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HomeMy WebLinkAboutMiscellaneous - 22 WOODLEA ROAD 4/30/2018 (2)N 0 4 �, 0 /J I Location No. Date �~ Q :f t i SORT►, TOWN OR NORTH ANDOVER Oft.•° ;•'�q.0 ',. i • OL .. 9 Certificate of Occupancy $ _ ,SSACNUSEt� Building/Frame Permit Fee $ `S Foundation Permit Fee $ Other Permit Fee $ TOTAL $ S " Check /F-3 V 1 4 1 6 5 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING /q r / DATE ISSUED: c� BUILDING PERMIT NUMBER: e-1 q SIGNATURE: 10A C Building Commissioner/lMictor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: Zz 4d 1.2 Assessors Map and Parcel Number: C /gp— Map Number Parcel Number "06veA 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard ReqWred Provide R 'red Provided Required Provided 1.7 Water Supply M.G.L.C.40. 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 OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record �/ B y�ywo- b !�/OLM � l/% 1(� ✓d/C �P� Z, z- f/✓Oa d� �e, Name (Print) ' Address for Service : 353-49� � Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES .,I Licensed Construction Supervisor: licensed Construction Supervisor: �� i✓kJY� fit, ✓vib�/�/�'b � a 1 � U � b /U Addr Signature Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone c L X .--i -- , i T SECTION 4 - WORKERS COMPENSATION (NLG.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. Si ned affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Desch tion of Proposed Work check all applicable 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+I'I+ Com leted by permit a licant,. OUSE OILY . 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 v' TZ 0 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Own 1 /Authorized Agent subject property Hereby authorize to act on My beh i al natters relative to work authorized by this building permit application. Si e of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Signature of Own er/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 ST 2 ND 3 kD 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 FORM - _U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all -necessary approval / permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements.. APPLICANT oClVouQ 14 v4f.5 42 3- 0SJ_ 5 ?'Z 9' ASSESSORS MAP NUMBER d LOT NUMBER SUBDIVISIONZXboo&, U & tz LOT NUMBER STREET 1A.)ao1,C Leser lk,64 STREET NUMBER 2 Z- ....■....■..............■.......■.........■■..■.....................■.... . OFFICIAL USE ONLY l........................................................................... IONS OF TOWN AGENTS .:... ... .. . .... ...................................................... DATE APPROVED O ONSERV ON AADMINISTRATOR j I `DATE REJECTEED CnAAk4Ftv-M TOWN PLANNER COMMENTS DATE APPROVED DATE REJECTED r07MI-MM01110001 FOOD INSPECTOR - HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR - HEALTH DATE REJECTED COMMENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE -REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 DEBRIS DISPOSAL FORM NORTfi 01�i�eo C CKKHCwKM IV Te D �9SSgcNus���y .rte' t' ; ` ►. +" In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in /at: Facility location Signature of Applicant 9—/W/V Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. F, A O • M f� o v x o w � C/)a u� cn o U � n w x o c� To x U co a w ® W as x o w c w" AG o W a w x o c4 CD w x z � • x o pG —co w z w E rA z cn v o C/) O U C/) O U C/) 1--�1 6 0 O L CL O CO) ® C cm ca CD _ I C C y C m m 0 CD CD O� OD CDQ CL cc 0 CL ® i 3: C CX CD ca Rca Z t5 +� CL 0 CD CD CL c� CO) c_ C .� _O CA LLI 0 U) LLJ V) crW w W U) CD • A o CD C y' O C ' � O vV � nc eo m c v'� E��J" r.+ C m O = V �' o a4*0 3 Ems_ o m Cyt. ftA OO V �. u cp m c� w. E � N W O O o 03� N m fib N 04 Vj* V ' c o0 -� 0 V h c s ea �E N A COD amo c p � y.. N wmo m OLqi 's O evo Z : Q�- O d0 C = CLD - o co N 'o m o m COO W o �..� D z .y ev c L=U0, .`m ar : ' C. Z O v m Ma H vs m m ` N ^� O A a 2 a=mF. 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LL F- o Q_ <t w o z M o a W H L V w Z .