HomeMy WebLinkAboutMiscellaneous - 28 ASHLAND STREET 4/30/2018 (2)4 V
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occupaiicy & Rea Checked
APPUCAIIONFOR PERMIT TO PERFORM ELEcnuCAL WORK
ALL WORK To BE PERFORMED IN ACCORDANCE WffH THE MASSACHUSSTS MICMICAL CODE, 527 CMIR 12:00
(PLEASE PRDIT IN INK OR TM ALL INFORMAIION)
Town of North Andover To the Inspector of Wires:
The under3iped applies for a permit to perform the electrical work described below.
Location (Street & Number) 7 3 -
Owner cc Tenet
Ow net's Address -/- X A ��A r, A/ - A
is this permit in conjunction with a building YesM\,' No
1:3
purpose of Building /,)e
Exi3ting Service Amps olts Overflew
New S Amps..../...Volts Overhead
Number of Feeders and Ampacity
L.ocation and Nam of Proposed Electrical Work
(Check Appropriate BojL)
mmmwmm� Utility Authorization No.
Underground C3 No. of Meters
Underground C3 No. of Metm
of uslid" Outlaw
Na Of Hot Tube
No. Of Tran�
Total
--
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KVA
Ha of Ugliling Fixtures
Swbmdng Pod Abu"
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171
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Dem', A
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KVA
No. of Receptacle Outleft
No. of Oil Bums
No. of Emergency Ugbdng Battery Uniti
No. of Switch Outlaw
No. of On Burnam
FIRE ALARMS No. of Zones
Nm of Rarign
NM of Air Cond. Told—
TOM
HL of Delactim said
Not of Dispoub
W of Hod Total
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TOM
Kw
Initiming Devion
No. of Smiding DWm
No. of Dishwashats
Spece Ana Heaft KW
?k of Sew Conwhwd
DeNctiom"Sou'adhis Devices
Local Mwdc4W
Other
No. of Drywe
Hoeft Dinficas xw
comectiom CI
No. of Wow Heatets KW
N06 of No. of
slag
Ballub
No. Hydw Mmqp Tube
N416 at moon
Total HP
OTHEIC
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Date ... 1 0-5—
.......................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that . LAO 49? .................
has permission to perform ..... Pa41,1jAA.a4,r./ e; 11-Od- r.. 5.
wiring in the building of ........ M/141 ...... .................................
at .......... 4-5414f1*0 ... 5-� . . ........................ . North Andover, Mass.
Fee.,7,9.9��. Lic. No. k1.6r-.53 .......... /.19' 'Ia� .....
Check #
0
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Occupwwy JL Fees Checked
L*up I I Y =7 WOMEMENUMMEMMIN
APPUCA71ONFOR PERMIT TO PERFORM ELECnUCAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSM ELECMICAL CODE, 527 CM 12:00
(PLEASE PRNr IN INK OR TYPE ALL UMMA710N) D
Town of North Andover
Ile undersigned applies for a permit to perforrii the electrical work described below.
Location (Street & Number) ?
owner or Tenant
Owner's Address
�Iee t- q 7S - ,2 -7 3 - z1Y 6
To the Inspector of Wires:
lS this perinit in conjunction with a building permit Yes "`1-1 No jCheck Appropriate Box)
Purpose of Building 1?e- 5 J4 Al. / ), a_ j I Utility Authorization No.
Existing Service &)0 Amps
�,Z Volts OVCftid E3 Underground C3 No. of Meters
New S Amps.. /Volts Overhead Underground No. of Metem
Number of Feeders and Ampacity
Location and Nature of Proposed Mectrical Work 4- io "L/ 0 'Ex)�s / /,�v
—1�6 of Lighting Outlm
Nm of Hot Tube
No. of Transawmwe
Tatfil
KVA
Na of Lighthis FiXtW"
Swbwdng Pool' Abu"
ground
rl
vatold
M
Genintem
No. of Emarpocy Ughting Bettery Unitil
KVA
. -
Nm of Receptech Outift
No. of Oil Rumens
No. of Switch Outlets
No. of Go B
FIRE ALARM
NO. Of zom
No. of Rango
No. of Air Cond. TWA
TO"
W of Dftdoa W
No. of Disponk
No. of Had Totd
— Panyll
Tons
Iflitiming Deviams
W of Smuwkg DeAcm
No. of Dishwuhars
Space Am Hedins KW
No. of Seff CambW
DetectionlSomading Dwica
Locd Mwdcipd
Odw
No. of Dryon
Hemins Devica KW
Comiectiom
No. of Water Heam KW
No. of NO. at
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No. Hydro Musqp Tube
No. of hinan
Total HP
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Date .1 I. -Y4....
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that ... P. q ��. � ! '. -:-� ........
has permission to perform .... f.� �-. �'� P� -: � ..................
plumbing in the buildings of ... �� I. I. .�r ..7 ......................
at. . x -I f'. .-� .............. North Andover, Mass.
Fee. .... Lic. No. Y .. ...... .......
PLUMBING INSPECTOR
Check #
6701
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or Type)
N Andover -Mass. Date 11/30 20 05 Permit -4*
Building Location 28 -Ashland Owner's Name Jim Wilen
Type of Occupancy ReS
New 0 Renovation Replacement 0 Plans Submitted: Yes 0
FIXTURES
AID *
M"Mar-M
SEPTIC *
nstalling Company Name Bowman Plumbina Servir-p-R Check one: Cert ificate
Address 6 Hor-ne Street 0 Corporation
Bradford, MA 01835
o Partnership
Business Tilephone 780 994=6907
0 FirmlCo.
Name of Licensed Plumber or Gas Fitter rd T awman
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL.Ch. 142.
Yes CK No 0
If you have checked ves, please indicate the type of coverage by checking the appropriate box.
A liability insurance policy Other type of indemnity 0 Bond 0
OWNER'S INSURNACE WAIVER: I am aware that the licensee does not have ' the insurance coverage required by Chapter
142 of the Mass, Gener�l Laws, and that my signature on this permit application waives this requirement.
Signature of Owner or Owner's Agent
Check one:
Owner 0 Agent 0
I hereby certify that all of the details and -information I have submitted (or ente d) In above'applicatt ar ' a nd accurate to the bost of
on u"
my knowledge and that all plumbing work and Installations performed u.nde per issued I �7hhis pli lion will be in compliance with
all pertinent provisions of the Massachusetts State Plumbing Code and . C ter 4 !a yGen �Law M..
7.
By r%in�aiec.e ns7ed'PI u rn 9*��
Tidt p I e of Li"n, 'MMaster JRJourn*eyman
City/Town pe ofLicense:"
APPROVED (OFFICE USE ONLY) I -
License Nu m ber Master #1 3496—Joumeyman #25201
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SUB-13SPIT
BA5EMENT
1ST FLOOR
2ND FLOOR
3RD FLOOR
4TH A OOR
5TH FLOOR
6TH FLOOR
7TH FLOOR'
8TH FLOOR
nstalling Company Name Bowman Plumbina Servir-p-R Check one: Cert ificate
Address 6 Hor-ne Street 0 Corporation
Bradford, MA 01835
o Partnership
Business Tilephone 780 994=6907
0 FirmlCo.
Name of Licensed Plumber or Gas Fitter rd T awman
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL.Ch. 142.
Yes CK No 0
If you have checked ves, please indicate the type of coverage by checking the appropriate box.
A liability insurance policy Other type of indemnity 0 Bond 0
OWNER'S INSURNACE WAIVER: I am aware that the licensee does not have ' the insurance coverage required by Chapter
142 of the Mass, Gener�l Laws, and that my signature on this permit application waives this requirement.
Signature of Owner or Owner's Agent
Check one:
Owner 0 Agent 0
I hereby certify that all of the details and -information I have submitted (or ente d) In above'applicatt ar ' a nd accurate to the bost of
on u"
my knowledge and that all plumbing work and Installations performed u.nde per issued I �7hhis pli lion will be in compliance with
all pertinent provisions of the Massachusetts State Plumbing Code and . C ter 4 !a yGen �Law M..
7.
By r%in�aiec.e ns7ed'PI u rn 9*��
Tidt p I e of Li"n, 'MMaster JRJourn*eyman
City/Town pe ofLicense:"
APPROVED (OFFICE USE ONLY) I -
License Nu m ber Master #1 3496—Joumeyman #25201
.0
ai 0
Location
No. Date 114 eu
40*T" TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
C14U
Foundation Permit Fee $
Check # r ��-jjl
18757
Other Permit Fee
TOTAL
Building Inspect zv
bl&L;1l1Vf4 1-blIE INYOKMAXION
TONM OF NORTH ANDOVER
1.1 Property Address:
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT ar
OR DEMOLISH A ONE OR TWO FAMILY DWELLING
; , ."., I-, ,I- .�RENOVAT
1.3 Zoning Information:
Zoning Nii �d Proposed Use
RI TIT DING PERMIT NUMBER:
DATE ISSUED:
Jr.
41, L--,
SIGNATURE:
Front Yard Side Yard Rear Yard
ReqWred Provide Rapfired
Building Commissi2REIgg)ector of Btulfings Date
bl&L;1l1Vf4 1-blIE INYOKMAXION
1.1 Property Address:
1.2 Assessors Map and Parcel Number:
71. 0
Map f4umber Parcel Number
1.3 Zoning Information:
Zoning Nii �d Proposed Use
1.4 Property Dimensions:
[Lot Am (sf) Frontage(ft)
1.6 BURDING SETBACKS (ft)
Front Yard Side Yard Rear Yard
ReqWred Provide Rapfired
Provi(w Raqttired Provided
1.7 Water Supply hCGI-C.40. 54) 1.5. Flood Zone Infonnafion: 1.8 Sewerage Disposal Systeni:
Public 0 Private 0 Zone Outside Flood Zone 0 municipal 0 On Site Disposal Syswm 0
SEMON 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No
2.1 Owner of Record
6ole
Name (Print)
&MqAlo S/
Address for Service
Telephone
2.2 Owner of Record:
Name Print
Address for Service:
Signature Telephone
UCTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
L=sd Construction Supervisor:
Address
Signature Telephone
Not Applicable 0
License Number
Expimtion Date
3.2 Registered Home Improvement Contructor
Not Applicable 0
Company Name
Registration Number
Address
EViratim Date
Signature Telephone.
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I SECTION 4 - WORKERS COMPENSATION (MLG.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 ....... 0 No ....... 0
-SECTION 5 Description Proposed Work (check appHcable)
New Construction 0 p.
E . sting Builtng Dr
Repair(s)
Alterations(J) 't(-- I
Addition 0
Accessory Bldg. 0
Demolition 0
Other 0 Specify
Brief Description of Proposed Work:
F'104)016 07,- f//2s/ 4/�
rt-ml,04,1111n '41 /�Ik/wu
L/
-SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item
Estimated Cost (Dollar) to be
Completed by permit licant
.................
0
R
1. Building
5/000
(a) Building Permit Fee
Multiplier
2 Electrical
zl000
(b) Estimated Total Cost of
Construction
-3 Plumbing
Building Permit fee (a) x (b)
4 MechanicaI (HVAC)
5 Fire Protection
-6 Total (1+2+3+4+5)
Check Number
SECTION 7a OWNER AUMORIZALTION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
T
1, 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
J K
L�' 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
J/" /M -Z 5. . �( - 6j"40/t," J
Print—
Signa4e 61 Owner/Agent Datd
-NO. OF S SIZE
BASEIVENT OR SLAB
-SIZE OF FLOOR TafflERS iST
2ND 3KD
SPAN
DUVENSIONS OF SILLS
DINENSIONS OF POSTS
DDvMNSIONS OF GIRDERS
-HEIGHT OF FOUNDATION
THICKNESS
-SIZE OF FOOTING
x
MATERIAL OF CHDANEY
-IS BUI1,DING ON SOLID OR FILLED LAND
-IS BUILDING CONNECTED TO NATURAL GAS LINE
I
VkoRrH TOWN OF NORTH ANDOVER
.0'20,6, .
_IV
OFFICE OF
BUILDING DEPARTMENT
400 Osgood Street
North Andover, Massachusetts 0 1845
Gerald A. Brown
Inspector of Buildings
HOMEOWNER LICENSE EXEMPTION
Please:Lnnt
DATE: //A/or
PRESENT MAILING ADDRESS Z
n'th RN1r)0VC^
City Town
Telephone (97.8) 688-9545
Fax (978) 688-9542
Map/Lot
IM C�,2y-- -2;73- 4,110 -VI
E4]
Work Phone
Q /rv,
Zip Code
The current exemption for "homeowners" was extended to include owner -occupied dwellings to two 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 108.3.5. 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 or two family structures. A person who constructs more that one home in a two-year period shall not
be considered a homeowner.
The undersigned "homeowner" assumes responsibility for compliances 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 North Andover Building Department
minimum inspection procedures and requirements an4 that he/she will comply with said procedures and
requirements. I it /
HOMEOWNERS SIGNA
APPROVAL OF BUILDING
Revised 10.2005
Form Homeowners Exemption
BOARD OFAPPEALS 688-95,41 CONS F.R VATION 688-9530 11FAL111 688-9540 PLA\NING 6,"-9535
JOBLOCATION:
45AICit"')
Number
Street Address
HOMEOINNERJ CA Mj�s
�v/ /?,,rL/
Name
Home PhonA
PRESENT MAILING ADDRESS Z
n'th RN1r)0VC^
City Town
Telephone (97.8) 688-9545
Fax (978) 688-9542
Map/Lot
IM C�,2y-- -2;73- 4,110 -VI
E4]
Work Phone
Q /rv,
Zip Code
The current exemption for "homeowners" was extended to include owner -occupied dwellings to two 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 108.3.5. 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 or two family structures. A person who constructs more that one home in a two-year period shall not
be considered a homeowner.
The undersigned "homeowner" assumes responsibility for compliances 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 North Andover Building Department
minimum inspection procedures and requirements an4 that he/she will comply with said procedures and
requirements. I it /
HOMEOWNERS SIGNA
APPROVAL OF BUILDING
Revised 10.2005
Form Homeowners Exemption
BOARD OFAPPEALS 688-95,41 CONS F.R VATION 688-9530 11FAL111 688-9540 PLA\NING 6,"-9535
NORTH ANDOVER BUILDING DEPARTMENT
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the pro�ision of MGL c 40 S 54, a condition of Building Permit
at: Z is that the debris resulting from this work shall be
disposed of in a property licensed solid waste disposal facility as defined by NIGL
1, S 150 A.
Also, note Pen -nits are required under Fire Prevention laws Chapter 148 Section
I OA.
The debris will be disposed of in:
Fire Department Sign off-
Dumpster Permit
(Location of Facility)
4
Date
Aicant
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Location -ZF -(-:- 7
No.
Date
TOWN OF NORTH ANDOVER
'aromwiSlIk Certificate of Occupancy $
41 wjww
Building/Frame Permit Fee $
,V ACHUS Foundation Permit Fee $
Other Permit Fee $
A�w-,6-,VED PAA�AwET,5f onnection Fee $
Water Connection Fee $
JAN 15 19T92TAL
No. Andover Col!ectolp Bullcli�g lnspect6F-�,'
Div. Public Works
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Town of North Andover
BUILDING DEPARTMENT
Homeowner License Exemption
(Please print)
DATE— 2 --
JOB LOCATION &,_WLi41t1_P
Number Street Address
gel
"HOMEOWNER"
Name Home Phone
. PRESENT MAILING ADDRESS
Section ot town
Work Phone
City/Town State Zip code
The current exemption for "homeowners" was extended to include owner
loccupied 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)
The undersigned "homeowner" assumes responsibility for compliance with the
State Building Code and other applicable codes, by-laws, rules and
regulations.
.: The' undersigned ;1 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.
,,-HOMEOWNER'S SIGNATUR)(
APPROVAL OF BUILDING OFE&CIAL —4)
'Note: Three family dwellings 35,000 cubic feet, or larger, will be
required to comply with State Building Code Section 127.0, Construction
Control.
OFFICES OF:
APPEALS
BUILDING
CONSERVATION
HEALTH
PLANNING
, N-1,
Town of
NORTH ANDOVER
�c U DIVISION OF
PLANNING & COMMUNITY DEVELOPMENT
KAREN H.P. NELSON, DIREC'I'OR
0
120 Main Street
North An(lover,
M�ISSM-1111-1;('Its () 1845
(6 17) 685-4775
In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit
Number 01/ 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 111, S
150A.
The debris will be disposed of in:
7 29A)
(Loc;
-/ V 1 /-7
of Facility)
K-ignature of nit Applicant
4,
',�Signature of
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector.