HomeMy WebLinkAboutMiscellaneous - 30 BARCO LANE 4/30/2018 (2)N
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Location Zo -� /-ZA-
No. -� 9-1 Date 'V
TOWN OF NORTH ANDOVER
Check # e", 6,0-A
I
I,k,-. r,:" --
L4 Building lnsp46tor
Certificate of Occupancy
$i
CHU
Building/Frame Permit Fee
$
Foundation Permit Fee
$
Other Permit Fee
$
TOTAL
$
Check # e", 6,0-A
I
I,k,-. r,:" --
L4 Building lnsp46tor
1. 1 Property Address:
S-1
1.2 Assessors Map and Parcel
o5s-0
Map Number
Number:
C)l 0 '7
Parcel Number
Name (Print)
1.3 Zoning Information:
Zoning District Proposed Use
Ma/uk
1.4 Property Dimensions:
Lot Am (sf)
Frontage (Ift)
1.6 WELDING SETBACKS (ft)
=2.2 Own f R d-
ok
Front Yard
Side Yard
Address for Service:
Rear Yard
Required Providc R�red
Pmi&d
Rc4*fimd
Pravi&d
SECTION 3 - CONSTRUCTION SERVICES
1.7 Water Supply MG.L.C.40. 54) 1.5.
Public 0 Privwe 0 zone
Flood Zone Infonustion:
Oubt& Rood Zone 0
1.9
Municipal
Sewersp Disposal System -
0 On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record
f"1,40/c
Name (Print)
Address for Service
Ma/uk
24- - 6 J'7 -
Signature Telephone
=2.2 Own f R d-
ok
Name Print
Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
%3.1 Licensed Construction Supervisor:
Not Applicable 0
censed Construction Supervisor:
License Number
Address
Signature Telephone
Expiration Date
3.2 Registered Home Improvement Contractor
Not Applicable 0
Company Name
too 1z C
Registrition Number
-3
Address
&,
� —,5
Expiration Date
Signature Telephone
I
0
SECTION 4 - WORKERS CO?"ENSATION (KG.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 buildinit permit.
Signed affidavit Attar -had Yes ....... X, No ....... 0
SECTIONS Descriptiono Proposed Work OhMeck appkable)
New Construction 0 Existing Building 0 Repair(s) 0 Alterations(s) on 0
Accessory Bldg. 0 Demolition 0 Other 0 Specify
-.Aj
Brief Description of Proposed Work:
Iffe
L4 C e Cfk A? ave9- A)
I CWVTlrnN A - R.QT1rMATW.D VONSTRUrTION rnqTS I
item Estimated Cost (Dollar) to be
Completed by pep*t applicant
0MCL41 USE ONLY
1. Building
(a) Building Permit Fee
Multiplier
BASEIVIENT OR SLAB
2 Electrical
(b) Estimated Total Cost of
Construction
2'J[) 31w
3 Plumbing
Building Permit fee (a) x (b)
DMENSIONS OF SILLS
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 BUELDING PERAHT
1, as Owner/Authorized Agent of subject property
Hereby authorize to act on
M halt . , all matters ati to work authorized by�[his buildiiig permit application.
Signature ot'Owner Date -A
SECTION 7b —'Jv0'XU-tHORIZED AGENT DECLARATION
117 'In - I
1, I-DL4 AJ Ho " (..- as Owner/Authorized Agent of subject
property It
Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief
Print Nam ,,- I f
Si ture of Owner/Agent
V
Date
NO. OF STORIES
SIZE
BASEIVIENT OR SLAB
SIZE OF FLOOR TUyIBERS I
2'J[) 31w
SPAN
DMENSIONS OF SILLS
DINENSIONS OF POSTS
DINIENSIONS OF GIRDERS
HEIGHT OF FOUNDATTON
THICKNESS
SIZE OF FOOTING
X
MATERIAL OF CHBANEY
A
IS BUILDING ON SOLID OR FILLED LAND
I IS BUILDING CONNECTED TO NATUIZAL GAS LINE
North Andover Building Department
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of IVIGL 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:
PO a te r e 5r/—e /Z -
(Location of Facility)
Signature of Permi pplicant
�4 — '�;- — as—
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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FROM : K;�IBLY
FAX NO. : 6033629679 Mar. 28 2005 09:51PM P5
HOME IMPROVEMVNTC0NTRAC`l'
Branch Name: 60-5j-0 Al
Dote:
7/44547
Sold, Furnished and Installed by!
f.ffD At -Home Services, Inc.
d/b/a '(lie Home Depot At -Home Services
Br-Anch Number:
—Job It:
345A Greenwood Street , Worcester, MA 0 1607
Toll Free (800) 057-5182; Fax: SOS -756-28.59
r,deral It)# 75-2699460 MF,. iic 4 C 02439 RI Colit. 1,iL4 16427
("I'l,ic#56552Z MA Home Imptowinent Contrautor Reg. #126993
Installation Address: Aclld &09a4z Ire ()?WS-
-o—Aeg Sr
City State Zip
rionne Auurubb; State Zip
(if different from Installation Address) City
Information: I/We/You ("Purchaser"), the owners of the property located at the above installation address, offer to
Pro V liver and iarrangc for the installation ofall materials its
1,21t with Home Depot U.S.A., Me. ("H D to furnish, de
described on the attached Spec Sheet incorporated herein by reference and made a part hereof.
florne Depot reserves the right to cancel this contract if, upon ro-inspection of the job, Home Depot determines that it
cannot 1! erfeirm its obligations title to a structural problem with the home or because work required to complete the job
was not Included in the contract.
CONTRACTAMOONT S
i�AfcKf� 16 -
*LESS DEPLT $_0 5�7_
BALANCE DUE
ON COMPLETION S.
*Minimum 25% 6fContract Amount due upon execution
ofthis contract.
Indicate Payment Method For
BALANCE DUE ON COMPLETION:
I e Cr -
))E POSIT PAVMENT OPTIONS
(Subject to fund veri6cation and/or crodit approval.)
I , Check , (:m1iiers Check or US Poll," I Se9ke Moncy Order
( (ic payable toThe Homo Do
MA .1).
2. Credit Curd* un r oale, paymeli ptions - Circle One Below
Vim Music ard Di ovei American Express
TheflomcrkpotHomelm v entLoun The Home nepot credit Cud
Available Credit: S HII, & HF)CC ONLY)
A6ct#; Eyp,
Nairc &q it appewus on d:
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be W4
*RyMy/DUrsipatu belowT/weaRr to allow Home Depot to charge the above
referenced credit c d for the deposit i cated.
t to
ure Date
H tith.
zation Codes
F" I HIL or HDCC AUtho
4
9
Purchaser agrees dint, immediately upon satisfactory completion of the work, Purchaser will execute a Completion Certificate
and pay an;balance due. Purchaser also agrees to bejointly and severally obligated and liable hereunder.
Fntire A re.em, nt: This agreement and its attachments, including any fi�nancing agreement, contain the complete agreement
etween
t 0 1 e.s led unless in writing in a separate agreement signed by both partici.
arnes and can not be amended or modir
NOTICE TO PURCHASER
Do not sign this contract before you read it You are entitled to a completely ralicti-in cog of the contract at the time you sign. Keep
it to protect your rights. Do not sign any Completion Certificate or agreement stating I at you are satisfied with the entire project
before thiq project is complete. Law prohibits home repair contractors from regeiting or accepting a Completion Certificate signed
I
by the owner prior to the actual completion of the work to be performed a nder I e contract
Y u may cancel this transaction at any time prior to midnipht of the third businc%-, day after the date of this contract. See Notice of
Cancellation for an explanation of this right. There will be it service charge equal to 25% of the contract amount if the job it
cancelled by Puichaqcr AFI'ER*the third-businc4s day.
BY MY/OUR SI(iNA:.rURF BELOW, UWE AGREE TO)IF BOIND BY THE TERMS Of TMS CONTRACT. I/W.E. ACKNOWLEDGE
RRCRIPT OF A COPY OF TMS CONTRACT AND TWO COMPLETED COPIES OF THr. No -110E OF CANCPLi.ATIoN.
BY MY/OUR SIGNATURE BELOW, UWr tMDERSTAND THAT THE AGFt.EpmF-.NT IS SUBJECT TO RRVIEW OF MY/OUR
CREDIT BTSTORY AND UWE AUTHORIZE HOME DEPOT AUTHORIZED CONTRACTOR, -1-0 VERIT-Y AND RFVIFW MYIOUR
CREDIT RECORD WTTI4 AN INDEPENDENT CREDIT RFPORT!NG AGENCY AND RRITASE THEM FROM ALL T..IARTLITY
INCUKRED FROM INADVE EN ISS 0 OR ERRORS. DO NOT SJGN THIS CONTRACT IF THERE ARE ANY BLANK
SPACE�.
