HomeMy WebLinkAboutMiscellaneous - 30 MATHEWS WAY 4/30/2018-7m
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Permit No.
i0epartinctit of pubuc ezifrtU
Occupancy A Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 1 3190 (leave blank) C�7
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CIAR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
City or Town of- NORTH ANDOVER �—? �
To the Inspector of Wires:
The udersigned applies for a permit to perform the electrical work described below
Location (Street & Numbe-rjA-3n� Z- 6 4- 2 17-1a4� k ZL,--) S
Owner or Tenant
Owner's Address
Is this permit in conjunction with Et building permit:
Purpose of Building
Existing Service Amps I __volts
New Service Amps Q& 12 Yo -volts
Number of Feeders and Ampacity
Location and Nature of Proposed I
Yes No (Check Appropriate Box)
Utility Authorization No. _Z20 OZ
OverheadEl Undgmd El No. of Meters
Overhead r 1 Undgrnd X No. of Meters
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers Total
KVA
No. of Lighting Fixtures
Swimming Pool Above In-
El 11
gmd. grnd.
Generators KVA
No. of Receptacle Outlets
No. of Oil Burners
No. of Emergency Lighting
Battery Units
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS No. of Zones
No. of Detection and
No. of Ranges
No. of Air Cond. Total
tons
Initiating Devices
No. of Disposals
No.of Heat Total Total
Pumps Tons KW
No. of Sounding Devices
No. of Self Contained
Detection/Sounding Devices
No. of Dishwashers
Space/Area Heating KW
No. of Dryers
Heating Devices KW
Local Municipal Other
1:1
C nnection
No. of No. of
Low Voltage
No. of Water Heaters KW
Signs Ballasts
Wiring
No. Hydro Massage Tubs
No. of Motors Total HP
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 [3 1
have submitted valid proof of same to the Office. YES
checking he app opriate box. V NO 0 If you have checked YES, please indicate the type of coverage by
INSURANCE W BOND 0 OTHER 0 (Please Specify)
Estimated Value of Electrical Work $ (Expiration Date)
Work to Start /-/& Inspection Date Requested: Rough 1,U;(( Final
Signed under the Penalties of perjury:
FIRM NAME to ga, F(�e-<-4-� CaY ci,
LIC. NO.
Licensee —CA,, -7-5 t7,4- Signature lfo!�- - 44 LIC. NO.
Bus. Tel. No. 6- tY� - 6 K14 (-,i
Address 1;?%-)- -��,Qs t0 r -,e- 1?_rt . /11A, 0 -4- 4 A Q AAMA Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re-
quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent
(Please check one) I
(Signature of Owner or Agent)
Telephone No. PERMIT FEE $
x-6565
Location LE�e
No.
Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Ir Foundation Permit Fee $
CHU
Other Permit Fee $
sewer connection Fee $ 1600- 1�70
7 Z water connection Fee $ 10 6 05-7
TOTAL $
uil g in cto
10
N2 9173 DiveuKic Works
100F
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PER1117F NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE I
MAP 4-40.
LOT NO. a
I
12 RECORD OF OWNERSHIP IDATE
BOOK '.PAGE
zo
� E 91-a
SUB DIV. LOT NO.
