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Home My WebLink AboutMiscellaneous - 262 PLEASANT STREET 4/30/2018o ON Z --1 �' o m b � r Date../ N2 . . ................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .................................. has permission to perform ............. wiring in the building of .. . ................................................ *�,"- -?- —4�0— ....... . North Andover, Mass. at .--. ................................................................... 0 -r -I Fee.-.-.:gl .... ::-i ...... Lic. ............................................................... ELEcrRicAL INSPECrOR 11/16/98 15:38 25-00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer =C0MV0]VffE4LTH0FA14MCHUSLM Office Use only DEPARTA1EVT0FP1JBL1CS4FWY Permit No. 713 BOAMOFFMEPREPEN7� "0AS527CW"--W occupancy& Fees Checked APPUCATION FOR PfRAff TO PIWORM ELECMCAL 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 /3 Town of North Andover To the Inspector of Wires: The undersigned annfies for a nermit to r)erfbrm the electrical work described below. -Ir-e- e- 7 Location (Street & Number) Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Purpose of Building AV el Existing Service P? 0 0 Amps/.20/ �?YdVolts New Service Amps Volts r -"--J( Yes M No L_0 (Check Appropriate Box) Utility Authorization No. Overhead M Underground No. of Meters Overhead Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 7 c, 5. 7- In 7, 72 T 77 T 77-777 77- e 7T No. of Lighting Outlets No. ofHot Tubs No. ofTransformers Total KVA No. ofLighting Fixtures SAimming Pool Above Below Generators KVA 02 ground E] ground No. ofReceptacle Outlets 13 No. ofOil Burners No. ofEmergency Lighting Battery Units No. of Switch Outlets 12, No. of Gas B umers FIRE ALARMS No. ofZones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW [nitiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. ofSelfContained Detection/Sounding Devices Local Municipal r7 Oth�"r- No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER - I!WrdnceCa,tr� Iha%eaomettAhltyhmm=PbhLymdudng0cimpkfc Cvma@Dcritsst1zWUa*ivalat N C:f NO YE NO W)mha%cdvdwdYESpimenbc*tc�WofwmaWbydnkxgthe fflropri*bcPL nt V4SLJRANCE BONDM OTHER = VcaseSpoffy) I P.— WctkiDStart 14-5A.0 hWeWwD*ReWcWd SigrW undeffie RnaNes ofpap FIRM NAME — _?� 40 Li== hh, 4)? C- /14 ; 1h 0 -� Sig� L."CMA, F-,,1'rd'"dEJwUicalWak$ 900---00 Rc* Fmal LiMnseNd 0 7 Bu4=TciNh AJLTUT�h OWMM'SPWRAN�MWATVMlammvmdgieLxnmdboW "tanTysigi�cnftpan*W*6mwa*r.�mftmW'gunant (Please check one) Owner M Agent M 1 elephone No. rCKIVII I 1-tr- I 10 41 7 5 Date ... L4 ly ... V. .............. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ...... ........................................................... ............................................. has permission to perform ..... ......... ..................................... plumbing in the buildings of .... ........ C.., ... S..t ... .................... at..)—..6.. .... ........ P ... ..... S T ...................................... North Andover, Mass. Fee?.(..X../. .... 7 ....... ....... Lic. No. 9.0.A.6 ...... PLUMBING INSPECTOR Check #) 4 6 5F �Vv I MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY MA DATE L�L�.Lyjj PERMIT# JOBSITE ADDRESS OWNER'S NAME P OWNER ADDRESS 1-;P TELI TYPE OR OCCUPANCYTYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW. F-11 RENOVATION: F—j REPLACEMENT: PLANS SUBMITTED: YES NOE] FIXTURES I FLOOR- BSM 1 2 3 4 5 6 7 8 1 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM I E ---j E -J DEDICATED GASIOILISAND SYSTEM ... . ...... . DEDICATED GREASE SYSTEM J DEDICATED GRAY WATER SYSTEM ...... ... ..... ... . .... . .. . ..... . DEDICATED WATER RECYCLE SYSTEM - ----- F-71 F DISHWASHER . ..... ......... .... . ....... ...... J ......... ... .. DRINKING FOUNTAIN . . ........ FOOD DISPOSER FLOOR/ AREA DRAIN INTERCEPTOR (INTEMO�) ............. j KITCHEN SINK LAVATORY .. . ... ...... . . ............. ROOF DRAIN .... . ........ SHOWER STALL - --------- - SERVICE MOP SINK . .... ..... TOILET F L URINAL ... ... WASHING MACHINE CONNECTION ......... .... . WATER HEATER ALL TYPES -J ---------- - WATER PIPING F 7 F ... ........ . F F -1 --- ------- ...... ...... OTHER -- ----- .. ...... .. 77 F-71 F77] F-11 J - ----- .... . ..... — ---- ----- . . ..... .— =]= ==.-- ... .... ......... INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES [:Jl NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICYEJ OTHER TYPE OF INDEMNITYE] BOND El 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. CHECK ONE ONLY: OWNER F-1 AGEN SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my kn�W—edge Inen ,ro s onjo and that all plumbing work and Installations performed under the permit issued for this application vAll be in compliance wth all Pert' t vi I f the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 17 PLUMBER'S NAME L i LICENSE # 6!';'IGNATURE MPEI ip Dj CORPORATION PARTNERSHIP El#[_ LLC [A# COMPANY NAME L ------------------ - ---- - - ---- ADDRESS L CITY STATE ZIP TEL [�IZ& FAX CELL 1 EMAILF��t- Pt 4 kxl-� �Vv I pvl� /�5�j fj, , 6, /, � i Location No. ) -, f , - ) - 4 - Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Otber Permit Fee $ TOTAL $ Check # 6 3 0 A-Ie� Building Inspector C,"' TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUELDING PERM[IT NUMBER: DATE ISSUED: SIGNATURE: * Uja Building Conir nspector of Buildings Date SECTION 1 -SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: *V- Number Parcel Number r4N 4r)d0&( 11A 0 1 q 1.3 Zoning Information: Zoning Diar �ct Proposed Use 1.4 Property Dimension Lot Area (sf) Frontage (ft) 1.6 BUHMING SETBACKS (ft) Front Yard Side Yard Rear Yard Rcquired Provide ReqWred Provi&d Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public ' 0 Private 0 Zone — Outside Flood Zone 0 1.8 Sewerage Disposal System: municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHEP/AUTHORIZED AGENT 2.1 Owner of Record VV M 4- U la. 4C:V10(j r /U0 4,kja Name (P—nni)' r Address fjr-Scr�vice iL��,&A ',4 A 4ij�� )% - SigAauwg) Tel6p-hone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Eicensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable Ap, License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name Registration Number Address Expiration Date Signature Telephone M M z 0 0 z M 90 0 "n M rM rM z G) SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6) I Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes ....... 11 No ....... 0 SECTION 5 Description o Proposed Work (check applicable) New Construction 11 Existing Building Ll Repair(s) 0 Alterations(s) 0 7 Addition 0 Accessory Bldg. 11 Demolition 11 Other 0 Specify Brief Description of Proposed Work I SECTION 6 - ESTIMATED CONSTRUCTION COSTS I Itera Estimated Cost (Dollar) to be Completed bv permit applicant OMCMUSE�ONLY I Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction -3 Plumbing Building Permit fee (a) x (b) -4 Mechanical (HVAC) -5 Fire Protection -6 Total (1+2+3+4+5) tv 73 ov Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLILES FOR BUILDING PERMIT ( _—) L_ 6 . I, /7j�z as Owner/Authorized Agent of subject property Hereby authorize to act on My i;n, I �auers realae to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, --,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Signature of Owner/A ent Date W0121511 -NO. OF STORIES SIZE BASENENT OR SLAB IST ND SIZE OF FLOOR TITVIBERS 2 3 SPAN DMENSIONS OF SILLS DIMENSIONS OF POSTS -DIMENSIONS OF GIRDERS I [EIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING x MATERIAL OF CHMNEY IS BUELDING ON SOLD) OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 6 Tel: 978-688-9545 Town of North Andover Building Department 27 Charles Street North Andover MA 01845 HOMEOWNER LICENSE EXEMPTION Please print. DATE mck� JOB LOCATION 6 2 P'k,_asay)� Number Street Address Section of Town "HOMEOWNER Number Home Phone Work Phone PRESENT MAILING ADDRESS - 7-672 flea5ckyA 'SL Na -4% Ar0ove PAA 01995 - 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 HOMEWOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one to six family dwelling, attached or detached structures ac- cessory to such use and and/or farm structures. 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, a form acceptable to the Building 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, The undersigned "homeowner" certifies that he/she understands the Town of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNA APPROVAL OF BUILDING OF Note: Three family dwelling 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0 Construction Control. North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by IVIGL c 11, S-150 A.. The debris will be disposed of in: 3 (Location of Facility) �J.0 Signature of Permit Applicant - Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through, the Office of the Building Inspector $04 .0 NOW �i 6 z M Cd I 0 0 LX4 V) — - I 0 PQ or - c Ll. 0 0 0= Ca u C: 0 0 U) X I 4;:5 C,3 ZW CLe 0 0 I tR GO uj C-) C c c CD C3 C-3 7ELo CL = Cc Cc 14D C* CD C, E cc w CF ts CD CL C— CD c CD CD = CL:= Cam ca Cc C42 cm CA E L- CA C2 in cm f C) cm ca 2c C=) C/) z 0 Cf) 7. 0 C/) z 0 u C/) C/) fil -R 42 4.J E co CL CD COD G3 CM CD CO) cop) -fE- G3 C) CD L- 1�- = CL CD CD cl CD cm cc CD M co Q ca = Cc gj —A = C= a CD ca ts G3 Q CL L.2 CO2 cc cc "a COD w C) C/) w (1) cl: w w CE w w U) 0 0 0= Ca C2 ca 'm CD 4;:5 MD 'm cc MA CLe E w .0 on cm Q or 0. 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