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HomeMy WebLinkAboutMiscellaneous - 230 GRANVILLE LANE 4/30/2018 (2) 230 GRANVILLE LANE 210/106.C-0080-0000.0 Date.7/l?-:/G. NpRT: p M TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING "SA HUS This certifies that . . .�� 1,!`�� �".c ` S has permission to perform . . . .�.t !� °� r F plumbing in the buildings of . �.. . . /. . . . . . at . .0 3 6. . G. !! '.` r.L t j.`. . . . . . . . . ., North Andover, Mass. Fee. . . . . . .Lic. No. .?`�.�.`. . . . . . . . . � . . . . . . . . 'LUMBING INSPECTOR Check * � 0317 9566 Date.............. Z, .... 4 f NORTN 1 TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUS� This certifies that ....... G!.T .........�—'Ie-<T .......................... has permission to perform ........ayD...6- 407y wiring in the building of....... k��7.--S........................................ at.......�30....� 1�!. ........w......... . North Andover,Mass. 4 Fee.... -1�. ' Lic.No./.7P77............. . ..�.. .. pp�� LECTRICAL INSPECTOR Check # �N L.ummunwcan,ir uiPer999�NEWmit No. J' 6 Department of Fire Services 1 Occupancy and Fee Checked ' �\\ BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (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: \ City or Town of. NORTH 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) (5oe,4111111e �v r Owner or Tenant 04.45 9� An-4,4 ��/e>ne.�s Telephone No.�ZLeV- V)??40 1 Owner's Address spoo Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building -rJZ-14e Utility Authorization No. Existing Service 2-W Amps 149 Z 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: y, r �,��f� �Z `,�p 7d (7�e 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- ❑ o.of Emergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets I No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump 'Number. ...............Tons..........J.KW KW No.of Self-Contained ...... .......... Totals: 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 No.of No.of Data Wiring: Heaters Signs Ballasts 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: 3Ila 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 9-'--BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true anti complete. FIRM NAME: LIC.NO.: ®¢/7x'77 Licensee: lvir,Z S` Signature C1 LIC.NO.: /�/70717 (If applicable, enter "exempt,,in the license number line.) Bus.Tel.No.: 971'-7Sd�735'- Address: g C97E+A�.-O!/r(�LcJ , /7fhv¢..:4 �„ o/9Z 3 Alt.Tel.No.: 227Y-06-5--FOG *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 Owner/Agent PERMIT FEE. $ Signature Telephone No. M i 'Y 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): �]j� tT U FAfL2t 3 2:T/ut+4/ %alL Address: City/State/Zip:_ PArhVM Phone #: �';2J -75"0-y7 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.�l am a sole proprietor or partner- listed on the attached sheet. 1 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers'comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.] t employees. [No workers' comp.insurance required.] 13.❑ Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f 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 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 pains and penalties of perjury that the information provided above is true and correct. Signature: ��� Date: Phone#: 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): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ,� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING n\ (Print Type) ,� '" " ��"�r�Mass. Date- -FZo1U Permit# 2 r t Building Location2,3© /14ti�� l�� ,�,, � r� C Owner's Name �iU✓/r/f� G/e�leif/�f Type of Occupancy New ❑ Renovation ❑ Replacements Plans Submitted: Yes El No ❑ FIXTURES z m z_ 0z Y Q h N N o O z r j W W Y J N V d N z W OJ N y 1- W to F C 0 < N Wz z z f. U Y 0 _ M O 0 W } < h 0 z c 6 O Q 0 Q O = 0: o: < W .., p .d 0 z ¢ a x J a W O - O O z Y Y d 0 ~ _z _X d W w Y W > h O _ . 0 N W r 0 U x < h < < S N y d < O < J J < 0: 0 0; Q O Q h O SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR / I 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name Ax C V D ''�� ro Check one: Certificate Address l� ✓-e— ❑ Corporation ❑ Partnership Business Telephone d 3�/ ❑ Fwm/Ca"_ Name of Licensed Plumber ' O -o r INSURANCE COVERAGE: I have It ❑ liability ns ❑ policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. YesIf you have checked yes,please Indicate the type coverage by checking the appropriate box. A liabllity 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 e< 142 Of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner Agent❑ Signature of Owner or 's Agent hereby certify that all of the details and information I have submitted(Ar entered)in above application are true and accurate to the best of my knowledge and that off plumbing work and installations performed under the permit issued for is "tion will be in compliance with all pertinent provisions of the Massachusetts State Plumbing1 2 of the rye BY Title Sig ure of Licensed PWnbee Type of license:Master❑ Journeyman(� City/1 own 2 APP1fib�VEO OFFICE USE ONL1n License