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Home My WebLink AboutMiscellaneous - 285 CHESTNUT STREET 4/30/20180 x m CD C) mi I Date ...... Y— / 3 - e)4 ......................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING 6 0 This certifies that ........... t.Alf ...... .................. . .............................. has permission to perform ......... r . ............................. wiring in the building of .... ................... at ........ , North Andover, Mass. Fee �� .............. Lic. No... R .......... LECTRICAL INSPECTOR' Check # C, Commonwealth of Massachusetts Official Use Only Permit No. 7, Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS I [Rev. 9/051 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PPJNTININK OR TYPE ALL INFORMATION) Date: \ \— \-1— 0 0 City or Town of- NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) OwnerorTenant -70y--N Telephone No.001 -SS7- %R03 Owner's Address Is this permit in conjunction with a building permit? Ves El No -'S (Check Appropriate Box) Purpose of Building Utility Authorization No. \-!1,-7 (9 ExistingService 6C) Amps \-2-0/7-APVolts OverheadF-1 Undgr-d"E] No. of Meters New Service -2,00 Amps \?-0/ZA0Volts Overhead Undgrd-E] No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 2- 06 Or\ r C� -r\,,& SA- - Completion of the followin.Q table may be waived bv the Inspector of Wires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above o In- grnd. grnd. No. ol Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS INo. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump7Number Totals: I Tons No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local o Munic 'PP' 0 Other Connection No. of Dryers Heating Appliances KW Security Svstems:* No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent IOTHER: -1 Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: 3 �700%C)C) (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE'�E BOND F1 OTHER [-] (Specify:) I certify, under lite pains andpenalties of perjuty, that the information on this application is true and complete. FIRM NAME: LIC. NO.: 001411sl�l Licensee: Signatu LIC. NO.: - 1% M&66& (If applicable, enter "exempt " in the licemLe number line.) 8 Bus. Tel. NoJ60'144\0 (o\571 Address: 9C6 G-ert-4 `Z�y- -`%N�nNNNN—R- )NO& 0 2-,k 4-� — Alt. Tel. No.: *Security System Contractor Ilicense required for this work; if applicable, enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage non-nally required by law. By my signature below, I hereby waive this requirement. I am the (check one)Elowner 0 owner's agent. Owner/Agent Signature Telephone No._ FPERMIT FEE. $ Date.//. This certifies that ... �5 ef.'-t-7. K ................................. has permission to perform plumbing in the buildings of .... ....... ........... ........... NDrth Andover, Mass. at . .6 . ...... .... ............... Lic. No. ....... ................. Fee .5 PLUMBING INSPECTOR Check # /q &� TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SS CHUS This certifies that ... �5 ef.'-t-7. K ................................. has permission to perform plumbing in the buildings of .... ....... ........... ........... NDrth Andover, Mass. at . .6 . ...... .... ............... Lic. No. ....... ................. Fee .5 PLUMBING INSPECTOR Check # /q &� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Loqation Owners Name fam Date P— Permit # Type of Occupancy 'j "L A- Amount New 1:1 RenovationE] Replacement [:] Plans Submitted Yes No FIXTURES (Print or type) ZD Check one: Certificate Installing Company Name Corp. Address Partner. t3 01 V -l\ Business Telephone Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy J2 Other type of indemnity E] Bond insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature I hereby certify that all of the details and inor best of my knowledge and that all plumbing � compliance with all pertinent provisions of the By: Title City/Town APPROVED (OFFICE USE ONLY ion I have and instal 11 led (or Type of Plumbing L cense 11cense iNumSer Master Agent [:] in above a ,Wi#tion are true and accurate to the r P9pit zZir this application will be in �W Ch =42 of the General Laws. jaJourneyman El ItMDate ........ /� .......... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .............. ................. has permission for gas installation � ............. in the buildings of . . ............... at ........... North Andover, Mass. ................ Fee. :2-.). Lic. No.. /0 . ............... ....... GASINSPECTOR Check # NLA%ACHUSEM UNIFORM APPUCATON FOR PERNIrr TO DO GAS FTrDNG (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations 0 Date //— //— oo Permit # -,mountp Owner's Name -1,91M F-towkvt New Renovation Replacement Plans Submitted )aj 1:1 Wrint or P, Address Name of Licensed Plumber or Gas Fitter -.1 H0 - Chtr(.k one: Certificate installing Company L1 Corp. Partner. faFirn-dCo. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 13 � NoO If you have checked e ' lease i dicate the type coverage by checking the appropriate box. Liability insurance policy W Other type of indemnity 1:1 Bond 13 Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. neCK one: Signature of Owner or Owner's Agent t, Owner I hereby certify that all of the details and informa�dn I have SuXitted (or enterWn abov-)ea lic. - are true and—accurate to the hest of my knowledge and that all plumbing wort and instaxions performe e��it I s this application will be in tssachuseits St )XI -hap er c General Laws. compliance with all pertinent provisions of the I W. . .. rid By: 'Title. City/Town ,\PPROVED (OFFICE USE ONLY) Signature of' Plumber Gas Fitter 71 INTaster '02 1:3 Journeyman P10ber Or Gas Fitter u WARS AM IN Nkl�=l KIM Wrint or P, Address Name of Licensed Plumber or Gas Fitter -.1 H0 - Chtr(.k one: Certificate installing Company L1 Corp. Partner. faFirn-dCo. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 13 � NoO If you have checked e ' lease i dicate the type coverage by checking the appropriate box. Liability insurance policy W Other type of indemnity 1:1 Bond 13 Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. neCK one: Signature of Owner or Owner's Agent t, Owner I hereby certify that all of the details and informa�dn I have SuXitted (or enterWn abov-)ea lic. - are true and—accurate to the hest of my knowledge and that all plumbing wort and instaxions performe e��it I s this application will be in tssachuseits St )XI -hap er c General Laws. compliance with all pertinent provisions of the I W. . .. rid By: 'Title. City/Town ,\PPROVED (OFFICE USE ONLY) Signature of' Plumber Gas Fitter 71 INTaster '02 1:3 Journeyman P10ber Or Gas Fitter Location No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ -' Foundation Permit Fee Other Permit Fee TOTAL Check # Buildin �,*ec to r X TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING for oliky BUELDING PERMIT NUMBER: DATE ISSUED: I'D A A -1, SIGNATURE- ACOW J4 Building Commissioner/lEELWor of Buildings Date SECTION I- SITE INFORMATION 1. 1 Property Addreks: e 1.2 Assessor; Map and Parcel Number: q19 0 Map Number Parcel Number 1.3 Zoning Information: Zoning Di�tr ict Proposed Use 1.4 Property Dimensions: Lot Area (sf) Fr-tage (ft) 1.6 BUILDING SETBACKS 00 Front Yard Side Yard Rear Yard Rapired PrOvidc Required Provi&d red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: lic 0 Private D Zone Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal 0 On Site Dispoml System 0 SECTION 2 - PROPERTY OWNERSHIEP/AUTHORIZED AGENT 2.1 Owner of Record Name (Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable D License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable D Company Name (21�1�-\,�- � '\ C Aj/ Registration Number Address Way Expiration Date Signituie Telephone I A 0 z M 0 M" memo M ru r z Q JA SECTION 4 - WORKERS COMEPENSATION (NLG.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 o Proposed Work (check applicable) New Construction 0 Existing Building 0 Repair(s) V Alterations(s),, .0, Addition 0 Accessory Bldg. 0 Demolition 0 Other El Specify Brief Description of Proposed Work: '__� �- � 'r-, — X\- , '�� 'P �? I SFCTTON 6 - RSTIMATRD CONSTRUCTION COqTq I Item Estimated Cost (Dollar) to be Com leted b permit applicant OFFICIAL USE ONLY 1. Building (3 CD (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) Mechanical (HVAC) .4 5 Fire Protection 6 Total (1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COM[PLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 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 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 Prin? Na -me SiguaCureo'f Own ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TTMBERS I sT 2 ND 3 RD SPAN 77 DIMENSIONS OF SILLS DMIENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION TMCKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE U 4 . 4 cr C> U-� CD C> cn 'm P, c= cf) c� uj w cr 0 o - 2m cc Cc LLA :,Eo . 4 4 1� The Commonwealth ofMassachusetts Department of Industrial Accidents mce offflyesaff2lims 600 Washina' Von Street Boston, Mass. 02111 Workers' Compensation Insurance Affidivit M 11 , X. . ... ...... 7. .4. ..... . .. xe� A& ......... Sol rM#:: C) I am a sole proprietor, general contractor, or homeowner (circle one) and ..... the following workers' compensation polices: ... . ........ hired the contractors listed below who have # 5.. Insur nilt e, Sm -:::r1h tg - --- I — —11 c —v- are R3 urqUIUCU UF1UCr OCUIUM AZA 01 fflqjl� 13A Can tend to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years' Imprisonment as well its civil peniffies In the form of a STOP WORK*ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may be rorw-trded to the Office or Investigations of the DIA for coverage verification. I do h'ereby cerroy' under the pains and pen ties ofperjury that tire information provided abo've is true and rrect d Date Print r le �A. (A, R I Z� C -Z) 11"e Phonefi! OMCIRI use only do not write In this area to be completed by city or town oMelal city or town: permit/license N ____09uilding Department CjL[ccnsing Board C] check if im media te response is required oSelectmen's Office contact person- phone N; Cjllealth Department ---00ther (revised V95 PJA) ril R.7� 0 I ** Ar F�� CA � CA cm .0 !7c 2 W LL. CA ui CO2 LU E CL ca CL m C.3 ci C.3 CD Cc ca E ACC CE CD :.s CL w E E CD c U CM CA cc CD 3: Cc CO2 CA E C., z s CL. CIO cc Mo Co Cc CL= CD J2 CL4— E V cm CD cm .s Me co CD C/) 0 C/) Q, RAW - CI S, �21 I" rS 6 u E CD coo C13 CM CD CO) CD CO) C) CD i2lo. co ci CL M C) = 136. CM< ca -0 Cl ca C.3 *FL C3 ca t; CL C.2 CO2 CL CO3 w 0 U) w U) cr w w (r LU w U) u 0 Cf) u 41 cn 0 go cz 110 �2 -C to C2 (U r u CIS a x = C2 co c x 0 —Cd .5 jo 00 , r. x w :� M - - C/) 0 co I ** Ar F�� CA � CA cm .0 !7c 2 W LL. CA ui CO2 LU E CL ca CL m C.3 ci C.3 CD Cc ca E ACC CE CD :.s CL w E E CD c U CM CA cc CD 3: Cc CO2 CA E C., z s CL. CIO cc Mo Co Cc CL= CD J2 CL4— E V cm CD cm .s Me co CD C/) 0 C/) Q, RAW - CI S, �21 I" rS 6 u E CD coo C13 CM CD CO) CD CO) C) CD i2lo. co ci CL M C) = 136. CM< ca -0 Cl ca C.3 *FL C3 ca t; CL C.2 CO2 CL CO3 w 0 U) w U) cr w w (r LU w U) jo I ** Ar F�� CA � CA cm .0 !7c 2 W LL. CA ui CO2 LU E CL ca CL m C.3 ci C.3 CD Cc ca E ACC CE CD :.s CL w E E CD c U CM CA cc CD 3: Cc CO2 CA E C., z s CL. CIO cc Mo Co Cc CL= CD J2 CL4— E V cm CD cm .s Me co CD C/) 0 C/) Q, RAW - CI S, �21 I" rS 6 u E CD coo C13 CM CD CO) CD CO) C) CD i2lo. co ci CL M C) = 136. CM< ca -0 Cl ca C.3 *FL C3 ca t; CL C.2 CO2 CL CO3 w 0 U) w U) cr w w (r LU w U) Location No. --- / . Check # Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Building lnspe�to'r 1. 1 Property AddressT 1.2 Assessors Map and Parcel Map Number Number: Parcel Number 1.3 Zoning hiformation: Zoning DiAr idt Proposed Use 1.4 Property Dimensions: I Lot Area (sf) Frontage (ft) 1.6 BUILDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide Required Provided Re(Vired Provided 1.7 Water Supply M.G.L.C.40. 54) Public 0 Private 11 1.5. Flood Zone In tion: Zone Outside Flood Zone 0 1.8 Municipal Sewerage Disposal System: 0 On Site Disposal System 0 NEU I 1VfN 2 - F-KUPEK I Y UWIN J6KStUF/AU'1'11UK1LED AGEINT 2.1 Owner of Record cc) V" Name�(P�rint) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable 0 Licensdd Construction Supervisor: Address Signature Home Improvement Contractor Company Name ,�Z, \ Addris—s ' Telephone License Number Expiration Date Not Applicable 0 Registration Number Expiration Date I I SECTION 4 - WORKERS COMPENSATION (MLG.L C 152 4 2506) 1 Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit %ill result in the denial of the issuance of the building permit. Signed affidavit Attached Yes ....... 0 No ....... 0 SECTION 5 Description o Proposed Work (check applicable) New Construction 0 Existing Building 0 Repair(s) V Alterations(s) 0 1 Addition 0 Accessory Bldg. 0 Demolition 0 Other 0 Specify Brief Description of Proposed Work: �- � v — �,\- — '��2e�rp SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY I . Building (a) Buildm7g 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) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 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 OWNERIAUTHORIZED AGENT DECLARATION le—lio as Owner/Authorized Agent of subject pr4rrty 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 §iid&e' of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS I ST 2 ND 3KD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GII(DERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CIIJI�MY IS BUILDING ON SOLM OR FELLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE The Commonwealth OfAlassachusetts Department ofIndustrialAccidents Me Af IflyeS99.7110fls 600 Washiq-ton Street Boston, Mass. 02111 -- — -------- j leAle): C] I am a sole proprietor, general contractor, or homeowner (circle one) and have the followinL, workers' camnensatinn nnficei! ' ' " hired the contractors listed below who have— - - - - -- -- -7- ' -- --.. -- -— .-- .- - - Y al— us L-111111MI pCissingC3 us M 11FIC up In ag,;)Uu.uu Anulor one years' imprisonment as well as civil penilties in the form or a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that& copy of this statement may be forwarded to the Orrice or Investigations of the DIA for coverage verification. I I do hereby ceritry under the pains and pS�qfies ofperjury draf Ih e information provided abo*O*e is true and correm rn P -W e Date Signatun Ck- R, C, Print name 4 C -In �"e hone N official use only city or town:_ do not write In this area to be completed by city or town official (3 check if immediate response is required contact person: (revised 3/95 PIA) permitAicense N —___OBuilding Department ClUcensing Board []Selectmen's Office ClIfealth Department phone 9; ----00ther C> cn < co w 3> 'o M M C.) co S w C" <D Cn C-) --4 IT) Mario Castricone, Prop. 'A 11 - m I CASTRICONE ROOFING & SIDING CO. �3 Tel. 682-4266 31 Court St, No. Andover, Mass. 01845 0-1kAA \S V0. Aao 6,� a_�k D. �w 1 rA rA cd �o 0 0 0 C/) 1:4 0 F-4 u w V) z 0 z go -0 -a C2 r u x 94 0 E-4 u w -a — co x 0 H u w u 04 w �2 V) co C/) z x to :j 0 P4 —cz LL, ZW C 90 v V) 0 C/) 6 CL z S� E I.. IE CA C43 CD cm C" S z 1= C/) 0 C/) P-4 C) :+4 cf) C/) z 0 u �D 0 cf) z 0 u C/) C/) 10. 4.j 2 ts 6 u co 0 E co CD CL CD cm C C CD MA E co Lft CD CD C.2 m CD 93. cm< ca ca CL o co ca Z *6 CD CL cc cc CL CO) A LLI 0 Fn LLJ U) Ir LLJ Lij cr LLJ LLI C/) CD CD C3 C2 C.3 C.) CL CD E t5 CD CD CD CJ t; CD C'n ca Go E CD C.3 CD CD :No '00 Is) M CL C, CD 0 4D r CO) uj 151 ;A- -M —M CL 4co., LU .0 Q CD cm U 0 0.0 e CA CL C2.s 0.5 .0 CL cc S� E I.. IE CA C43 CD cm C" S z 1= C/) 0 C/) P-4 C) :+4 cf) C/) z 0 u �D 0 cf) z 0 u C/) C/) 10. 4.j 2 ts 6 u co 0 E co CD CL CD cm C C CD MA E co Lft CD CD C.2 m CD 93. cm< ca ca CL o co ca Z *6 CD CL cc cc CL CO) A LLI 0 Fn LLJ U) Ir LLJ Lij cr LLJ LLI C/)