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HomeMy WebLinkAboutMiscellaneous - 224 CHESTNUT STREET 4/30/2018 224 CHESTNUT STREET 210/060.0-0134-0000.0 , r� / No r j Date.... :../� ' G(i / �. Ot pORTN 1ti TOWN OF NORTH ANDOVER PERMIT FOR WIRING �SSACNUS� This certifies that ..�1.!l.f f'�!.'�./ /� . '.'...:1 ................. ...,... ; .............. ............ has permission to perform �G Sr, 1I c f I� �'<t I !rj" ............................................................................... wiring in the building of......�� :,.:.:..:.�....`...................................................... at.............� .... r�.f�. n.u.y.... . .:.._.- ,.... ,NorthAndover,Mass. .... Lic.N . ........ .... I................ �� /..y3.......... .:.. ..... � ................ ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer TBi C0W0N TH0FM4 "CqUSE77` Office Use only DEPARTMEAT0FPUBLIC&1FETY Permit No. BOARD OFFW PREVEN770NREGM4T10AS 5270fR 12:00 Occupancy&Fees Checked A PPUCATION FOR PRRMUTO PERFORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 A J 1 c, (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat__ 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) (-4 P,,:5T-u)C' �S-r D,-) 1 Owner or Tenant MSS T-)3r h P,rjs4 Owner's Address Is this permit in conjunction with a building permit: Yes No ® (Check Appropriate Box) Purpose of Building ✓by-�,P e rrr- Utility Authorization No. .• rrrr� ���r Existing Service „_ Amps / Volts Overhead Underground M No.of Meters New Service Amps / Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work peiqr W 2 -�k L I t h Co No.of Lighting Outlets No.of Hot Tubs No.ofTransforffiers Total KVA No.of Lighting Fixtures j Swimming Pool Above Below Generators KVA and round No.of Receptacle Outlets ^-L No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets T No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW LocalMunicipal Other Connections No.of Water Heaters KW No.of No.of _ Signs Bailasis To.Hydro Massage Tubs No.of Motors Total HP O5f'HER- Ct oy—,V;ty S cy-&s 10 S•-a; .Y►Q`,,� "j 1R�c e�Sr'Q, C-T` , /V h(2±i F.�IV L-r no r✓Lr-, A-r lnstm=Ccneage. Laws IhaveaamatLiabiliyk PoixyurdudingCat>pktOperjicnsCaerdgecritssklartalecivdkit YES NO IhaNesthruttedvandptoofofsane1DtheOffim YES U NO Ifj uhaveduiWYES,plemmk*thetypeof'oom Wbyd=kingthe ©-BOND o 0 o ) r�c��— Datew Esti n&d Valu dEkcftxal Wak S Wcricbst�t v 1 hq)eWcnD*RwsWd Ra# >>nal Signed trlkofpetjtay FIRM NAME ` (1 Li a=Na nn Sig ne Lice . A T59 LI-3 Ti �/� � .3i��' B�IessTd.Na Q 7& y,S�3 SSI r�J _ Arm I�cs C'S-#tf�l� ( jyG � Li`IVJ��i�� }�aPr a3 AkTeLNa OWNER'SMRAMMWANFR;IamawaletlnticUcmdo t t r tlreQmratmeoove ores lep%alatasrmphdbyM%saftta7C)Laws and that my seon this perrr�al�p�otr tivai�this rec�raerwrt. (Please check one) Owner Agent C v Telephone No. PERMIT FEES a J S FROM : CLOUTIER INS AGCY PHONE NO. : 978 957 7230 Aug. 18 2000 10:39AM P2 ACORD.,, CERTIFICATE OF LIABILITY INSURANCE OATE(MWDD/YY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTERTOFINFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR CI. UTIER INSURANCE': AGENCY ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 14?0 LAKEVIFW AVE:NI,ii MA o1��, INSURERS AFFORDING COVERAGE _ INSURED .INSURERA' MERC:F{PNTS & BUSZ•NESShiEN'S,[LIA$ILT7Y AY? INC ANTHONY BARRY INSURFA8 I rGTAN TiUS CO/LIORK�RS COMP t'G BOX 8'� ,INsuRE�+c: ?.DWELL, MA 018853 INSURED: ' Ix$uHER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR COND(TION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY TNF POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR_ POS UCY ELFECYrJE 1 vOLICY EXPIRATION T.... TYPE OF INSURANCE POLICY NUMBER DATE lR LIMITS GENERALUABIIITV I nn2d.s5GO/3 EACHOCCUkRENCE .... 1$1,060,000 rCOMMERCIAL GENERAL LIABILITY I j FIAE DAMAGE(AA y.one fire) !S 50.000 CLAIMS MADE OCCUR' I MEO EXP(Any pna Wt*n) $ CJ OOO PERSOtu+I.a ADV INJI RY s 1.000.000 --•- _.__ GENERAL AGGREGATE s 2 _000 000 GEN'L AGGREGATE LIMIT APPLIES PER:f PRODUCTS_COMPlOP AGC% 8 G 000.000 i POLICY-�PRO LOC l AUTOMOBILE LIABILITY I I l COMBINED SINGLE LIMIT ANY AUTO I I (Ea acodent) $ I ALL OWNED AUTOS BODILY INJURY – i SCNEOULEO AUTOS I (Per versos) i=HIRED AUTOS S BODILY INJURY 8 I NON-OWNED AUTOS (Per amdent) —•— -.—_...... ... PROPERTY DAMAGE I E ' (Po'atddent) GARAGE LIABILITY AUTO ONLY•EA ACCIDENT Is ANY AUTO I II O�TH�ER THAN EA ACC $ _ I I I�AUiO ONLY: AC30 I S EXCESS LIABILITY I EACH OCCURRENC.F Is OCCUR J__ CLAIMS MADE :AGGREGATE S _i OEOVOTiSLE RETENTION 5 I I $ WORKERS COMPENSATION AND i WC6- 0929174 Oda/28/00 09/28/01 ITORYIMU' OER TR' _ EMPLOYERS'LIABILITY - ? F.L.EACH ACCIDENT g 100,000 E.L.DISEASE-EA EMPLOYE E 100,000 E.L.DISEASE-POLIO'LIMIT S SOO,OOO OTHER I DESCRIPTION OF OPERATtONSILOCATIONSNF.RICLESMXCLUSIONS ADDED BY ENOORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED:INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABovE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 277 C 'c AR LE:; c�TR€E-�NORTH ANOL)Vf F. DATE THEAEOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN I•iAFt NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SNALL Ar�00vR +� 01$45 IMPOSE NO OOLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR REPRESENTATIVES. AvTHO REPAfSENTA ACORD 25-S(7197) 0 ACORD CORPORATION 1998 r� Location z No. %' Date He oT hTOWN OF NORTH ANDOVER F y # Certificate of Occupancy $ t i � �'+S •Eta cMus Building/Frame Permit Fee $ 16. s� Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # 14 `3 Building In for TON" OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING 5 777 BUILDING PERMIT NUMBER: Ain DATE ISSUED: M SIGNATURE: ASSESSORS COPY I Building Commissioner/1 for of Buildin Date krE tt a SECTION 1-SITE INFORMATION PERMIT PENDING 1.1 Property Address: 1.2 Assessors Map and Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Rapired Provided 1.7 Water Supply M.GI—C.40.11 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public Private ❑ Zone Outside Flood Zone Municipal On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record Name(Print) Address for Service d'A� 5 / Signature Telephone 2.2 Owner of Record: t Name Print Address for Service: M jSignature Telephone SECTION 3-CONSTRUCTION SERVICES 3.I Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: JZ �� +/Wr` License Number !w '' t1/`` r/ Addr ss // 0 ko > Z��, , , �A Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name ! c) ���, _ } I Registration Number M � + I Add—�— - "s _� c ! e� 6 6 Expiration Date Signature =� � Telephone SECTION 4-WORKERS COMPENSATION(NLG.L C 152 § 25c(6) a 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.......❑ No.......❑ SECTION 5 Description of Proposed Work check au applicable) New Construction ❑ Existing Building ❑ Repair(s) 0 Alterations(s) ❑ Addition 0 Accessory Bldg. 0 Demolition ❑ Other 0 Specify Brief Description of Proposed Work: 421 SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be ;.OFFICIALUSE QNLY Completed b permit a licant 1. Building C (a) Building Permit Fee // fidO 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 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 ate SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, ,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 Siattire of Owner/A ent Date 0"9900425- i NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS I)EIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUII DING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NAT URAL GAS LINE NORTIy �. F ® of d No. L4a q =_ tw ~ ® , dower 1Viass. 8 �� too O�A COCMICMEWICK`y DRATED P`P��,�Gj S H � BOARD OF HEALTH Food/Kitchen PERM,-,..IT Septic System BUILDING INSPECTOR THIS CERTIFIES THAT O �M N ......................�............................ ...................................�............ .............. ............... ............... ... Foundation !o a y c � s� has permission to erect.....�IAII�.�...... .... buildings on.............. ... ............. ... .......�f/.......................... Rough to be occupied as.....�ASS �� top, P04494-0-1 ISI 81�'y' Chimney .....................................ry......p........................... .......................................................... provided that the person accepting this permit shall in eve respect conform tot a terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and C nstruction of Buildings in the Town of North Andover. in to iCW*Im PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION S.I. ELECTRICAL INSPECTOR Rough .......... ... ... .... ............................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in. a Conspicuous Place on the Premises — Do Not Remove F naih No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. SEE REVERSE SII7F Smoke Det. 'r // Date. . / . . . . . . ... No ` "0R'M TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING • o a ., SSACMUSE� r This certifies that . . . . . '. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . has permission to perform . :. . ." : . . . . . . . . . :. : . . . . . . . . . .I~ plumbing in the buildings of . . . . . . ' . . . . . . . . . . . . . . . . . at. . . . . .,. . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . North Andover, Mass. 7- Fee. .-. . . Li c. No.. . . . . . . . . :,-C. . . . . . . . . . . ` PLUMSMG,Ii SPECTOR Check # / C WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS -^•�� Date Building Location cZ''-'-/ lQwners Name L,�+'tL 5Dolls�-7-4y-Permit# a Amount Type of Occupancy New Renovation Replacement El PlansSubmitted No FIXTURES z > At a: p a Cn rn LL w W d w O ,wjQL.' A a a FC� a x N d w w H z d d SLR1M HJ00 t 21-Il BOON 3MHjOOR alai BOOR 5IR RD(R six ROCR s1H FLOOR (Print or type) � Check one: Certificate Installing Company Name c`6 .-A�— 't ? f/` i�- 0 Corp. Address l 0 Partner. 21/ .✓r-513c1Zo A- v 11 Z Business 2,f� rte/ 1-2 i Z 41 �irm/Co. 0 ., Name of Licensed Plumber b-isurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner El Agent 11 I hereby certify that all of the details and information Ihave submi 0(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and instalIati s performed under Permit Issued for application will be in compliance with all pertinent provisions of the Massac tate Plumbing C and C ter of the General Laws. By: S—ip--aM of Licenseaum er Type of Plumbing License Title a�2/7/- City/Townrc�erase um er Master Joumeyman APPROVED(OFFICE USE ONLY tt��