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HomeMy WebLinkAboutMiscellaneous - 255 STEVENS STREET 4/30/2018XT O N o co $ m NZ N O O cn M o m o M J � .. The Commonwealth of Massachusetts FOR OFFICE USE ONLY Permit No. (o Department of Public Safety Occupancy dr Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work will be performed in accordance with the Massachusetts General Code. 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date �` 9 7 City or Town of to ;�ti��7��7Q To the inspector of Wires: The undersigned applies for a permit to perform the electrical work described below: Location (Street and Number) o7Sr .S%�vEy' ST Map: Lot: Owner or Tenant 77�yl%S U✓C 6:7T _ Zone: Owner's Address 3115W,1�7 Is this permit in conjunction with a building permit? Yes Q'No El (Check Appropriate Box) Purpose of Building /�E� �b"UJ Utility Authorization No. % OS % Existing Service Amps / New Service ;2o -o Amps / Volts Overhead ❑ Volts Overhead ❑ Underground ❑ Underground ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 'y� sew rr� e, --- No. of Meters No. of Meters No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above grnd. ❑ In-grnd. ❑ Generators KVA No. of Receptacle Outlets �t/ No. of Oil Burners No. of Emerg. Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection'and Initiating Devices No. of Sounding Devices No. of Self -Contained Detection/Sounding Devices No. of Ranges No. of Air Cond. Total Tons No. of Disposals No. of Total Total Heat Pumps Tons 1'W No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No. of Signs No. of Ballasts Local ❑ Muncipal Connection ❑ Other No. of Hydro Massage Tubs No. of Motors Total HP Low Voltage Wiring INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts Geral Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES Eff NO 111 have submitted valid proof of same to this office. YES L1 NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE LT BOND ❑ OTHER ❑ (Please Specify) Estimated Value of Electrical Work $ Work to Start Signed under the penalties of perjury: FIRM NAME G�i�l/D2s EG�CT� i C Licensee 01,10EA17- • LW cWS Address elf g±±� /,�;Z• (Expiration Date) Inspection Date Requested: Rough l� C Final o/ ryr _ ~LIC. NO. LIC NO. 114SS'/ o7— Bus. Tel. No. SW- K R e�— 3 e ,- 2 Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee 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 requireme t. Owner ❑ . Agent ❑ (Please check one) Telephone No. PERMIT FEE $ (Siznature of Owner or Aeent) N° I b- b 8 Date ........... ... . .... ... ... .. $ P4 f NORTI� " TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACHUS�N O This certifies that ....Z.a e?...... s � . ���.��< « � ................................. has permission to perform ....... k) 40. L ,...1......... ...... ....................... wiring in the building of ............ .tl.t..". J'R..:i: f .................................. at .... . ........... : zs........ . ........................... , North Andover, Mass. Fee ... 3C� 1.� Lic. No. � �r'' .... ............................................................ ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer i % The Commonwealth of Massachusetts FOR OFFICE USE ONLY Permit No. ,. Department of Public Safety Occupancy & Fee Checked u,p BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 (leave blank) APPLICATION FOR PERMIT TO.PERFORM ELECTRICAL WORK All work will be performed in accordance with the Massachusetts General Code. 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date �� �' 7 __ v City or Town of 'Albdy��7e To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below: Location (Street and Number) �S� SyE�'' Sr Map: Lot: Owner or Tenant y /�GUG E %% _ Zone: Owner's Address Is this permit in conjunction with a building permit? Purpose of Building �1E&/ 141,v�� Existing Service Amps /. New Service Amps / Yes Q -'No ❑ (Check Appropriate Box) Utility Authorization No. ;�;�,7,57,--,% Volts Overhead ❑ Volts Overhead ❑ Underground ❑ Underground ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work � Sew U" e, --- No. of Meters No. of Meters No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above grnd. ❑ In-grnd. ❑ Generators KVA No. of Receptacle Outlets No. of;bil Burners " No. of Emerg: Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection'and Initiating Devices No. of Sounding Devices No. of Self -Contained Detection/Sounding Devices No. of Ranges No. of Air Cond. Total Tons No. of Disposals No. of Total Total Heat Pumps Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No. of Signs No. of Ballasts Local ❑ Muncipal Connection ❑ Other No. of Hydro Massage Tubs No. of Motors Total HP Low Voltage Wiring OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts Geral Laws I have a current Liability Insurance Policy including Cgnpleted Operations Coverage or its substantial equivalent. YES L►1 NO 111 have submitted valid proof of same to this office. YES M NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE LTBOND ❑ OTHER ❑ (Please Specify) (Expiration Date) Estimated Value of Electrical Work $ Work to Start Inspection Date Requested: Rough e Final Signed under the penalties of perjury: _ FIRM NAME G�A/.Dl_10s C. - - LIC NO 597 -- Licensee 0A1CF,t17_9- W,6WS Address /&" 157' :�e �S AM LIC NO.off— Bus. Tel. No. Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee 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 th' requirement; Owner ❑ Agent ❑ (Please check one) L Telephone No. PERMIT FEE $ J (Signature of Owner or Agent) 1 A I -* - N-01 401 -/-w Date.. .1 .................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that.... ........ —21 .............................................................................. has permission to perform . ................ wiringin the building of ... ..................................................................... at ... ...... ;t'!1 .................................. ...... .North Andover, Mass. ... Fee..- .T.J. Lic. NoA41�')Zi .......................................................... 1,117 ELECTRICAL IwEcroR 01/22198 14:28 75.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Y C The Commonwealth of Massachusetts Department of Public Safety rBOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 FOR OFFICE US ONNLY� Permit No. ami Occupancy & Fee Checked (leave blank) `�'e 1 ✓ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work will be performed in accordance with the Massachusetts General Code. 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date �' � �- ?7 City or Town of /uG. Y11ht-P11UF11 To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below: Location (Street and Number) Ja S� S //�tl-- ' S7. Map: Owner or Tenant �>7°/tel¢ !`fes 6V G C 7�— _ Zone: Owner's Address SSE Is this permit in conjunction with a building permit? Purpose of Building ii/EGd /�v E Existing Service Amps / New Service Amps / Volts Yes 2`*No ❑ (Check Appropriate Box) Utility Authorization No. �/–n 7 O_�-z Overhead ❑ Underground ❑ No. of Meters Volts Overhead ❑ Underground ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work / �''� y f fe G� ' No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above grnd. ❑ In-grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emerg. Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection'and Initiating Devices No. of Sounding Devices No. of Self-Contained Detection/Sounding Devices No. of Ranges No. of Air Cond. Total Tons No. of Disposals No. of Total Total Heat Pumps Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No. of Signs No. of Ballasts Local ❑ Muncipal Connection ❑ Other No. of Hydro Massage Tubs No. of Motors Total HP Low Voltage Wiring OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts Ge�neerral Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES LJ NO 111 have submitted valid proof of same to this office. YES 9'KO❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE 131BOND ❑ OTHER ❑ (Please Specify) (Expiration Date) Estimated Value of Electrical Work $ Work to Start Inspection Date Requested: Rough —2� e Final Signed under the penalties of perjury: FIRM NAME Gi4�/11>`S E`GFCY7�i C�� Z ) n, eve. p - LIC. NO. ZT9/­7– Licensee Signature LIC NO. _ S2/2— Address 4400 ST 110. '1g7U64ViPe /U% -el P_YS Bus. Tel. No. .0's- Alt. 6 Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee 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) �4 Telephone No. PERMIT FEE $ elk (Signature of Owner or Agent) The Commonwealth of Massochuseirs a.aae`i' ►i:, - Deportment of hiblic Sofcry o�..T.Kr s ►.. o�eetsf BOARD OF FIRE PREYEHi10N REGULATlOh4S S27 CMR 12bp 3/90 9148.4 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK AU work to d< pctiormed in accordance with the Maeuehusens Eleetrkal Coda. S27 CBR 12:00 (PLEASE PRINT IN nM OR TYPE AIL,41NFORHMON) Date f City or lova o. /y" %�i✓ dvf! It To the Inspector of Wires: The unC*rsigned applies for a permit to perform the electrical work described below. Location ('.treet 6 Number)S�- 0.rer or Tenant a+ner's Address --I- Is is this permit in conjunction with a building perait: Yes ❑ No (Check Appropriate Box A , rpose of Building_ ' /[ Utility Authorization NO _ Existing Service Amps / volt Overhead t►ndgtd C No. of ::etlYs New Strwice _haps / Volts Overbtad ❑ Undd ❑ Sr No. of lieters Nuaber of Feeders and Annaciry Location and Nature of proposed Electrical Work A. 119, 1 � ? No. of Lightistg Outlets No. of Hot TubsTotal No. of Transformers ao. of Lighting Fixtures Sw=ing Pool Above ❑ In- arnd. ❑ EyA Generators i:o. of Receptacle Outlets grnd. No. of Oil Burners XVA No. of Emergency Lighting No. of Switch Outlets No. of Gas Burners BatteryUnits FIRE ALUWS No. of Zones No. of Ranges No. of Air Cond. Total tons No. of Detection and INC of Disposals No. of Hest 2ou1 2ou1 Initiating Devices Pu=Ps s Ret No. of Sounding Devices 00. of Dishwashers Space/Area Heating gu No. of Self Contained No. of Dryers Detection/Sounding Devices Heating Devices KW _ I-OCal ❑ Kmieipal []Other Connection No. of Water treaters No, of o. o St s Ballasts Low Voltage Wir1n No. Hydro Massage Tubs No. of !Bofors Iota! HP OAR: INSURANCE Co,,T Cr. Pu nt to the requireaents of Has:achusetts General Laws e have a current Lia ty Insurance Policy including Cospleted Operations Coverage or its substantial equivalent. YES NO (� 1 have submitted valid proof of same to this office. YES ®— Ii you have ehe YES, please indicate the type of coverage by checkingthe appropriate box. INSURANCE BOND [] MMM ❑ (please Specify) Estimated Value of Electrical Work S (Expirration ate 41ork to Start -i - //- y� Inspection Date Requested: Rough j %/J '/ ;fFSnal Signed under the penalties of perjury: FIRH G� Licensee� S Signature LIC. No.� /address %,�S Eus. Tel. NO. �/�-7 vet Alt 0"'L;.'S INSURANCE WAIVER: I am aware that the Licensee does not have the •i Insurance coverage or is sub- stantial equivalent as required by Massachusetts General vs . cast my signature on this t application waives this requirement. Owner Agent (Please ehcck one) Telephone No.PE.RHIT FEE S S b Signature of Owner or Agent 940 Of HORTM 1h, O F 9 SACNUS Date .... �7� ... /n . ..... .... . /21-/ TOWN OF NORTH ANDOVER PERMIT FOR WIRING �op O This certifies that .......�:!' ................... .................................................... has permission to perform ....... ..........K.�.t...L . ............... a wiring in the building of ........ ...v. V !V.(' ... ................. •, at .....Z...7..v. P ....... ........................ . North Andover, Mass. Fe .. � 5.:. Lic. No.� �............. e ................................................ ........... ELECTRICAL INSPECTOR C � 11 -1f(3/ WHITE: Applicant CANARY: Building Dept. PINK: Treasurer T 1222 #'40 4, 0 0 r o 0 SACHU Date.... //y/V TOWN OF NORTH ANDOVER PERMIT FOR WIRING Ljc..- I, j -E d — j This certifies that ............................. S ......... has permission to perform ... TkAmg� ......... ........................ wiring in the building of ...1.14-6 -yyw ...... Aa w .. WtP ...................... at ... ...... ... S.1 .................................. . North Andover, Mass. Fee. ler — 0 ........... L i c. N (A .... 3 .. ........ ............................................................... 6 1� ELECTRICAL INSPECTOR '6110120/97 12:25 5o.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer _ T12e Commonwealth of Massachusetts Office Use Only t = - Permit No. i; Department of Public Safety Occupancy & Fee Checked &(6 3/92 OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/92 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 Q (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date— 377"v�9/90'r _ To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) d5-5 STeyeiYr 17- Owner T Owner or Tenant /GY% W P_�yH4r%/1 .1y4e 1t/�1 11Ve Owner's Address yd �i/`7 S7-1 h/a. 10/l/m/4:16— Is this permit In conjunction with a building permit: YES 0 NO ❑ (Check Appropriate Box) Building Permit No. Purpose of Buillding Utility Authorization No. Existing Service Amps Volts Overhead ❑ Underground ❑ No. of Meters New $cry:cz —Amps—/— Volts Overhead ❑ Underground ❑ No. of Meters Number of Feeders and Ampocity Location and Nature of Proposed Electrical Work No. of Lighting outlets - — No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Above Swimming Pool ground In - ❑ ground ❑ Generators KVA No. of Receptacle Outlets No.—Of Oil Burners____ No. of Emergency Lighting Battery Units No. of Switch Outlets No. of GasBurners FIRE ALARMS No. of Zones_ No. of Detection and initiating Devices No. of Sounding Devices No, of Self Contained Detection/Sounding Devices Municipal Local ❑ Connection ❑ Other No. of Ranges _ - Total No. cf Air Conditioners Tons No. of Disposals _ _ Total Total No. of Heat Pumps Tons KW _ Space/Area Heating KW No. of Dishwashers No. of Dryers y _ _ _ Heating Devices KW No. of Water Heaters KW No. of Signs No. of Ballasts _ _ Low Voltage Wiring SECVLlTy�SY No. Hydro Massage Tubs No. of Motors Total HP _�iY1.r�t/.r I�.G.�.T'AOf �'?�tw✓.CO OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy inciluding Completexl Operations Coverage or its substantial equivalent. YES NO ❑ I have submitted valid proof of some, to this office. YES ❑ NO If you hove checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify) Estimated Value of Electrical Work (Expiration Dote) Work to Start Inspection Date Requested: Rough Final Signed under the penalties of perjur ? FIRM NAME 1 � l�i�% ��iG4.101 LIC. NO. /�-•+�� Licensee G�- .6 Signature LIC. N/0_.. // //77'�/V 57 �l/ /Y�J�'/� d ��'/ g Bus. Tel. No. Address OWNER'S INSURANCE WAIVER: Aft, Tel. No. I am aware that the Licensee does not have the insurance coverage or its substantiae e required by Massachusetts General Laws, and that my signature on chis permit application, waives this requirement. Owner _aAglent as .gent (Please check ane) Telephcne '1iT FE= S (Signature :i Dwner or Agent) N2 1403 C, Date..Z-.. .. .... .. . ..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that ............................................................... ............. ............... has permission to perform,-.-. wiring in the building of ........... .................................................... . ............ at.,,---�5 ..... .................. . North Andover MassQ ti Fee\,2,.�--.G . .... Lic. No. .. . ............................................................ c—,/ --# cP�l ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer A AP *1P MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT T0:D0'pLU f4 (Type or Print) NORTH ANDOVER ,Mass. < . `I •Date: -2rj 19 Building Locationi-j �� e, ve10 Permlt 'y WQ�. Owners Name t3 W�11 q New Renovation Replacement Plans S bmitted FIXTURF w x' z Y a to vl O x F to W W Y a >~ v 0 zcc = W a O W t- W pr I,., 0 X X t m W = Z W 01 K v Cr v vzi YXI a• a I- H z o a o cc a o. x 0= a 4 03 sit: Q W to cc J x a .0 J a W F- I.. WO J cc91. 0 le • i 'F• V Y 1' O N N 7 N 1- X O V Ol W I.. O 0 X • a < a x—_ a a O a -j a cc 0: 1* 4C 0 < t- 3 Y J on Gila O J 3:: = 1- N W O O a <3;; 'fc to O sus-,eSMT, BASEMENT IST FLOOR it 2NO FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 0 11TH FLOOR t (Print or Type) installing Company Name — Address k f z - Business Telephone 0 Name of Licensed Plumber: I'. Check one: Certificate (� Corp. Partner. Cj Firm/Co. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Bond Ci Insurance Waiver: 1, the undersigned, have been made aware - that the licensee of i this application does not have any one of the above three insurance coverages. Signature of ownerlagent of property Owner Agent\k (� booby certify tial all of dic details and information 1 Iu.c subiniltcd (ot cntcicd) in at -we application site (tut atl4�c late IQ the belt of 111r iutowledge and that all Plumbing work and inslallations loco for mcd undcr rcrit, it issucd for this applicalion wi11 be in colty11iatwe Wilk 1111 pat614601 VW14 •ilio" of the Musachusetls Slaw Plumbing Codc and C aptcs It 2 of lllc Gcocral Laws. iN B i iTitle City/Town: i -• .A ooprwrn 7nFFICF USE ONLY1 Signature of 'Licensed Plumber Typpe of Plumbing License License Number A^1 Master ❑ Journeyman i Date. € � 3546 . Oq Hoar„ TOWN OF NORTH ANDOVER o ; 40 PERMIT FOR PLUMBING I'SSAGMus� This certifies that ..�. 4 `� �.'.�q �.I�.t.................... has permission to perform .. W? .. .o. �-^. �................ plumbing in the buildings of ... 9A ...... at r�J. S ^.. �' �. �. t �...? .... North Andover, Mass. Fee. -3.9 6.....Lic. No..`11Y.1.Y.. ..... �.... '~�% ....... PLUMBING INSPECTOR 11/28/97 08:38 WHITE: Applicant 3%.00 PAID CANARY: Building Dept. PINK: Treasurer v MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFiTTIN1G (Prit'tt or Type) [FORTH ANDOVER Mass. Date tuilding Location Zr'j �j c�� Q V�l� �� Permit ># 01 O as .lt Owners Name W ? New �Z Renovation II Replacement Pans Submitted II (Print or Type) Check one: Certificate Installing Company Name Q Corp. Address Partner. Firm./Co. Business Telephone:g Name or Licensed Plumber or Cas Fitter Ir.surance Coverage. Indicate the type Of insurance coverage_ by checking the aoorocriate box: Liability .insurance .policy+- Ct;.er type o; indemnity Bond Insurance Waiver: 1, the u ndersic.n.ed , have been made aware that -the licensee of this appiication does not have ar.v one o: the above three. insurance coverages._-. .. Signature or owner/agent or property Owner Agent Q I hc:ehy ccr ily that ail or the details and information Lave uthrnit:ed (or entered) in above aopiiotion ate true and arcuate to the best of my k-lowtedge and taut atl plumbing worst and Instadatiotss ;crior d unds' t-srnit izsc d fo: this appiication will be in compiisrtca vittz ad ,tet —t provisions of the blassaehuaetts slate eat Gide anC Gupta l<-, zr t: a ce.,cr_i laws 3v TV?= LIC�V�' Titre l Gasiitter Signature of Licensec Master Plumber or Gasfi.tter C` `'T�TO`"'�' Sot.:_neyma n Qr )--I I iAPPROVED (OFFICE USE ONLY} Lice se Ndmoer . as C va 05 _.. W � m c I o v a �-• __ as ul < C C C O O F U4 - -- < - - - m H W < _ u+ a C- C W 4 - - -- - - ._. _ UJ to _W . tfT a < j UA- < W }!- C G IG v B A srzMEEaT I I -I I I I I I I I I I L_.._I - I. -I-.� ::4-,=F:_1__.. I 1ST FLOOR I I I I( I i j M ► l i! i i I! ►. .._.I .1 : I 2`LB FLOOR I I I +II I I I f I I I I I I I I ( I I I I. t I __;. tI . _.I .- I 3Rn FLOOR 47 FLOOR 5TH FLOOR -1-71 7TH FLOOR I I I I I I I I I I I I I ( I I I I aTF4 FLOOR I I I I I ( I I I I I (Print or Type) Check one: Certificate Installing Company Name Q Corp. Address Partner. Firm./Co. Business Telephone:g Name or Licensed Plumber or Cas Fitter Ir.surance Coverage. Indicate the type Of insurance coverage_ by checking the aoorocriate box: Liability .insurance .policy+- Ct;.er type o; indemnity Bond Insurance Waiver: 1, the u ndersic.n.ed , have been made aware that -the licensee of this appiication does not have ar.v one o: the above three. insurance coverages._-. .. Signature or owner/agent or property Owner Agent Q I hc:ehy ccr ily that ail or the details and information Lave uthrnit:ed (or entered) in above aopiiotion ate true and arcuate to the best of my k-lowtedge and taut atl plumbing worst and Instadatiotss ;crior d unds' t-srnit izsc d fo: this appiication will be in compiisrtca vittz ad ,tet —t provisions of the blassaehuaetts slate eat Gide anC Gupta l<-, zr t: a ce.,cr_i laws 3v TV?= LIC�V�' Titre l Gasiitter Signature of Licensec Master Plumber or Gasfi.tter C` `'T�TO`"'�' Sot.:_neyma n Qr )--I I iAPPROVED (OFFICE USE ONLY} Lice se Ndmoer . G C 0 8 Date.. y.. j../........ i gORTM TOWN OF NORTH ANDOVER pf 4��to ,s,ti0 3? PERMIT FOR GAS INSTALLATION %4 9SSACHUSEt p0'� This hi certifies that ... ". —` .. ....... has permission for gas installation .�? �-"'-''`�•' ,� 1�. -� ..G. in the buildings,, of �.... .................... . at .. ; ; .... • .. • • . • . • . , North Andover, Mass. Fee.7,.1 ..... Lic. No.?�7..... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. 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S ° T C HO w1 ETT 21 Dt N`i 'DRIVE Z "'AL EM H 013079 I m NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY iSTAMPED - OR - SIGNATURE OF THE COMMISSIONER 1 1 '' SIGNATURE OF LICENSEE J 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 of Property for Permit (below) f 11bill4s �. I 1�1�ru� SUSM L �' L'AeH ��`� J1LjLf1S ' Map and Parcel : urposeo> plication (check below) Phone Number of Applicant: _Single 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. LAAJL� alth(7 -13-9 nature of Ownerloy Authorized Agent who sig the Attache Building Permit Date This form must be attached to the Building Permit upon application for such permit RISC 2 6 1997 f rlL.LiNG CFF 0 x FORM U - VERIF"ICATION FORM INSTRUCTIONS: This form is 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. ************1****Applicant hills out this section******f"*9********** APPLICANT: t �GiIVi1�S {��VVI �)�51�'h� �. I I�u ���� Phone W u 2 LOCATION: Assessor's Map Number f��,� ©I�� Parcel Subdivision 'Lot(s) Street �s6"s a(,Lt St Number ****************** *****Official Use Only************************ i� RECNDAJON AGENTS : O1iA ldI' Conservation Fo dlInspe o - e lth S i Inspector -Health Comments Date Approved nAt-,n R.P1PC`t-=A Date Approved Date Rejected Date Approved.�� Date Rejected ublic Works - sewer/water connections _7 - driveway permit I re epart�ent Received by Building Inspector Date M2 6 X97 E L, °1LDING DERA.i TW -i C. f . 'Lease print) Town. of North Andover BUILDING DEPARTMENT Homeowner License Exemption DATE���_����-" JOB LOCATION c;) S UPS ;)MEOWNER" lvumoer. Street Address Section 11 y of town , ''RESENT MAILING ADDRESS 40 CC a r4 S f 2 00 City Town State Zip code 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, provided that the owner acts as'supervisor. (State Building Code, 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 tq_be, a one to six family dwell- ing, attached'or detached structures accessory Lo such use and/or farm :>tructures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, on a form'acceptable to the Bulding Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and .other applicable codes, by-laws, rules and. regulations. Phe undersigned "homeowner" certifies that he/she understands the Town of .orth Andover Building Department minimum inspection procedures and ,,quirements and that he/she will comply with said procedures and ,quirements. IOMEOWNER'S SIGNATURE \PPROVAL OF BUILDING OFFICIAL 'Jote: Three family dwellings 35,000 cubic feet, or larger, will be .-equired to comply with State Building Code Section 127.0, Construction :Ontrol. C_ ' ,,CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number �7 3 Date F fid— THIS CERTIFIES THAT THE BUILDING LOCATED ON ',rO MAY BE OCCUPIED AS CCORDANCE WITH THE PROVISIONS OF TH MASSACHUSETTS STATE BUI DING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO ADDRESS Building Inspector �I Z 01- C\ 0 ui om " J v v all 0 ;, 9 w g 'o G G .•�� C� F. o c'o C/)cn EW ui om I M 2 O O co . V Z co CL O CO) D � c CD I Q •E m m CD 0 co CL = ca � 3� CD m L !C O a o Cc .V CD �. co V y •C •C C 0 " J v v }: r- C.) EW C •h. �O U ;rh • d C • O . cf) V • r✓ r � a y; � � f ,�i E= V / O m O�l r m C y m w C m d �! C � ? •• m 3 N � vJ cm • � `� : C � O ►►F --+W-111 / !1 V J •w. _. m [_ca 'cCD y O .may wU m O dGL-: m C=C-) N m / /) C O Q ^ y 1 ► 7 Fh--rel Cis y O �- V • O d = m m G N W C r C w H cc Q CO2 d O� o •O 043 44 A . y I M 2 O O co . V Z co CL O CO) D � c CD I Q •E m m CD 0 co CL = ca � 3� CD m L !C O a o Cc .V CD �. co V y •C •C C 0 -.0 4 2'15 1 Date ... / TOWN OF NORTH ANDOVER 0, PERMIT FOR WIRING Thiscertifies that ............................................................................................. has permission to perform ........ /- ................................................................ wiring in the building of ........ IfIr ............................................ at ...... v..... ................. ,.,,riqorth And ver, Fee67— f� ......... Lic. No..43.212 SECTOR. .................. EL CTRICALI Check # The Commonwealth of Massachusetts FOR OFFICE E ONL Permit No. 41 Department of Public Safety Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 (leave blank)V-1 ` APPLICATION FOR PERMIT: -TO PERFORM ELECTRICAL WORK;. All work will be performed in accordance with the Massachusetts General Code. 527 CMR 12:00/ (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) _ Date' City or Town of, �ZMZLQ1ZFit — To the inspector of Wires: — The undersigned applies for a permit to perform the e ectrical work described below: Location (Street and Number) Y S S/ Mar: Lot: Owner or Tenant G Zone: Owner's Address Is. this p�jmit in conjunction with a bt ilding permit? Purpose 6f Building A Existing 5ervice Amps / Vous New Service Amps Number,pf Feeders and Ampacity Location'and Nature of Proposed Electrical Work ( a Yes ❑ No Utility Authorization No. Overhead ❑ Volts Overhead ❑ J Underground ❑ Underground ❑ (Check Appropriate Box) No. of Meters No. of Meters I No. of Lighting Outlets No. of Hot Tubs ` I No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above gmd. ❑ In-grnd. ❑ Generators - KVA No. of Receptacle Outlets I No. of Oil Bumers- No: of Emerg. Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection'and Initiating Devices g No. of Sounding Devices No. of Self -Contained Detection/Sounding Devices No. of Ranges No. of Air Cond. Total Tons No. of Disposals No. of Total Total Heat Pumps Tons KW tio. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW ;o. of Water Heaters KW No. of Signs No. of Ballasts Local ❑ MuncipaI Connec+ion ❑ Other No. of Hydro Massage Tubs No. of Motors Total HP Low Voltage Wiring OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts Geral Lars I have a current Liability Insurance Policy including Cor�pleted Operations Coverage or its substantial equivalent. YES F NO ❑ I have submitted valid proof of same to this office. YES LJ NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE (BOND ❑ OTHER ❑ (Please Specify) (Expiration (late) Estimated Value of Electrical Work $ Work to Start Inspection Date Requested: Rough Final Signed under the penalties of perjury: FIRM NAME 614l.l AC5 *67&ECY'77l (; CD—� �/�' LIC. NO. LicenseeV_Z� Z/T l n/D 1'� Signature 4 LIC NO. A-5- 2/-7— Address /aAddress GDD�AIX Bus. Tel. No. 1�7S7 6 .0 0/� ,' Alt. TeL No. OWNER'S INSURANCE WAIVER I am aware that the Licensee 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 11 (P lease Owner ❑ Agent (Please check one) Telephone No. PERMIT FEE $ (Sienature of Owner or Aeent) ,