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HomeMy WebLinkAboutMiscellaneous - 27 MARBLERIDGE ROAD 4/30/2018C, .,4 ca F— m m 0 0 m 00 b 0 T c cr 0 r- 0 0 R 0 OIC, 10 2 mpl; CD > 0 0 0 0 3 0 s 0 :3 c -p " 0) 0 0 � 0 0 C'D 0 —i o * Z 0 0 = 0 -n CD CD 0 = 0 -n cD cD -n M m m , 3 -n (D CD 3 CD -a CD " 3 n CD CD 0 00 c -0 A) :3 0 '< z 0 M x 69 49 69 69 164 69 69 > z CD 0 m r- 0 0 R 0 OIC, 10 2 mpl; CD 0 > 4 z m c ol z rn x 0 c 0 N m z -4 r_� m r m n m -4 m c 0 z 0 c m 0 c r 0 z > rn 0 r r o c m n -4 0 z z M c 0 J 0 z 0 JO W 0 * i i � > o a 0 m r 0 * 0 * x o o o > ;D 0 r r ; (A > > Z > Z r 0 0 Z 0 > Z rq 4 -4 z m 0 z z z M M > z Z p > z > > m 0 I 0 I ro r r n > 3: m m > r 0 r rn m o — -4 m r 0 m -4 m > > I m m m T T X E -1 8 n 0 n 0 6 z 0 -4 E X m m U) A o z m 0 3 0 Z z m U) M 0 u) r Z 0 m 0 > z m ID U) 6 m z cl g z 0 �AJ c m . q6 r m x m 14 0 z 0 -Ilk z 0 n 0 p 0 Z > JO �4 0 cli —i 0 z m 0 z 0 10 x z a 0 m W 0 * i i � > o a 0 > 0 n 0 * 0 * r'N 0 0 M > > ;D 0 r r C > 0 > Z > Z > Z r Z Z 0 > Z rq 0 m 0 n 0 n M M > z Z p > z > > z 0 I 0 I 0 z z > r z 0 0 > 3: m m > r 0 r rn m o — -4 m r 0 m -4 m > > I m > n z 1" 0 > -4 - 6 z -4 E X m m U) A 0 3 0 Z z m U) -4 c u) r Z 0 c 0 > z m ID U) 6 m z cl g z 0 c m . q6 r m x m 14 0 z 0 -Ilk z 0 n 0 p 0 Z > > i N m m I c N FFrr;on-i cm M 0 0 X m z U) Z 0 qm M 3 M m 2 z 2 z z 0 z 0 > r 0 0 0 0 -q 5 z U) r 0 z -4 0 0 0 Iq n 0 n 0 n 0 n 0 0 Z T -4 Z- 0 C z 0 0 m x M C M 0 z z z z Z z 0 x Z > 0 i T 0 ul r -4 r > w F 0 0 n r Z 0 m 0 m a m 0 0 m z A 0 Z -1 0 -4 -1 0 r m M > -1 0 * 0 * r tm) c m > z m z r > r m > Z > M M m > r z x -i m m 0 z in 0 U) 0 0 X > m �4 0 cli —i 0 z m 0 z 0 10 x z a 0 m 0 U U, z �i I ,,i -p -4. u z D) u u 0 X� 00 0: LL 4i w w u I Z u z- .000., -:.-j () �- ALZO 10 6-1. 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Public Works M Lobation *2_7 rM OD 4a No. Date TOWN OF NORTH ANDOVER of Occupancy $ SZ -Certificate Building/Frame Permit Fee $ 1-�3sz Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $V__Azh Water Connection Fee $ Rk I All � I TOTAL $ &*_ */L-)O.T 0 _tUat 12:46 �- 7M 1,3a2.00 PAID Building Inspector Div. Public Works Location -ZMAZe>LElZk06(E 1�t> 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 $ TOTAL $ o Building Inspector PAID -to 7790 Div. Public Works Location 22 NkF,6 1% 5"B -1 F_ Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other r-ermR ree ip s -Sewer Connection Fee A,1z> 4::�# wat'dr Connection Fee s lo7, o TOTAL $ 3 0-7 '? , :sz T3 8449 Id' Ins 17000.00 Div ub C PER111T NO. !26:1 0-- — MAP 4-40 �olp-ll fpl�16 I V- t -"L M -"04)A -10--a 14lcAyvI6kA- APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. (A; It tAC t W Z) PAGE I INSTRUCTIONS SEE BOTH SIDES PAGE I FILL OUT SECTIONS I - 3 PAGE 2 FILL OUT