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HomeMy WebLinkAboutMiscellaneous - 2230 TURNPIKE STREET 4/30/2018I A Date...... 2 ... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .... ............................................. has permission to perform....... .. . ............ .. wiring in the building of ......................................... at North Andover, Mass. .................. Fee-. .............. Lic. Noiq-iG-/ ............ �f LE ICAL INSPE Check 4 8274 1 N Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. �� Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/051 leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7/28/2008 City or Town of. N. Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 2230 Turnpike Street Owner or Tenant Aboobacker Thanikkal Telephone No. 978-687-2672 Owner's Address same as above Is this permit in conjunction with a building permit? Purpose of Building Residential Yes ❑ No ® (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Add 2 Circuits on First Floor Completion of the following table may be waived by the Inspector of Wires No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In -[ED]. rnd. rnd. o mergency Lighting Baotte Units No. of Receptacle Outlets 2 No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: ...................................................... KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters No. of No. o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or E uivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. 4 Estimated Value of Electrical Work: $275.00 (When required by municipal policy.) Work to Start: 8/1/2008 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE E BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Folsetter Electric, Inc. J 147 LIC. NO.: 20421A Licensee: Signature fir/ LIC. NO.: (If applicable, enter "exempt" in the license number line) Bus. Tel. No.:- 978-658-9975 Address: 30 Parker Avenue, Tewksbury, MA 01876 Alt. Tel. No.: 978-387-9709 *Security System Contractor License required for this work; if applicable, enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE. $ 35.00 Signature Telephone No. The Commonwealth of Massachusetts Department ofIndustrial Accidents J Q ffwe of Investigations 600 Washington Street' , Boston, MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers _ Applicant Information Please Print Legibly Name (Business/Organization/individual): ro 4i�-E^GT�IC Address: 30 P4 �.P Are you an employer? Check the aplin 1.191 am a employer with & employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partner- ship and have no employees woding for me in any capacity. [No worbers' comp. insurance ret(tired.] ` �. ❑ I am ahomeowner doing all work my, self. [No workers' comp. insurance required.] t Phone #: riate boa: . 4. 0 1 am a general 'contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.* 5. ❑ We are a corporation and its officers have a orcised their right of exemption per MGL c. 152, §1(4), and we have no employees. [No workers' comp. insurance required.] la SR' - 7Y70 Type of project (required): 6. ❑ Nen construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition. 10 jaElectrical repairs or additions 11.❑ Plumbing repairs or additions 12:❑ Roof repairs 13.❑ Other *Any applicant that checks box M must also fill out the section below snowing mea woncers cumpcnMuv.. PUMIJI ..u... —w— t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. if the sub -contractors have employees; they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 1`?, ,0-77 /it%Sy A,#'C%:V— .y — Policy # or Self -.ins. Lic. #: O Fns. 2 Expiration Date: -- ! D Job Site Address: 1.L / DG4'T70A1S l7✓ City/Slate/Zip: Al. 4/x&wl- A14 Ol PS/S Attach a copy of the workers' compensation policy declaration page (showing the policy number,and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up.to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator: Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify. under the ins and penahies of perjury that the information provided &cove f� tMe and correct 7.2,8% C%mMfileta' � p' , Pi,�„P #. 