HomeMy WebLinkAboutMiscellaneous - 250 BRIDLE PATH 4/30/2018 (2)r
it
Date...../
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ...............
yre 0
...................................................................
has permission to perform ........ ..........................
wiring in the building of ............. V4. W. ...... M'Pkgoe .............................
I # 71�-"
at ......... � �A R. ..... k� ....... . North Andover, Mass.
Fee.,,'.,.,I ...... Lic. No.-ZA�.................1!1- �^r- ". K" &z . . .......
ELECTRICAL INSPECTOR V
Check #
66' 6
d
10,
Commonwealth of Massachusetts
y Department of Fire Services
51 BOARD OF FIRE PREVENTION REGULATIONS
M
Official Use Only
Permit No. &
Occupancy and Fee Checked
[Rev. 9/051 (leave blank)
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 A IN O TION) Date: y — 2—' d L
City or own f: N"T+ � V �Y To the Inspector of Wires.:
By this application the undersigned gives notice of his or her intention to performthe electr cal work described below.
Location (Street &Number) _V, L7 20 � y , � I R l hrl
Owner or Tenant
Owner's Address v j A" 'L, t I
Is this pert' in conjunction with a uilding ermi ? Yes
Purpose
Purpose of wilding S ��t��l oJ(/t%A \A b til
Existing Service Amps / �olts Overhead ❑
New Service Amps 12 p /X\ -Q Volts Overhead ❑
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
Telephone No.' q S
No ❑ (Check Appropriate x)
ty Authorization No. (- -� 7
Undgrd ❑ No. of Meters
Undgrd No. of Meters
Completion of the following table may be waived by the Inspector of Wires.
No. of Recessed Luminaires I :2
No. of Ceil.-Susp. (Paddle) FansNo.
3
of Tota
Transformers KVA
No. of Luminaire Outlets
No. of Hot Tubs
Generators KVA
No. of Luminaires
Swimming Pool Above ❑In- ❑
rnd. grnd.
o. of Emergency Lighting
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
Initiating Devices
No. of Ranges
No. of Air Cond. Total 5
Tons
No. of Alerting Devices
No. of Waste Disposers
Heat Pump
Totals:
Number
Tons
I
KW
I
No. of Self -Contained
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local ❑ Municipal ❑ Other
Connection
No. of Dryers
Heating Appliances Kms,
Security Systems:
No. of Devices or E uivalent
No. of Water KW
Heaters
No. of No. of
Signs Ballasts
Data Wiring:
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: 1 �)) (When required by municipal policy.)
Work to Start: �— I f �J. 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 BOND ❑ OTHER ❑ (Specify:)
certify, under �thpa irs andpe�laltiesof perjury, that tthieeinformation on thisap lication is true and completeFIRM NA E:1co L� , C 1 ' LIC. NO.:
Licensee: Q_ ry It � y p ;, Signature
Y4 LIC. NO.:
(If applicable, enter "e ein t" in the lice4e um er line.) / Bus. Tel. No.t�y
Address: � � O �1 oc� I a� S"1- lnl Q l�_ �/I. J � "t Alt. Tel. No.: Jq =;s
Security System Contractor License required for is work; if applicable, enter the license number here:
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) F_] owner ❑ owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE. $ a
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CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number 738 (5/26/061 Date: March 30, 2007
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 250 Bridle Path
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: Henry Kucharuk
250 Bridle Path
North Andover MA 01845
�!7�_
Building Inspector
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APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION
Building Permit #
ADDRESS/LOCATION OF PROPERTY: J� I JY��
&A
U , I
-<--Parcel i
SUBDIVISION
Lot Number
DATE RE UES ED FILED/READY FOR INSPECTION.,*- J -d9 e 7
CLI,
L ING DATE ON PROPERTY:
FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED
ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-
INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE CHARGED IF THE STRUCTURE
nn=Q A1nT MFFT Al 1 APPI 1(%ARI F CODES_
Permit Issued to:PJ0
✓ 2 LL
Address l
SIGNED
ROUTIN
CONSERVATION
PLANNING
DPW - WATER METER ffll
/`�
SEWER/WATER CONNECTION
NOTE
DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO
SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST
DPW
Signature
File: Application for OC form revised Jan 2007
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TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
-QAC MUS'
��.�
This certifies that .. ...................
has permission to perform ......... !. ...................
plumbing,in the buildings of V�-IIO ''..... .
at ....... NorthlA-ridover, Mass.
