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HomeMy WebLinkAboutMiscellaneous - 24 PETERSON ROAD 4/30/2018_N O N A CT m m g -M m co 0 O Z ;o O D o 0 i a Y North Andover Board of Assessors Public Access OE..NOHT1t _.� Y 4SSACHUSEt Click Seal To Return Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial Page 1 of 1 Sroperty Record Card Location: 24 PETERSON ROAD Owner Name: KANTESARIA, SUKESH, H. KANTESARIA, SWAROOPA Owner Address: 24 PETERSON ROAD City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 5 - 5 Land Area: 0.12 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 1556 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 319,100 319,100 Building Value: 170,400 170,400 Land Value: 148,700 148,700 Market Land Value: 148,700 Chanter Land Value: http://csc-ma.us/PROPAPP/display.do?linkld=1888960&town=NandoverPubAcc 5/17/2012 N O N LLLL. 0 O w z O U) Ix W I -- LU W CL N U) U � 20 00 � J U a� W o Q. �o (Do •� o O J t0 to O Y U O lb O in N Q Oo Oo I,- r - LO vvrn U CO w J •. d IO t6 er, > 00 0 00000 ;s 0 � Z, ' O T+rlpp Z t0 C ~ eft Awa �t rt Q WfA" Z p cv p N )o LL o o `tit p Q Z LL Z It z o o�\��`��� W p �� QN U1 aP1f J o) rn p r Q c z M �� CDC) z 0 [C) C-1) cc O 411 >,, U H '(L 00 F- O 0 $ d ' c C) � j o I r- E� o Wim'>_> Q IE+-' t0J Q �I C q ILLG Q M LL �m of i 2 fn U Q Q 1 C7 LL Z 00 ;Do w M W, C IM "0) 0rn u to p rn in �f�i in CD f c6 j [ NW Nm v - O Q� Q m` (DQi �`'!= c na m ZcQ I c CLL II m €m o �1i' m ,^ n C .Nla� U. c }m N C.'� F[U I O oc 7 V I H, W.}U�UIIIIa'o Z i f 0 m N �t W tp I i/i �W/ N (6 X LL •11 @1 f MLL C) U)k.. LL O 4 md. n = (0 14,� O OM M N (1 d 2 O1N 7 O coII- X116 .01—x C7 HoDLL2WmYW mm,Q J C U N C9 jLL IM z (.i LLL C7 IQ > j � i L 'C C d = �a�E0 o .IO{X w �:.cn U) O � O 3: Y U) W to ,w LL = IL .U- k a a Date -77.) 115 ............... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION ,� sSACHUtiB .This cernfies that .....�....'. Q1f ..........I.... .......... has permission for gas install tion ............... .N. e„............................... > in the;buildin` s of ........k—A- ....... . ........ ................................................ :::.. . . ..c .................................................................. North Andover, Mass. Fee ::.:..... ..................................................................... p GASINSPECTOR Check #,5q MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY o r' MA DATE 12 Q I PERMIT # JOBSITE ADDRESS Z ` e�l-c Esc ► U A�� OWNER'S NAME GOWNER ADDRESS TE ��FAX TYPE OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ® RESIDENTIALO T PRINT CLEARLY NEW: RENOVATION: 0 REPLACEMENTr4Rfr PLANS SUBMITTED: YES N0 0 APPLIANCES Z FLOORS- BSM'l 1 1 2 1 3 1 4 1 5 1 6 7 8 9 1 10 11 12 13 14 BOILER 11 111 111 111 111 111 111 1111 CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUPAIR UNIT OVEN POOL HEATER ROOM/ SPACE HEATEF ROOF TOP UNIT WNVENTED ROOM HEATER WATER HEATER INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVE CSE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY M OTHER TYPE INDEMNITY 0 BOND OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CH CK ONE ONLY: SIGNATURE OF OWNER OR AGENT 1 hereby certify that all of the details and information I have submitted or entered regarding this applicatio re true and aca and that all plumbing work and Installations performed under the permit issued for this application will be In q3 pliance with Massachusetts State Plumbing Code and Chapter 142 of the C,eneral Laws. PLUMBER-GASFITTER NA ! ICENSE # 6?� I MP MGF ® JP ® JGF Q L GI ® CORPORATION # PARTNERSHIP#� COMPANY NA i it ADDRESS ' (✓G_ CIS' ✓ _ STATE ZIP TEL FAX I� CEL�AIL P p c ER 0 U MW kip_AIWRMM IN ►91� LLC ®# i ' W I 11-1��QllkL j zo El o yEl CD o: W o E{ a mc a Q ' W a ! p! a COrA w< J H Q d4 N S H LLI W ti I z o H U W v� 741 •. The Commonwealth;of.Massachicsetts, ,- Department oflndustrialAccidents ` 1 Congress Sheet, °Suite 100 ' _ Boston, MA' 02114 2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Name Wi m a City/State/Zip: �L' .r Phone #: 9 �A--- 6fl —d -?2 (0 5. ❑ lain 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.$ 6. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employ.,ees. [No workers'. comp. insurance required.] *Anv annlicant that checks box 41must also fill out the section below showine their workers' comnensatiot I Homeowners who'submit this affidavit indicating they $Contractors that check thtsbpx must attached an additic employees. If the sub-contradiors have employees, they f'am an enipioyer thai is providing workers' information. Insurance Company Name: . AAr Policy # or Self -ins. Lic. #; Type of project (required): 7. ❑ New construction 8. 0 Remodeling 9. ❑ Demolition 10 ❑ Building addition I ❑ Electrical repairs or additions 12. ❑ Plumbing repairs or additions 13.❑ Roof repairs 14. ❑ 'Other L policyinformation. are doing all work and then hire outside contractors must submit a new affidavit indicating such mal sheet showing the name of the sub -contractors and state whether or not those entities have must provide their workers' tomo. poliev number. insurance for my employees.' Below is the policy and job site Expiration Date: Job Site Address: City/State/Zip:. Attach a copy of t_e orkers' compensation policy declaration age:(showing the policy number andexpiration date). Failure to secure coverage a equired under c..152, §25 a riminal violation punishable by a foie, up to $1;500.00 and/or ode -year imprisonment; well as ci altt sin. Form fu STOP WORK ORDER and a fine of up to $250:00 a dayainst the violator. A copy f this sta nt mayib rward to the' Qffice of Investigations of the, DIA for insurance coverage verification. I do�hereby certify under the information provided above is true and correct. 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 #• M t` 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 o'r "tr6s'te�,e of,an individual; partnership, association -or other legal entity, employing employee's. However -the owner of a dwelling house having not more than three apartments and who resides 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 because of such employment be deemed to be an employer.' - I MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in,the commonwealth for any. applicant who liasnotproduced acceptable evidence of compliance with the insurance`toverage'required. Additionally, MGL chapter 152,'§25C(7) states "Neither the commonwealth nor anyof 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 Departmerit,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 . town that the application for the permit or license is being. requested, riot 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 onthe appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy, information (ifnecessary) and under' Job Site Address" the applicant should write "all locations 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 dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial,Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia Location,`�C toy lD No. Date -TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ / Water Connection Fee $ /677, Sy TOTAL � B idin hs r 29/ ` 07/29w%9!s�� I 7/9�9$;V ` .� PAID i -:? 902 Div. P IidWorks ` Location No. S d Date /"ZY 40*T" TOWN OF NORTH ANDOVER p: ••lAhLOw Sc� „ Certificate of Occupancy $ ` Building/Frame Permit Fee $ s�cMus Foundation Permit Fee $ A0 0 t, Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ % � isa. oo I f�ng Inspector N2 10,0 9'� M/1% 08:5 Div. Public Works MJ.� � ��� � :> J � � ..i �. _ , 4,,. p,ryl � �.a,^�. .. r: 5, -. �"a _.._ _ � ,- - ` / •» w ,. • 173 Locations No n Date 2-2" ORTH N�ao TOWN OF NORTH ANDOVER pf , ,�aa OL p Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee Sewer Connection Fee Water Connection Fee TOTAL 'J %� 1�116f�5 12.16 Building Inspector 705.00 PAIR Div. Public Works PERMIT NO, APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 .MAP 4-40. ONE' _� LOT NO. SUB DIV. LOT NO. 2 RECORD OF OWNERSHIP (DATE -I BOOK 'PAGE 1 LOCATION PURPOSE OF BUILDING l OWNER'S NAME NO. OF STORIES 0 SIZE OWNERS ADD' TSS BASEMENT OR SLAB 1 71 ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST -//k 2N l �d 3RD BUILDER'S NOME SPAN 19 s DISTANCE TO NEAREST BUILDING (/ DIMENSIONS OF SILLS _ -- --- DISTANCE FROM STREET _ +/- " POSTS 9 X4 DISTANCE FROM LOT LINES - SIDES/r TIC,.REAR /� ! GIRDERS j AREA OF LOT .t,„ FRONTAGE HEIGHT OF FOUNDATION '��'' � / " THICKNESS 6� 1 IS BUILDING NEW SIZE OF FOOTING l� I X IS BUILDING ADDITION A./D - MATER:AL OF CHIMNEY ' IS BUILDING ALTERATION Nn IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE r „ Y IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER . IS BUILDING CONNECTED TO NATURAL GAS IINE - INSTRUCTIONS F 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 E E PERMIT° GRANTED 7—ze! ,9 t. Few vwx M ' I 9E PERMIT 3 - � PROPERTY INFORMATION LAND COST EST. BLDG. COST 00 U ) EST. BLDG., COST PER 94. rldX 4/C- EST. BLDG. COST PER ROOM 1 SEPTIC PERMIT NO.: 4 APPROVED BY BUILDING INtP[C' ilt OWNER TEL. # CONTR. TEL. # 'V -r jV- CONTR. LIC.# H.I.C. # 19. j t. Few vwx M ' I 9E PERMIT 3 - � PROPERTY INFORMATION LAND COST EST. BLDG. COST 00 U ) EST. BLDG., COST PER 94. rldX 4/C- EST. BLDG. COST PER ROOM 1 SEPTIC PERMIT NO.: 4 APPROVED BY BUILDING INtP[C' ilt OWNER TEL. # CONTR. TEL. # 'V -r jV- CONTR. LIC.# H.I.C. # BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY = _4. 5toR1E5 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 _ 8 INTERIOR FINISH CONCRETE" _ CONCRETE BL: K. PINE BRICK OR STONE P PIERS PLASTER - _ DRY WALL UNFIN. 3 BASEMENT. �. • I _ - - " AREA FULL 1 II FIN. B'M'T' AREA I 'T 4 WALLS 9 FLOORS CLAPBOARDS - - B 1 6Rl4P CONCRETE _ WOOD SHINGLES EARTH -" _ ASPHALT SIDING _ _ HARDIIJ'D ASBESTOS SIDING COMMON VERT. SIDING ASPH. TILE _ • STUCCO ON MASONRY _ -STUCCO ON FRAME, _ STONE ON MASONRY WIRING _ STONE ON FRAME SUPERIOR I'� POOR ADEOUATE NONE 5 ROOF 10 PLUMBING GABLEIP GAMBREL MANSARD FLATSHED ASPHALT SHINGLESLAVATORY LWOOD JOIST BATH 13 FIX.) TOILET RM. (2 FIX.) WATER CLOSET IPELESS FURNACE - rlL1R��� l TILE DADO 6 FRAMING II 11 HEATING LWOOD JOIST IPELESS FURNACE - FORCED HOT AIR FU$ TIMBER BMS. d COLS. STEAM STEEL BMS. & COLS: HOT W'T'R OR VAPO WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS GAS j NO. OF ROOMS OIL B'M'T 2nd _ ELECTRIC l�L 13rd I NO HEATING rlL1R��� l C3 _. co, o a CO) CA d O C COO CD p o CA CD 03 ': m c -r1 Cama. o m C ° Fn - CID ti O o ?m m x p� O o --w o H C310 CD ca n o ZS.ca O O CD CD O 'O Cr7 CL -« <a o s ar mmCO) : m momCD _: Ce ,^ O O y H a. a1 Q 'O O flri c CD M CO) cb C2 V C/)-+ m c CD O. �♦ t�N 1 (1 O a m 03 ca CD n 3 O W G c� CD O CD Q o zmCD ODp 0• � �0 co CD O. C7.t/� � � 'ao• CD s cta : lV CO ��� _ p � M '"� n � � �►I OCO3 O ®�' Z �.►: a CD CD d� -. CD a — CD O : co cn cn tw "a Pi cn PC ;c m .. n ;* T, cn rb -p a rR °�' x :- Cif r" S- "� w 3 x a. CJ ^ o d o < 0 N O R 99 ~ VI GO c� C o 3 H b y� rA �O y 0 0 c r �_ w t �, � ._ '� �� i. E � � � _. �. �; r I FORM U - LOT RELEASE FORM INSTRUCTIONS: This formis used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: Phone 62c-- LOCATION: Assessor's Map Number V (9-10 Parcell Subdivision Lot(s) Street ��Q, St. Number Use Only************************ RECOMMENDATIO Z�. OS AGENTS: Conservation Adm nis rator Comments romme-m—wir =4 Town Planner Comments Food Inspector -Health Date Approved / Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approved Septic Inspector -Health Date Rejected Comments Public Works - sewer/water connections driveway permit s %-M Fire Department Received by Building Inspector C r ti ml Date i, JUL 1 91996 A 1 I r f r A -a 1 I r f -a f Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of Applicant on Building Permit (below) Address o Property for Permit (below) Map and Parcel : Purp se of Ap ' ation (check below) Phone Number of Applicant: ingle Family _ Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the Building Permit. Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building Department and is only officially accepted when the Building Permit is issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement, restoration, or reconstruction of a dwelling in existence as of the effective date of this by-law, provided that no additional residential unit is created. The lot(s) were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning Bylaw. This application is for dwelling units for low and/or moderate income families or individuals, where all of the conditions of 8.7.6.c are met and/or represents Dwelling units for senior residents, where occupancy of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this Section "senior" shall mean persons over the age of 55. This application is a part of a development project which voluntarily agreed to a minimum 40% permanent reduction in density, (buildable lots), below the density, (buildable lots), permitted under zoning and feasible given the environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently designated as open space and/or farmland. The land to be preserved shall be protected from development by an Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism approved by the Planning Board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for building permits,(i.e, all other permits from all other boards and commissions have been received and the project is in compliance with those permits), and the Development Schedule does not accommodate issuing a building permit in that Year, one building permit will be issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate information, or the checking off of an above item which does not comply, whether done to my knowledge or not, is grounds for refusal by the Building Department to issue a Building Permit. Signature cFf OWner or Authoriz6fd 04ent wh signed the Attached Building Permit Dg to This form must be attached to the Building Per it upon application for such permit. 4 jr 191996 t ,S7a 36 . O w - ��24',41s5E,/> %✓o�sE GotA7'ipc/ . �Nm ��4ytt, of o� JEFFREY _ S. /%7E.vG�jws .P�AGry %vs T-' HORAANN �ilE.P.P/�l.4Gt� E.1/Git/EE,P�.t�G SE.P�/�'ES A.VOOYE.� �1ASS,4G//!/SETTS O/8/D 'CERTIFICATE OIF USf &OCCUPANCY Town of North. Andover Building Permit Number 35 Date November 21 1996 THIS CERTIFIES THAT THE BUILDING 10CATED ON 24 Peterson Road MAY BE OCCUPIED AS -•SINGLE FAMILY DWELLING IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY, CERTIFICATE ISSUED TO _H_; 11 s i de R a f t nrn 733 Tbrnpike S t . ADDRESS Nor Anr�nvar Mq ,Building Inspector i �� 4 �� .. �. �� n �� . ''i � R .. y ,� .. 3 � f .1 �� IrI I :,}�� .. �. .. . ]. � ! 4i 1 .. � . � � y CO CO) Cl) 10 0CD� Z y CD O .. C) O Cz O-' E= = ato 10 Q C c CD CD CD cr CD CD 0 C w w B. C� CD CO) CD OL Cl O CO) CO C=D I S o CO) O '0 Z CD O CD O C CD w :L • A C O O 2 0 CD O _ O W c a _ CD m S. l 0 _ C. C 0 a H N W I p' p R Co d N C H _a O col) wpm O mQao CD '' Cl) m = 1 c o = d d� n O =rQ..a m CD d m H Q V �o = ON = N : o� �o A M y � tz O H, n io m ay = CLCD G7 ao N to y !� ad 00 n. CD • A C O O 2 0 CD O _ O W c a _ CD m S. l 0 _ C. C 0 a H N W I (D p' p R Co d N C H _a O col) wpm O mQao CD '' Cl) m = 1 c o = d d� fA =rQ..a m CD d m H Q y �o = = N : CCD, A ZC to O H, n io m ay = CLCD ao N to y !� ad 00 � CD 1 O N 'O U2 C2 N o CD CD o CD 5 CD CDCD I CD to -« (D p' p R Co d o w G' r \ Z n w C (o a'a = 1 c o !D - 24 cn cn to � r O M \ tv_\ p' p R C17 4 o w G' r \ Z n w C (o T1 (/� O 'd Off. cn M v 10 I&A )-o H 0 0- m O H 0 0- m �(Q Office Use Only uhe Tnmmnnwralt4 of filtt000l husPfts Permit No. IlepaPtmint f]f Itubli[ *afttq Occupancy & Fee Checked r' a BOARD OF FIRE PREVENTION REGULATIONS 527 CIMR 12:00 3190 peave blank) ''•ate APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electricai Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date / 6 — AL SK (M* or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street &N/umber) v 7 i�c�TPr-�nr.� rcr� 4 `cs w . Owner or Tenant '1 1,l/sf_d(9. Cwner's Address !s t!iis permit in conjunction with a building permit: Yes No (Check ApprCDriate °ex)t,� Purccse of ?uilding 5J (a, 'b L---)-4 -1 It c Utility Authorization No. 10 2 existing Service Amos _� `Jolts Cvernead _ Undgrnd n No. of Meters New Service u0 Amps /2rd! ZyU `/bits Cvernead _ Undgrnd No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical 'Ncrx UA Jj4 No. of Lighting Outlets ; No. of Hot '--cs No. of Transformers K A No. of Lighting Fixtures Swimming Psot 4ocve— 'n- — grr.c. _ _:r.c. _ Generators KVA INSURANCE COVERAGE: Pursuant to the recu,rements of Massacnusens 4erera! Laws I have a current Liaoiiity Insurance Policy inc:ucirceiec Cceravcns Coverage or its substantial ecuivaient. YES VO = I nave submitted valid proof of same to the Cffice_ YES NO = J you nave cneckcov eci YES. please ineicate :he type erage by checking the app oortate box. INSURANCE BOND = OTHER = tP!ease Scec:`:) (Exoirauon Date) Estimated Value of Electrical Work 5 ',Mork to Start 16 - ,IS ` 26 !nscec::cn Date Racues:ec: Rougn Wy f� � �� F,nai Signec uncer the Penalties of perjury! e- A C / / /, FiR'.1 NARtE ' L NC. Licensee g�t t' (s J,_3 "V -AJC 2 Signature L!C. NO. / L�Bus. lei. No. 669" Address /i�ct dsr lS.S�r; / e '�✓o �l�tr.ti/ Att. Tal. No. —.— OWNER'S INSURANCE WAIVER: I am aware that the Licensee cces not nave the Insurance coverage or its substantial eeuivatent as re- curred ov Massacnusetts General Laws. and that my s:gnature on :his permit abpiicat.on •Halves this reouirement. Owner Aeent ,Please check enol 'eiecnone No. PERMIT FEE 3 tVf' v ,.Signature of Owner or Agenn t-65_5 No. of Emergency Lighting No. of Receotacle Cutlets No. of Cil 9urners Sattery Units `:e. of Switch Outlets I No. of Gas 3urrers FIRE ALARMS No. of Zones No. Detection ar.c Initiais ting DevicesHea No. of Air Cana. No. of Ranges � tons c n JI No. Oisoosats No•cr of Putmos ons K:J No. of Souncing Devices No. of Self Contatneg No. of Dishwashers ScaceiArea ^!eatinC 4'.V ` Oetagt:On/Sounding Devices Local ;Other Con ec-i Connec::on Heating Devices KW No. of Dryers g No. of "J c. of I Low Voltage No. of Water Heaters KW S;cns ?a::as:s ! Wiring No. Hyaro Massage Tubs i No. of Motors 7otai HP 07HER: INSURANCE COVERAGE: Pursuant to the recu,rements of Massacnusens 4erera! Laws I have a current Liaoiiity Insurance Policy inc:ucirceiec Cceravcns Coverage or its substantial ecuivaient. YES VO = I nave submitted valid proof of same to the Cffice_ YES NO = J you nave cneckcov eci YES. please ineicate :he type erage by checking the app oortate box. INSURANCE BOND = OTHER = tP!ease Scec:`:) (Exoirauon Date) Estimated Value of Electrical Work 5 ',Mork to Start 16 - ,IS ` 26 !nscec::cn Date Racues:ec: Rougn Wy f� � �� F,nai Signec uncer the Penalties of perjury! e- A C / / /, FiR'.1 NARtE ' L NC. Licensee g�t t' (s J,_3 "V -AJC 2 Signature L!C. NO. / L�Bus. lei. No. 669" Address /i�ct dsr lS.S�r; / e '�✓o �l�tr.ti/ Att. Tal. No. —.— OWNER'S INSURANCE WAIVER: I am aware that the Licensee cces not nave the Insurance coverage or its substantial eeuivatent as re- curred ov Massacnusetts General Laws. and that my s:gnature on :his permit abpiicat.on •Halves this reouirement. Owner Aeent ,Please check enol 'eiecnone No. PERMIT FEE 3 tVf' v ,.Signature of Owner or Agenn t-65_5 -- i •- �. � '�. e �• � ��`*�� ,.n. ., � I �I :y. ` . r f � ` ..r ._- -_ -. � - ,.. ` . r ;� j �':1 Ly �4 � r Date ... 1..... ....%�....../..0 519 OtNooTe,h F: oLp TOWN OF NORTH ANDOVER PERMIT FOR WIRING �,SSACMUS� This certifies that ...... �.. `. e SAA . t ........................................................................ has permission to perform ... . ....... . wiring in the building of........,, C F, tT„�( c... l.(..s..!.. Ln at ........ ............................. . North Andover, Mass. o Fee..i..7S...:.Jf-,Lic. No.Jam/ ........................................................ . ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer i'. � Office Use Only q �� uhr �UmUtUUwrttl tts ttt U59ii9 Permit No. ~ _ r �E}turtmErit ofuhl'ttufEtg Occupancy & Fee Checked 4 : 3/90 (leave blank) BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 [qJ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 1 ` �s Vi or Town of NORTH ANDOVER To the I spector of Wires: The udersigned applies for a permit/tto perform the electrical /work described below. Location (Street & Number) 44 1-1 �`7�f�^Ad r�( Owner or Tenant YJ 11si0e Oe Owner's Address 733 % Vo''1vP,, A 4), 111,191 Is this permit in conjunction with a building permit: Yes E--:r----No (Check Appropriate Box) Purcose of Bulidina ��h �i�B /i�n9 Utility Authorization No. ,jd� Existino Service Amos _J Volts Overhead ❑ Undgrnd ❑ No. of Meters New Sernce -- Amps 12:5LJ K� Volts Overhead L_ Undgrnd C No. of Meters Number of Feeders and Ampacity Al Location and Nature of Proposed Electrical Work e -w O Uv( !fes%i S �9 No. of L:cni nc Out ets No. of Hot Tubs total No. of Transformers KVA Above, In - No. of L:gnt)ng Fixtures Swimming Poolgrnd. I grind. Generators KVA No. of Emergency Lighting No. of Receotac:e Cutlets No. of Oil Burners Battery Units No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones Total No. of Detection and No. of Ranges No. of Air Cond. tons Initiating Devices No. of Cisoosais Heat Total I No.of Pumps Tons Total KW No. of Sounding Devices No. of Self Contained No. of D snwasners I Space/Area Heating KW Detection/Sounding Devices No. of Dryers Heating Devices KW Municipal Locai jj Connection' Other No. of No. of Low Voltage No. 0 Water Heaters KW I Signs Ballasts Wiring Nn. of Motors Total HP OTHER. INSURANCE CC.'ER.AGE: Pursuant to the reowrements of Massachusetts general Laws_ I have a current Liamitty Insurance Policy including Comp Cperations Coverage or its substantial equivalent. YES NO — I have suomttteo vaud orcof of same to the Office. YES C NO - If you have checked YES, please indicate the type of coverage by checK ng the aocro to oox. INSURANCE _ BOND - OTHER - (Please Soecrty) (Expiration Datei Estimates Value of Eiectn alll Work 5 WorK to Start �/ Inspection Date Recuested: Rough G—'¢i .�� Final Signeo unser the Penalties of perjury: L V �9 FIRM NAfv1E (/V �L �� LIC. NO. G,�; LIC: NO. censee //�� �r'0�✓��� « Signature _; cj 9 /� 1 6, W ' " "' %�%� Bus. Tel, No. � � � s 6,?1/6 Aceress 247g 1-11410 Ila /�` 4h_ /1 ,ah Alt. Tel. No. OWNERS INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re cuired ov Massacnusetts General Laws, and that my signature on this permit application waives this redu)rement. Owner Agent (P!ease check one) Telephone No. PERMIT FEE 5 Sionature of Owner or Aaentl Y•5 65 ..._.. �_ .. �._..- h • + '�.1 ..- Y'+F. 1 ... �1: � �. i to /i' `, .! moi. .. 1'T. - 'rte � � i l �¢ d �3 � �,'� ��• y '' 1 ��• � - �� .. s eM. ) ( r�.t s —,. i 1F -i f� ;� .1 Ii _,. .. . _� . ` ' -. `� ` , f !. � ,� .. .. , l � _ a.. ._ _.. l� r ... .. .. .. ._ ..._ _.... ... _. `� A F .. 1 7. i .. �- __� L�., ' :,�. .. �fi w,, . 1 � ` � � r' �1 ." .. i . r � ,..r� 1 Date ............ / .. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............................... :..A ...... I, ............... ...................... has permission to perform ..... ...... ......... ......... ..... Z.: ..... ............ . . . ...................... wiring in the building of .... ......... ... . .. / atZ ........ .. . . r.......................... . North Andover, Mass. Fee.. Lic. ................ .. .T..R..I...... ...... ....... ................. INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File