HomeMy WebLinkAboutMiscellaneous - 30 SUMMER STREET 4/30/2018r��
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f. Tlie Commonwealth of Massachusetts
1
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BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 12.00 3/90 tee C nt,itwt
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
NI urork to be performed In accordance with the Ma xachusetu Electrical Code. 521 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 7- 9-97
City or Town of IVOe771 Ay an /E a To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street lir Number) _ ��O J Cl /Y! rYi�,e -S741,eEE1-
Owner or Tenant
Owner's Address SAME sob) 83 2S/G 7 _
Is this permit in conjunction with a building permit: Yes ❑ No a (Check Appropriate Box)
Purpose of Building Utility Authorization 110.
Existing Service Amps / Volts Overhead ❑ Underdr� ! No. of Meters _
New Service Amps / Volts Overhead ❑ Undgrd ❑ Ito. of Meters
N—ber of Feeders and Ampacity
Location and Nature of Proposed Electrical Work Installation of Alarm System
No. of Lighting Outlets
No. of Hot Tubs '
No. of Transformers Total
No. of Lighting Fixtures
Swimming Pool Above In-
grnd. ❑ grnd. ❑
Generators KVA
No. of Receptacle Outlets
No. of Oil Burners ,
Battery Emergency Lighting
UniNo.
of Switch Outlets
No. of Gas Burners
FIRE ALARMS. No. of Zones
No. of Detection and
Initiating Devices'
No. of Sounding Devices
No. ofSelfContained
Detection/ding devices
Local Municipal
1:1 ❑ Other
Connection
No. of Ran es
B.
Total
No. of. Air Cond. tons
No. of Disposals
No. of Heat Total Total
Pumps Tons KW
No. of Dishwashers
Space/Area Heating KW
No. of Dryers
Heating Devices KW
No. of Water Heaters KW
Signs Ballasts
Wirinoltage
No. Hydro Massage Tubs
No. of Motors Total HP
OTHER: 0 ) SrrloK.E eT-EeT`o 2
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 ❑ I have submitted valid proof of same to this office. YES ❑ NO
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify)
Estimated Value of Electrical Work S/,95? e e
Work to Start d - .AS - 97 Inspection Date Requested:
Signed under the penalties of perjury:
Rough
Expiration Date
Final 7--3'- 97
FIRM NAME A.D.T. S6CURITV SYSTEMS NORTHEAST _INC. . _, LIC. No. 1231C
Licensee DONALD A BROOKS. Signat e _ .Ir." NO. 12 31 C
Address 60 William Street, Wellesley, 8 s. el. No. 413-732-4400
Alt. Tel. No.617-431-5831
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or is sub-
stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit
application waives this requirement. Owner Agent (Please check one)
Telephone No. 5 .i PERMIT FEE S 3S
Signature of Owner or Agent
-12 1655
0,
I (I.. clw.�
Date
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
cc
M
This certifies that ..... ....... ....... ................
has permission to perform ..... A. q..W.A.! .......... I ....................
wiring in the building of ........ /I.x A. ............................................
at ..... 7.0 ..... ............................. . North Andover, Mass.
Re.—,e...) ........... Lic. Nod; )x . ................................................................
ELECTRICAL INSPECTOR
;7,Y
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
Locatio 2,
No. Date
-0
I
�IL "Il 5�-
TOWN OF NORM ANDOVER
Certificate of 0
- o '%40
Building/F�
it Fee $
X�
mit Fee �,:h
Foundaty%%Q
bUkermit Fee IV
-
Sewer Connecti
Water ConnectioQOeq,
TOTAL
Building Inspector
3Y,4
Div. Public Works
Location
No. Date
TOWN OF NORTH ANDOVER
.Certificate of Occupancy $P0 -713 a/ - 2—
.Building/Frame Permit Fee
Foundation Permit Fee $ -7 '2
Other Permit Fee $
A
�%Ajver Connection Fee $
Connection Fee $ 7/3 e,
TO�2' $
do, .4,
()(<'_Building Inspector
Div. Public Works
&ocation 36
—,2
-No. Date
TOWN OF NORTH ANDOVER
ertificate of Occupancy $
uilding/Frame Permit Fee $
oundation Permit Fee $
ther Permit Fee
'rQpdMer Connection Fee
�
le9
M!� I $
1.53 Water Connection Fee
TOTAL
),,Building Inspector
Div. Public Works
PERMIT11TH .
7
APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. /PAGE, 1
MAP d40.
ZONE
h
LOT NO. 3
SUB DIV. LOT NO.
2 RECORD OF OWNERSHIP .'DATE
Q/hcA Gun✓.' 2?1C
BOOK .'PAGE
LbCATION L� r3 Sv�� �`
S�JZ��� -
PURPOSE OF BUILDING
OWNER'S NAME/I T
NO. OF STORIES S SIZE 3 F
of 6
OWNER'S ADDRESSBASEMENT
3 Fv .�t1' �c7'ote
cs� �•-.
OR SLAB f
ARCHITECT'S NAME
SIZE OF FLOOR TIMBERS1ST v� 0 2ND t �// 0 3RD
✓` Ol,/`
BUILDER'S NAME G�/,�DN1
SPAN /3
DISTANCE TO NEAREST BUILDING /OO -
DIMENSIONS OF SILLS N /
DISTANCE FROM STREET /
POSTS
DISTANCE FROM LOT LINES — SIDES Z�
REAR D f�
GIRDERS b /✓'x/77/ b -
./`�
AREA OF LOT
FRONTAGE rO 1
!
HEIGHT OF FOUNDATION THICKNESS / a
IS BUILDING NEW Y -e1
i
SIZE OF FOOTING / % S
IS BUILDING ADDITION /�/
MATERNAL OF CHIMNEY
-NICD
IS BUILDING ALTERATION Q
IS BUILDING ON SOLID OR FILLED LA
S oh,
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE Yes
IS BUILDING CONNECTED TO TOWN WATER y-ef
BOARD OF APPEALS ACTION. IF ANY /�/�
/./
IS BUILDING CONNECTED TO TOWN SEWER A/ O
IS BUILDING CONNECTED TO NATURAL GAS LINE .es
INSTRUCTIONS
SEE
SEE BOTH SIDES pp f��O��qq{1�j�1��� M OW
LL�1UMD BY PAPA 11-43& &M
PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12 1A1TT1�[��,
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDDA c' - � ..�`f FEE PAID 0 L V 0
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
F PLANS MUST BE FIL-E-D7 AND APPROVED BY BUILDING INSPECT Et&
DATE FILED / 9-a, Q C� , ell. 0
• SIGNATURE OF OWNER OR AUTHORIZED AGEN
FEE
S'd e Lie) g /w 7—,2 OWNER TEL. o3
PERMIT GRANTED CONTR. TEL. #6'63 9 cs
Ie 4 CONTR. LIC. # eA y7;Z
<� I; PERMIT FOR FRAME/BUILDING
t 2 4 1992
JUL < <
cj
DATE.------._ FEE
T-PAIO�
BUILDING DEPART'
-.
s PROPERTY INFORMATION
LAND COST
-EST. BLDG. COST
EST. BLDG.. COST PER SQ. FT. fT
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
r
r
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
1 OCCUPANCY
SINGLE FAMILY
j<
STORIES
MULTI. •FAM iY, .
OFFICES
APARTMENTS
1/1 1/: 1/.
CONSTRUCTION
2 FOUNDATION
NO BM T
8 INTERIOR FINISH
CONCRETE
B
1
2
_
CONCRETE BL'K.
BRICK OR STONE
_
PINE
HARDW D
PIERS PLASTER
DRY WALL _
UNFIN. J(
M
R
d
BUILDING RECORD 4
12 'r
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.
3 BASEMENT II
AREA FULL
FIN. B'M'TAREA
1/1 1/: 1/.
FIN. ATTIC AREA
_
NO BM T
FIRE PLACES
HEAD ROOM
MODERN KITCHEN
4 WALLS I
9 FLOORS
CLAPBOARDS
B
1
2
3
DROP .SIDING
CONCRETE
�_
WOOD SHINGLES
EARTH
ASPHALT SIDING
✓'D
XI_
ASBESTOS SIDING
_
COMtA
COMMCN
VERT. SIDING
ASPH. TILE
STUCCO ON MASONRY—
STUCCO ON FRAME
_
F �Il{fi7
BRICK ON MASONRY
ATTIC STRS. 8 FLOOR I_
l p�' GITm- =t'!
�8 A"•9 ;$ b 3E.7
BRICK ON FRAME
`
CONC. OR CINDER BLK.
STONE ON MASONRY
WIRING'
STONE ON FRAME
SUPERIOR I POOR
W^ ` �13 1
ADEQUATE NONE
5 ROOF
10 PLUMBING
GABLE HIP
GAMBREL MANSARD
BATH 13 FIX.)
TOILET RM. 12 FIX.)
_
3
FLAT SHED
WATER CLOSET
ASPHALT SHINGLES
LAVATORY
_
_
WOOD SHINGES
KITCHEN SINK
ow
SLATE
NO PLUMBING
_
TAR & GRAVEL STALL SHOWER
ROLL ROOFING MODERN FIXTURES AIj
TILE FLOOR -
TILE DADO
6 FRAMING I 11 HEATING
WOOD JOIST PIPELESS FURNACE y
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 1
UNIT HEATERS
7 NO. OF ROOMS
B'M'T2nd
Ist y 13rd'• I
4
GAS
OIL
ELECTRIC
NO HEATING '
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FORDS U
TOWN OF NORTH ANDOVER
LOT RELEASE FORM
SUBDIVISION
ASSESSORS MAP
SUBDIVISION LOT(S)
PERMANENT ADDRESS (ASSIGNED BY D.P.W.
STREET.
APPLICANT-�%� �� �J/Z% �HJS CPHONE
DATE OF APPLICATION
ING B
0
TOWN USE BELOW THIS LINE
PATE APPROVED 'I •j •cj �.
DATE REJECTED
CONSERVATION COM1IISSION /
DATE APPROVED 7/
CONSERVATION ADMIN. DATE REJECTED
BOARD OF HEALTH
This form shall be signed by the agents of the'Planning and Health Boards,
the Conservation Commission prior to the issuance of any building permits
for the subject lot. This form shall not releive the applicant from the
compliance of any applicable Town requirement or Bylaw.
_
DATE APPROVED ��/,3
��/���/
HEALTH—
DATE REJECTED
DEPARTMENT
OF PUBLIC WORKS
--712, 1 9'
�•7
DRIVEWAY PERMIT
( C
Q �.�r�
v` ��
SEWER/WATER
CONNECTIONS
Ag
FIRE DEPT. '
1111" /'l ��"''�1 �� v /'.�
,r �r
��''��. %L �!��✓
•�.
_
71
RECEIVED BY
BUILDING INSPECTION
DATE
@ # Jill 2
A J= { t
This form shall be signed by the agents of the'Planning and Health Boards,
the Conservation Commission prior to the issuance of any building permits
for the subject lot. This form shall not releive the applicant from the
compliance of any applicable Town requirement or Bylaw.
DRIVER'S LICENSE
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06-10-57 M
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ENVIRONEERS.,,-ac Tm Aloer.,, Ae�v4z-r.' 111A
ALFRED Ai. SHABDO, P.E.
P.O. Box 516,160 Pleasant Street, North Andover MA 01845 • (508) 683-3893
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