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Home My WebLink AboutMiscellaneous - 234 HAY MEADOW ROAD 4/30/2018 �e 234 HAY MEADOW ROAD 210/104.B-0079-0000.0 I N2 1927 t NORTp, 0 TOWN OF NORTH ANDOVER p PERMIT FOR WIRING CHUgE� !r This certifies that .�..... - -��t.. .............. ...................................................... has permission to perform ... .r?% �� 1 .................................................. wiring in the building of........ �_. ...... ............................................. .eta.......,North Andover,Mass. tx l/ r Fee..-"?.:..... Lic.N6.1::, ELECTRICAL INSPECTOR 10/15/9913:40 40,00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer THE CONA10AIVEALTHOFALUSACRU.SETTS' 1 ®a OfficeUseUse Z only D�OFPUIiI.IC&4= Permit No. �� / BOARD OFFIREPREV=ONREGUTATIONS527C�1?-Lid Occupancy&Fees Checked 14PPLICATTONFORPERAET TOPERFORM==(= 'AL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date V Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. IAP PARCEL ? Location(Street&Number) a3�l �,�y rn e e�C)c"') Owner or Tenant M� 1< y y Owner's Address Q11C^��e�/\2 , Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building 0. Utility Authorization No. Existing Service Amps / Volts Overhead Underground No.of Meters —_ New Service Amps / Volts Overhead Underground Q No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work VG.v—\ l/ NO0 V 0c) tt(O V-\ No.of Lighting Outlets No.of Hot Tubs No.of Trrnsformers Total qW KVA No.sof Lighting Fixtures /= Swimming Pool Above Below Generators KVA l(� pround ground No.of Receptacle Outlets I 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 I 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 Local Municipal r= Other ,, : Conncciions No.of Water Heaters KW No.of No.of Sims Bailasis Hydro Massage Tubs No iof.Motors Total HP OT�IER- } Cae$age,R.ust�t4theze�tal�sofNlass�a�ellsCxra-alLaws IbawaamatLiabtlitylns==PdRmchi n Cm-Ticle ' Cows- cr&st> leq.� YES NO Ilawskn7&dvalidp:ocfcfsar=totheOfce YES = NO Ifywla,&dmdmdYFSpka9eiaicatlbetypeofwwriF ydr-dmgdr INSURANCE BOND MER (lease Spedy) E�aticni� � FSa�ValueofliWc�c Wodcto sett } q >i>sp x,) R 1 Ra ii 1�-\ Final Si.edtn±aTiel ofpejuty: F ZMNAM6 LiomseNo Lice;cis V; cQ . S,/, — LicaiseNo 3 o a ` a urssTelNo. ,� r— 3 3 S Mck_\ )...ems (Db-) L Alt Tel Na OWNER'SINSURANCEWAIVER;Iamaw&ed3la eL.iomsedoes riot lstved-�emsLrnce cr IS abmrAkal eqUIVdialasretmecjbYIv sadhizetsCa=1Laws and dratmysigrntiaea d-isp mtapp}icaliamwai csdmTq=rai (Please check one) Owner Agent Telephone No. PERMIT FEES I 6i�ma[ure of Jwner or Agent Location a�7 No. --?4 b Date %0RTh TOWN OF NORTH ANDOVER AL gig} - p Certificate of Occupancy $ ` Building/Frame Permit Fee $ Foundation Permit Fee $ aACMUSE Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector 3 3 U 08/16/99 14:47 195.00 RAID Div. Public Works PERMIT NO. c3 /,,o APPLICATION FOY2 PERMIT TO BUILD********NORTI-i ANDOVER, MA � q t IAP No. I.or NO. Q� 2. RECoRDoFo%vN`ERsUU' DATE ROOK - PAGE LONE S1111 DIV. LOT NO. LO('.)IION ^ �J PUlil'OSt:OFI3II11.111NG i �� "i, (( n OWNER'S NAME ► v`LIf , �,� `� J� � NO.OF STORIES ( S17.E OWNER'S ADIIRESS ^A'�/\^C lX l ❑ASEMENTORSLAB aRCllfl'EC'1"'S NAM (J - SIZE OF F'1.00R"I"mIBERS 2ND �___.�—� 3RD ❑UII.DEIi'SNAME 1 N., / SPAN \ - I DISTANCE:'FO NE:ARESTBU1LDING I�\ 1 1 T i( 1)1IMENS1ONSOFSILIS ` 1115 rANCL FROM STREET Q DIMENSIONS OF POSTS DISTANCE FROM LOT LINES-SIDES 15? 5 111EAll DIMENSIONS OF GIRDERS Z AREA OF 1.0'1' )� FRONTAGE Q 1 IIEIGIITOF FOUNDATION `{ ��( y _./ (� 3 -111ICKNESS � IS BUILDING NEW L n 1'/Jv l SIZE OF FOOTING C� ISBII1LnINCADDITION Yew til I NIATERIALOFCIIIAINEY IBJ C/ :.� . , �� f,• / �,; rt IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED L'1N� � J r. WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TORN WATER' I: ) BOARD OF APPEALS ACTION, IF ANY f ) IS BUILDING CONNECTED TO TOWN SEWER'' v --_ IS BUILDING CONNECTED TO NATURAL GAS LINE �U 1 a+ 1NSTOCTIONS 3. PROPERTY INFORMATION ,LAND COST EST. BLDG.COST +� { 1'%(',E I I'ILI.OUTSECl"IONS I-3 EST.BLDG.COST'PEIiSQ. FT. 9'+f 11 EST. BLDG.COST PER ROOM F.I FCTit IC ME'T'ERS AIIIST BE ON 011 TS11)E OF BII11.1)1NG SEPTIC PERMIT NO.' G)R:)GES NIUSTCONPORM TO STATE FIRE REGULATIONS �. APPROVED BY: PLANS\HIST BE FILED AND APPROVED B\'BUILDING INSPECTOR - RIIILDING INSPECTORWin is DATE FILED t 1`NEB 1 \ T i S E I Pl , �sl CONTR.TEiLN SICNA'fIIRF: OP-0)VNER OR AUTHORIZED AGENT CONTRA ICH - FEE -•� -I1 i.c.H � D � _ _-•---- _ t � reRanTCR:w'rEn � ( f " I2c)'isetl i/5/99 .II\i tA" D �� '� _� � �° P a REGISTRY: 655r.r /YDRTiS/ TITLE REFERENCE dA' /97Z �G ZSTa PLAN REFERENCE: Ae 40 919/ o ji OL # 968d Z07 I IP � o t I � a CERTIFIED PLOT PLAN ; LOCATION °34 HAf ME.7G?9w RD /✓GRTfl /INLbYE.4' ,M/� r. SCALE: /�= DATE: 6-3c•-88 This planf was not prepared from an instrument survey. CERTIFIED TO: Offsets and distances shown should not be used to establish ptopaty es. I �J/c//H TION/5 SU/6 tN This Plan intended for mortgage purposes only. certify at the structure shown on this Plan By>MW >111-:FL��O�/T ♦ TiPL'S7 Go ,�, W in.conformance with zoning setbacks in effect i the time of coaunutim i Lao f certify I tat the parcel shown is tiOT tocued within I JOB a flood trce rd area as depicted on HUD Flood InsurrRa CAMERON BROS. INC. te NO• r .Maps for Community No MAIDEN,MASSICHUSETfS i t s ' FORM U - LOT RELEASE FORM is, INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from a j Boards and Departmentshaving jurisdiction have been obtained. This does not relieve g the applicant and/or landowner from compliance with any applicable or requirements. r *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT ✓ tAlfLHONE LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT (S) STREET �-�A cam,. e arl¢-w l ST. NUMBER��L/ ******E***************************** *O F F IC IAL USE RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED �7 DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED 1 ECTOR-H DATE APPROVED AF Q 4 DATE REJECTED COMMENTS P� c.�Gas� 7�(r�E.� - _ 57 7/:4C _5 s7c�r-1 PUBLIC WORKS -SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197jm �� + �a„ � � ` �. ��g �a-�. 4r �£,p� ��. ., I 1 I I I I I V i I I I A . I I I I I I I 11 it Ole I I I AC 1L I I I I i _ , I I I I I 1 I I I I I I I — i - I 1 I 1 I I i I I I i 1 I Jill Ao- r I ; 4— �— - - sb ----- - I I , - ' I I I T hit -I ! I I , � I - 1 I f I I 1 1 FT�--�-T I iI I I 1 1 I I I 1 1 1 I I I I I I 1 i ' I � I I I � I � � I � ��✓ 1 I _ I _ I i I - 1 _ ' I _ t 1 • I � I _I` i I I i ' I I i I ' I _ I I -I- I _ -- I _17 IF T-1 -f- - -� -I - . -i- l I -i_ 1 ; -T- i i fI I I I , I i 1 1 I I I l i l l i I I 1 , , AMA" I In I ! � 1 I � - '- ; I I 1 II � 1 1 1 ' I i I - I i ! � - - -1- - -I- - - ,--- - - - - -r I - - -'—�--' - —r- --C- - - - ! -- _ i � ' it I I I I 1 1 I I � ;� ! ► I I I ; NORTH • Town of dover No. dover, Mass. COCHI �p CRATED PPS` I 1S Is BOARD OF HEALTH Food/Kitchen PERMIT T Septic System THIS CERTIFIES THAT... .�. �, ,� I. ........ vt BUILDING INSPECTOR / """..... Foundation has permission to maN.AV-1 w1I. .j....... buildings on .. .�}..........y.A Y. a 0 N�....�Q�.. Rough to be occupied as.. � #.#wp �........ � N��on fil e�r� Chimney provided that the person accepting this permit shall in every respect conform to the terms of the a lication i pp n 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. P d p S s w # ,1L J0104 SWO/y COLS PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 � � �� MONTHS Final UNLESS CONSTRUCTIO ST TS ELECTRICAL INSPECTOR �9" • C Rough 1 C*- / �/v O� Service ..................................... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. L (i Date.. .:..�...: . . . ....... NORTH TOWN OF NORTH ANDOVER OF #0 ° PERMIT FOR GAS INSTALLATION j i F .: sem........-.'�^' E ,SSACHUSEt This certifies that . . . . . . . .. . . . . .. . ... .. . . . . . . . . has permission for gas installation . . . . :. . . . : '. . . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . ..`./. . ... . .. . . . . . . . . . . . . . . . . . . .. . North Andover, Mass. Fee. . . . :. . . . Lic:�No.. . . . . : ?. . % :. . . . . . . ;� nG7 GAS INSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS/FITTING (Print or Type) yo, MA Date NQ V %19C/9' Receipt# V/Permit# Building Location�� ajou� OwneesName T�n,`C� Map: Lot: Zone:— TypeofOocupancy Y'FS�c,FYICG- tM' New ❑ Renovation O Replacement O Plans Submitted: Yes 0 No O Fee: N ¢ y GY W ¢ y N N N 0 2 H W ¢ N 2 O ¢ x ~ WLU ¢ O U S fr+ Z J ¢ W +- > m Z OF Q V Q m N H W W O d O ~ W Q O 0: W W4 ' C7 x Z F- N O > W N D: V W NW < QF O H 2 W cc 0 H Z J H Z r W W O O > LL. H W J F W Z Q W _ Q F' ! N m Z O Z O N x Q W > Q W O Z < R Q < O O W Q O W �• `` Cr I= 0 a x W 3 o 0 J 0 Cr > O a H 0 SUB—$SMT. �. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR w , Installing Company Name jl�As6r+n 5?r nna`i12 Y-1 Checkone: Certificate Address 131. W Q 1�t' A Ig Corporation Estimate-Value of Work: 0 Partnership Business Telephone ❑ Firm/Co. NameofLicensed PlumberorGasFitter bh INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes Mr No ❑ If you have checked es please indicate the type coverage by checking the appropriate box. A liability insurance policy IM' Other type of indemnity❑ Bond 0 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. Checkone: Owner AgentO Signature of Owner or Owner's 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 the permit issued for this applicatio ill in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the I ws. By Type of License: Plumber Signature of licensed Plumber or Gas Fitter Title Gasfitter Master License Number City/Town Journeyman APPROVED (OFFICE USE ONLY) • r BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. APPLICATION FOR PERMIT TO DO GASFITTING ' r NAME A TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED DATE 19 OASINSPECTOR Date... ORTPI TOWN OF NORTH ANDOVER PERMIT FOR WIRING ^Z CMU5 rC This certifies that ...... .......... CJ� ............ . ............................. has permission to perform ..... ..... ................ kA, CI, r wiring in the building of........... at.... P4. .. ,North Andover, ass. /M...... ................... o h And Fee... ../........... ..... Lic.No. ELECTRICAL ffspEcroR Check # 5203 Official Use Only Permit No. `ZEE COQ `KOT�iEAGf O�912�7.SSA vSE`17,5 Department of 2vu6fic Safety Occupancy&Fee Checked BOARD OF FIRE PREVENTION REGULAT NS 527 CMR 12:00 APPLICATION FOR PERMIT TO ERFORM ELECTRICAL WORK All work to be performed in accordance with the.` assachusetts Electrical Code 527 MR 2:00 i (Please Print in ink or type all Information) date d G To the I r ofWires: ' Town of North Andover The undersigned applies for a permit to perform the electrical work des below.elo_w. I Location(Street&Number �3 i4 �✓ j Owner or Tenant Owner's Address Is this permit in conjunction with a building it Yes 0 No (Check Appropriate Box) Purpose of Building- 5 rn Utility Authorization No. Existing Service Amps Vohs Overhead n Undgmd 0 No.of Meters New Service Amps Voits Overhead 9 Undgmd 0 No.of Meters Number of Feeders and Amp city Location and Nature of Proposed Electrical Work L Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above 0 In 0 No.of Lighting Fixtures Swimming Pool gmd 0 gmd 0 Generators KVA ?' No.of Emergency Lighting As No.of Receptacles Outlets No.of Oil Burners Battery Units r No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone '. Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Diposal No. Pumps Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers Area Heating KW DetectioMSounding Devices 0 Municipal 0 Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or substantial equivalent YES C% NO o .` have submitted valid proof of same to the Office YES 0 NO 0 S please indicate the tA of by checking the appropriate box INSURANCE 0 BOND 0 OTHER 0 (Please Specify) Estimated Value of Electrical Warks L Work to Start Inspection Date R ested Rough Final Signed underthe Penalties of perjury: n J FIRM NAME t/ LIC.NO. 33 Licensee Signature UC.NO. - Add �itG CZ Bus.Tel No Aft Tel.No, OWNER'S INSURANCE WAIVER: I am awardythafffie Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE E ($ignature of Owner or Agent) z The Commonwealth of Massachusetts Department of Industrial Accidents d Office of investigations � W L F` Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: Location: ct 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 my employees working on this job. Com an name: Address Ci : Phone#: Insurance Co Policv# Company name: 1 Address Ci : Phone# Insurance Co Policv# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of.a fine up to$1,500.00 and/or one years'imprisonment-as well as.civil.penaltiesinsheformrda STOP WORK ORDFR.and_a fine_d_($1D0.00)a day.against_me. understand that a copy d this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone official use only do not write in this area to be completed by city or town official' ` City or Town Permit/Licensingi I] Building Dept ❑Check if immediate response is required licensing Board E] Selectman's Office Contact person: Phone#: 0 Health Department El Other