--
I F -
LOCATION
M A*W-k,8
LAA&
PURPOSE OF BUILDING
OWNER'S NAME
I
NO. OF STORIES SIZE
OWNER'S ADDRESS -733
BASEMENT OR SLAB
ARCHITECT'S NAME Inn :Z 0
A
SIZE OF FLOOR TIMBERS IST,_;, () 2ND
3RD ll�-
BUILDER'S NAME
SPAN
DISTANCE TO NEAREST BUILDAIG 60 4-
DIMENSIONS OF SILLS
POSTS
DISTANCE FROM STREET
DISTANCE FROM LOT LINES - SIDES
GIRDERS C;V
AREA OF LOT a.5 -3
Q 6
FRONTAGE
Jay
4�*
HEIGHT OF FOUNDATION -f. - THICKNESS
SIZE OF FOOTING X
IS BUILDING NEW ___, -
IS BUILDING ADDITi6N
AkO
MATER:AL OF CHIMNEY
IS BUILDING ALTERATION
A A!��
IS BUILDING ON SOLID OR FILLED LAND gA
WILL BUILDING CONFORM TO REQUIREMENTS OF
CODE
IS BUILDING CONNECTED TO TOWN WATER
m
BOARD OF APPEALS ACTION. IF ANY
IS BUILDING CONNECTED TO TOWN SEWE -
R_
ke 4
IS BUILDING CONNECTED TO NATURAL GAS LINE
ym
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 APPROVED BY BUILDING INSPECTOR
DATE FILED A A
SIGNATURE OF OWNER OR AUTAOWI;'ED ;�EN; Vj
F E E
PERMIT GRANTED
19
NOV - 6 1996
8
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST d
EST. BLDG. COST PER 9Q. "112k,
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
suiLimipto imspacrok
OWNER TEL. # 6 "- 7�
CONTR. TEL. #
CONTR. LIC. #
H.I.C.#
BUILDING RECORD
OCCUPANCY 12
�INGLE FAMILY
S'ORIES
MULTI. FAMILY
FICES
:l
APARTMENTS
CONSTRUCTION
2 FOUNDATION
CONCRETE 1
CONCRETE BL
BRICK OR STONE
PIERS
8 INTERIOR
3
PINE
—KARDW D
PLASTER
TRY WALL
LINFIN.
FINISH
11
2
13
3 BASEMENT
AREA FULL
FIN. B*M T AREA
1/1 V2
FIN. ATTIC AREA
NO BMT
FIRE PLACES
HEAD ROOM
MODERN KITCHEN
4 WALLS
9 FLOORS
CLAPBOARDS
DROP SIDING
WOOD SHINGLES
1
3
CONCRETE
ARTH
ASPHALT SIDI G
ASBESTOS SIDING
VERT. SIDING
HARMU'D
COMMON
ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY
BRICK ON FRAME
ATTIC STRS. & FLOOR
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR
�DEQIJATE NONE
5 R qOO F
10 PLUMBING
E
HIP
Loo�
BATH (3 FIX.)
GAMj�GABL
QEL
E L
I
MANSARD
TOILET RM. (2 FIX.)
FLAT
SHED
WATER CLOSET
ASPHALT SHINGLES
LAVATORY
WOOD SHINGEs—
KITCHEN SINK
SLATE
NO PLUMBING
TAR & GRAVEL
ILL SHOWER
ROLL ROOFING__
MODERN FIXTURES
TILE FLOOR
TILE DADO
6 FRAMING
IXI HEATING
WOOD JOIST
I.,,"
PIPELESS FURNACE
—0
FORCED HOT AIR FURN.
TIMBER BMS. & COLS.
STEAM
STEEL SMS. & COLS.
LiOT W'T'R OR VAPOR
WOOD RAFTERS
AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS
GAS
OIL
2n
B'M'T 2 d
3rd
ELECTRIC
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.
PERMIT NO. -
APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
PAGE I I
M A P itO.
LOT NO. a
2 RECORD OF OWNERSHIP IDATE
BOOK :PAGE
ZONE
. . PU-o-t
SUB 0 IV. LOT NO.
I
F -
LOCATION
__t+
PURPOSE OF BUILDING
OWNER'S NAME
'tot,NO.
C
OF STORIES
__
OWNER'S ADDRESS
BASEMENT OR SLAB
ARCHITECT'S NAME
SIZE OF FLOOR TIMBERS IST,-;�, 2ND
3RD
BUILDER'S NAME
DISTANCE TO NEAREST BUILDIMG 60
SPAN
DIMENSIONS OF SILLS X 6 FIT
POSTS
DISTANCE FROM STREET
DISTANCE FROM LOT LINES - SIDES REAR
GIRDERS
AREA OF LOT FRONTAGE tt�%t*
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW
SIZE OF FOOTING x
IS BUILDING ADDITIC5N
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 SElW
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
I
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED
SIGNATURE OF OWNER OR
F E E
PERMIT GRANTED
19
AGENT
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST 49
EST. BLDG. COST PER SQ. FT"41!r
mm I - P660%-- L -WO I rILK KUVM
SEPTIC PERMIT NO.
