt (Please check one) Owner M Agent signature or Owner or Agent EslimaldValueofEbcticalWoik $ Rough Final LiociwNo. _ LiariseNo BusalessTel. No. Alt Tel No. cowaage orits substantial equivalent as mg med by MasadRiseM Cvnaal Laws Telephone No. PERMIT FEE $ y