SECTIONS I - 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 DATE FILL. -12 —A— 9tlf I j3IGNATURE OF OWNER OR AUTHO-91ZED AGENT FEE PERMIT GRANTED ?A 19 DUE FRAME PERMIT $—l'!i-2--= I- 6b Ct'- L3B ZIP0 3 PROPWT-Y INFORMATION - 0 � LAND COST 06uo C'�' %-., EST. BLDG. COST // A A- I Ly W, EST. BLDG. COST PER SQ. FT. X45— L) -0 4 - LAJO I rr-K KUUM SEPTIC PERMIT NO. 4 APPROVED BY BUILDING INSPRCTOR --) to OWNERTEL.# A--,- D q CONTR. TEL. # It�T CO NTR. LI C. # 2a H.I.C. # Cie /oos- c4- �?B 2&- LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK ;PAGE ZONE SUB DIV;_L LOCATION NO F URPOSE OF BUILDING iwd, Ls S NAME NO. OF STORIE IZ�' SIZE 4 OWNER'S ADhIREiS �R SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS I ST ��Xjb 2ND SPAN /5' � 16), DIMENSIONS OF SILLS POSTS -2>- Ise 2X 10 3RD BUILDER*S NAME A -A k\) c DISTANCE TO NEAREST BUILDING DISTANCE FROM STREET DISTANCE FROM LOT LIN ES - SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS /0 It IS BUILDING NEW 5-5 SIZE OF FOOTING x. IS BUILDING ADDITION a & MATER:AL OF CHIMNEY dc==22% IS BUILDING ALTERATION A)o Is BUILDING *11 nLI D R FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CO�E IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY No IS BUILDING CONNECTED TO TOWN SEWER i -s IS BUILDING CONNECTED TO NATURAL G INSTRUCTIONS SEE BOTH SIDES PAGE I FILL OUT SECTIONS I - 3 PAGE 2 FILL OUT SECTIONS I - 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 DATE FILL. -12 —A— 9tlf I j3IGNATURE OF OWNER OR AUTHO-91ZED AGENT FEE PERMIT GRANTED ?A 19 DUE FRAME PERMIT $—l'!i-2--= I- 6b Ct'- L3B ZIP0 3 PROPWT-Y INFORMATION - 0 � LAND COST 06uo C'�' %-., EST. BLDG. COST // A A- I Ly W, EST. BLDG. COST PER SQ. FT. X45— L) -0 4 - LAJO I rr-K KUUM SEPTIC PERMIT NO. 4 APPROVED BY BUILDING INSPRCTOR --) to OWNERTEL.# A--,- D q CONTR. TEL. # It�T CO NTR. LI C. # 2a H.I.C. # Cie /oos- c4- �?B 2&- BUILDING RECORD I OCCUPANCY 12 SINGLE FAMILY S-ORIES MULTI. FAMILY :-_-::j—r�FFICES APARTMENTS CONSTRUCTION 2 FOUNDATION CONCRETE CONCRETE BL K. BRICK OR STONE PIERS � 8 INTERIOR 3 PINE HARDW D PLASTER DRY WALL UNFIN. FINISH J/- 2 13 3 BASEMENT AREA FULL FIN. B*M T AREA 1/1 1/2 1/. FIN. ATTIC AREA t1O B M T FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS FLOORS CLAPBOARDS B oo' 1 vo 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING ASBESTOS SIDING HARDW 0 COMMON ASPH. T ILE VERT. SIDING STUCCO ON MASONRY STUCCO ON FRAME. 1­�IDEQUATE BRICK ON MASONRY' ATTIC STRS. & FLOOR BRICK ON FRAME CONIC. OR CINDER BLK. WIRING STONE ON MASO: NRY. STONE ON FRAME SUPERIOR 1__� t0OR NONE 5 396F 10 _ PILUMBING GABLE I HIP BATH (3 FIX.) AMBQEL � MANSARD TOILET RM. (2 FIX.) �`LATII SHED WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER ROLL ROOFING M DERN FIXTURES TILE FLOOR TILE DADC) 6 FRAMING 11"', HEATING WOOD JOIST PIPELESS FURNArE FORCED HOT AIR FURN. TIMBER BMS. & COLS. ATEAM STEEL BMS. & COLS. HOT W T' R OR VAPOR WOOD RAFTERS__ AIR CONDITIONING RADIANT H'T 6 UNIT HEATERS GA 7 NO. OF ROOMS 14 Oil i—mT 2nd Ito Ist I 3rd I ELECTRIC NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. ml Moll i4 )p (3t)J6 kA PIEWMIT NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVE*, MASS. PA G E, I MAP 4-40. J.- LOT NO. ;z 2 RECORD OF OWNERSHIP IDATE I BOOK ;PAGE - 70NE - SUB DIV. COT NO. LOCATION e-bl, N- OUR PURPOSE OF BUILDING UJI Soudt1f, ,ow S NAM 1, z -* k ff -... — I (A-1 I yj NO. OF STORIES SIZE 6%VNEFI�b-ADDRES) 2-, '77,st, ��R SLAB ARCHITECT'S NAAE SIZE OF FLOOR TIMBERS IST 2ND -2,( (o 3RD 2-9 1 Z - BUILDER'S NAME mpkz�]ILL� SPAN IH DIMENSIONS OF SILLS POSTS 14 'i s Ic DISTANCE TO NEAREST BUILDING DISTANCE FROM STREET DISTANCE FROM LOT LINES - SIDES REAR GIRDERS AREA OF LOT FRONTAGE 141Q 0 f HEIGHT OF FOUNDATION THICKNESS 16 IS BUILDING NEW SIZE OF FOOTING x IS BUILDING ADDITION MATER:AL OF CHIMNEY IS BUILDING ALTERATION Is BUILDING ONeOLID FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY 60 IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE S INSTRUCTIONS SEE BOTH SIDES PERMIT FOR FOUNDATION ONLY PAGE I FILL OUT SECTIONS 1 3 REGULATED BY PAR 114.8-S. B.C. PAGE 2 FILL OUT SECTIONS 1 12 TE 124'1�4 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDIDA JEE PAID ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE Fl�.%D VIGNATURE OF OWNER OR AUTHOAIZED AGENT 4 E E -zm:, PERMIT GRANTED pn 19 ct4 3 PROPERTY INFORMATION .0 - LAND COST A104� LIDO "OL) EST. BLDG. COST c_ue_i EST. BLDG. COST PER SQ. FT. 7 - EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY f4uAoAlt,(3x3 oli% w - BUILDING INSPECTOR — ;1% OWNER TEL# (00— CONTR.TEL.# 19(41 CONTR.LIC.#. BUIL61NG RECORD OCCUPANCY 12 SINGLE FAMILY Si RIES MULTI. FAMILY OFFICES APARTMENTS CONSTR,UCTION 2 FOUNDATION CONCRETE op 8 INTERIOR FINISH INE 'DRY 3 1 2 3 CONCRETE SL K. BRICK OR STONE HARDW D PIERS PLASTER WALL _UNFIN 3 BASEMENT AREA FULL 1/1 1/2 1/1 IN. B M*T AREA FIN. ATTIC AREA �10 8 M T FIRE PLACES ' HEAD ROOM MODERN KITCHEN 4 WALLS FLOORS CLAPBOARDS CONCRETE EARTH B 1 2 3 DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING HARDW D COMIAGN ASPH TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. & FLOOR BRICK ON FRAME CONC. OR CINDER BLK. 00 WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR —A POOR I _�DEQUATE I NONE 1 5 10 PLUMBING GABLE GAMBllLj T�LAT 1 %00'1 H I P MANSARD SHED BATH (3 FIX.) T?ILIT �M 12 IIX-I_ C,8iE 00%A T ASPHALT_ SHINGLES K LAVATORY WOOD SHINGES__ KITCHEN -SINK SLATE lio– PLUMBING TAR & GRAVEL STALL SHOWER ROLL ROOFING M DERN FIXTURES TILE FLOOR 'TILE DADO 6 FRAMING I HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. eTEAM STEEL EMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H*T'G UNIT HEATERS GAS OIL 7 NO. OF ROOMS B'M'T 2�d ELECTRIC NO HEATING I , —d' —3,d THIS SECTION MUST SHOW EXACT DI MENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA- RAGES, ETC. SUPERIMPOSED. THIS.REPLACES PLOT -PLAN. 0:'. IN 12.1 q 4 a pal E; 0 c� n 0 z cm z 0 U2 UR CO) CL C40) C, 0 E GO 702� C6 -M rn rn 0 Ma, 0 cr CA CD CO) =CLO co CCOL CD M ="O COD 0 — CO -* CD =r CL P-4. CL rn CD =r go CO2 CD =rcD 0 ;; VV -00 a 2>4 cwj Al -to CD CL =r Sr CD CD CLW cr 03 = a C:L :E CID. CO3 CAQ 0 CD CA C.) CD Fan 0 ca 0 ca a . in a, a-cD m CD a' =r, CD, c CK -g c C V C C/) C/) to 0 cp po 0 -x gi Ix C) P� 0 C/) m CD 0 pk;- CO) ca r- aq w r- :5 00 tz CD P) r- (IQ �L c: Ro aq '0 0 r -L rD 1-n CA m > CD 0 z CO) cp CD CL cj) rD CO) > CD CL cr C�D CD 0 CD C) m cn w w CD a m :V < CL W CD CO) CD co 0 CD z 0 0 CD CD a pal E; 0 c� n 0 z cm z 0 U2 UR CO) CL C40) C, 0 E GO 702� C6 -M rn rn 0 Ma, 0 cr CA CD CO) =CLO co CCOL CD M ="O COD 0 — CO -* CD =r CL P-4. 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CD 1171 0 tz �cj CD C) :v n ;z 0 C: UQ :T, al C :j CL 0 CD 0 C/) CD 10 C! * cn -< 91 0 CL ;;* rb C) > C co CO ic co) CD .4:;;; CD -M CL. -S: Cl) bo Sa co: :T Em m V 0 cn (D r) 1171 0 0 C) :v n ;z 0 C: UQ :T, al C :j CL 0 z C/) CD 10 C! * cn -< 91 0 CL ;;* rb C) > C 0 0 0 < tP 0 (P m p H 0 411� 4 0 411� FORM U - LOT RELEASE 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. ****************Applicant fills t this section***************** �u APPLICANT: Phone LOCATION: Assessor's M Number Parcel Subdivision Lot(s) Street St. Number Z7 Use only************************ RECO N N OF 0 AGENTS: WN' P Date Approved 121�15q ConservAion'Administrator Date Rejected Comments V- P �, ( � L� 'fo'wn Planner - Comments Food Inspec�or-Health A111114 Septic Idspector-Health, Comments Date Approved T21-�;Lq� Date Rejected I I Date Approved Date Rejected Date Approved Date Rejected Public Works - sewer/water connections -�� - k) 12 - driveway permit _K7z4) I z —,L 24L Fire Department.&!Je/,A" eqo��, fil2je— 7� Received by Building Inspector Date AA Z, ............. 72. rz ;N. 0 1 -10 10 -x bf) 46 Ilk I-) '57 OOP W 7K Z d 22 -ja- Lb I �gzl Z67; s- ojpeo 16 71 'Ole N*\ I 1 4.1- P2 ,.6,' a �g�l I of N*\ I VQ 0 1 4.1- P2 ,.6,' a �g�l I of 9-5 0/-. 9/ CeA7-1,-Y 70-7,41.- 7-17,�-- 1A1S6X0,f 400 Rz or Rz,41V %.';Afd #VV 0// C*,, -,+eq "z1A117')- 11UAlel. 0* Vk OF 2S -00-m JE sl Ae-w y 774,e6-41 /WW 4 64 /WW -rrefe7- A /' r Location NO. Date 41 ,,,TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building, Inspector Div. Public Works 10 CHIMNEY APPLICATION AND PERMIT DATE - V C, LOCATION /C kc 1 14 / 7 OWNER'S NAME BUILDER'S NAME MASON'S NAME &42'L N (-L 'ij 411 1 IJ 120 Main Street, 01845 (508) 682-6483 1;rl PERMIT # '7 �t- MASON'S ADDRESS J-5 L2 r a A) V -x I I,-'- ZA22 LL MASON'S TELEPHONE 9 MATERIAL OF CHIMNEY INTERIOR CHIMNEY rl�lf Q-1 EXTERIOR CHIMNEY 14,11.)dc NUMBER AND SIZE OF FLUES THICKNESS OF HEARTH Will chimney or fireplace conform'to requirements of the code and have rule ,Land regulations been received: ,4,h dr DATE- # 0 ONTR. LIC. SIGNATURE OF MASON-,:f��? a EST. CONSTRUCTION COST/CONTRACT PRICE 2S PERMIT GRANTED FEE ROBERT NICETTA, BUILDING INSPECTOR_4W�� INSPECTED REMARKS SOLID BRICK REQUIRED THIS PERMIT MUST BE DISPLAYED ON THE PREMISES �A ot KAREN H.P. NELSON Town of Director NORTH ANDOVER BUILDING CONSERVATION A ��5 DIVISION OF HEALTH PLANNING & COMMUNITY DEVELOPMENT PLANNING CHIMNEY APPLICATION AND PERMIT DATE - V C, LOCATION /C kc 1 14 / 7 OWNER'S NAME BUILDER'S NAME MASON'S NAME &42'L N (-L 'ij 411 1 IJ 120 Main Street, 01845 (508) 682-6483 1;rl PERMIT # '7 �t- MASON'S ADDRESS J-5 L2 r a A) V -x I I,-'- ZA22 LL MASON'S TELEPHONE 9 MATERIAL OF CHIMNEY INTERIOR CHIMNEY rl�lf Q-1 EXTERIOR CHIMNEY 14,11.)dc NUMBER AND SIZE OF FLUES THICKNESS OF HEARTH Will chimney or fireplace conform'to requirements of the code and have rule ,Land regulations been received: ,4,h dr DATE- # 0 ONTR. LIC. SIGNATURE OF MASON-,:f��? a EST. CONSTRUCTION COST/CONTRACT PRICE 2S PERMIT GRANTED FEE ROBERT NICETTA, BUILDING INSPECTOR_4W�� INSPECTED REMARKS SOLID BRICK REQUIRED THIS PERMIT MUST BE DISPLAYED ON THE PREMISES �A 41 'US ?f M to M r7 > rA tv cc Oil >= DD ri >> b, Iq 0 IV n 9 9, MN Poo Cl) m go *q CL 0 > D D > z AW4 ro 41 'US ?f M to M r7 > rA tv cc Oil >= DD ri >> b, Iq 0 IV n 9 9, MN Poo Cl) m go *q CL 0 > D D > z AW4 Cf) -0 m Q-- CO) CD 0 z -n CD 0 EE = r— > M -00 CD CL CD C-) CD 0 C) M C/) CD m > < :< > m �7 co CD < CO) m CD = I -� -I- 0 c I IM CA "0 03 C"D CO) CA C7 CD 0 CD CD W CD CO) co a 0 CD 1-1 E; 0 n 0 z C� n �:J- cn 2 ON CD r*4 CD CM 0 CC) co CE CA COD -1 -M rn rn ;9 r -do CCI 5-0 � =r --4 X— SuFa rr cools, EL- 0 :s a F = CL C2 = CD CA C13 co FF i n COD m CD =r-6 co MIS "P 4, z =r CL -0 CL 0 m CD =r 02 1� CD CAOO) WO ca =rcD: a --I :, C', -% CD M-4 -0 0 Cl) CD CW2 ca 0 c') E. 0 c CD pf CD CL CD C, rA =r%, CL r C; < :E CD "I C', 7V cc n: cc, C05 C.) Co. its% Gn 'RI n m W -I CLR. ET Q - (A U) 1w 0 t7l 0) C/) 0 0 !V co MIS "P 4, z 01. WO Omq 0 qq� 01 4t Lfammunwr# of flaosar4usEtts Mepartmient of Public ftfltg BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12.00 otfice Use only Permit No. � 10 3 Occupancy & Fee Checked 3/90 (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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date V� or Town of NORTH ANDOVER — To the inspector of Wires: The udersigned applies for a permit to perform the eiectr_ical work described below. Location (Street & Numbtr) If Owner or Tenant Idj<i_ V,&y 64 f _' �jT Ovv n e r' s Address 2 3 3 Ye' No El (Check Appropriate Box) Is triis permit :In ccnjunction with a. building petmit: S lc� Puroose of Buiiding 6) M!7 1e.— Ouw e Utility Authorization No. 5-0 0 6? C/ Existing Service — Amos —Volts Overhead 7_1 Undgrnd No. of Meters New Ser.,ice 9�00 Amps129__/ d_-'fo N Its Overhead Undgrnd No. of Meters Number of Feeoers and Ampacity Location and Nature of Proposed Electrical Work /do '0 TC Total No. of L:cniinci Cuue!s I No. of Hot Tubs No. of Transformers KVA No. of Licntinci �:xtureS Swimming Pool Above— grnd. __�l In- gmd. Generators KVA No. of Emergency Lighting No� of Receotac�e Cutlets No. of Oil Burners Battery Units No. of Sw)tch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Total No. of Ranges No. of Air Cond. tons Initiating Devices No. of Sounding Devices No. of Disoosais No.of Heat Total Total Pumps Tons KW No. of Self Contained Soace/Area Heating KW Detection/Sounding Devices No� of Disnwasners Municioal Other Local 1 1 Connection No. of Drvers Heatina Devices KW No. of No. of Low Voltage No. of Water Heaters KW Sians Ballasts Wirinc; No. Hvcro 1.1assace No. of Motors Total HP OTHER, NSURANCE COVERAGE: Pursuant to the reautrements of MS�sachusetls general Laws I jai eauivaient. YES e__NO I have a current Liaimity Insurance Policy including Com(��eo operations Coverage or :is substant have sucmitteo valid proof of same to the Office. YES :!: NO __ If you have cheCKeo YES. please indicate the type of coverage by checKino the aop��ate cox. INSURANCE Z BOND — OTHER (Please Soecify) (Exoiration Date) V:;q i ork Estimateo Value of W s "VorK �o Star-, c4f — Sionecl uncler the Penalties of perjury: FIRM NAME I—A Pu_ A 15 Insoection Date Recuesteci 1- Rouan CAII — Final L - C_ej - LIC. NO. // 12 & Licensee Q, W 11-4 C Signature Ve- �6 Te �IN o. Adcress gna 2 - -e &0, Alt. Tel. No. 1 1 ectuivalent as re - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substan ia outrea nv Massachusetts General Laws, ano that my signature on this permit application waives this reouirement. Owney Agent Rof ILA iP!ease cneCK one) Teleohone No. — PERMIT FEE S rc/jub iSionature of owner or Agent) .......... 2103 Date....-,.. TOWN OF NORTH ANDOVER PERMIT FOR WIRING &S"C US This certifies that .... 4��. i. m.f ....... has permission to perform ....... hA f. / ...... 1. ........ wiring in the building of ....... (U at.."� .7 ................... . North Andover, Mass. FZA.q0A.M. Lic. No. I/ ............................................................. ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File