9-72' - 6.45'90- 99 75 Official use only. Do not unite in tltis area, to be completed by city or torn official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. Cityfrown Clerk, :t. Electrical Inspector S. Plumbing Inspector 6. Other ; Contact Person: Phone M. Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity; employing employees. However the owner of a dwelling househaviag ndt mM thanthree ^9pWVepWaad.who�esades therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work'on such dwelling house or on the grounds or building appurtenant thereto shall not beca_pS�,of su , _bmploy�negt be -.#p! �d to. �i� an employer." MGL chapter' M,t§TSG(61 A[so s4fes.th_at L' 6yery state or, 1901 lignsipg asge�cy sh it v of :the issuance or renewal of a license or permit to operate a business or to construct buildings'm i e commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town thatthe application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. k: . City or Town Officials Pleasebe sure that the affidavit is complete and printeit' grlfly.. The Depa%tin�e�t'lia�� fiovided a space at the bottom of the affidavit16T you,to fill out in the event the Office of Investigativris has.,t uontpct,yoiyegarding the applicant. Please lie sure to'fill in the permit/license'number which wili be used as a refe de-numbef." In addition, im applicant y ';that mist;submit-%V4iglb.Termit/licenseaapplications in any given ygar, nee4 onsubmit }one affidavit -indicating current policy information (if necessary) and under "Job Site Address" the ipplicant should ivi rte all locafion§ in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant•as proof that a valid affidavit is'on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is'obtaining a license or permit not related to any business or commercial venture (i.e. a dog1icense or permit to bum leaves etc.) said person is NOT required to complete this affidavit. ; The Office of Investigations would like to thank you in advance for your cooperation and should you have any'questions,.. please do not hesitate to give us a call. The Department's address;telepkone and fax number: The Commonwealth of Massachug&t Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. '# 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.ma,ss.gov/dia N tZ m Date 2F.....o.�. poRTPI Of `1O ,e 1'�'O a� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that``- t..!..« .:.....s:'.................................................... has permission to perform ......�......�.....:........F-............................................. wiring in the buildingo ` ate ............................................... ,North Andover Mass. r ��S Fee .. �......... Lic. No`���? ...........: ...:. ....ELECTRICTOR Check #�Q 8335 Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No.� Occupancy and Fee CheckedS p o� [Rev. 1/071 leave blank APPLICATION FOR PERMIT TO PERFORM EL All work to be performed in accordance with the Massachusetts Electrical Code (1 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: "I City or Town of. NORTH ANDOVER To the I pe By this application the undersigned gives notice of his or her intention to perfonn Jba elect Location (Street & Number) Z 3.0 Owner or Tenant Owner's Address ECTRICAL WORK � ), 527 CMR 12.00 of Wires: work described below Telephone No. Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building ./' l/�W 5�,, /7fcoM_ 6©f Utility Authorization No. Existing Service Amps 119V / a%dVolts Overhead ❑ Und rd g ❑ No. of Meters New Service Amps / Volts Overhead ❑ Und rd g ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Cmmnlotin" nithp fnlln,.:.,o t.,R1., ., . 1 No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans y.... ..... w.. y...1 .;;Kwwr v rr tr cJ. tal T TransNo.formers Trsformers KVA No. of Luminaire Outlets a- No. of Hot Tubs Generators KVA No. of LuminairesSwimming Pool Above ❑ In- E] rnd. rnd. No. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches f! No. of Gas Burners No. of Detection and Dlevices No. of Ranges TotInitiatin No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: 1.Number .Tons KW .............. No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local. Municipal ❑ Other Connection No. of Dryers No. of Water Imo' Heaters Heating Appliances Imo' No. of No. of Si s Ballasts Sectio. of Systems:* Devices or Equivalent Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME:4�C -e •� ' eG r -f C-- LIC. NO.: Licensee: J9Sav1 <,-a r 3e- Signature �, LIC. NO.: 3 / (If applicable, tenum r "exempt " in the lice se ber li e.) Bus. Tel. No.: t;1V ��/'G/ P-16Address: a C>c� cG7¢ ac' Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No.PFFEE: .o �iwt cc.� (y -rt %- r(_o S The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: t4"di _/h%4. ®r+,/ Phone #: -el, sq — d(a� Are you an employer? Check the appropriate Vox: 1 L ❑ I am a employer with 4. ❑ I am a general contractor and I noyees (full and/or part-time).* 2.2' I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t have hired the sub -contractors Iisted on the attached sheet. I These sub -contractors have workers' comp. insurance. 5. ❑ We are a corporation and its officers have exercised their right of exemption per *MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions I1.❑ Plumbing repairs or additions 12.❑ Roof repairs 13. ❑ Other .yny apptIcant mat cnecxs oox ff i must also nil out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). ,Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of.a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine hof up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of jnvestigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. 7-7 �- Official use only. Do not write in this area, to be completed by city or town official, City or Town: Permit/License # Issuing Authority (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: 0 Date !' 6 ' 119 Petit 62 /L Building Location %L,�r�' 7'.) .% :er'sName e�- %ill aIVP 14 Type of Occupar.y ' New Renovation Replacerent C PlansS b ut' ed Yes ❑ No ❑ �• N L H L � A L N � tC L C n of C C N C y C in CS. O G C C y r FIXTURES c c C C N C y C in CS. O G C C y r C L 1 C IST FLOOR :.::.COR 3RD FLOOR I I I I I I I 57r! r. FLOOR 7-1'H FLCOR I FLOOR Installing Company Name_ EA— Ce FA (2 �S i- .SGh Address . JL) 10 HHr'1 PbAL) 1 8 f l bg l r I` -i13- 016-7—t Business Telephon Name of Licensed Check One: Corporation ❑ partnership ❑ Firm/Co. Certificate INSURANCE COVERAGE: I have c-arrent liability insurance policy or its substantial equivalent which meets the requirements of MGL CIL 142. Yes No ❑ L° you have ch =please indicate the type of coverage by che6dng the appropriate box A liability Insurance policy Other type of indemnity ❑ Bond ❑ Owner's I.-tsurance Waiver. Ilam aware that the license 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 Age—it Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above avvlication.are true and accurate to the best of my xnowledge and that all plumbing work and installations performed under the permit issued i;application a in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Charter 142 of the General taws. By - Signature of Licensed umber Title Type of License: Master journeyman ❑ City/Town License Numbe _ %� sV, Its Date.. ....... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that A .................. .:........ . has permission to perform ... ................... . plumbing in the buildings of ................. at .. '.' ? :.. ......................... .North Andover, Mass. Fee...' ..F... Lic. No ........... .............................. PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File 0 ;n+s\ Oftice Use Only 01 4r Permit No. �epartmLent if PUbl.it gAfEtU Occupancy &Fee Checked �� U (JK_3/90 (leave blank) 3 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All .vork to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 1 / _ 5;3 (X, or Town of NORTH ANDOV •R To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) Owner or Tenant cZ ` Owners Address Is this permit in conjunction with building permit: Yes �! No � f eck Appropriate Box) Purcose of BulidinO e /11 /i' `= Utility Authorization No. ExistinO service Amps _J Volts Overhead 'I Undgrnd No. of Meters New Service 1A 'r" Amps Z2 -0 —J 2 k-' VOIts Overhead '�Undgrnd iL- No. of Meters l Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of L:cn;inc Out:ets No. of Hot Tubs I Swimming Pool No, of L!cnung Fixtures I 9 Total No. of Transformers KVA Above-- In- I— i grnd. ` grnd. '_ Generators KVA No. of Receotac.e Outlets I No. of Oil Burners I No. of Emergency Lighting . Battery Units No. of Gas Burners FIRE ALARMS No. of Zones No. of Switch Outlets Total No. of Detection and No. of Ranges No. of Air Cond. tons Initiating Devices Heat Total Total No. of Disposals � No.of Pumps Tons KW No. of Sounding Devices No. of Self Contained Soace/Area Heating KW Detection/Sounding Devices No. ct Dism::asners Heating Devices KW — Municipal Other 77 Locai I i Connection — No. of Dryers i No. of No. of Low Voltage No, of Water Heaters KW I Sians Ballasts Wiring No. Hvcro t.lassace Tubs No. of Motors Total HP OTHER. INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current LiaoJity Insurance Policy including Comoiete tions Coverage or its substantial eauivaient. YES _ NO - nave sucmrttee valid proof of same to the Office. YES NO If you have checked YES. please indicate the type of coverage by cheCKing- the aocroorlate box. INSURANCE ND = OTHER - (Please Specify) (ExDiration Date) Estimates Value of Electrical Work S Start — /3 -% Inspection Date Recuestee: Rough z —�� '�VgrK i0 tart Sioneo uncer the Penalties of perjury: _ y� FIRM NAME v LIC. NO. y Signatur LIC. NO,; t 1� g � ? censee 2/lj5/ Bus. Tel. No. 5 �� 'K 9_7 — o. e Alt. Tel. No. Address OWNERS INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial egurvaient as re- cuirec by 'Aassacnusetts General Laws. and that my signature on this permit application waives this requirement. Owner Agent (P!ease cnecK one) ` 3J�, d) Telephone No. PERMIT FEE S Sionature of Owner or Adent) '05�6� d Date ...... ..... e../25 °„`° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING % 8 This certifies that ....... �O ...`''' �!.' .k .. { : 1%................................................. °' i has permission to perform ......... L wiring in the building of .....-c`.. Vit_ . ....... }.................. at ......... r� l f" �, , .....::�..:.... �............................................ .North Andover, Mass. Fee ...�3A. .�... Lic. No.: ..3 ............. .E.............................................. LECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File Location Z2SO t vet-�Ptxc . �T No. Date Z t dqS� - A �oRTM TOWN OF NORTH ANDOVERcL o,�1tio � a Certificate of -occupancy $ .. + : Building/Frame Permit Fee $ sA�N�SEc� Foundation Permit Fee $ Other Permit Fee $01 _ ... Sewer Connection Fee $ _ Water Connection Fee $ TOTAL $ ' € Building Inspector 7,0 7918 Div. Public Works ee CP- PeQmiC &,Ro —400 PER3flT NO. !APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MIP 4.40. I LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK :PAGE — ZONE i? SUB DIV. LOT NO. CDC LOCATION ►VF NP� K� �� PURPOSE OF BUILDING �',t, ,n)t� OWNER'S NAME 'J`t,�ill✓S NO. OF STORIES z SIZE OWNER'S ADDRESS BASEMENT OR SLAB L. ..zc3 G�3RD 1 •, ARCHITECT'S NAME -_ SIZE OF FLOOR TIMBERS 1ST ZIXLO 2ND �j11V Gi BUILDER'S NAME �y SPAN DISTANCE TO NEARESTBUILDING So' DIMENSIONS OF SILLS POSTS�7� V1J DISTANCE FROM STREET y"�.� PL7 DISTANCE FROM LOT LINES-CSIDES REAR GIRDERS AREA OF LOT l `/IA 1 sOJ`+ FRONTAGE �y _ vV HEIGHT OF FOUNDATION C� i THICKNESS ti QIP O IS BUILDING NEW i SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND S6-I'o - WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 7 IS BUILDING CONNECTED TO TOWN WATER 'I s c> �� BOARD OF APPEALS ACTION. IF AN '��a—e G30 IS BUILDING CONNECTED TO TOWN SEWER t, 1 tl - I I IS BUILDING CONNECTED TO NATURAL GAS LINE '4 INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE kILED 1 I CS\C4. �; SI TURE OF OW AUTHORIZED AGENT FEE PERMIT GRANTED 19� 3 PROPERTY INFORMATION LAND COST S-8 _ EST. BLDG. COST 1-1 EST. BLDG. COST PER SQ. FT. `. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BUILDING INSPECTOR OWNER TEL # S�g T CONTR. TEL. # CONTR. LIC. # `ct9 z H.I.C. # VERMIT FOR FRAME/BUILDING Ugh i6c� CIO DATE: 3 ` `�' FEE PAID: Lt DUE E PERMIT $1 � t � I BUILDING RECORD 1 OCCUPANCY. " 12 SINGLE FAMILY sioRIES THIS SECTION MUST SHOW EXACT DIMENSIONS OFLOT AND:DISTANCE FROM MULTi. FAMILY oFFIEEs- LOT LINES AND EXACT DIMENSIONS OF BUILDINGS, WITH PORCHES, GA- APARTMENTS,-.•,. :. RAGES, ETC. SUPERIMPOSED, THIS REPLACES PLOT. PLAN. - - CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE d 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDw D _ PIERS _ PLASTER DRY WALL 3 BASEMENT' UNFIN. AREA FULL FIN. BM'TAREA _ FIN. ATTIC AREA _ NO B M T FIRE PLACES _ HEAD ROOM MODERN, KITCHEN 4 WALLS I 9,,;, FLOORS- CLAPBOARDS..' CONCRETE B 1 2 3 �_ DROP SIDING WOOD SHINGLES 'EARTH ASPHALT SIDING HARDW D _ ASBESTOS SIDING _ COMMCN _ VERT. SIDING ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY- ATTIC STRS. 8 FLOOR _ BRICK ON FRAME -'-' CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR POOR ADEQUATE NONE I-] 5 ROOF 10 PLUMBING GABLEHIP GAMBREL MANSARD BATH (3 FIX.) TOILET RM. 12 FIX.) _ FLAT I SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES - TILE FLOOR t '.TILE DADO 6FRAMING II 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. & COLS. _ HOT W'T R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS ;-_;;,>• - GAS _- 7 NO. OF ROOMS B'M'T 2nd _ OIL ELECTRIC44 {++ Ist 13rd I NO HEATING w 1 w x A p W � o fi a cn � O v z z -� o w °�° E U ti tL � � z z z G ° m = G p z tdj w m v cn _ 1. w w .t :3 ° —ccu A w c z .: Q -0 GC CD � c o C5 co Q Lai jf L co M LW v V :ear � CD ® � CD o O "a C v w to y a. ma y�j C!� � p � z f°C- O �I! L o � cli � ( w Cm ca2 CO — ccE C� �� w ( C) CD u M Co z c co s a—' t= o mc E i.., v L co N . n G d ce .40 �4.4 cc CD CA U = Q CD L J� z o m N2 ,�. Z co z Q QCT o v y V y O L ' Z 0 0 t- ¢ `^^ i m c co C. 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APa O lq 8t, I;cz- T-ealt se- . lbforu - O; rid -bey�. 1�2eS Weil' -out, -bo -t-b Ecogdnnlc V"Swi "-t smut' ausk& * 0 54 205c) Sr— Lout u (o + ©f- l°�C(S (026, 6.AR- 277110 S r 144 - � - \ � 1. \ _ 1 ... � ♦ �(. - -. (�� .. �.y,. �1�+C^,r �-`�.2. ( `�. •tib 1"'�tjab- �:\ ( Y`( -6. � �` t .y .i� � `( (� ��„ \ (? �( �< Ile FORM U TOWN OF NORTH ANDOVER LOT RELEASE FORM SUBDIVISION ASSESSORS MAP1 C_ SUBDIVISION LOT(S) L 6 i (, PERMANENT ADDRESS (ASSIGNED BY D.P.W. STREET -1_,1d�n, ;T fi' l y APPLICANT7 / ���' T/<,;r� ► PHONE DATE OF APPLICATION n. 3 0 �'L ' !Yo —Inn/�!� (�i � l TOWN USE BELOW -'1:111SLINE � PLANNING BOARD DA'L'E APPROVED TO N PLANNER DATE REJECTED CONSERVATION COMMISSION _1Z Iok. 1�31��5 UATE APPROVED CONSERVATION ADMIN. DATE REJECTED BOARD OF HEALTH / i�LLIH DA'I'S APPROVED SANI ARIAN llAIE REJECTED i DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT2 i SEWER/WATER CONNECTIONS Pv7 lig ,j>;>� Lxi��;�,� (;1L `—j•�%(� FIRE DEPT. JJLLi-3t- ' S l RECEIVED BY BUILDING INSPECTION DATE /1'I /-�ry2c I E o'er , 19 9,z This form shall be signed by the agents of the Planning and health Boards, the Conservation Commission prior to the issuance of any building; permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requireinenr or Bylaw. 