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Miscellaneous - 31 SKYVIEW TERRACE 4/30/2018
31 SKYVIEW TERRACE / 210/098.B-0082-0000.0 c i i Claim # Advantage Claim Services Adjuster Assigned: Glenn Guarente 522 Chickering Road #B North Andover, MA 01845 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec. 3B To: Building Commissioner Board of Health or Inspector of Buildings Board of Selectmen Town Hall Town Hall North Andover, MA 01845 North Andover, MA Re: Insured: James D. Stevens Property address: 31 Skyview Terrace North Andover, MA 01845 Policy #: 2366410 Loss of: 2016/01/22 File or Claim No. AD 1976 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1, 000.00 or cause Mass._Gen._Laws,_Chapter_143,_Section_6 to be applicable. If any notice under Mass_Gen_Laws,_Ch._139_Sec._3B is appropriate please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. Glenn Guarente Title: Adjuster On this date, I caused copies of this notice to be sent to the persons named at the addresses indicated above by first class mail. Signature and date Date. . /.�.j7. . .O/V r "ORT„ TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING 40 • : s''�ACMUS� This certifies that . . .. . . . . . .... . . I. . . .. . . . . . . . . . . . . . . . . . . . has permission to perform . . �. . .. . ..... .. . �-'. . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . V at -?/. .. . '.�. . . . . . . . . . . . . ...North Andover, Mass. . `. .Lic. No.��f /-: ... . . . . . . . . . . . . . Fee - - / PLUMBING INSPECTOR i � Check # v 6786 M MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS c Date Building Location 31 Sky Vi@k/ Owners Name Jim gev nsPermit#��� Type of Occupancy Amount S�na�P �trY►i�V pw���G r New Renovation Replacement Plans Submitted Yes 0 No ❑ FIXTURES z w c o z a U o z.. c x a d� H O V SZQ a � �� RASEMENr 1 7— bT M ulnar ; 3M HDD 4M KjOCIR SAH PIDGIN 6M HiOCIR M- >HDMLILL,-- 9MriDat (Print or type) �-4C Check one: Certificate Installing Company Name / i v,-•, jI !` � Corp. Address - 3 5 [ t/ l�r^n,�c. l(� f� Partner. Businessa a pnone Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the t insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnityElBond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent I hereby certify that all of the details and information I have sub r entered)in above applicatio ru and accurate to the best of my knowledge and that all plumbing work and in atiorformed under I ed f p ication will be in compliance.with all pertinent provisions of the Mass Plumbing e an apte o eneral Law--&— By: s____By' a e oki-icetrpa riumoer Title Type 6f Plumbing License City/Town e er Master Journeyman f '�' ❑ APPROVED(OFFICE USE ONLY License, �1 63 6 Date............... .............. All ` NORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING ACMU ........ This certifies that ......s.....�.�... ........ ........................... ........ has permission to perform .......... .......... ..... ................... .............................. wiring in the building of .....:. .................................................... at- �........ }I.... ,North Andover,Mass. ,Fee-..................... No ........ �................`*' ..................... ELi;t RICAL 1;SACCOR C/Check # _ Commonwealth of Massachusetts Official Use Only - — Permit No. G,36 Io - Department of Fire Services Occupancy and Fee Checked r' BOARD OF FIRE PREVENTION REGULATIONSRev. 9,'05 REGULATIONS [Rev. (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( EC):527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: fo City or Town of: 1 )I)"j'� �A�©yii To the r Ins ect of Wires: By this application the undersigned gives not ce of his or her intention to perform the electrical work described below. Location(Street& Number) 3 ) �K II/f al �,�/��/�►G �. Owner or Tenant IJ),M S-7-1,J£/I'S Telephone No.50 fa 02- Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building 5 t itI6 Z ("d--Al 1 C-/ �Gv�Lc.,,463tility Authorization No. Existing Service Amps / -Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity.. Location and Nature of Proposed Electrical Work: ,q,s C'om lesion of the following table may be waived by the lis ector of 6Vires. 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 ❑ In- ❑ o.o Emergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets _3 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and InitiatingDevices Tons g No.of Ranges No.of Air Cond. Total No.of Alerting Devices ,+ No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained . . ....... ................................................. Totals: Detection/Alerting Devices r No.of Dishwashers Space/Area Heating KW Local El Municipal F-1Other1 Connection No. of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: ,attach additional detail if desired, or cis required by the hispector ql' Pires. Estimated Value of Electrical Work: (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 ins rance 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 BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,nkat the information on this tip licatiorr is trrre ant/complete. FIRM NAME: b .1 P7 LIC. NO.: Licensee: ,L SignatureLIC. NO.: U G (/f al)phcable, ,ver "exempt-in the licen e number line.) / Bus.Tel. No.: 1vI Address: /(/�f_G ��' + � //l� Alt.Tel. No.: *Security System Contractor License required for this work; if applicable, enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee sloes not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(check one)[:] owner ❑ owner's agent. Owner/Agent Signature Telephone No. P ERMIT FEE: $ -31 Location , �;VL, To—f{q-ecer No. Date 'Aw AORT" TOWN OF NORTH ANDOVER IO 9 Certificate of Occupancy $ s••^ Eta' Building/Frame Permit Fee $ s�cMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ j lt�6 4 OD Check # 3 b6 18898 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVATJ OR DEMOLISH A ONE OR TWO FAMILY DWELLING I WELDING PERMIT NUMBER: 7-7 DATE ISSUED: 1 _\ X SIGNATURE: Building Commissioner r of Buildings Date Z SECTION 1-SITE INFORMATION 0 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 3 I �/v V 4) --c IV I Map Number Parcel Number ,� r 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Fronts ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard R 'red Provide ReqWred Provided ReqWred Provided 1.7 Water supply.M.G.L.Q.40. 34) 1.5. Flood Zone lnfomntion: 1.8 sewerage Disposal system Public ❑ Private ., ❑ zone outside Flood Zone ❑ Municipal ❑ On site Disposal system ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No M 2.1 Owner of Record s Name(Print) Address for Service: I Signatuie Telephone O 2.2 Owner of Record: vV T p N e Pri t iq�tAddress for Service: Z Si to Telephone SEN46N 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ cv�ie, a Soo Licensed CUrstruction Supervisor: /� 070q r- O /10 01910 License Number Mn Y Ad di�== 7/18/07 > SU8 Expiration Date ic afore Telephone r r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Q ( ��D11lG Ui �IAGe bey Company Name �3 ��j'Q M !v pl Registration Number r Addre _r Expiration Date Z Si atu re Telephone SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) 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.......❑ No.......❑ SECTION 5 Description of Proposed Work(check an applicable) New Construction ❑ Existing.Building [IRepair(s) ❑ Alteratioris(s)_ Addition El _ t Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed ProposedWork: /lYDAbMe Iylew yatlii l 4A, 56e 6 Vt SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be ITICIAL USE ONLY Completed bV permit applicant 1. Building I" �2� (a) Building Permit Fee Av i Multiplier 2 Electrical ��5-0 (b) Estimated Total Cost of Construction 3 Plumbing ,000 Building Permit fee(a)X(b) 4 Mechanical HVAC 5 Fire Protection /' L 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 I, 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 SECTIONN 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Omm/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 P tN f _ aur Owner/AizentDate NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS 1 ST2ND 3RD SPAN DUVIENSIONS OF SILLS DIN ENSIONS OF POSTS DMIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE NORTH own of Andover 0 No. dover, Mass dge COCHICHE WICK RATED BOARD OF HEALTH Food/Kitchen Septic System PERMIT T D BUILDING INSPECTOR Foundation THIS CERTIFIES THAT.............kY4.� ..........5ia�� ...................................... ................................................ has permission to erect.....:'...'� Vi.094qfe' buildings on ...J..1....... Rough to be occupied as....M'. r...... ...... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application an file in Final this office, and to the provisions of the Codes and By-Laws lBlatin g_to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. q% , 13 / i? ;66- PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTES ELECTRICAL INSPECTOR UNLESS CONSTRU20N STARTS Rough loll... ...... ..... .. Service DING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. - --------- -----___------ _ -cut-- -- kit., The Commonwealth of Massachusetts Department of Fire Services Office of the State Fire Marshal P.0.Box 1025 State Road,Stow,MA 01775 PERMIT Date: / North Andover permit No (City of Town) If Applicable) Dig Safe Number In accordance with the provisions of M.G.L.14 8 Chapter1()_as provided in section-52J--f-MR 34 This Permit is granted to: Start Date ��;� .. t.,,—I`-,G� '�f, ;�!/;� ;- Full name of person,Firm or Corporation Permissionto locate dumpster for construction/renovation/demolition of building Comments: dumpster must be 251 from structure if unable tolace with required Restrictions: clearance dumpster must be covered with 1 wood or tar end of work day at (Give 1 ation by street and no.,or desenbe in such manner as to provied adequate identification of location) Fee Paid$ 50.00 Fire Chief This Permit will expire (Signature of of tcal granting permit) ffical granting permit (Title) �riy TI-11C PERMIT MI ICT R1= (`r)m.gDir'I Iry IQI V Pr1CT;=n 1.113r)M TNF PRFMICI=•C ♦� NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM r In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: 31 Sk.-I View is that the debris resulting from this work shall be disposed of E a properly licensed solid waste disposal facility as defined by MGL c11, S150A. Also, note Permits are required under Fire Prevention laws:Chapter 148 Section 10A. The debris will be disposed of in: ©�LYIt�►�1Q �U�� c�/� (L-u&ion of Facility)„ ignature of Permit Applicant Fire Department Sign off P g Dumpster Permit Date ~_.—.•--� ✓fie �a»Urnanusealf� c��,G�aoacrc�cuaP,�/a BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 070415 Birthdate: 07/18/1972 Expires: 07/18/2007 Tr.no: 13889 `nnc�rr nn. •• Restricted: 00 CRAIG A HANSON 40-4 COLONIAL DR ANDOVER, MA 01810 Commissioner /rc �anamonuc�/�fi cf,_ C(��rn:sacfase�� � Board of Building Regulations and Standards 6 HOME IMPROVEMENT CONTRALTO >„ t's, Registration: 134690 1 Expiration: 11412006 Type: Private Corporation II COLONIAL VILLAGE DEVELOPMENT CORP. CHARLES PISCATELLI ` 1049 TURNPIKE ST. � i��f"t°� N.ANDOVER,MA 01845 \dministrator n �X151"ING WINvOW TO hrMAIN HVAC 5UPPL-Y I?�GIST�e NSW 1 ri1 TO !?,MAIN I - Q NI;W FeEE5TANPING C,I. TUi3 (68" X 30"> SCAT pp!VACY J J MASS I;LE:V, 13 EXISTING t�00p y � TO MAIN € s NSW SNOWIrI? NSW VANITY N; W SINKS eE�LOCATin WAC "�12AM�L�55" NE�VV WC UPPP-Y I?�GIST>;p 6LA55 ENCL05UFE-� I?!;-IN5-TALL AT • CLlf?I�NT . LOCATION t'I.rWS FC4'. S�V��15 p�5fb��1Cc 31 5KYVIM 1U.,Act NO,TH ANPOVEP, MA O PAM- The Commonwealth of Massachusetts Department of Industrial Accidents ll:. 'A"Lt. Office of Investigations 600 Washington Street ' Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (IIUSiness/OrganiAlt ion/Inclivi(lual): O✓1 D��i1UG1't0� Address: civ Ion Ial Q1- City/State/Zip:4AQVeF 012l0 Phone #: Are you an employer?Check the appropriate box: Type of project(required): I.❑ I am a employer with 4• ❑ I am a general contractor and l 6. ❑ New construction employees(full and/or part-tithe).* have hired the sub-contractors 2.P61 am a sole proprietor or partner- listed on the attached sheet. * �] Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. q, ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.0 Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs insurance required.]t employees. [No workers' 13.0 Other comp. insurance required.] ':any applicant that checks box#1 must also till out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box most attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am aan employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy 1i or Self-ins. Lic. #: Expiration Date:_____ Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a Fine LIP to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer ' ' ntder the pains a nd penalties of perjury that the information provided above is true and correct. Si �n afar _ Date: Phone It: (/ficial use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Location No. Date i u' °•,�OoT;�tio TOWN OF NORTH ANDOVER p Certificate of Occupancy $ Building/Frame Permit Fee $ 3.1,4:Ku Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ _ Water Connection Fee $ TOTAL $ �� Building Inspector _ I 1r74805/97 11:39 35.00 ppID Div. Public Works PER311T NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 ,_MAP 4-40. OT NO. �n,c- 7_ 2 RECORD OF OWNERSHIP "DATE BOOK "PAGE ZONE SUB DIV. LOT NO. i LOCATION �`�\ �(�1 �, ��nC PURPOSE OF BUILDING pe _D c7 `[ v t�w G Pf Zs OWNER'S NAME ' �..�-y-1 � NO. OF STORIES OWNER'S ADDRESS ?� 1 y I ZZL) CA— BASEMENT OR SLAB - ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME �Uil d./�f A iv �q. / SPAN -- DISTANCE TO NEAREST BUILDING V~' DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES—SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION C u�. �"�y� , w IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER dg BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER f"� IS BUILDING CONNECTED TO NATURAL GAS LINE L �--'5— INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH BIDES EST. BLDG. COST Q� PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM v SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED 3 - 4--f7 v BUILDING INSPECTOR 81GNATVRX OF OWNER OR UT ORIZED AGENT FEE OWNERTEL.# 681 -8077 /11 PERMIT GRANTED CONTR.TEL.# 8 `TK 19 CONTR.UC.# 050 Z-81 H.I.C.# -1041(o4 BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY — STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE d 1 2 I3 CONCRETE BL'K. PINE DRY WALL BRICK OR STONE HARDW D PIERS PLASTER _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ 1/1 1/7 '/, FIN. ATTIC AREA _ NO 8 M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARD\14'D _ ASBESTOS SIDING COMhACN _ VERT. SIDING ASPH.TILE STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIORI� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH 13 FIX.) GAMBRELMANSARD TOILET RM. )2 FIX.) FLAT I SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE 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 UNIT HEATERS 7 NO. OF ROOMS OA` B'M'T 2nd _ ELECTRIC isf 13rd I NO HEATING T40RT Town of - Andover No. 96 - �` _ over, Mass., 19 ?' 0 i LAKE COCHICHE WICK Dq'a E S E ` BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT �l wt................ ?L�.�vS....................................... .............................................................. ....... Foundation has permission to erect.-AX,.1- &-'Z............ buildings on ....... ......... ...... -9*-Cr1__ Rough to be occupied as..................... ..... F/�1.�f�.... / `301 _5& �o Chimney .r—p Truer-�............ y e provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough • Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough .................................. :. ....... ............ ............................ Service IN INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. Smoke Det. I 1 �I • I 1T1 f J W j i I i ca�s�N�'r 101'5T4 nV 6LA55 IM Lo Se T eV /aacm �af4a j v 90X 176 LAWRENCE. MASSACHUSETTS 01840 DESIGNS - REPORTS - SURVEYS - SUPERVISION TEL. 617 / 688-1866 MR AND MRS JAMES STEVENS 31 SKYVIEW WAY NORTH ANDOVER, MA. ,01845 DESIGN OF BASEMENT VENTILATION REQUIREMENTS The ventilation design of the above address comprises of three systems. First, furnish and install an electrically operated automatic combustion air intake unit in the storage area,in the proximity of the heating equipment, but not closer than three feet of the furnace or water heater.The unit shall operate when the furnace or water heater go on and shut off when the furnace and heater shut off. Secondly, furnish and install exhaust fan in basement toilet room. fan shall be rated at 75 CFM and be vented to the out doors. And lastly, furnish and install air handling unit and ducts as shown on the drawing V-1 dated 2-21-97 by S. Jason Lebowitz. This unit shall be rated at least 450 CFM @ 1/211 s.p. and have a dampered fresh air intake duct from the out doors.Also,there shall be an electric 1.5 KW thermo- statically controlled with remote thermostat. The occupied area of 650 square feet will have a six minute air change and a 15% fresh air make up.A 8% make up air would be about 52 CFM.The toilet exhaust fan and the ventilation system shall be interlocked electrically with the lighting system in this basement area, such that when the lights are turned on the ventilation will be activated. It should be noted that the design of this system does not take into account that there are windows and natural vent- ilation in the area under consideration. submitted by 40 , . J on Lebowi P. . �,. . .._. C .v A 0.9 PVT -L)vc-1 d� � � G3llvpoW �j�vi113� Lcl ,7XO& vi=,�) 051;, 'a lal Cl Wvh -sty "J2 Q. a-3avN 1->IDQ 'Aaw'113 MA 511 - Nv'- 1-SfMfi JM .00/ 0y7 17nQ J�7d�� AW RNlr-LA"l �i�+ Nn�l sn,�^avoJ "X�� 06�1- �31 S/S3� a►/V �7Sd/r� 0 0 0 0 ' FAMILY ROOM 75 WATT A-19 LAMP INCANDESCENT DOWNL IGHT 0 (TYP.) O O O O BATH UP Sdim (1500 WATT) Ff SS 0 0 I ` �p�tK OF S PROJECT NAME STEVENS RESIDENCE 31 SKYVIEW TER., NO. ANDOVER . gam � • RONALD W. BUTA, INC V.�u DESIGNED K.M.C. DATE a 2/28/97 ELECTRICAL ENGINEERS DRAWN a d, RIVERWAL.K BLDG. 5 R.W.B. MAL E� 360 MERRIMACK STREET CHECKED 000 2 LAWRENCE, MA. 41843 R.W.B. 5 g �� R.W.B. � prt,�QQAU4yUZct 1-S UNIFORM APPUCATiON FOR PERMIT TU UU t'LU61t11C4U ``Z—� (Prini or Type) ff _NORTH ANDOVER , I,,taae, Date jo, a9 Building Permit # S a2 Owner's Name �" u ej✓S New ❑ Renovation 53 Replacement ❑ Plana Submitted: Yes❑ No Ia FIXTURE6 Zhd M « M o st Z A • } u s « o °1xi s e, o J « « « = s H V Is » st < • x s N s Y Z < w s « .. O < MM s M IL 4 �. h Y oo O < J « ` J .. O et O r<44 IL 19 s 0 44 su/—ssarT. /A//al/HT IST FLOOR !HO FLOOR SAO FLOOR 1THFLOOR aTH FLOOR STH FLOOR. JTH FLOOR ITH FLOOR //�� / Check one: Certwicate 19 4t' Installing Company Name e 1—d1-4,qb l pew,,,, ❑Corp. Address r 7 0 ❑Partnership 0 Firm/Co. Business Telephone���� l27 77y0 Name of Licensed Plumber, L ISA w ✓ C C_ INSURANCE COVERAGE: checKwe 1 have ■ current Ilabilty Insurance policy or its substantial equivalent. Yea 0 No ❑ If you have checked yn, please Indicate the type coverage by checking the appropriate box A Itablily Insurance polcyL Other type of Indernnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licenses does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on thla permit appflcatlon waives this requirement. Check one: SIgnsture of Owner or Owner s Agent Owner ❑ Agent ❑ 1 hereby certify that alt of the delafls and Information I have subrtutit+d sot entered)in above appfkation are true and accurate to the best of my knowledge and that aA plumbing work and Installations performed under the permit Issued for tNs ap tion wil be in compla with aH pertinent provisions of the Massachusetts State Plumbing Code and Chapter 1�oto EY Title bignatuts City/Town Lima*Number /0(a Y/ Type of Plumbing license: Master Mf'fiOVED (OFFICE USE ONLY) Journeyman 0 Date, l;!.9. J. . i ` 3273 oTM,tiO TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING - • . ,SSACMUSE� This certifies that .A r fb. . . . . 1-�. . . . . . . . . . . . . . g has permission to perform . . .Re.,tv.a f—AIZ1.0 r. J. . . . . . . . . . . . . . . . plumbing in the buildings of t J. . . . . . . . . . . . at—).l . . S�`.�.� 1�'.�-�-. . . . . . . . . . , N Andover, Mass. FeeLic. No. . . . . . . . . . . .w LUMBING INSPECT '~ Q' 1 WHITE: Applicant CANARY: Building Dept. PINK:Treasurer d 1 - �O �No. - Date kN1 40RTq TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ AHis Foundation Permit Fee $ ; AY" �I \ �- ermit Fee $ �) "Sewer Connection Fee $ Water Connection Fee $ o TOTAL $ --� 0 /Building Inspector Tos�v Div. Public Works Location. JVf No.* Date r Of o "'" TOWN OF NORTH ANDOVE9 p Certificate of Occupancy $ Building/Frame Permit Fee $ , s� Foundation Permit Fee $ � s�cMus t Other Permit'Fee $ Sewer Connection Fee $ Water Connection Fee $ Q TOTAL $ S `� uilding Inspector 7798 Div. Public Works Location . J 'LI Vi 1 e /'xpca- /® IJ Fro. Date f 2-� "ORTN TOWN OF NORTH ANDOVER «.. C? •�` ` O� Certificate of Occupancy $ +� Building/Frame Permit Fee $ ca Foundation Permit Fee $ ` sAC14 Other Permit Fee $ a All- G V Sewer Connection Fee $ / � W3kc�fo7 Water Connection Fee $ lla3,456 TOTAL $ �Q- Qi 8446 Dl�R&bllc Works '" . Location y � No. Date A 6 ORTM TOWN OF NORTH ANDOVEF ro Ot .ao ,•�ti0 p Certificate of Occupancy $ �� R 41 Q s Building/Frame Permit Fee $ ss�cMusE Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ S� tr TOTAL $ �+ Building Inspector 7799 Div. Public Works \l laz _ r R�ttT r:'o.. OR PERMIT O BtNLD — NORTHANDOVER, MASS. rACF z APPLICATION F3t s MAP id0. LOT NO. 2 RECORD OF OWNERSHIP iDATE BOOK iPAGE ZONE �Z I SUB DIV. LOT NO. /3 —I JLOCATIONI Q.i. loa *3 �1/�/��C,,\ 1'�GA(1A PURPOSE OF BUILDING C,WNER'S NAME �/ ,o � j 1` ,lC�A DRIES y"/•Cr SIZEr ' OWNER'S ADDRESS ?JAS�"" t/ Arp /f_�� i.../iP� BASEMENT RSLAB ARCHITECT'S NAME yry� c ren✓ f2o�/LK'G /��� SIZE OF FLOOR TIMBERS ISTA"O 2NO z�O 3RD FJILDER-S NAME 7 �.►�/1l V/,GUfiZ/ orkA•vev'j SPAN DISTANCE TO NEAREST BUILDING✓'1 DIMENSIONS OF SILLS a�R� Q•]� DISTANCE FROM STREET Tr - POSTS (/Y/V_/ DISTANCE FROM LOT LINES -SIDES REAR •' GIRDERS Lt'p"IfJV`JI AREA OF LOT 3Q �/ '(• L FRONTAGE /�� HEIGHT OF FOUNDATION —xv b[f THICKNESS /o opt IS BUILDING NEW , , lay G SIZE OF FOOTING "21 y�c( X IS BUILDING ADDITION G�,arG, MATERIAL OF CHIMNEY N.,.a/` u /C,� 90IS BUILDING ALTERATION 0 IS BUILDING O OLID O FILLED LAND •+ WILL BUILDING CONFORM TO REQUIREMENTS OF CODE trL S IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY L/ IS BUILDING CONNECTED TO TOWN SEWER lle--;, IS BUILDING CONNECTED TO NATURAL GAS LINE 1p INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES ^� [ n� (� EST. BLDG. COST � IY �)Ic-1i� Mir EST. BLDG. COST PER SQ. FT. PAGE I FILL OUT SECTIONS I - 3 EST. BLDG. COST PER ROOM ` 4PAGE 2 FILL OUT SECTIONS I - 12 l��o i�/ SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING PERMIT FOR FOUNDATION ONL 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGU REBATED BY PARA. 114.8-S. Bt. PLANS MUST BE FILED AND PROVED BY BUILDING INSPECTOR f DATE FILED DATE 12 t E AID I /co 6 W— BOARD OF HEALTH SIGNATURE OF OWN R OR AUTHORIZED • FEE W446-30 PERMIT GRANTED -t- PERMIT FOR FRAME/BUILDING PLANNING BOARD • t ,s qA- —DATA F FEE PAID• I!-vl s. WARD OF SELECTMEN .1 DEC T 1994 BUILDING INSPECTOR • Ir � �19�� �r��-�� �fcC� ♦ k BUILDING RECORD 1 OCCUBANCY 12 SINGLF FAMILY S-OPIES THIS SECTION MUSTSHOW EXACT DIMENSIONSOF LOT AND DISTANCE FROM ` MULTI FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 1 2 FOUNDATION $ INTERIOR FINISH � r- CONCRETE _ 3 2_I,_ CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS PLASTER DRY WALL UNfIN � 3 BASEMENT AREA FULL FIN. B M T- AREA _ FIN. ATTIC AREA _ NO B M T.i FIRE PLACES HEAD ROOM MODERN KITCHEN i 4 WALLS I 9 FLOORS CLAPBOARDS -• 8 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARD"J D _ ASBESTOS SIDING COrdMIACN VERT. SIDING ASPH.TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MAS NRY ATTIC STIRS. S fIOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. / STONE ON MASONRY WIRING i STONE ON FRAME SUPERIOR POOR _ ADEQUATE I NONE 5 OF 10 PLUMBING GABLE I HIP BATH (3 FIX.) + GAMBREL MANSARD TOILET RM. (2 FIX.I FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR a GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR ` TILE DADO 6 FRAMING 1 i HEATING c 'r+ f"� VIP— fil � 'CT WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. . TIMBER BMS. 6 COLS. STEAM STEEL BMS. b COLS. HOT W T R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T G SS \ Till UNIT HEATERS 7 NO. OF ROOMS GAS OIL s B MJ 2nd _ ELECTRIC - - "0 - Isr 13.d I NO HEATING +Iq g R sem— n.s s wa�.as F' �0R 1-a 0 of -off over 0 i14- 0. T)9.0 JK dower, Mass., ` D f-f—annMEZ °l 19 q 4 ` o ' LAKE \ t LIC HE WICK o�ATE D BOARD OF HEALTH Food/Kitchen PERMIT To BUILD Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... S-S(:PCO)(....(1 O=.&.....);m...� .................................................... Foundation f has permission to erect..41 00.0....Fc?,1 M.F—.. buildings on ..I�.R" .........*..3.t.... 7 rkpla � Rough • n_ n . �i�4�,...fxnl ..... �.t,1 r, 1�6�............T...p r�.... .......aw4 �.'�`...�0 119��....��. Chimney to be occupied as.. t� provided that the person accepting this permit shall in every respect co orm to the terms of the application on file In Final this office, and to the provisions of the Codes and By-Laws relating to the inspection,�� *WRObvity Buildings in the Town of North Andover. RMULATED BY PARA. 114.8-S. B.C. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. 0/0 Rough q FEE PAI -- Final PERMIT EXPIRES IN 6 MON 0' ELECTRICAL INSPECTOR UNLESS CONS T NST. T . Rough -- r, ....... .. . ..... ......... ............ ............... .. ...................... Service .•... BUIL G..INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR - Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathingor Dr Wall To Be Done Y FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT . ti. , FORM U - IAT 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 law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT,.i Kocsir�.&-e s xixa- aQ P#4;6w*5 4;n Phone 5 82 1 9 LOCATION: Assessor' s Map Number Parcel Subdivision Wwo.- O'KO uIEd2 &4"±S' Lot(s) l 3 Street sk(jyiceu-) Vie- 4koC a St. Number _ { ************************Official Use Only************************ RECOMMENDTI/OONS OF TO 7S: 9 114 ✓ Date Approved �Z 2 / Conservation Administrator Date Rejected Comments .) _ tx� Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected a —� Date Approved L Septic Inspector-Health Date Rejected T_ Comments CDh Public Works - sewer/water connections `j1,J - driveway permit FireeDepartment Ir Oft cd A*,J(LAned Sn-!{,e4gr -r.1-a,�t-417.L V2-) 111- A-Ik, Received by Building Inspector Date 35-Z LoT 13 3$6 TC 3S6 35 o o of G''P-vC .35(o.l'i IWV 3s2' 94 --, L o T i 5 '�" N ;CQ .�9 ....► I N lz� �Ob' OF a rc = 3co s, oo ` � clv� GrA¢ =3(04 , O O A NO.31oll SSLAg -3 5 7 ., '' �o� ��STEP INV = 35G. � 1 I 0 Lk 1 U In 4 co L ( 50 NOTE: ALL UTILITY LOCATIONS ARE TO BE FIELD VERIFIED BY THE GRADING / SITE PLAN SITE CONTRACTOR, 100= AT LOT 13 HEICHTS C o R nJ E t o L-... NORTH �� )(A NrAIM va LAND PLANNING TOLL BROTHERS, INC. ENGMMMG & SURVEY 1600 WWT PSC DRIVE > ZSMIDO. MA 01561 167 HARTFORD AVENUE, BEII&GHAK MA 02019 (508) H6-4130 I►AX (608) 066-6064 I Z Z -9 Q 1 " = 4 0 ' N R H 5E I �pRTh+ Town of yo over - z `=Nort ►,ndover, Mass., �n M EZ °l 19 8 4 00,< ?ATED BU BOARD OF HEALTH Food/Kitchen Septic System PERMIT TO " ILD BUILDING INSPECTOR a .P..... I1 THIS CERTIFIES THAT...... 5 I1�E[�'ta .... 5..... TQ.......... .. Foundatio "� has permission to erect...UAOO.(:�....KAMEL.. buildings on A.* .I3........ *.-31... 751 Rough N pl��.... �.JR. .a..�:O IAr�.,. A • Chimney to be occupied as.2�it44t'E,,... 741�4'�i�.�.. .ctrl ........... �. .... . .. . provided that the person accepting this permit shall in every respect corfform to the terms of the application on file 1rt' Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PERMIT FOR FOUNDATION ONLY PLUMBING INSPECTOR I' VIOLATION of the Zoning or Building Regulations Voids this Permit. REGULATED BY PARA. 114.8-S. B.C. Rough 1 1i � Final PERMIT EXPIRES IN 6 MO r 2 9 FEE Pr e nyl� + 5a n n `.,D ELECTRICAL INSPECTOR UNLESS CONS N T T Rough PERMIT FOR FRACt/IEI�i.a,l_ . : ,:, l Service BUILDNG INSPECTOR 1/ b/ J! /5`2� y, SP Final DATE: FEE PAID: • Occupancy~Permit Required to Occupy Building GAS INSPECTOR Rough • Display in a Conspicuous Place on the Premises — Do Not Remove Final i No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT 7 -7 R4 LOT 13 1 1� L o7 IS— a N 407 14 BERMW MUN o SR. 9No. 3w� ^ Fb uN tCGI$T�Q Cf 14 T/O/V .: Tc u R, 1 , ,ht.�✓ o SR. w : .r Wo r L= 6-7.04 SRYVIEW TERRACE FOUNDATION AS-BUILT WCAM a I CERTIFY THAT THE STRUCTURE SHOWN IS LOCATED LOT 13 ON THE LOT AS SHOWN ON THIS PLAN AND THE NORTH ANDOVER HEIGHTS LOCATION DOES CONFORM WITH THE FRONT, SIDE, NORTH ANDOVER, ILA AND REAR SETBACK REQUIREMENTS SET FORTH IN rWAM FOR THE TOWN'S ZONING BYLAWS AT THE TIME OF TOLL BROTHERS, INC. CONSTRUCTION. I FURTHER CERTIFY THAT THE 1800 VM PARK DRIVE STRUCTURE IS NOT LOCATED IN THE SPECIAL wzsmrto, MA 01581 100 YEAR FLOOD HAZARD ZONE. THIS PLAN IS NOT TO BE USED FOR THE ESTABLISHMENT OF PROPERTY I,Aj�D PLANNING , ANDxNGDnP k LINES, ERECTION OF FENCES, OR CONSTRUCTION OF � � SURM AMMM EKLMU. ti *M9 ADDITIONAL STRUCTURES ON THE LOT. •(No) M-41M ►nye (M) •se-Goa, MAP NO.00c�65: COM N0.25oo98 DATE: 6 -2-93 I_I _ 9v Pr1 ORT fjU Tovvn of � � � , 4 over O 110. � '�g -� * 4*;- �= dover, Mass.,I&C 9' 19 4� T O l L A KE ORATED E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System - BUILDING INSPECTOR THIS CERTIFIES THAT....�.�.b41�4� .W��...l�?..'`�!4t'1;R�,�Cl S ���' =oundatio�uo) k\ 1� has permission to erect.L\4000..'t'i< up-.... buildings onto a . ai. 1�Lk, �'l �." � r t0 be OCCllpled QWtXtt �t.. �.. .. . �. �`.�... Chimney6-3W� provided that the erson tin � permit shall 1�6. res e1R conform to the terms of thea licatioh on file in P P P 9 P rY P PP this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PERMIT FOR FOUNDATION ONLY PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. REGULATED BY PARA. 114.8-S. B.C. gh.,,'/m,=. %`�/�•'. �R�"{ �2 9 na � � PERMIT EXPIRES IN 6 MO FEE PP i n ELECTRICAL INSPECTO UNLESS CONSUC ON STo /�ys PERMIT FOR ervice 5/r/s 0 1 BUILDIN PECTOR t � •, ',t° m✓aI ' DATE: FEE PAID: Occupancy`-Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough r c Out /`No Lathing or Dry Mall To Be DoneFIR EPARTME T Until Inspected and Approved by the Building Inspector �j Burner 1�I 1 ,l "4T PLANNING INAL CONSERVATION �'ft "V�Tol 41 � g. �� street No.. ��' ��e �. I Smoke Det. �i� it SEWER/WATER %/� FINAL DRIVEWAY ENTRY PERMIT �� �� CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number 94--5 i c� Date THIS CERTIFIES THAT THE BUILDING LOCATED ON Mm3 � �l•ort 13� MAY BE OCCUPIED ASJ` 6 TAS 1 d-4k w Z C4&,"-- XACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO S104M UWS Lit 'Net *p ADDr=d l �. ;'+O°• o•A '� • ,sn A 0- S,qCMUS� Inspec or Office Use Only uhe Tommilumealt4 of flas Permit No. legm tnfrnt of Itublic —flog C=pancy A Fee Checked f/1 BOARD OF FIRE PREVENTION REGULATIONS 527 C'dR 12:00 3190 peave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massacnusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date (X* or Town of NORTH ANDOVER To the In ecto of Wires: The udersigned applies for a permit to perform �te electrical) work described below. Location (Street & Number) Owner or Tenant "cA Owner's Addressy � Is this permit in conjunction with a building permit: Yes _ No - (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing ServiceAmos 16�1-20r Voits Overhead Undgrnd i No. of Meters New Service Amps Ycits Overhead Undgrnc No. of Meters Number of Feeders and Ampacity Location and Nature of ?r000sed Electrical Work Totat rrr/ff No. of Hct T,bs No. of Transformers No. of Lighting Outlets / � I KVA No. of Lignnng Fixtures // i Swimming Pcci gena e— cmc.In- 77_ I Generators KVA No. at Emergency Lighting No. at gecectac:e Cutlets I No. of Oil turners I Battery Units No. of Switch Outlets I No. at GasBurners FIRE ALARMS No. of Zones No. of Ran es No. c'. Air Conc. °Say No. of Detection and 9 ions InitiatingC. Devices No.of Heat Tctat To;ai No. of Disposals � I Heat Tons .cta No. of Bouncing Devices No. of Sett Contained No. of Oishwasners �—�- I SoacerArea Heatird K`:J Detac:con/Sounding Devices No. of Orvers -�� I Heating Devices Kbv Local _ Municioai .Other Connection No. of No. ar Low Vcitage No. of Water Heaters KW I Signs Saiiasts Winnc No Hyaro Massage Tubs I No. of Motors Totai HP OTHER: INSURANCE CC`JERAGE. Pursuant :O the redutrements at r.tas -c't:serts general Laws I have a current Liaciiity Insurance Policy inctucing C2'-.e c Ccerauens Coverage or its substantial esuivaient. YES - have suomirtea valid P591-at same to the Office. YES NC = It you `;ave checxed YES. please indicate the type of coverage cy cnecxing the aopro3pdte oox. INSURANCE SCNO = OTHER = (Please Scec::y) (Expiration Datei Estimates Value o E?ectnc Work S Final Wary to Start l Inspection Date Recues:ec: Rougn Signed unser:he Pea es of e ury: 05r FIRM NAME LIC. NO.`! Licensee igr.a:ure —LIC. NO. fi us. Tel. No. ,� Address G� Alt. OWNER'S INSURANCE WAIVER: I am aware that trip -c s tees not nave the insurance coverage or its substantial eduivalent as re. duirea by Massacnusetts General Laws. and that my signature on :his --ermit application waives this redutrement. Owner . Agent (PteaSe CheCK Oriel �/l :eiecrone No. PERMIT FEE 5A-0. v (Signature of Owner or Agent) - x-5�ii_ - �' *i Office Use Only p� 1l�prtrhnent rr/ Public SgMy �i�U u» BOARD OF FIRE C'RFVI:N f ION REC;UI AI IONS i"J_7 CMR 17:(10 Permit No. GV Occupancy & Fee Checked APPLICATION FOR PERMIT- -1- �` 3/90 (leave blank) FRFOW_ - O ELECTRICAL WORK All wink to hr•prrinnned in arrortlame with file M,wml wtfs Llertric'al Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INfOItI LITTON( Z Z,`x- Date The undersi rn�d a i dies icrr�.1��_H�.,��/ .,----------- - - -- --.-- Cit or lawn of K f( a permit to perfoon the rte chical work described helow. ----------To the Inspector of Wires> Location (Street & Number) Owner or Tenant Owner's Address ---- Is this pennil in conjunction will, a bf.rildiny, pennih Yes u Nu L� (Check Appropriate Box) Purpose of IiuildingC J ( � -(Y11Ly 0W_j ' ' - t,,;,;ty Authorization No. Existing Service Ampti /-..�_.._._. Valls Overhead ❑ Undgrd ❑ No. of Meters New Service Volts Overhead ❑ Undgrd ❑ No. of Meters Number of I(TdCrS dad Ampacity --.-.---- _ ---- -- Location and Nature of Proposed Electrical Work No. of Lighting Outlets No, of Hot Tula vv C- TOTAL -- No. of l ransformers KVA No, of Lighting Fixtures A'we j Swimming Pool Emil. ❑ ra d. ❑ Generators KVA No. of Receptacle OutletsNo. o Emergency Lig ting _No. of Oil &users Battery Units No, of Switch Outlets No. of Gas Burners Iota FIRE ALARMS No. of Zones No. of Ranges - No. of Air Conditioners Ions No. of Detection and Ileal ota Tola Initiating Devices No. of Uis fowls No. of PurMs lolls KW No. of Sounding Devices. No. of Self Contained No. of Dishwashers Space/Area I Icaling KW Detection/Sounding Devices municipal No. of Dryers IlcalinSi KW Devices Local❑ Connection ❑Other No, of Water Healerstcrs No. o No, o Low Vo Cage K1•V _ ; asts ns Ball - Wirin l:.v 1� No. Hydro Massage Tubs Nn. of Motors Total Iii' J� m OTHER: INSURANCE COVERAGE: Pursuant to Il,e requiremenls of Massa(.1notes Genetal laws 1 have a current Liabilily Insurance. Policy including(-ornpleted Operations Coverage or its substantial equivalent. YES O NO[i I have submitted valid proof of sdme to [his office. YES f I NO LI If you have ch((e��,��(/ked YES, please indicate Ill(! type of covotage by checking the_ appropriate box. INSURANCE [A BOND 1-101I IFRD IPlea c S rer if Estimated Value of Electrical Work $ 0160 U_ (Expiration Date) Work to Start //5_-_-_�_/Z _ -- Inspection Dale Requested: Rough Signed under the f�en,rlties of perjury: --- Final FIRM NAh1E ��- rtis_P-_eQ1.►_ mukucA4D u&E j�l,f/1 L_t' �- LIC. NO. Licensee 1--L __ SiKnature -_- 2�%�,//�/� LIC. NO. Address _ �2 rn_- A( m -- 0�0 Bus. Tel. No. ` OWNER'S INSURANCE WAIVER:I am aware that the Licensee does nol have the insurance coverage or its substantial equ Ivalent aN required by Massachusetts General Laws, and that my signature on this permit application waives this rerlrrirement. Owner Agent t; (Please check one) --------- ---- - - - Telephon`• No. - - (Signature of Owner or Agent) - -- - - ------ PERMIT FEE $ �},, Office Use Only �( �`� Q` u (�4E �ummutut# If gags ustf s Permit No. c J i3epartment of Public %feta Occupancy&Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 1 also (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Ql;( r or Town of NORTH ANDOVER To the 1 pector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Numbed S. V/�� Owner or Tenant Eefa264 Owner's Address Is this permit in conjunction with a buiidi g per it: Yes o i' (Check Appropriate Box))-� I Utilit P::rocse of i3uildir.a Y Authorization No. Cxistina Service Amps __/ Vcits Overhead ! Undgrnd o. of Meters New Service 4&V— Amps 01C;40vcits , Ove ead r Undgrnd No. of Meters Number of Feeders and Ampacity O i Location and Nature of Proposed Electrical Work Total 'No. or Licnung Outlets i No. of Hct cgs — No. of Transformers KVA ` No. of Lignting Fixtures Swimming Pcci Above— In crna. — crna _ I Generators KVA C ` No. of Emergency Lighting No. of Receotacie Cutlets No. of Oil Burners I Battery Units No. of Saitcn Outlets I No. of Gas burners FIRE ALARMS No. of Zones Totai No. of Cetection and No. of Ranges No. of Air Conc. n a i tons Initiating •�evices ,No. of DispHeat ,–oral oriosals I No.of Pumos Tons KW No. of Sounding Devices I No. of Serf Contained No. of Cishwasners I SeaceiArea Heatina KbV Deter,:cniSounding Devices No. of Dryers I Heating Devices K'.J Local - Municipal -Other Connection No. of ":c. of Low Voitage No. of Water Heaters KW Signs Ballasts Wirina No. Hydro Massage Tubs I I No. of Motors Total HP OTHER: i INSURANCZQ COVERAGE: Pursuant to the reawrements of massacniuserts general Laws I have a current Liability Insurance Policy incluctnc Com^,:e�ta Operations Coverage or its substantial equivalent. YES NO = i nave sudmnec .slid proof of same to the Office. YES ; NO - It you nave checxea YES. piease indicate the type of coverage my checking the abbro to box. INSURANCE BOND = OTHER = (Please S=ec;1,Ir) �) (Expiration Date) Estimated Value of E' ctnc I Wo K S �2 �w / L/y�/� Work to Start InsbeCUon Date Recuestec: Rouch Final Signed uncer the P;l 14 ties f erlury: FiRf.1 NAME LIC. NC. Licensee signatureCr4_L!C. NO. _ 2 �� / Sus. Tei. No. Address All. 'ei. No. !1 C'vVNER'S INSURANCE "JAIVER: I am aware tnat the .cens ai9cees not have the insurance coverage or its substantial eau,vaient as re- cuirea by Massachusetts General Laws. and :hat my s:gnalure on :his cermtt aopiication waives this requirement. Ownergq Agent ` (Please check one) r '1 eiechone No. PERMIT FEE S v ;Signature of Owner or Agentl x•5£c� C �r� �� 33 Commonwealth of Massachusetts Official Use only Permit No. Department of Fire Services .26 Occupancy and Fee Checked - BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9i05 "- ] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance Nkith the Massachusetts Electrical Code t..1V.EC). 527('MR 12.00 /PLEASE PRINT LV I,VK OR TYPE ALL IWORK4TIOiV) Date: City or Town of: f`'1`�� i �,�' I)J � To the Inst ecl� ro/ . 'Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street& Number) ) !,`I c'f1�,•tl Owner or Tenant J, ;\ S,Z J c S Telephone No. <> Owner's Address t I� Is this permit in conjunction with a building permit? Yes a No ❑ (Check Appropriate Box) Purpose of Building j,vl_,C 2 ;] 1,411 c 9 w� kility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 'r Completion oJ the blhms ing sable rrrav be waived by the Inspector o/ff"ires. No.of Recessed Luminaires 4" 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 ❑ In- ❑ o.o Emergency Lighting rnd. rnd. Battery Units ' No.of Receptacle Outlets —3 No.of Oil Burners FIRE ALARMS No.of Zones bNo.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KWNo.of Self-Contained Totals- Detection/Alerting Devices ! No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: ! No.of Devices or Equivalent No. of Water No.of No.of Heaters KW Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: 1 ,tltach addilional delail y desired, or as required by the hispeclor o/ {Vires. ' Estimated Value of Electrical Work: (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 b the owner, no permit for the performance of electrical work may issue unless i the licensee provides proof of liability insurance including"completed o eration"coverage e 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 ED," BOND ❑ (.ETHER ❑ (Specify:) /c•ert0y,under the pains anis penalties of perjury,that the itifurnxaliun nn this applienliot►is trite and cur»plele. FIRM NAME: `� ,. o'l` l .t, 1 .� t f? f l LIC. NO.: Licensee: aT `, ,,,v%;'i e / i' 'c„y Signature `� �r , 1' / t " / l,�i .:, _ LIC. NO.: (11'applicahl, c't/ r exemm 'nr the license number line.) Bus.Tel. No. Address t��uL/_. c5i7 �% 1.l ) t' /e� t/ Alt / .Tel No.: 7(4J '• *Security System Contractor License required for this work, if applicable, enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee dots nol have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(check one)❑ owner ❑ owner's agent. Owner/Agent `signature Telephone No. PERMIT FF.,F: .S ��.�-�.( d SCC / - / !� . o G �� �° Date.....1. (...0�..... .... 5 2232 A °T TOWN OF NORTH ANDOVER a misligh p PERMIT FOR WIRING _ • • . CU SACMUSES This certifies that .....BUJ12f .... .......... .1......fR<< ...........................,, has permission to perform ...--. i}.......QY .Qv..#vM.�..........9 L��, wiring in the building of......./...O.Z/............1,,' ��0��..:............................ Is at......5(...... �. (Jr.C.W..... ... j2-.................... .North Andover,Mass. Fee....CIL/A J0 Lic.No.A 4�..W.......................................................... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File Date... .......... 04.1 22 NORT -14, TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING 4, ;,SSACMuSES This certifies that.. Z.,e.. has permission to perform ......... ...............F{.. ..................... _7 A wiring in the building of......-.J..... ........... .........f............................................ at................... ...... ............ ...................................:...... I North Andover,Mass. Fee.......N............ Lic.No..:,_.....:.................................................................C, ELECTRICAL INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File is Y Date... � ....c?...z i2 808 NORTN TOWN OF NORTH ANDOVER 3? saP a OL p PERMIT FOR WIRING ,SSAcm 1 This certifies that .... v��.f,I�..0.g ... .......... .l i°C has permission to perform ..... ��SP.f.!!Py ......43. .f!C�� S! wiring in the building of.......a5.7C'.�J.�f.1.......................................................... at......21........ .l.��U.i. A, p.......f:Pz���c.<.f....... ,North Andover,MassN Fee..1// V:dU.... Lic.Noll" X............. ... .......... . ........................ ELECTRICAL INSPECTOR `+ M 0 WHITE:Applicant CANARY: Building Dept. PINK:Treasurer