- N M d �.- zo W -0� Nm� �Ma U u Lo fi a �y5�,1T8 � a •( � M � n � O X r �wNOa v; � v C 11 J 'O o (01 00 N N l� NQ U- 0) 0) g 04 �. o Z N 0 � O L` cD � \ F-- 0 N 03SOd0itiJd n z to O � NOIly0N00d x —I ►� lll(18"Sb w o / O F- O 3' o J o Qi 22 8 z �, in N zp ti/ 0 = z � o �b0 �os , WQ F- a . z w o w 0 LA- < � Dw V)< >w Date. 41� ~/' . a e - N2 4462 •� -:��, TOWN OF NORTH ANDOVER a ° PERMIT FOR PLUMBING 'Q �i_'• Teo 'A`,9 This certifies that /.?�!�)J- .... /?') A/ ...................... . has permission to perform ... r:.�4.�:1i ................ plumbing in the buildings of .. . S w �.'.... eco......... . at ...a .1.. Lt, R h Andover, Mass. Fee f � .`... Lic. No. �.... 1......... ; 1. .T. ........ . �Y� PLUMBING INSPECTOR Check # � � WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO D UM SING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date 1,9-1;2 —0d Building Location Permit # /�'--- Amount L Type of Occupancy 5,6y6l `/� , IY New r Renovation F1 Replacement E] Plans Submitted Yes [ No rl (Print or type)/ Check one: Installing Company Name '6WS I�/iJ/rlk)t/G 1 Corp. Address rk �S/fre 97- • Partner RFirtn/Co. Name of.Licensed Plumber.1: s iJ�,,oa- Insurance Coverage: Indicate the type of insucanc coverage by checking the appropriate box: Liability insurance policyC Other type of indemnityEl Bond Certificate 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 Signature Owner Agent E] 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 application will be in compliance with all pertinent provisions of the Mass c usetts tate Plumbing Spde and Chapter 142 of the General Laws. By: Nignall1re 01 ZledffeTFIUM Der Type of Plumbing License Title City/Town License iNuinoer Master Journeyman APPROVED (OFFICE USE ONLY :1 1.1:04 IRMO WMMMMMMMMMMMMMMMMMMMM (Print or type)/ Check one: Installing Company Name '6WS I�/iJ/rlk)t/G 1 Corp. Address rk �S/fre 97- • Partner RFirtn/Co. Name of.Licensed Plumber.1: s iJ�,,oa- Insurance Coverage: Indicate the type of insucanc coverage by checking the appropriate box: Liability insurance policyC Other type of indemnityEl Bond Certificate 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 Signature Owner Agent E] 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 application will be in compliance with all pertinent provisions of the Mass c usetts tate Plumbing Spde and Chapter 142 of the General Laws. By: Nignall1re 01 ZledffeTFIUM Der Type of Plumbing License Title City/Town License iNuinoer Master Journeyman APPROVED (OFFICE USE ONLY 3 4 5 6 Date. � �1.......... . NORTH , TOWN OF NORTH ANDOVER py .ao ,atiOL p PERMIT FOR GAS INSTALLATION This certifies that .,..�.�%... S 12--1 ... .......... . has permission for gas installation ... in the buildings of .. . G: ......... ............... at �. 1. ".�: �.��y....�.�: r ... • North Andover, Mass. Fee. �� Lic. No. `' .. � . ? .. .1.. 2�-- ! , .... . 0AS INSPECTOR s WHITE: Applicant CANARY: Building Dept. PINK: Treasurer r MASSACHUSETTS UNIFORM APPLICATON FOR PERNYITT TO DO (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations Owner's Name New LJ Renovation ❑ Replacement ❑ FITTING p / Permit # ��~G ` Amount S "?f� Plans Submitted ❑ (Print or type Check one: Certificat Installing Company Name �/�PS ldy„�,3y� ` �� t' Corp. Address • �� S% ❑ Partner. l0% /)/Ir1rU Business Telephone fp7,o Qf9 ^-� yv/ ❑ Firm/Co- Name of Licensed Plumber or Gas Fitter2W/4f INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No ❑ If you have checked ves• please indicate the type coverage by checking the appropriate box. 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. Check one: ❑ Sienature 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 per tormed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By: Title CiryiTown APPROVED (oFFICH use om.Y) Signature of Licensed Plumber Or Gas Fitter Plumber 992 ❑ Gas Fitter tcense iNumoer r `� Nlaster ❑ Journeyman Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 NORTH �O�st�eo i6�1r0 OL Q ~ : ear APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS w�d� LOT NUMBER l/ SUBDIVISIONpI�' /�� DATE REQUEST FILED _34) DATE READY FOR INSPECTION FIVE (5) 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 CTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE�� OFFICIAL USE ONLY ROUTING CONSERVATION PLANNING D.P.W. — WATER METER D.P.W. MUST INDICATE THAT DATE C 5 O DATE O Nl 60 DATEa ATER METER HAS BEEN INSTALLED PRIOR TM-INSPECTI N REQUEST DATE. SIGNATURE / DPW AUTHORIZATION CERTIFICATE OF USE. &OCCUPANCY Building Permit Number 17"10 0 THIS THE BUILDING LOCATED ON Date V 4�0-296 THAT j y MAY BE OCCUPIED AS /��� f' i1 l y ��� �l P i l A0 91LIN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TOs�d� ��jj,�, 4 ADDRESS q 1 �K� <S`7� WWM fT BuildingInspector O EM4 d WD CIS ►, i`��C p +.r C v CL. �c • O v * c O �o 6 • � x dd � ": ,r � CD CD �_ 4 s ..� P 1N P7 y dommo C 7_ O c w cm J i C a CD h � 3 = cm C C � O 2 �'� m O � H � H : m m O aC.i O Q =-COD �� -o c �..!� C Ha O mss ca O 9 • r ��; C O O C 0 CL ID I CD H aO+ dJ O w ~ m LLA t H . to a t to C Z • v m o 10 CM m c g O ti a. 4D � 10 _ ` ti•� O a.- Oo f O E • 0 s Z � Q C D W cm CA CMe CD CD•� '— m m L- H= 3�CD � G O C Q CDd M: c4 Q ca VCc J •� CO3Z CD CD CL C.2 H cc C C C cc y C2 O l'{7 w �V�y O z �,.✓' w U V N `� U ^ �p v U w w o r� V) V) WD CIS ►, i`��C p +.r C v CL. �c • O v * c O �o 6 • � x dd � ": ,r � CD CD �_ 4 s ..� P 1N P7 y dommo C 7_ O c w cm J i C a CD h � 3 = cm C C � O 2 �'� m O � H � H : m m O aC.i O Q =-COD �� -o c �..!� C Ha O mss ca O 9 • r ��; C O O C 0 CL ID I CD H aO+ dJ O w ~ m LLA t H . to a t to C Z • v m o 10 CM m c g O ti a. 4D � 10 _ ` ti•� O a.- Oo f O E • 0 s Z � Q C D W cm CA CMe CD CD•� '— m m L- H= 3�CD � G O C Q CDd M: c4 Q ca VCc J •� CO3Z CD CD CL C.2 H cc C C C cc y C2 Date..... /./. 7/w. TOWN OF NORTH ANDOVER PERMIT FOR WIRING 7- -- This certifies that .... 1..... R.. /. 6. t) ...... f, 4n 5�. ..................... has permission to perform ...... YOM-() ..................................... wiring in the building of I.c .............................. at North Zdo,....(Mass. sZ F Fee.kv.�A . ..... ......... Lic. Pro. ......... E;11�rll Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer ThEC0AW0AW1E4L77I0 A (71USEM Office Use only DEPARTARI NTOFPUBLIC&*= Permit No.�- BOAROOFFMPREVEMOIVREGUL4770AS527C$flt 12.00 Occupancy & Fees Checked i A1'1-LJ(-ATTONFOR1-L1VVU1 1 U1- RFORIVIEL L.11 L -AL WO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 �y.�y (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date e Town of North Andover The undersigned applies for a permit to perform the electrical work described Location (Street & Number) Owner or Tenant 7�Q Owner's Address ` S Is this permit in conjunction with a building Purpose of Building Existing Service New Service it. Yes 1ZT No To the Inspector of Wires: AP PARCEL (Check Appropriate Box) J Utility Authorization No. ew eq1/ Amps / Volts Overhead Underground No. of Meters Amps �%/ `'11 olts Overhead Underground ®/ No. of Meters Numhcr of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. 9f Lighting Outlets -o No. of Hot Tubs No. of Transformers Total `.5 KVA No. of Lighting Fixtures Swimming Pool Above BelowGenerators KVA ground p ground No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No, of Switch Outlets ..7 No. of Gas Bumcra 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 Cormcctions No.lof Water Heaters KW No. of No. of R Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER• • Ir: :�•, 11 1 �� 1 •" •01 1 ire , 11 ! I•,:1" t1 •: .IIA • r :✓..•:" •. 1 •:11 •1: :• 1 i I I• 111':• :I• • ••' ••" - 1. 1 �IIY . • • :61:0 ..::.- 1 •I HIS 1 •" •' •• • • :1 •I .! 1 - Wciktc, &mt Eshm�Vahxdt 1aZcal Wd k $ bpxftcnD*Reqxsled Ra# I Final /e e Lioamilb Lioa�eNgo oK t ,ate A1tTeLNa eg;0- ' OWNER'SINSURANCEWAIVER;Iarnaw&et-&&L—,wdoesrothav+etheiaaaar=am%WcritsahtrtalegriAutasmgxedbyMandimmC*rIaalL3ws ' pit (Please check one) Owner Agent Telephone No. PERMIT FEE $ �/ 3C)d tgnature ot Uwner or 7gent