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"D U01 19 '1 Iia PoIU I R envy ShP (04 IS UW4 W4114PAO 0161 S14L uuwaTugo z J z O 0 O C g �o z z z 5 • O a i m V- O \ W O LWA. m o Y O 0 W CL I Z GFP o 1= W Q T LL C m m m �\ O E LL LL LL a v cc0 Q Z a E m 0 0 p \�1 LL O E aLL c c l5 O O 0 8 c E c c T Zm L)-�J> r ° a46 L a' r►'� ! MCIco LL 0 A z 0 i - Z c 8 m i� d W W F 8O Z 0 L F u u U C Z 0 u 0 m m 0 m d u z I- I.: I.: z J z O 0 O C g �o z z z 5 • O a i m V- O \ W O LWA. m o Y O 0 W CL I Z GFP o 1= W Q T LL C m m m �\ O E LL LL LL a v cc0 Q Z a E m 0 0 p \�1 LL O E aLL c c l5 O O 0 8 c E c c T Zm L)-�J> r ° a46 L a' r►'� ! MCIco LL 0 A s A za F. L'L ••` � .'j'• •V V 11'�� M\� Z v• Q �' • `o � � sr • Zs �. Vf +•. •'ti u ce- rad• 1 k � C =� .� CQ y C CL C CA o d'' Q �� C � •; c� z � � Q C Z a y W Ll Q. Q c C y � Q • c ` Q u % V LIJCA L� ID ca r u Z E V Q O O O (� ♦r N .. �+w. O d C �� ��- a s o = a oo y � air r. O aJ•� •y � tl! cd C �ON 333 0610 .3 He a _ o0.8'S-8•Vi i :VdVd AS URvi d Q 'Z A1N0 N011VONnoi 801 1IW83d � x 0 � 0 u cc ^Q W W d 0 Nf Z z W ZU ZU. oC t..• V z o 0 CD L Jm YO E sJ �> � E�uF-:! cl U LL cc LL Q fn_) lL co LLc i D(1)o E ,. ) ••` � .'j'• •V V 11'�� M\� Z v• Q �' • `o � � sr • Zs �. Vf +•. •'ti u ce- rad• 1 k � C =� .� CQ y C CL C CA o d'' Q �� C � •; c� z � � Q C Z a y W Ll Q. Q c C y � Q • c ` Q u % V LIJCA L� ID ca r u Z E V Q O O O (� ♦r N .. �+w. O d C �� ��- a s o = a oo y � air r. O aJ•� •y � tl! cd C �ON 333 0610 .3 He a _ o0.8'S-8•Vi i :VdVd AS URvi d Q 'Z A1N0 N011VONnoi 801 1IW83d ************************ * * * James Hartigan * 15 Appaloosa Lane Hamilton, MA 01982 * ************************ BOARD OF APPEALS Petition #: 120-88 DECISION The Board of Appeals held a public hearing on April 12, 1988 on the application of James Hartigan requesting a variance from the requirements of Section 7, Paragraph 7.3 and Table 2 of the Zoning ByLaw so as to permit reduction of the setback requirement of 100' to 75' on the premises located at Lot 6C, Turnpike Street. The following members were present and voting: Frank Serio, Jr., Chair- man, Augustine Nickerson, Clerk, William Sullivan, Walter Soule and Raymond Vivenzio. The hearing was advertised in the North Andover Citizen on February 11 and February 18, 1988 and all abutters were notified by regular mail. Upon a motion made by Mr. Vivenzio and seconded by Mr. Soule, the Board voted, unanimously, to GRANT the variance as requested. The Board finds that the petitioner has satisfied the provisions of Section 10, Paragraph 10.4 of the Zoning ByLaw and the granting of this variance in particular will not derogate from the intent and purpose of the ByLaw nor will it adversely affect the neighborhood. Dated this 14th day of April, 1988. BOARD OF// APPEALS �y a: Frank Serio, Jr. Chairman / awt This Is to cerafy that twenty (20) days have elapsed tram date of derision flied ATTEST i; ; without of. A True. Co IOl /9 FR Town Clerk Town Clerk " OD 133 a > n ap -;a! S';cl,!I he i!c'd bi U11NORTH rTtTf�� F q t : ' ; ,� ,..•�., y..,: .a OL i LU CC CD �_ O p r QC�It��� vl ii„�.' Cid• Li;t:J i'JC�I�Ce in the Ofiiee of the Town Clerk. ' .. �SSACNUS�� TOWN OF NORTH ANDOVER MASSACHUSETTS ************************ * * * James Hartigan * 15 Appaloosa Lane Hamilton, MA 01982 * ************************ BOARD OF APPEALS Petition #: 120-88 DECISION The Board of Appeals held a public hearing on April 12, 1988 on the application of James Hartigan requesting a variance from the requirements of Section 7, Paragraph 7.3 and Table 2 of the Zoning ByLaw so as to permit reduction of the setback requirement of 100' to 75' on the premises located at Lot 6C, Turnpike Street. The following members were present and voting: Frank Serio, Jr., Chair- man, Augustine Nickerson, Clerk, William Sullivan, Walter Soule and Raymond Vivenzio. The hearing was advertised in the North Andover Citizen on February 11 and February 18, 1988 and all