4 APPROVED BY
NUILMING INSPKC-MR I
OWNER TEL. #
CONTR. TEL. # 5A YrLe
CONTR. LIC. #
H.I.C.#
BUILDING RECORD
OCf
>pANCY 12
SINGLE FAMILY
S"ORIES
MULTI. FAMILL:::�
OFFICES
APARTMENTS
CONSTRUCTION
2 FOUNDATION
V 1
8 INTERIOR FINISH
CONCRETE
___
PINE
a
1
2
13
CONCRETE BL*K.
BRICK OR STONE
HARDW D
PLASTER
DRY WALL
_�NFIN
_A
PIERS
3 BASEMENT
AREA FULL
'14 1/2
FIN. B M -T AOI�ki
FIN. ATTIC AREA
t!O 8 M T
HEAD ROOM
FIRE 'PLACES
MODERN KITCHEN
4 WALLS *,Or 9 FLOORS
CLAPBOARDS
1
2 3
DROP SIDING
WOOD SHINGLES
C NCRETE
EARTH
ASPHALT SIDING
ASBESTOS SIDI�G
VERT. SIDING
_�ARDVV D
COMIACN
�SPH TILE
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY
BRICK ON FRAME
CONC. OR CINDER BLK.
ATTIC STRS. & FLOOR
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR ltoe—POOR
_�DEQUATE NONE
5 J,40OF
10 PLUMBING
GABLE
GAMBREL
A
HIP
BATH (3 FIX.)
MANSARD
TOILET RM. (2 FIX.)
FLAT
I
SHED
WATER CLOSET
ASPHALT SHINGLES
LAVATORY
WOOD SHINGES
KITCHEN SINK
SLATE
NO PLUMBING
TAR & GRAVEL
STALL SHOWER
ROLL ROOFING
MODERN FIXTURES
TILE FLOOR
TILE DADO
6 FRAMING &.Oof
11 HEATING
WOOD JOIST
PIPELESS FURNACE i
—of
FORCED HOT AIR FURN.
TIMBER BMS. & COLS.
es—TEAM
STEEL BMS. & COLS.
HOT W-T'R OR VAPOR
WOOD RAFTERS
AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
7 NO. OF #OMS
GAS
OIL
2BS 2nd
I., ard
ELECTRIC
FNO 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.
1-14-
MERRIMACK ENGINEERING SERVICES, INC.
PROFESSIONAL ENGINEERS 0 LAND SURVEYORS 0 PLANNERS
66 PARK STREET ANDOVER, MASSACHUSETTS 01810 e TEL. (5'08) 475-3555, 373-5721 FAX (508) 4 75-1448
September 16, 1996
Town of North Andover BY FAX & MAIL
Planning Board
Town Hall - 120 Main Street
North Andover, MA 0 1845
Attention: Ms. Kathleen Colwell
RE: Pin6wood Develppment
Salem Street - North Andover
Eve�green Mana ement Corp.
9
Dear Ms. CO;lwell:
Regarding the subject and the correspondence of Evergreen Management Corp. dated September
12, 1,996, concerning the development oP foundations on lots, 12, 3, 4 and 5, 1 recommend that the'
Planning Board consider allowing jnstallation of the found
ations concurrent with or prior to the
filling and grading of th& lots. Due to the proximity of these lots to the wetlands� and detention
areas and the slopes and �activity associated with the lot and foundation construction, and given
the excellent job which the site contractor has undertaken to date in controlling all activity on the
site, I recommend the contractor's request be granted so as to allow stabilization, before the
growing season is over.
Please contact me should. you, have que . stions or comments regarding the above.
cd
cc
.Evergreen Management Corp.