Fee`,. ?)r). Lic. No. ... ...............
UPLUMBI GANSPECTOR
Check x� 7
7081
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building Location 9 �o t 7^Z �Q 1 e^ C
New d
Type of
Name N e„
Taney
Date U b
Permit
Amount �
Renovation 1:1 Replacement 171 Plans Submitted Yes n Nn M
Installing Company Name (ii% leo f �`,,,ti ; v-necx one: Certificate
{ �j n ', ' *- �rf�1✓IC; ❑ Corp.
Address c{ J 7 e G� d ✓� 5- Partner.
L' `., f f- 0 �01
Business Telephone 'Z P, Cp C> ® FirnVCo.
;Name of Licensed Plumber: IN � (� i a tM k e C) /-Z I
Insurance Coverajze: Indicate the 1xpe of insurance coverage by checking the appropriate box:
Liability insurance policy IT Other type of indemnity Bond
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any cne of the above
three insurance
Signature I
Owner
I hereby certify That all of the details and information I have
best of my knowledge and that ;ill plumbing work and inst,
compliance with all pertinent provisions of the NIassachrLlen
BY
Title
City,Town
APPRON'ED (OFFICE USE ONLY
❑ Agent ❑
itted ((-,r entered) in above application are true and accurate to the
d under Permit Issued Cor this application will he in
State bines e ltd ChapVf 142 of the General Laws.
Type of Plumbing Licens�
/D2� v
tcense 777,577 Master0/ Journe,,man 11
owl
Date.. 11-011=1
*x" �o� TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
L
This certifies that ...... ............-�F^�...�-.......................n......................................
has permission to perform ....."t...P........l .........00,gt
wiring in the building of .............4C H.. V . Z. y A............................
Z04
at L°r......... % l D.Z.I.P�'�Y North Andover Mass.
Fee..A,I�.s �Lic. No.3%3.4.7................
ELECTRICAL INSPECTOR �
Check # (T/
6 6 .)
r
J
r1
Commonwealth of Massachusetts
lugDepartment of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
Official Use Only
Permit No. �j 605'
Occupancy and Fee Checked
[Rev. 9/051 (leave blank
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 PRI TIN W
OR TYPE A L IN O TION) Date: ��
City 0 40,wn f: �1 Q To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the elpctrical work described below.
Location (Street & N70-%-
ber)
Owner or Tenant
Owner's Address
Telephone No.�
01;'- z 3
Is this permit in conjunction with a building permit? Yes No ❑ (Check Appro 'ate Box)
Purpose of Building " , ,p t eta; r e Utility Authorization No. 611-
Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
New Service Amps Z1,J p Volts Overhead ❑ Undgrd No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
Completion of the following table nzay 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
Above In-
Swimming Pool rnd. El d. 0
o. o mergency Lighting
Batter Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
No. of Detection an
Initiating Devices
No. of Ranges
No. of Air Cond. Total
Tons
No. of Alerting Devices
g
No. of Waste Disposers
Heat Pump
Totals:
Number
Tons
....
KW
No. of Self -Contained
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
Heaters
No. o No. o
Signs Ballasts
Data Wiring:
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: 3 0Z) (When required by municipal policy.)
Work to Start: -S' I —,� L 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 �qov rage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCF� BOND ❑ OTHER ❑ (Specify:)
I certify, under the pains and penalties of perjury, that the information on this application is true and complete.