"N ta_A6—
Date,
SUBMITTEDAY;
S t
ACCEPTED BY; -A)) Date:
10 Olt'
r
li�,_ Date;
NOTicr, ADDiTtONAL TERMS, CONDITIONS AJ9 WAkkANT?fSARESTATFn ON THE REVERSE SIDE AND ARA PART (IF rHiS COMMACT
Wiiiie - Branch File yejlnw c —t— ri,,k - Sales Consultant
10-7-04 G -SC
6�ybo
FROM :,%�KIMBLY FAX NO. : 6033629679 Mar. 29 2005 09:48PM P1
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.WA wqgq-[g
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544 -
Date.. / /
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ..... /.' �qfl? ...... ........................................
has permission to perform ........ 5��M.k� ...... 11)f / .............................
wiring in the building of ...... /Yf./-f!�? ........ ......................
�at ..... . 3...) ....... ..... ............. . North Andover"Mass.
cd
Fee .... Z� ......... Lic. No.l.�1,7�
. ... .. ..................
Check # -35 NSPECTOR
4 37)
Commonwealth of Massachusetts Official Use Only
W :CL Pennit no. !Kt7 7
Department of Fire Services 4, - - � .
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION Kt:UULA I IONS [Rev. 11/99] (leave blank)
00V
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be perfonned in accordance with the Mas`sachusetts� Electrical Code (MEC),527 CMR 12.00
(PLEA SE PRINT IN INK OR TYPE ALL 17VFORMA TION) Date: 11.18.2003
City or Town of-. North Andover To the Jn ect
S 'e
By this application the undersigned gives notice of his or her intention t erform electricaelwoOeotcrWig'el bielow.
Location (Street & Number) 30 Barco Lane I ?
Owner or Tenant Helen
Hooper
Owner's Address 30 Barco Lane North MA 01845
Telephone No.
Is this pel7Mit in conjunction with a building permit? Yes F-] No [7,] (Check Appropriate Box)
Purpose of Building residential Utility Authorization No.
I
Existing Service Amps Overhead Undgrd
New Service Amps Overhead Undgrd
Number of Feeders and Ampacity
No of Meters
No of Meters
1-978-975-2151
Locatiod i and Nature of Proposed Electrical Work: replace 3 smoke detectors: I on 2nd floor; I on I st floor; I in
baseip,ent
No. of Rectssed Fixtures
No. of Ceil.-Susp. (Paddle) Fans
No. of Total
Transformers KVA
No. of LigAting Outlets
No. of Hot Tubs
Generators KVA
No. of Lighting Fixtures
Swimming Pool A ove [] n-
No. of Emergency Liahtinu
grnd. 9 d
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS No. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
Initiatin Devices
No. of Ranges
No of Air Cond.
No of Alerting Devices
No. of Waste Disposers
Heat Pump
Number
Tons
KW
No. of Self -Contained 3
Totals:
Detection/Alerting Devices
'No. of Dishwashers
Space/Area Heating KW
Local Municipal Other
��No.
[:] Connection El
of Dryers
Heating Applicances
KW
Security Systems:
No. of Devices or Equivalent
No. of Water KW
No. of No. of
Data Wiring:
Heaters
of Devices of Equivalent
No. of Hydromassage Bathtubs No of Motors Total HP Telecommunications Wirmg:
No. of Devices of Equivalent
OTHER:
Atta h dd*t'onal detail ifVeqired,.or s req red by 4he Inspec(or oflVires.
tfi a
INSURANCE COVERAGE: Unless waived by the owner, no permit for e perTormance or electricay worti may issue uniess 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.
V-1
CHECK ONE: INSURANCE �, I BOND n OTHERDSpecify:) (Expiration Date)
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: 11-12-2003 Inspections to be requested in accordance with MEC Rule 10, and upon completion
I certify, under the pains andpenalties ofperjuty, that the information on this application is true and complete.
FIRM NAME Power Wiring & Emergency Response, Inc.- LIC. NO.: A17354
Licensee: Stephen Decker Signature LIC. NO.: 1-800-418-3221
(If applicable enter "exempt" in the license number line) Bus. Tel. No.:
Address: 44 Stedman St, Unit 2, Lowell, MA 0 1851 Alt. Tel. No:
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does no-t-h-aw-e-the-Tiability insurance coverage normally
required by law. By my signature below, I hereby waive this requirement. I am the (check one) ElowneC]ownees agent.
Owner/Agent MIT FEE $ 35.00
N2 2029
Date ...... 14-1191,97
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ........... VVVn.c .. ...... 0..� ... ..........
has permission to perform ............. Z-:� .... W ..... .............................
wiring in the building of ........ Adf.)�P�J / L ................................................
at ........ .................... North Andover,, -,Mass.
Fee. .... Lic. No—ORVA9 ....................... .........................
/ ELEcrRICAL NSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
q
The 'Commonwealth of Massachusetts Notes 111" My
so.
Depariment of Public Sofety
I am"ACY4 too
up BOARD OF FIRE PREVE"ON REGULknONS 5V CMR I= -3/90
APPLICATION FOR PERMIT T'O PERFORM ELECTRICAL WORK
AD vpwfg to be porfwmed k &ecordaut -k U7 CMR IL -00
(PLEASE PRXHT Xv XK'OZ TrPS ALL MWORN=OH) Date 23 - 22
City or Tow& of t4O. dove& To the Inspector of Viress
1he unders"d applies (Or A permit 10 perform the electrical work described Wow.
LO"tiotk (Street &Number) RMACID IA.) q2 )!Ft
OwnerorTe"at
Owner's Address
Is this Permit in tonjunctLon with a building permits yes 0 MoJK (Check Appropriate Box)
Purpose of suildino I&NAL - Qjffs, C�euc 'Utility AuthorLtation NO.
Existing Smice Amps V�lts Overhead[] Vndjr4 [] No. of Meters
New servIte Amps 4 Overbe,94 [I Undgrd 0 No. of Meters
to
N=ber of Tee4ers and Ampaci
locatlott end, Katurs of Proposed Electrical Work
- i4yr&jqjfzz &IA&c-
No. of Lighting Outlets
No. of Not Tubs
No. of Transformers Total
KWA
No. of Lighting Fixtures
d,.,
Swimming Pool 1"v
Generators XVA
No. of R"44-ple outlets
of SwLtchlbut-lets
_jp�d,
No. of Oil Imars r!
No* of as$
110. of EMerj:=j EIDER
Battelz Uni
FW ALAW- * No. of Zones
of Detection and
InLtL&tLngAkv1ces
Noe of Som4ftS Vevft"
Ito. of Self Contained
DetsctLoa/SoundLng Devices
Local 0 Municipal oother
Connection
ft. of Ranges
No. of Air cond's Total
tons
No. of Disposals
NO* Of Heat' total Tout
r=Ps -- Tons
No. of hits
—Ky
SPSC4/kes meeting IN
tl�. of * Dryerl 1
Heating Dev Less 1KW
No. of Water He#ters KW
No, of--
-S-f Wns lillasts
LOV voltage
No. Rydro Hass&g4 Tubs
I
No. of Motors Total HP
- - i
cloivml
MbUXJWCX 0UVEV=3 Pursuant to the requirements of Massachusetts Cenjr&l LeVs
I h"Q a tUrrentALgabilfty Insurance Policy Lnclufti$ Completed Operations Cove go or its substantial
equivalento. YES 1W NOE] I have suVaLtted vaIL4 proof of same to this f,,,,r.8 YSEI NO
I WV
f 7W hays cb4cA 4, please Lat!LcAe the type of costs&* by cbecking the opproprLat4L box.
usinwa ITIM C] (Please, Specify)
EstWted Value Of Electrical Work
Work to Start Inspection Date R4questeds -Routh.
S.Igned 4�.4*r the penalties of perjurys
j , oi L LIC. No.
L: cmi & a , re, a - 1 6=2
Signature'— LIC. Noa
Address A L Tj
Bus. Tel so. Ast - (411
jug* 261. ft.
owws usumcs unvims I so aware' thai the does a t bav!k'the Luoutshce toverage 0-c-LtAL sub-
st&ntfsl equivalent as required by Massachusetts Cenera. An -d that my fLipature on this p4ivLt
application valves this requirement. owner- Agent Vlease check one)
Telephone No,
%aignature or Owner of ASOR. j