abutters were notified by regular mail. Upon a motion made by Mr. Vivenzio and seconded by Mr. Soule, the Board voted, unanimously, to GRANT the variance as requested. The Board finds that the petitioner has satisfied the provisions of Section 10, Paragraph 10.4 of the Zoning ByLaw and the granting of this variance in particular will not derogate from the intent and purpose of the ByLaw nor will it adversely affect the neighborhood. Dated this 14th day of April, 1988. BOARD OF// APPEALS �y a: Frank Serio, Jr. Chairman / awt This Is to cerafy that twenty (20) days have elapsed tram date of derision flied ATTEST i; ; without of. A True. Co IOl /9 FR Town Clerk Town Clerk " r: . APRIL?" :•. 1853 TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS NOTICE OF DECISION Any ar (,. c'a In i� 7 ii;ij I,' clerk. Ur17ee .of the Town James Hartigan Date April 14, 1988. 15 Appaloosa Lane Hamilton, MA 01982 Petition No... 120-88............. Date of Hearing .. ,April 12 , 19 88 Petitionof ............................ ...........................I........ Premises affected ... L.o.t .6C.. Turnpike. S.t.reet......................................... . Referring to the above petition for a variation from the requirements of the . S e c t ion .7 ...... Paragraph 7.3 and Table 2 of the Zoning ByLaw ... ......................................... .................. :........................... so as to permit ..reduction. of. setback .requirement .of. 10.0'. to. 75.'..on. the. p.remises.. lacated.at..Lot.6C,. Turnpike..Street..................................................:.. After a public hearing given on the above date, the Board of Appeals voted to .GRANT .....: the variance ............................ and hereby authorize the Building Inspector to issue a permit to..James. Hartigan ............................. ............................... .............. for the construction of the above work, Signed Frank Serio, Jr., Chairman ......... Augustine * Nitkerson*,- Clerk, ....•......... . Y, Walter Soule ......................................... Raymond Vivenzio ........................................ .................................. Board. of Appeals �' Recorded June 13,1988 at 1:59PIll #13424 F' r c Y CD o'"> elm ocl 40� 4 7' 4. Q r: . APRIL?" :•. 1853 TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS NOTICE OF DECISION Any ar (,. c'a In i� 7 ii;ij I,' clerk. Ur17ee .of the Town James Hartigan Date April 14, 1988. 15 Appaloosa Lane Hamilton, MA 01982 Petition No... 120-88............. Date of Hearing .. ,April 12 , 19 88 Petitionof ............................ ...........................I........ Premises affected ... L.o.t .6C.. Turnpike. S.t.reet......................................... . Referring to the above petition for a variation from the requirements of the . S e c t ion .7 ...... Paragraph 7.3 and Table 2 of the Zoning ByLaw ... ......................................... .................. :........................... so as to permit ..reduction. of. setback .requirement .of. 10.0'. to. 75.'..on. the. p.remises.. lacated.at..Lot.6C,. Turnpike..Street..................................................:.. After a public hearing given on the above date, the Board of Appeals voted to .GRANT .....: the variance ............................ and hereby authorize the Building Inspector to issue a permit to..James. Hartigan ............................. ............................... .............. for the construction of the above work, Signed Frank Serio, Jr., Chairman ......... Augustine * Nitkerson*,- Clerk, ....•......... . Y, Walter Soule ......................................... Raymond Vivenzio ........................................ .................................. Board. of Appeals �' Recorded June 13,1988 at 1:59PIll #13424 A J / \ rn q \ .n � �� \ § � , � ` Ao \ �� q 1, o -r- C-. 8 L.C�GAT�-tom 1 ►...1 �o'�TN A�.-�yoyrc.2.��, . �^ pp t2�2I 90 SG aTT �. C --a l LrC. `�. �v •L•S . d't' (::�o G ®wr`rr i v Sv S. L. i L E s L��->•E n 44vdi;. k C � 14 (c. AS- .1 8�1�1.Y DouEr W l2(2i(4o rO' V I , leo• �Z Z. t�o.tS t %, l S4.4 -o IE -xi sr u 7. (54.33 to 4• I SFs•47 y t l• lS8.46 -. 90 (So.00 l Au p gT'�T�otl iQ.o�Bg SFl A2P�AE.:2� S P .� o lc�,a Tz " Q 1 Y.-., E'E —r' -v-- r--- r----T— T-" ----T— 2 GE,6z.Tlti=� THAT o �FS�TS Slow �J A�� �OT� T"Q THEA d F F SrcTS USE. o f TF+QE— I3 tJ L lo..L 6 Z u SPECTC)F— Sl;C S k -t o w ►.� C.ot-�tPt_y O i.1 v'r' A fl S VG 4-1 V S rC. l S V= -Cm. 9i;- a \•c_! lT 1-i T K e� ZAu �E,T P.J (Z 8Y L.AvtJ S F Cro �. t 1= 02 ! �l lT y oTZ- k..1 1-1�'Fc Au�.o��FQ�Nt�_ \T?/ �J H �• �,l Go ►J ST2rVGTE�D. ��i � L.T 12121 (40 The Commonwealth of Massachuset7s " "°"` ` ¢ yrt= ?}` ' t Dcpartmcnt of Public Scfciy ••" '° r �. s 1 o«rr+Mr a fee Ch jkelt BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 1200 3/90 ;J^ APPLICATION FORPERMITwth e u TOPERFORM ELECTRICAL ANORK bmeaccordanceCode. sn (PLEASE PRXn IN M OR TYPE ALL INFORHMON) Date / Z - 2 - City City or Town of A/; ��r✓�(/vE - To the Inspector of Wires: The untersigned applies for a permit to perform the electrical work described belov, Location (Street � Number)_ Z 2 3 fi C-ner or Tenant Owner's Address 111 61 0/?e-- Is this permit in conjunction Wth a building permit: Yes� No (Check Appropriate Box) A rpose of Building Utility Authorization NO. </ s Existing Serr.ice Amps volts Overread ^ Und d No. of New Service dfJ Amps / --4c/ / ,a.y o Volts Overbead [ egrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work rX No. of Lightirig Outlets 2V No. of Hot Tubs '-'o. of Lighting Fixtures Swimming Pool Above 8rnd. ❑ No. of Receptacle Outlets 7S No. of Oil Burners No, of Switch Outlets y No, of Gas Burners No, of Ranges Nr, of Disposal ;`io. of Dishwashers No. of Dryers No. of Water Neaters No. Hydro Massage Tubs OAR: KW INo. of Air Cond. Total tons No. of Heat Total Iotal Space/Area Heating Heating Devices KW Sys Ballasts No. of Motors Iotal HP No. of Transformers lora ❑ ,Generators KVA No. of Emercencv Lichtinc FIRE ALARMS No. of Zones No. of Detection and > Initiating Devices J No. of Sounding Devices No. of Self Contained Detection/Sounding Devices Local ❑ Municipal Connection❑ Other Low Voltage Wirine INSURANCE COVERAGE: Pursuant to the requirements of hassachusetts Central Lave I have a current Liabi Insurance Policy including Completed Operations Coverage or -its s tantial equivalent. YES ®/f10 [J I have submitted valid proof of same to this office. YES ` 0 Q Ii you have checked YES; please indicate the type of coverage by checking the appropriate box. INSURANCE OND OTHER ❑ (Please Specify) Estimated Value of Electrical Work S piration ate Work to Start 12- _`>-C -$j In Date Requested: Rough/ %I � �� Fina Signed under the penalties of perjury: FIRM NAME ^�G LIC.. NO.J�f 3__s`` Licensee y f _ �.-,g �� Signature- LIC. NO. Address �/� j_�_Z6S- - Iel. No._5 -,g4p% 2/G� Alt. Tei. No. OWNEZ'S INSURANCE WAIVER: I am aware that the Licensee does not lyave the insurance coverage or its sub- stantial equivalent as required by Massachusetts General v3T.a and that my signature on this pe application waives this requitement. Owner Agent (Please check one) 9 9 -- Signature of Owner or Agent Telephone No. PERMIT FEE S g , U \\ V Date.. 27861 HORTI{ "° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that..........�! S i 1� ' �� �� / � / "� C ..................... ........................... has permission to perform� '..Cn..1........:f. ' .............................................. wiring in the building of .... % . �l !<...1�r... �,Z ................................................... at .... ..: ��...................... North Andover, Mass. r`,q '.v�.... Lic. Nox..,1................. ..................:.......... ....... . ELECT..RICALINSPEC........TOR 12/28/9512:00 262.00 RAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File