FIRM NAM : Cr "-"4LIC. NO.:
Licensee: yV ,.a k'Q Signature 4 t , LIC. NO.:
(If applicabl , enter "exAipt" in the lic'enieJuniber line.) Bus. Tel. A11- �
Address: L 11 2 C Tel. No.: QJ JU
*Security System Contractor License re4ired for this work; if applicable, enter the license number here:
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 agent.
Owner/Agent 0%
Signature Telephone No. PERMIT FEE. $5 � .
r
Date.'.. & ......
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that. v- `D ...( ,' <, ��f
has permission for gas installation .... ......... .
in the buildings of ...,�-`. --r .F-!-� . .......... .
at :?....................... t , N�rt Andover, Mass.
Fee���? .Lic. No. /nom --a .. . ..............
GAS v vPE'CTOR
Check # %
57U4
1NIASSACHUSEITS UNIFORM APPLICATON FOR PERNUT TO DO GAS F frMG
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building Locations
5'y �r� a� 2 ) a
Date l ^ (—o ^ 0
��.�. Permit# 7
Amount $ /0V
e�.r y _ l c, cker 1,z`=
Plans Submitted ❑
Owner's Name
New[Er Renovation ❑ Replacement ❑
(Print or type ; (C v p 16
, , /
Name 'l ►'J jfij-
Address
L7 e ✓n s 77 r
Busine� ss'rT one 7
4 q S�
C,< 0 1 $:�,a
Check one: Certificate Installing Company
Corp.
Partner.
Firm/Co.
Name of Licensed Plumber or Gas Fitter M a.7 Cc -q -T
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes No 13
If you have checked Yes, please ' icate the type coverage by checking the appropriate box.
Liability insurance policy Other type of indemnity 13 Bond 13
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.
Check one:
Signature of Owner or Owner's Agent Owner � Agent 13
1......L.. _. �: L'_..L_� _I1 _
..j I.., W1 Lt— --La uilu 1111v1u1auvu I 11uvc suurluueu for enterea) in above application are true and accurate to the
best of my knowledge and that all plumbing work and i tallat'ons per ned under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massa usetts S , to gas C fle2tnXhapt3t4'21--f the General Laws.
By:
Title
City/Town
APPROVED (OFFICE USE ONLY)
,nature of Li
Lj
Plumber
El
IL
13
Master
13
Journeyman
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SUB -BASEM ENT
B A S E M ENT
1ST. FLOOR
2N D. F L O O R
3R D. F L O O R
4T 11. FLOOR
5TH. FLOOR
6TH. FLOOR
7TH. FLOOR
8TH. FLOOR
(Print or type ; (C v p 16
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Name 'l ►'J jfij-
Address
L7 e ✓n s 77 r
Busine� ss'rT one 7
4 q S�
C,< 0 1 $:�,a
Check one: Certificate Installing Company
Corp.
Partner.
Firm/Co.
Name of Licensed Plumber or Gas Fitter M a.7 Cc -q -T
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes No 13
If you have checked Yes, please ' icate the type coverage by checking the appropriate box.
Liability insurance policy Other type of indemnity 13 Bond 13
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.
Check one:
Signature of Owner or Owner's Agent Owner � Agent 13
1......L.. _. �: L'_..L_� _I1 _
..j I.., W1 Lt— --La uilu 1111v1u1auvu I 11uvc suurluueu for enterea) in above application are true and accurate to the
best of my knowledge and that all plumbing work and i tallat'ons per ned under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massa usetts S , to gas C fle2tnXhapt3t4'21--f the General Laws.
By:
Title
City/Town
APPROVED (OFFICE USE ONLY)
,nature of Li
Lj
Plumber
El
Gas Fitter
13
Master
13
Journeyman
seyi Plumber Or Gas Fitter
'4,7 IV,-/ 0 25-c)
License Number
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