Number Brian Leathe Local Building Inspector Building Department Town of North Andover as rt. 1600 Osgood Street I Bldg 20 Suite 2-36 North Andover,MA 01845 NOTICE ph: 978-688-9545 fes: 978-688-9542 Date Bleathe@townofnorthandover.com Office hours:8:30 am—10:00 am,1-2 pm action the Zoning Ordinance -VIwouvellapSection of the Building Code( have been found on Article , Section of the Code these premises, IT IS HEREBY RDERED In accordance with t e above Code that all persons cease, desist from, and dr-'��l�t�•��t STOP WORK at once pertag to` const etion, alterati ns or repai on these premises known as All persons acting contrary to this order or removing or mutilating this notice are liable to arrest unless such action is authorized by the Department. j BUILDING OFFICIAL i Location - o " ' l' } 'ZZ-�- No. 4 t. Date NORTp TOWN OF NORTH ANDOVER C? +• a OR Certificate of Occupancy $ Building/Frame Permit Fee $ <� Foundation Permit Fee $ Apr Permit Fee�f G $ Se�ty ` ction Fee $ VymConnection Fee $ tJYY TOTAL $ ` Building Inspector Div. Public Works PEaJ1IT Nd. � �/ APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE ZONEI SUB DIV. LOT NO. LOCATION l jQ �2�Gti/y1^L J J�./� PURPOSE OF BUILDING OWNER'S NA.M�EE �/ - �[i.t• /GD�/�`Y NO. OF STORIES S �^ OWNER'S ADDRESS� (/f 7' t/�/ / / I(JIJI// � BASEMENT OR SLAB -- `LIY ARCHITECT'S NAME SIZE OF FLOOR TIMBERS MT� D 3RD BUILDER'S NAME Gtyv C0�' SPAN DISTANCE TO NEARESTdull-DING DIMENSIONS OF SILLS DISTANCE FROM STR POSTS DISTANCE FROM LOT LINES-SIDES REAR " " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW 'v SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION�� IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM 10 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 PAGE I FILL OUT#ECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. `O PAGE 2 FILL OUT SECTIONS I - 12 EST. BLDG. COST PER ROOM 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;71 AN APPROVED BY BUILDING INSPECTOR DA7E F LED r K� BOARD OF HEALTH IGNATURE OF OWNER OR AUTH RIZED AGENT F E E OWNER TEL. CONTR.TEL.M PLANNING BOARD PERMIT GRANTED CONTR.LIC.# f 19 BOARD OF SELECTMEN Cl BUILDING INSPECTOR 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 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D __ __ PIERS PLASTER _ DRY WALL _ _ _ UNFIN. 3 BASEMENT il AREA FULL FIN. B'MTAREA _ '/ 1/1 1/1 FIN. ATTIC AREA _ NO B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDVV'D _ ASBESTOS SIDING _ COMMON VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORI� POOR _ ADEQUATE NONE 5 ROOF 11 10 PLUMBING GABLE I HIP BATH )3 FIX.) _ 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 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 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING k Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption (Please print) t. ., DATE G/y' JOB LOCATI N 7C-2 �� ��`�L Number Street A dress Section of town L"HOMEOWNER" — C Name Hork�"' �� ` ome Phone Phone PRESENT MAILING ADDRESS City Town State Zip co e The current exemption for "homeowners" was extended to include owner occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license , that the owner acts as e provided supervisor. 09 . p isor. St (State Building CoCde , Section 109 . 1 . 1 ) . .DEFINITION OF HOMEOWNER: ' Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is , or is intended to be ix ly .: ing , attached or detached structures accessory toa asuch uses and/orlfarmwell- �` structures . A person who constructs more than one home in a t period shall not be considered a homeowner. Such "homeowner" wo year to the Building Official, on a form acceptable to the Buldin Oshal ffic , sub►nit g that he/she shall be responsible for all such work performed under building permit . (Section 109 . 1 . 1) e The undersigned "homeowner" assumes responsibility for State Building Code and other applicable codes , by-laws with the regulations . , ruleance s and The undersigned "homeowner" certifies that he/she understands North Andover Building Department minimum inspection procedures�1nd a Iowa of te ' 'requirements and that he/she will comply wi .requirements . said procedures and .'.HOMEOWNER' S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note : Three family dwellings 35 , 000 cubic feet , or larger, will be required to comply with State Building Code Section 127 .01 Construction Control . P P,I'r T NORTH rINALown of 6 0 n over 0 No. OU J er, Mass 19 19 HE 11C K 0 ? BOARD OF HEALTH PERMIT T LD THIS CERTIFIES THAT..V. /;*.........i.A........ �P.4%0........................ BUILDING INSPECTOR has permission to erdtng&4vv 611146.. buildings on Rough to be occupied as..... jr ....... Chimney Final —P&N'v- provided that the person accepting this permit shall in every respect conform to the terms of the application on rile in PLUMBING INSPECTOR this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough UNLESS CONSTTION STARTS Service Final doz: .....11111111111111160 ........... BUILDING INSPECTOR GAS INSPECTOR Occupancjl, Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector