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HomeMy WebLinkAboutMiscellaneous - 27 TYLER ROAD 4/30/2018N° 4.;,i' Date. ..... `.. C.. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... `� .� ./.�, ..�: c.. :7. t... �,............... . has permission to perform .......................... plumbing in the buildings of ..�'.0 .!.1 ...................... at ..?..? ..� . .�.'... �..........:'... , forth Andover, Mass. r ' Fee;,% >.,..... Lic. No.. �. . ...... �..... Y� ...... . PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer .�..1 ,••••�Prini or Type)+ ! 1'L1JAdlviJUllla��� -3 — A— NORTH ANDOVER, Mass. Dats I _ Bullding Permit #. e Location . a7 K New 0 Renovation p ReplacamerA FIXTUREd . .a 'doe- Loco— Pians Submitted: Yea ❑ No, p Check ane: Installing Company Name ANDOVER PLBG. & •HTG. CO. INC. • OCy. Address 20 AEGEAN DRIVE UNIT# 10 OParinerahip METHUEN MA. 01844 OFirm/Co. Business Telephone 978-685-8383 Name of Licensed Plumber rFnRr;F I AROSE INSURANCE COVERAGE: ec 1 have a current Ilabllty Insurance policy or Re substantial equNalenl. Yes C?7 No O It you have checked yn, please Indicate the type coverage by checking the appropriate box A liability Insurance policy 63""' . Other type of Indemnity O Bond Certificate 2122 OWNER'S INSURANCE WAIVER: 1 am aware that the Ilcensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waNas this requirement. Check one: N—Paftma Of era owners Acent Owner O Agent O I hereby certify that alt of the details v* W' I-or.MIM I hays subrr M*d for sntsr64 in above appl;cauen. e.irw and.aocurab to the bast of my know4edp• and that'a1 plumbing work aril! in laMatiofia performd t dam the'p m�tC tssu d ta'thts Uoir wit d, b 3fatsbont the with f pertinent provisions of the MaisachtueNrSlatra'M mbinq Coda ark! Chapter 142W the Oitwtil. ` ' Thlegnas g rasa um rte' atyfra" Ucenss Numbw 9983 ATTTCPAD (OFnCE USE ONLY) Type of Plumbing Ucenss: Master Journeyman 0 areae■������w������oe��������■ mom Non noun ii� Check ane: Installing Company Name ANDOVER PLBG. & •HTG. CO. INC. • OCy. Address 20 AEGEAN DRIVE UNIT# 10 OParinerahip METHUEN MA. 01844 OFirm/Co. Business Telephone 978-685-8383 Name of Licensed Plumber rFnRr;F I AROSE INSURANCE COVERAGE: ec 1 have a current Ilabllty Insurance policy or Re substantial equNalenl. Yes C?7 No O It you have checked yn, please Indicate the type coverage by checking the appropriate box A liability Insurance policy 63""' . Other type of Indemnity O Bond Certificate 2122 OWNER'S INSURANCE WAIVER: 1 am aware that the Ilcensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waNas this requirement. Check one: N—Paftma Of era owners Acent Owner O Agent O I hereby certify that alt of the details v* W' I-or.MIM I hays subrr M*d for sntsr64 in above appl;cauen. e.irw and.aocurab to the bast of my know4edp• and that'a1 plumbing work aril! in laMatiofia performd t dam the'p m�tC tssu d ta'thts Uoir wit d, b 3fatsbont the with f pertinent provisions of the MaisachtueNrSlatra'M mbinq Coda ark! Chapter 142W the Oitwtil. ` ' Thlegnas g rasa um rte' atyfra" Ucenss Numbw 9983 ATTTCPAD (OFnCE USE ONLY) Type of Plumbing Ucenss: Master Journeyman 0 NORTH TOWN OF NORTH ANDOVER pf ao ,e,tiOO PERMIT FOR GAS INSTALLATION i This certifies that .. y�1 �!..� . r ........... ................ has permission for gas installation .. .................... in the buildings of ...! at ... ...... ..': ............. , North Andover, Mass. Fee.. !....... Lic. No......':i .'.. ................... ' ...... GASINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS .UNIFORM APPLICATION FOP; PERMIT TO 00 GASFITTI ' ( Print or Type) NORTH ANDOVER Mass. Date QD �uilding `Location "7 le r Permit _.3 �,/� e Owners Name ' New "71 Renovation Replacement Plans;, d, 9 FIXTURES (Print or Type) Check one: Certificate Installing Company Name ANDOVER PLBG. & HTG CO IN _.Qa Corp. 9122 Address 20 AEGEAN DR. UNIT # 10 Partner. METHUEN, MA. 01844 Firm/Co. Business Telephone: 978_685_8383 Name of Licensed Plumber or Gas Fitter rF0grF I AgnSF Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy = Other type of indemnity D Bond Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above 'three Insurance coverages. Signature of owner agent of property Owner 0 Agent r7 1 hcicby certiry that all of the dcuils and Information 1 have submitted (or entescd) to above application eco true and accurate to the bat of inr rcnowlcdgc and tint atl plumbing work and tasaUations pesformcd tander•Permit issued ror this appliatioo wiU_ba in compliance With all pestineat pcorisions of tho Marsachusctts State Cas Code and Chapter 14' of" Genera! Laws. By Title City/Town: APPROVED (OFFICE USE ONLY) PE LICENSE: ,Gasfitter• SigzMture of Licensed Master Plumber or Gasfitter Journeyman 9983 License Number iiESiiiiiiiiii:iEEsiiii MEN MEN MEMO MIN IMMUMMIMEMSEMEM ME MENEMEM MEMEEN OEM 41 (Print or Type) Check one: Certificate Installing Company Name ANDOVER PLBG. & HTG CO IN _.Qa Corp. 9122 Address 20 AEGEAN DR. UNIT # 10 Partner. METHUEN, MA. 01844 Firm/Co. Business Telephone: 978_685_8383 Name of Licensed Plumber or Gas Fitter rF0grF I AgnSF Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy = Other type of indemnity D Bond Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above 'three Insurance coverages. Signature of owner agent of property Owner 0 Agent r7 1 hcicby certiry that all of the dcuils and Information 1 have submitted (or entescd) to above application eco true and accurate to the bat of inr rcnowlcdgc and tint atl plumbing work and tasaUations pesformcd tander•Permit issued ror this appliatioo wiU_ba in compliance With all pestineat pcorisions of tho Marsachusctts State Cas Code and Chapter 14' of" Genera! Laws. By Title City/Town: APPROVED (OFFICE USE ONLY) PE LICENSE: ,Gasfitter• SigzMture of Licensed Master Plumber or Gasfitter Journeyman 9983 License Number 0 , r N2 Date.. ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING J This certifies that F, r .............................. ......................... has permission to perform L l �... c ..........:.................................................................. wiring in the building of ...� .... <...... /"......................................................... at .............. .i.. ..1 ......./..................... ,North Andover, Mass. Fee ..................... Lic. No.............. ... _. 3 , C/ %/ s ,/ELECfR1CAL INSPECTOR 08/26/99 12:27 35.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer • �—\ Office Use O�!Y The Commonwealth of Massachusetts Permit No. �F=,20 Occupanci & fee Checked _ _J?i Department of Public Safety 3/90 (leave blankl BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:W APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 A rl I (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 9 TOWN OF N. 4nD.-mele To the Inspector of Wires: The undersigned applies for apermit to perform the electrical work described below. Location (Street & Number)d / c7ZU Z L g Ii d Owner or Tenant TOL Co 74 Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No ©- (Check Appropriate Box) Purpose of Building � W e/�//1G9 Utility Authorization N0. 7 .0 ,o '031 Existing Service Amps /dy /JYV Volts Overhead 3 9/Undgrd ❑ No. of Meters_ New Service Amps /, / Yd Volts Overhead `(_J' Undgrd ❑ No. of Meters Number of Feeders and Ampacity /�_, Location and Nature of Proposed Electrical Work Sin 0 et e, ft 4 No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimmin Above In- g Pool grnd. ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emergency LightingBattery 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 Local ❑ Municipal ❑Other Connection No. of Ranges No. of Air Cond. Total tong No. of Disposals eat No. of Pumps Total Total Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No, of No. of Signs Ballasts Low Voltage Wirin No. Hydro Massage Tubs No. of Motors Total HP Telephone No. OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES ❑ NO ❑ I have submitted valid proof of same to this office. YES ❑ NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE D-IOND ❑ OTHER ❑ (Please Specify) '-07 a- dd Expiration Date Estimated Value of Electrical Work S Work to Start 1- .7 y 9 .7 Inspection Date Requested: Rough Final loll 6A// Signed under the penalties of perjury: FIRM NAME T %aiLLCS,_Im- C-'Ct'c/K,Ct9Av LIC. N'1. Licensee 7Z;eAM4 J' <//���� c�' Signature LIC. N0. y7/� Address �d/�'i �(',� �,�JLvGG� /uIEI'�S lry3 Bus. Tel. Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE $ ?,J '_ Signature of Owner or Agent Location Z-1 -T No. Date a f 7596 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee&00-S6 $ 2� Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Z, Building Inspector Div. 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O 'O O co r, ViCD a. n H j :r CD dd CL C-) cI N O c p o ~" co p Cn a a '^rl 0 G7 ?7 C/) 71 n b til rb r to C orf n `r l� •rf w C d C/) cn rt Eg ny x t tz O o y \) 4L .4 0 C Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption (Please print) DATE JOB LOCATION 7 YZ ryry , Lvumoer H0,1E01� NER" Street -Address Sc17/1'7ulcr/�I L ame Home Phone PRESENT MAILING ADDRESS City/Town Section of town s�vo� s Work Phone 0 State 'Lip code ib .�s 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 to be, a one to six family dwell- ing, attached or detached structures accessory to such use 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, 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) he undersigned "homeowner" assumes responsibility for compliance with the State building Code and other applicable codes, by-laws, rules and "Eculations. "lie undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. r HO:.;LOT.:?,ER' S SIGNATURE RPROVAL OF BUILDING OFFICIAL -0 te: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0, Construction Control. Location No. �.� d 4 Date TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee TOTAL Check #J/ 1 C`s 7Z - H U Building inspe TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVAT E,, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ti)i! BUILDING PERMIT NUMBER: /'---Tim DATE ISSUED: �r SIGNATURE: C�`� Building Commissioner for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: IILZ11� 37/01- ca 3 A� Map Number Parcel Number / r f 11-+J 6 c j —..o( 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Dii—ric—t Proposed Use Lot Area Fronts ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided ReqWred Provided t54) 1.5. Flood Zone Information: 1.7 Water SupplyM.G.L.C.40. ❑ Private❑ Zone Outside Flood Zone ❑ PublicSECTION 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record I 511- r /4 C 4\ .5 W e fesa% Name (Print) Address for Service Signature Telephone 2.2 Owner of Record: A Name Print Address for Service: 1 Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ ( H Al1 a^ ) T —� r^ U Licensed Co struction Supervisor: �G , , I02 Add gg:SP 4 - %4S 9' 77y/ �a:'/Telephone - License Number 7' Expiration Date' _ Registered Home Improvement Contractor Not Applicable ❑ 9 b e�.-Lv Com any am /.6 S5 � S Registration Number c� Address., Expiration Date Signature _ Telephone D SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 25c(6) 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 .......0 No ....... 0 SECTION 5 Description of Proposed Work check aH a cable New Construction ❑ Existing Building 0 Repair(s) 0Mterations(s) ❑ Tdclition 0 t . - ) Accessory Bldg. ❑ Demolition 0 Other 0 Specify Brief Desccrip7tion of Proposed Work: ICrie i- cf O � I SF.C_TION 6 - F.STTMATF.n CnNCTRrTrTinN rnc•rc Item Estimated Cost (Dollar) to be Completed by permit applicant OMCUL USE ONLY 1. Building 5 G (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 CL`f-1r1rr%VU -7- ^%Wr im AiT7+tTAnTrs •.ni�v ... Check Number ------'- .--.-__-------•---�-�"- ::v.. avuri1.v1�LCJur, a1La/ VVn1%\ OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I• as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby Clare that the statements and information on the foregoing application are Lrue and accurate, to the best of my knowledge and belief Print NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1' 2' 3 SPAN DIMENSIONS OF SELLS D12VIENSIONS OF POSTS D]MENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE �1ze 1°omv�nd�euxalbi a�'✓�aaaac�icreefd BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 035867 Birthdate: 12/15/1941 Expires: 12/15/2005 Tr. no: 11958 • Restricted: 00 RAYMOND V BEWSE 361 CHICKERING RD N ANDOVER, MA 01845 Administrator e#_ of with payments to be made as follows: Any alteration or deviation from above specifications involving extra costs will be Respectfully executed only upon written order, and will become an extra charge over and submitted above the estimate. All agreements contingent upon strikes, accidents, or delays beyond our control. Note — this proposal a withdrawn by us if not accepted within 2cceptance of Propoo The above prices, specifications and conditions are satisfactory and areSignature hereby accepted. You are authorized to do the work as specified. \,. Payments will be made as outlined above. Date of Acceptance Signature NC3819 MADE IN USA Dollars days. 11 m m m oc x m y m C2 CA 'C O CD Z y CD o �• � � o C. = y a� � o m oo� CD o CL Q = CD CD O CCTe C CD yCDCD � =o y CC CD I S 0 CO)CD O .0 O CD C CD z r m O V M, C W �� ? O Qo S.m SO y mmmc� C2 �+ S 3 0 �� 5 �, •'.• RL IT � T m �� -,=m o y N � o" � m ; • 2 _•fA m o� 0 o zT.Ica, o c ? ME a� _ :: . CL � mc:: , oa m J, _ a �y y +� O O ti x y = S C F•rvj a d � C d C/)• COD O CD 1 9 w3 =•:� co C -S O t9 _ O 1 N Or � O O O CD .Z -416N p7 � CL C-) o IA _ cn 0 R B z T 'X0 0 w o c° 0 °c 03 d t Nl� Now jyq Ijo ► • O C CD The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 workers Comperes UW Insurance Afliirie * Naaln>• Please Print e- r-0 c1ty /V( q72 z1 G v rc� v Phone ! 7Y C;, 4E7 / C — 0 I am a homeawner performing all work myself. El— I am a sok pmpridw and have no one working In any capacity 0 I am an employer providing workers' compensation for my employees working on this job. rmsarm Co. Po1cv ! Faure to :ecus coverape m requUed undo► Secd n 25A or MGL 162 can Iced to the hrposricn d aknhal peneMles d.a thre up to $1,5W.W sndfor one ye ' Imprbgv- eert_s.rirsr.as.der4wuM WJof ob=xfA STDPWOMORDER..aodA fb d.(SIWAM-AAW MOMIM.ma I understand that a copy d thk sWunant may be forwarded to the Office d ln%vmWskm d tit DIA for cwAnpe verUcatl m. I db hereby cv* wdar ft pains and pwmWOse d psdimy that Nw kdbrnratbn provided above b bum and correct: SignatureDate Print dame Phone! Official use only do not write in this area to be completed by city or town ciMdal' City or Town Psrnyfllicernino ❑ 9u11 *V Dept' []Check Y immedlete reaponae /s rMulrod ❑ Lterkft Board ❑ SGhx* en's OftO Contact person: Pham rt ❑ Health Depalfm nt 13 Other 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 MGL c 11, S 150 A. The debris will be disposed of in: L L �- S Lti er, (Location of Facility) 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