HomeMy WebLinkAboutMiscellaneous - 271 BOSTON STREET 4/30/2018 (2)6
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Date ....... 2.-. 61 -7
.....................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that .................. 4.0 ..... (.. ( .......................................
has permission to perform ............. ...... '4.7 .............
wiring in the building of ............. .... 6 ........................................
......................
/*
at ................................ North Andover, Mass.
Fee...'�.' �17 0 5 '0V
.... Lic. No. 13:f� . .. ........... /'� .......
i��AL INSP, R
Check
-7650
a
The Commonwealth of Massachusetts LIN 0*
PWR* W.
Department of Public Safety Oomov4y & fte Ch~
BOARD OF FIRE PREVENTION REGULATIONS 527 CIVIR 12M 3/90 On" W010
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL W.O.R.K,
All woric to be pwkffrwd in socorckince *ft the Massachusaft Elsolvical Code, 527 CMR 12,W
(PLEASE PIRIW IN INK OR TYPE ALL INFORMATION) -7 :IQ
City or Town of To the lns�sdor of
Th.9 undersigned applies for a permit to perform the electrical work dewribed below.
Locabon (Stvat & 14umber) e—;71 a—
Owner or Tenant
OwrWe Addrew
Is Oft permit In conju�;;� with a bukWV permit: Yes 13 No 0' (Check Appropriate Sox)
Piurpose of Lftft Auffwl;zat ion NO.
ExWft Service ZeQ Ann ZA2 1 //0 Yoft Owhead f3-- Undgrd 13 No..of Metem
Now Serelm Amps --I- -VOft Ovedmd 0 Undgrd 0 NO. Of M an
Number of Feeders and AmW-Ity
Location and Nature of Proposed Elec"
No. of Lightino Oudeft
No. of Hot Tubs
TOW
No. of Transformers KVA
NO. Of L40V Fixtures
Above In -
ming Pool grncL 0 Q"W. [3
Generatom AA
No. of Receptede, Outlets
W. of Oil Burners
Noof mmi-W-Wen Light!
8"atlery
No. of Switch Ou9W
No. of G" burners
Fl 6 ALAR of
FIRE ALARMS Zorm
No. of Delectlon
of Deleod
Nn�
Initiating DeW
ng 0
No. of RwVn
Tbtld
NO. at Air Cond. torle
TOW
No. of Dh000ds
No, of KW
Na of Sou Devices
ISM
No. of 80
Dft mZftD*vk*s
etjNo.
J L.. 0 Munldpel
Connection 130ther
of WshwW*9k1
Space/Area HeMing KW
NO. Of 0
Hemkv Devices KW
No. of NO. of
Low Vdfte
No. of Water Healim KW
Silva Boliaeft
Wring
No. Hydo MasseW Tubs
r4o, Of mowa TOW HP L/L I
OTHER:
INSURANCE COVERAGE Pursuant to the requirements of Mawadu&wft G.emnW UWA
I have a current Uability Inwronoe Poky including Completed . Nam . Covers" or ft substantim equivahw* YES NOO
,00sra_
I hfte wbrnlitted valid proof of mme to this office. YES L3 NO L -J.
If you have cheolce4XIM pimm kx" the type of covenVe by oheciting go appropriote bo3L
INSURANCE USONDO OTHER 11 (Please specim
(Expkadon Date)
EWMaUd VWW of Weatricel Wbrk S
Work to SWA Z�
Signed under the pon*!"s of periury.
FIRM NWE
UC. 140. —/V,6222i,
z 52.W
Ucenew Swatun a h^ MO%
SUL TIL 2-4/
Addrew— e�2��
AIL Tel . r�-4/
OWNERIS INSURANCE WANER: I om aware that the Now4m does not *0 InSUM"00 00VOTap 114ftnt'sleQuWaWdes
required by MemnWhuaft Gw" L&*% wW that my slipuoure an pgm* VaimWon Waives two rew,wrient
Owner 0 Agerd 0 Minesech d one)
(SigneWre of Owner cowr Telephone NO. PERMIT FEE $ .......
- - ". � '. . , '. - I
Location 4271
GL.�et--O/J Slre-Z7
No. 35-f- Date Y— 0 -
&ORTPI
TOWN OF NORTH
ANDOVER
Certificate of occupancy
$
Building/Frame Permit Fee
$ 110
,4C
Foundation Permit Fee
$
Other Permit Fee
$
Sewer Connection Fee
$
Watpr ConnPrtion Fee
$
TOTAL
8098
26.00 PAID
$
Build! nonsodc-tor
Div. Public Works
PERMIT NO' APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS.
-t
PAGE I
MAP 4-40.
LOT NO.
2 RECORD OF OWNERSHIP IDATE
F—
BOOK :PAGE
ZON E
SUB DIV. LOT NO.
LOCATION &V&t,/ S'7,
PURPOSE OF BUILDING ger/ntz- FA'ail*
OWNER'S NAME
NO. OF STORIES SIZE QA)
OWNER'S ADDRESSq
BASEMENT OR SLAB
ARCHITECT'S NAME Nl
SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME A)/?
SPAN
DISTANCE TO NEAREST BUILDING
DIMENSIONS OF SILLS
POSTS
DISTANCE FROM STREET
DISTANCE FROM LOT LINES - SIDES REAR
GIRDERS
AREA OF LOT FRONTAGE
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW
SIZE OF FOOTING x
IS BUILDING ADDITION
MATER:AL OF CHIMNEY
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE
IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY
IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
SEE BOTH SIDES
PAGE I FILL OUT SECTIONS 1 3
PAGE 2 FILL OUT SECTIONS 1 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND R VED BY BUILDING INSPECTOR
::7P 0
DATE FI
'000"00000"'.�
SiGP(ATURE OF OWNER OR le THORIZED AGENT
F E
PERMIT GRANTED
19
3 PROPERTY INFORMATION
LAND COST if
;EST. 13LD . COST 7 etv, o -,o
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BUILDING TN-SPICCTOR
OWNER TEL. #
CONTR.TEL.#
CONTR. LIC. # o 5-14 3-T
H. I. C. # /0950-,-s
G71
BUILDING RECORD
OCCUPANC Y 12
SINGLE FAMILY s �OPIES
MULTI. FAMILY OFFICES
APARTMENTS
CONSTRUCTION
2 FOUNDATION
CONCRETE
8 INTERIOR
FINISH
P I E
HARDW D
3
1
2 13
CONCRETE SL K.
BRICK OR STONE
PIERS
PLASTER
DRY WALL
_dNFIN
3 BASEMENT
AREA FULL
FIN. B M T AREA
V, 1/7 1/1
FIN. ATTIC AREA
�jO 8 M T
HEAD ROOM
FIRE PLACES
MODERN KITCHEN
4 WALLS
FLOORS
CLAPBOARDS
B
1
2
3
DROP SIDING
�ONCRETE
WOOD SHINGLF-_
�ARTH
ASPHALT SIDING
_�ARDVJ D
ASBESTOS SIDING
VERT. SIDING
STUCCO ON MASONRY
il__iDEQUATE
COMtACN
ASPH. TILE
STUCCO ON FRAME
BRICK ON MASONRY
ATTICSTRS. &
BRICK ON FRAME
CONC.OR CINDER BILK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR POOR
I NONE
5 ROOF
10 PLUMBING
GABLE
GAMBIELl
I
_HI
MANSARD
BATH 13 FIX.)
TOILET RM. (2 FIX.)
FLAT
SHED
WATER CLOSET
ASPHALT SHINGLES
LAVATORY
WOOD SHINGES
KITCHEN SINK
SLATE
NO PLUMBING
TAR & GRAVEL
STALL SHOWER
ROLL ROOFING
DERN FIXTURES
TIL FLOOR
TIL DADO
6 FRAMING
11 HEATING
WOOD JOIST
PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. & COILS.
STEAM
STEEL BMS. & COLS.
HOT W T'R OR VAPOR
WOOD RAFTERS
AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS
GA
B'M'T 2�
I.f I 3,d
ELECTRIC
I NO HEATING
THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA-
11AGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
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Location _2 4?ol��
No. IZ
Date
TOWN OF NORiW�WR
I certificate of Occupancy $
41
Building/Frame Permi4ku. $2
Foundation Permit FeeP $
-r Rzrv�w
Other ermit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL
I r2l� 6-,
Building'inspector
-6297 Div. Public Works
PER-mrnvo. 3 d X
I/
APPLICATION FOR PERMIT TO BUILD --NORTH ANDOVER, MASS.
(,//PAGE I
MAP 4-40.
LOT NO.
2 RECORD OF OWNERSHIP IDATE
BOOK "PAGE
ZONE
SUB DIV. LOT NO.
F
ATION
.271 13. 5 1. N a 4 1,
PURPOSE OF BUILDING
5'1,c r r Xzfw 4 a
NAME
NO. OF STORIES SIZE
OWNER'S ADDRESS A-7(
BASEMENT OR SLAB
4 HITECT'S NAME
SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME
SPAN
DISTANCE TO NEAREST�BUILDING
DIMENSIONS OF SILLS
DISTANCE FROM STREET
POSTS
DISTANCE FROM LOT LINES - SIDES REAR
GIRDERS
AREA OF LOT FRONTAGE
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW
SIZE OF FOOTING x
IS BUILDING ADDITION
MATER:AL OF CHIMNEY
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE
IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY
IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
SEE BOTH SIDES
PAGE I FILL OUT SECTIONS 1 3
PAGE 2 FILL OUT SECTIONS 1 12
INSTRUCTIONS
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST HE FILED AND APPROVED BY BUILDING INSPECTOR
C_/,,TE FILED
r"r RE OF OWNER OR AUTHORIZED AGENT
/0 NE I
PERMIT GRANTED r RTEL.#l&T7-*4/i
4. /w 19 tt/ONTR. TEL.# &0-'3 9_2 f
VCONTR. LIC. #
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COlrT PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
NUAL"Im4a [No
BUILDING RECORD
OCCUPANCY 12
SINGLE FAMILY
S-ORIES
MULTI. FAMILY
MICES
APARTMENTS
—1
CONSTRUCTION
2 FOUNDATION
8 INTERIOR FINISH
a 2 13
p I E
CONCRETE
CONCRETE BL*K.
BRICK OR STONE
HARDW D
PIERS
PLASTER
DRY WALL
NFIN
3 BASEMENT
AREA FULL
FIN. B M'T AREA
1/1 1/2 1/1
FIN. ATTIC AREA
t!O 8 M T
FIRE PLACES
HEAD ROOM
MODERN KITCHEN
4 WALL$
9 FLOORS
CLAPBOARDS
B
1
2
3
DROP SIDING
WOOD SHINGLES
ASPHALT SIDING
ASBESTOS SIDING
CONCRETE
EARTH
-iTARDIIJ
D
COMIACN
VERT. SIDING
�SPH TILE
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASO RY
BRICK ON FRAME
ATTIC STRS. & FLOOR
CONC. OR CINDER BILK.
WIRING
STONE ON MASONRY
tj
STONE ON FRAM
SUPERIOR POOR
DEQUATE NONE
10 PLUMBING
5 ROOF
GABLE
GAMBREL
11
I
BATH Q FIX.)
_!jIP
MANSARD
TOILET RM. (2 FIX.)
FLAT
SHED
WATER CLOSET
ASPHALT SHINGLES
LAVATORY
WOOD SHINGES
KITCHEN SINK
SLATE
NO PLUMBING
TAR & GRAVEL
STALL SHOWER
ROLL ROOFING
MODERN FIXTURES
TILE FLOOR
TIL DADO
6 FRAMING
11 HEATING
WOOD JOIST
PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. & COLS.
STEAM
STEEL BMS. & COLS.
HOT W'T'R OR VAPOR
WOOD RAFTERS
AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS
GAS
12L
B'M*T 2nd
lit 3rd
ELiCTRIC
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.
r—
-0
G**
Suggested Affidavit for Home Improvement Contractor Permit Application
For Ofnce Use Only NAME OF CITY/TOWN
Permit No. &J s 0 va---
Date
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGL c. 142A req uires that the "reconst ru ction, a Itera t ion, renova tion, repa i r, modern iza tion, conversion, in provem e n t, remova 1, demol i t ion,
or constru ct ion of a n add i tion t o any pre -exist i n g own er-occupied bui Iding contain in g at least one bu t not more t han fou r dwe I I in g u n i ts .... or
to structures which are adjacent to such residence or building" be done by registered contractors, with certain CXceptions, along with other
requirements.
Type of
Address of Work
&-i rect t'-'
Owner Name: d -L 6 - � I I' C
V
Date of Permit Application: '7 - ;Z Z - � .3
I hereby certify that:
Registration is not required for the following reason(s):
—Work excluded by law
Job under $1,000
—Building not owner -occupied
-`Owner pulling own permit
—Other (specify)
Notice is hereby given that:
3(
Cost
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL
c. 142A.
Signed under penalties of perjury:
I hereby apply for a permit as the agent of the owner:
Date
OR:
Contractor Name
Registration No.
Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property:
7-2
Date Owner(-Kamc 12z,
Gary P. Boutin Proposal
Proposal No.* 7/
F m Boutin Roofin2 & Siding-
RO A
192 Millville t.
Sheet No.
Salem, N.H. 03079
Date 7
Proposal Submitted To
Work To Be Performed At
Name -eV io�' /17/T -S L) C,-/
Stree
Stree �2 -7 / X3 0 -Y 7*0 ,J 577,
City, State
City—AZO - A1J4_)-6L1,!!;22 ^4S5
Date of Plan
Architect........
Stat
Telephone Number >_7 — q1 Y
We hereby propose to furnish all the materials and perform all the labor necessary for the completion of 7_10' 'eAl-I'VV,41
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All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings
and specifications submitted for above work and completed in a substantial workmanlike manner for the sum of
Dollars ($
with payments to be made as follows -01 All,
A,' /�<'00-00
(19 R'>714efle 7,*, xj
.Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will
become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our
control. Owner to carry fire, to ' rnado and other necessary insurance upon above work. Workmen's Compensation and Public
Liability Insurance on above work to be taken out by
Respectfully subm itted "�X,,_
7 Per
Note —This proposal may be withdrawn by us if not accepted within days
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as
specified. Payment will be made as outlined above. C
73
Accepted Signatura�g &,q67VU
Date Signature
TOPS FORM 3450 LITHO IN U. 5. A.
KAREN H.P. NELSON, DIRECTOR
P*
�'- I
In accordance with the provisions of MGL c 40, S 54, a, condition of Building Permit
Number 2-2,07— is that the dcbris resulting from this work shall be
disposed of in a properly liccnsed solid wastd disposal facility as dcfincd by MGL c 111, S
150A.
ne debris will be disposed of in:
(Location of;Paciility)
gnature of Permit Applicant
7 - ;? 2 -
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector.
TOW -n -,0f.
120 Main Street
OFFICES OF:
- IM0
",,,,JL V
NORTH ER
North Andover. -
APPEALS
Massachusetts 0 1845
BUILDING
DIVISION OF -
(617)685 -4775
CONSERVATION
HEALTH
PLANNING & COMMUNITY DEVELOPMENT
PLANNING
KAREN H.P. NELSON, DIRECTOR
P*
�'- I
In accordance with the provisions of MGL c 40, S 54, a, condition of Building Permit
Number 2-2,07— is that the dcbris resulting from this work shall be
disposed of in a properly liccnsed solid wastd disposal facility as dcfincd by MGL c 111, S
150A.
ne debris will be disposed of in:
(Location of;Paciility)
gnature of Permit Applicant
7 - ;? 2 -
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector.
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