North Andover Conservation Commission
Mr. Curt Young .
SERVICES .
FORM U - IOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state lawl
regulations or. requirements.
****************Applicant fills out this section*****************
APPLICANT: &-loemi'LA 6,0�,fPhone q
LOCATION: Assessor's Map Number Parcel
subdivision Lot(s) 2
Street St. Number— 30
************************Official Use Only************************
RECO NDATI/PNVSO , N AGENTS:
77.
If Date Approved - /100�
conservation—id—min'lstrator Date Rejected
Comments 11 -
Date Approved
Town Planner Date Rejected
Comments A� 7),� W
— A rk"LIA F d, /c,
Food Inspector -Health
Septic Inspector -Health
Comments
Date Approved
Date Rejected
Date Approved
Date Rejected
Public Works - sewer/water connections
- driveway permit
tt
Fire Department
Received by Building Inspector Date
NOV - 6 1996
Growth Management Bylaw Exemption Statement
Town of North Andover Building Department
This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the
Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information
as requested below.
Name of Applicant on Building Permit (below) Address of Property for Permit (below)
Map and Parcel: Purpose qf A
,,�pplication (check below)
Phone Number of Applicant: Single Family Two Family
I the undersigned applicant for the above property attest that the attached building permit for which this
form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth
Management Bylaw. I also understand providing this form does not absolve me or any party to this permit
from the requirements of obtaining other permits required prior to the issuance of the Building Permit.
Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building
Department and is only officially accepted when the Building Permit is issued.
Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the
above lot, in the building permit application and associated attachments, complies with one or more of the
following sections as indicated by a check mark.
— This is an application for a building permit for the enlargement, restoration, or reconstruction of a dwelling in
ex�is�teas of the effective date of this by-law, provided that no additional residential unit is created.
I The lot(s) were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning
Bylaw.
— This application is for dwelling units for low and/or moderate income families or individuals, where all of the
conditions of 8.7.6.c are met and/or represents Dwelling units for senior residents, where occupancy of the units is
restricted to senior persons through a properly executed and recorded deed restriction running with the land. For
purposes of this Section "senior" shall mean persons over the age of 55.
— This application is a part of a development project which voluntarily agreed to a minimum 40% permanent
reduction in density, (buildable lots), below the density, (buildable lots), permitted under zoning and feasible given the
environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently
designated as open space and/or farmland. The land to be preserved shall be protected from development by an
Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism
approved by the Planning Board that will ensure its protection.
— This application represents a tract of land existing and not held by a Developer in common ownership with an
adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth
Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the
parcel.
— This application represents a lot which is ready for building permits,(i.e. all other permits from all other boards and
commissions have been received and the project is in compliance with those permits), and the Development Schedule
does not accommodate issuing a building permit in that Year, one building permit will be issued per Year per
Development until such time as the Development Schedule accommodates issuing building permits. Applicant must
supply approved form U with this EXEMPTION.
Please provide any and all information that would assist the Building Department in making a determination
that your application is allowed one or more of the above EXEMPTIONS.
By signing below I attest to the accuracy of the information provided and that the attached building permit is
allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or
inaccurate information, or the checking off of an above item which does not comply, whether done to my
knowledge or not,_ji§,�uncls for refusal by the Building Department to issue a Building Permit.
ature or—o—wn��o'F_Autqtr ' `dA__gen_twhq0ned theAttached Building Permit Date
form must be attach2t the Buildl#§ Permit upon application for such permit.
NOV - a 199,9
r -
'A
Date .... ......
-12 689
40RTpl
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
41
S CHUS
This certifies that .... ...... ............
A 11104, Va, V,
'has permission to perform .................... ...........
..........
wiring in the building of ... ........................
36)
Zt t Mdover, Mass."
V ......... . Nor h
Fee..—')O.::77 ....... Lic. No. ..........
'iL'E** C*'T* R**I*C* A**L* 1'4*S* P-L"T, 0"R
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer