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HomeMy WebLinkAboutMiscellaneous - 226 REA STREET 4/30/2018 (2) 226 REA STREET 210/038.0-0131-0000.0 \d Date./,..-/d..<j AORTPI °f,"`°:•1"° TOWN OF NORTH ANDOVER 3? •` PERMIT FOR WIRING SSACMuS� ,,This certifies that ...,.... L . ..............�.. .... .... has permission to perform ...�:.....:. —...,.*!,v .......................................... wiring in the building of. ...— ...... :.`rte' .....::..":......................................................... at .. :....................................... ................ ,North Andover,Mass. Fee..�/.............. Lic.No,/'........ ; �..... ................�Iz............. ELECTRICALINSPECTOR Check # 5 Date./5�.. ........ Of N°orM 1h 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING Ibis certifies that .. ............... jas permission to perform ......... .. ........... . . ......................................... wiringin the bu' ig. of......... ......................................................................... .................... ................ ....... .NorthArjd1over,Mass. Lic.No,009Z s Fee.. ......... 0� Check # 4906 TBE COA MONWEALTHOFMASSACHUSETTS Office Use only DEPARTAfflW0FPM1CS4FMY permit No. l / lc BOARDOFFIREPREVE MONREGULAHONS527CMRl2.M Occupancy&Fees Checked APPLICATTONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CdDE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date /d- Town of North Andover d To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work descnbed below./� Location(Street&Nu ber) Owner or Tenant ` Owner's Address 54- Is this permit in conjunction with a building permit: Yes m No (Check Appropriate Box) Purpose of Building Utility Authorization No. _ Existing Service Z4,V AmpZ, Volts Overhead © UndergroundED No.of Meters J New Service Amps / Volts Overhead l:3 Underground r-1 No. of Meters _ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work `737.& n, -t l Prx"gO No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA round ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets 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.o4 Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.ZDryers Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of _ Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER• h>Surattoe@0wrage.Aust nttothers}mana�tsofMassad>< Ga�aaliaws IhawaomaiLiab&yhmax=PobcyzrlldmgCarrn"CE] 0�orit &k9Xt0lec}rivalat YES NO st> Iha exiinedvanddpmdcfsamebtheO�e YES F)mbaNedrdodYESpkein�thetypeofcov�by dleddngt} E X°�boxx INSURANCE LT BOND CIIHQt (Pleaw Spaofy) EVimtimDae Fsti�ValtrofFlechical Work$ WodCtDStWt ItN)ecliottDaleRequested Rough Fala1 sigrledunderTrPbmyrsofpesjwy. — FIRMNANM G L LiarwNo. Licer>see Zzy :1�_ Signature �' ( � LioawNo �l5% BusnffmTe].Tb. 222r 10'7417 Adrhrcc �J ���o U l �c�/� Alt,Tel No. OA7 EI SINSURANCEWAIVER;IamawatetAftLmisedoesnothavelheinstlx=oc)wrageoritssubstantialecpvalatasregmedbyMa%achusctsGffralLaws and that mysigrlahneon thispemut*pheabon waives this regm'm alt (Please check one) Owner Agent p Telephone No. PERMIT FEE$ d signature ot Uwner or Agent T. Z ql The Commonwealth of Massachusetts a. Y Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 °+M 5,0 Workers'Compensation Insurance Atidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for rry employees working on this job. Company name: Address City Phone#: Insurance.Co. Policy# Company name: Address City: Phone#: Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,afine up to$1,500.00 andior one years'impmommtas_we[Las_cn d_penalties-oshelam-fa-STOP V*VW9RDFRamd of w—ct_($1DD-00)atlayagainstme I understand that a copy of this statement may be forwarded to the Office of Investigations of the DtA for coverage verification. /do hereby certdy under the pains and penalties of perjury that the information prowled above is true and coreat Signature Date Print name Pbone.# Official use only do not write in this area to be completed by city or town dficiar City or Town Permit4kensing Building Dept El Check if immediate response is required E] Licensing Board p Selectman's Office Contact person: Phone#. Ej Health Department Other •t� 3n^ F`-:c e.': ..ry.�; ,2_4"'*. . ';1g; .a•.a .t ...rf 'z* _,..... } -{: �.".'a Location F No. - Date 17, r_4 i a a g, °f "O;T;,tio TOWN OF NORTH ANDOVER F p Certificate of Occupancy $ +� Building/Frame Permit Fee $ '�/ ono�� •� r 'F ACFoundation Perm! Fee $ Other Permit Fee j $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector a 7811 Div. Public Works i PERJtIT NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP 4d0. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK ;PAGE ZONE SUB DIV. LOT NO. F - LOCATION_ G dJ�-n PURPOSE OF BUILDING Zre,03F- (31�FAZ- ekl9 1,91 - ,,,"OWNER'S NAME I �. rT� NO. OF STORIES SIZE OWNER'S ADDRESS .�f" D / BASEMENT OR SLAB ARCHITECT'S NAME Wl- SIZE OF FLOOR TIMBERS IST 2ND T ,L 3RD r BUILDER'S NAME SPAN O'ISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS -- --- D STANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING % IS BUILDING ADDITION MATERIAL OF CHIMNEY S BUILDING ALTERATION �/� IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST ^��i•-�Y� PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE/FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED' /,� -1Z "9 BUILD d N�PECTOR SIGNATUJCE OF O ER R A T O D AGENT FEE ��� OWNER TEL. !r PERMIT GRANTED CONTR.TEL.# CONTR.LIC.#. H.I.C.# v BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION Ilk 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE d 1 2 I3 CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS PLASTER — DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B M'T' AREA _ 7, '/r '/. FIN. ATTIC AREA _ N_O 8 M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDVJ D _ ASBESTOS SIDING COMMCN VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STRILIC ON FRAME BCK ON MASONRY ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I--I POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLEHIP BATH (3BATH (3 FIXE_ GAMBREL MANSARD TOILET RM. (2 FIX.( _ FLAT � SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I) 11 HEATING 7 WOOD JOIST PIP ELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM ,y STEEL BMS. & COLS. HOT W T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS' 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd 11 NO HEATING < Town of �� r_i Andover 2 l O.- A No. 593 " ort", dover, Mass., Dec. l co 1994 Q LAKE I- COCHICHEwICH V _r AORq T�p PP \ C9 BOARD OF HEALTH 4 Food/Kitchen PERMIT T D Septic System ' I BUILDING INSPECTOR THIS CERTIFIES THAT..TTUI� aL......WA... ...............�..p..�............................................................... Foundation • buildin s on ZZf,O �/J Rough has permission to erect....�%�?i� ......... g ................................................................................... Chimney to be occupied as...? ..... Tr ... CWT.....1..� . �ct ...../d�t�kh�4 ...... . .. . t�Q provided that the person accepting this permit shall in every aspect conform to the 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 Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRE 6 MONTHS ELECTRICAL INSPECTOR UNLESS CO TRUnT Sta Rough —_ .... .. .... .......................... .................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough ' Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT "7a�1 CessA i Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption (P-le-ase print ) �Vumce_ Street Address Sec :ion oz to,;,-, L Z­ .,/�����S/��i✓�j ��. 770 X 97- Z!2 :Ia-E Home Phone 'tor:. ?!lone ,G AiEr-'RZES T State exer- on for "homeowners" was extendEd to include owner::: c r i' = -ZS of six units or less and to allow such nomeo`•�n�Er= to a:: ori for hire who does not possess a License , pr0v�0=^ ind� duan ac _s as supervisor- (State BuildIng Code Sec_-on l� O • '- • ' 07 a parcel of Lana on which he/she res�des or 1. r _ _s _..= . on wh :,_.. th .M,ere is , or is in _ended to be , a one to s_x fa -'' ^ a= :aC::eC Or QE=aCaed StrllCtures acCessor;; to Suc., use aI1C ;c r tar.: _�._ _..�_s DErson who constructs more than one home in a two- • =-r Der=CCySi.ali no : be Considered a homeowner . Such "homeowner" Si.aL: SLiG�- - �o _..= Bu�ld�rL Of__c_a1 , on a fors acceptable to the Buid_ns Site Sn .l_ bE res:OnSible f0.. all such wOr:�_ Der-or.::E^_Z `_on 100 . 1 i � _ pon ' bi _ �0r c0 1 _a E� :C 'EC'.vnEr aS u.T:E_ reS S� __ �. - ; a%d OthE_" a=L_..3..Le , _ems D`'- _a':5 .�_= a _ cE_ ___ _e5 tha : ne, Si.e 1P.CE_ aC_ on T�- = -.. ....�., �cr Ju-----• _ <�� .-.,1., rii _:i - _d ?raced• - - a::� or Lar=er . wL_ _ Date. �l _ . . NORTH ti TOWN OF NORTH ANDOVER '• O PERMIT FOR PLUMBING ,SSACMUSE` This certifies that . . Y-�1 C)� . . . 1�. . .S. l S has permission to perform . . . . . . . . . . . . . . .A )p of... . . . . . . . . . . . . . . . . plumbing in the buildings of . .�1' /1.V.�'�. �. . . . . . . . . . . . . . . . . . . at . . . . .. . . . . . . . . . .. . . .. . . . . . . . . . . . . ., North Andover, Mass. Fee. Lic. No.Jo).98s:Q. . . . . .� :. 1Q2Z1 .�(.f�g•� O PLUMBING IN/ECT R Check # 6661 1 ' MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMB IN (Type or print) NORTH ANDOVER,MASSACHUSETTS Building Location Z Z(p �(U G` 1� Owners 1 ameCcJeTat�.�c Permit#� Amount Type of Occu ncy5��� New Renovation Replacement El Plans Submitted Yes No ❑ FIXTURES EF 00 O I SOB)E� )Ei�iSIIVIIVT in FLOOIt ZaROOR 3M OM 4II3FIOCR SM FLOOR 6M FLOOR 7II3 FIOQit 9M FLOOR (Print or type) i ' Check one: Installing Company Name__ roy 1 izls�� ❑ rp Co Certificate Address 9 SuY r e`a ❑ Partner. IZ ✓lit l�� Business Telep one10- /—&.5C5,—.1-re E] Firm/Co. Name of Licensed Plumber: Insurance 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 threeinsurance Signature. Owner El 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 application will be in compliance with all pertinent provisions of the Massais State Plumbing Code and Chapter 142 of the General Laws. By: Signature o'cense um er Type of Plumbing License Title City/Town icense Numoer Master Journeyman APPROVED(OFFICE USE ONLY ZASZ- COMMONWEALTH OF MASSACHUSETTS DIVISION OF PROFESSIONAL LICENSURE IN PLUMBERS AND GASFITTERS ; ICENSED AS A JOURNEYMAN PLUMBER ISSUES THIS LICENSE TO 4 LEROY D HOSKINS 9 SURREY ROAD N i WINCHESTER MA 01890-2304 25149 05/01/06 897379 COMMONWEALTH OF MASSACHUSETTS IN PLUMBERS AND GASFITTERS LICENSED AS A MASTER PLUMBER, ISSUES THIS LICENSE TO LEROY D HOSKINS 9 SURREY ROAD N WINCHESTER MA 01890-2304) , 12982 05/01/06 897378 ' • mmff*' I;hNdlol 7 f � Location No. �) 70� Date NORTH TOWN OF NORTH ANDOVER ?Of�„ao ,a,•yG ►° . 09 f Certificate of Occupancy $ scwus`� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ i TOTAL $ A, Check # E59,C1 E 17398 -tuilding Inspector ..7 4. TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI&RENOVATf2 OR DEMOLISH A ONE OR TWO FAMILY DWELLING "A+ 0w,a , , .. t , ti ,,f '4 1� �Xw BUILDING PERMIT NUMBER. DATE ISSUED: rn ic SIGNATURE: .q Building Commissioner/InEeEtor of Buildings Date z SECTION I-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 0 so Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage(iff) 1.6 BUILDING SETBACKS(ft) Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: > Public 0 Private D Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 —4 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No 2.1 Owner of Record e;7 Name(Print) Address for Service Signature Telephone !J--2 Owner of Record: Name Print Address for Service: rn Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable 0 Licensed Construction Supervisor: CS C) ? --/Z& 1-8 (,P-�k 6,�Aj Vsuv% <S4_ License Number mn Address 15 > 29-22-3—&62- Expiration Date ignqeure Telephone 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name z M Z7,3 e/*I/Cfratex-s,-,"� Registration Number rm r" Address Z Expiration Date Sigin-aturo," Telephone 6) 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.......❑ No.......❑ SECTION 5 Description 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 betIFFICIALUSE(N .Y Completed by permit applicant. 1. Building (a) Building Permit Fee v�• 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 BUH DING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all afters elative to work authorized by this building permit application. F -Signature of Owner Date 1 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 Signature of Owner/A ent Date NO.OF STORIES SIZE BASEMENT OR SLAB RD SIZE OF FLOOR TEVIBERS 1 2 3 SPAN DIMENSIONS OF SILLS DEvIENSIONS OF POSTS DPAENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHEVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 074261 7. Birthdate: 04/29/1973 Expires: 04/29/2006 Tr.no: 23789 Restricted: 00 LEROY D HOSKINS 173 W EMERSON ST. MELROSE, MA 02176 Acting�Cmll ner Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 140293 Expiration: 9/29/2005 Type: DBA CEP �s LEROY HOSKINS 173 WEST EMERSON ST G � MELROSE,MA 02176 Administrator I L c �r' v—' NORTH Town of And No. rl a -_ LAKO dower, MaSS., COCMICKEWICK �d ADRATED PC `s U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System ...... BUILDING INSPECTOR THIS CERTIFIES THAT...........5 .V; �.�7..... �� Foundation .. ...... . .. .. . ;�O...... .. has permission to erect... . ............... buildings on .4 .......... . '......5............................... Rough to be occupied as it PACE f� CA' !~�4-A.. Chimney ..................... .. ...'............ .................. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspecti , Alteration and Construction of Buildings in the Town of North Andover. 43 is / /a / PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR Rough ......... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner 9 Street No. SEE REVERSE SIDE Smoke Det. 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: /X/,7554— 1,07 ocation of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector i