HomeMy WebLinkAboutMiscellaneous - 33 PATRIOT STREET 4/30/2018�,
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Location J 7—
N o.
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No. , Date 41,17 X?
„aR*� TOWN OF NORTH ANDOVER
O?O•,*`•o I •,hOOA
jj
Certificate of Occupancy $
+� ,, : Building/Frame Permit Fee $ 2-
sAr a& t�' Foundation Permit Fee $HU
Q
Other Permit Fee $`
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
Building Inspector
Uj
10529
Div. Public Works
CU
PE)itJ1IT NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
PAGE 1
MAP 4qO.
LOT NO.
2 RECORD OF OWNERSHIP ;DATE
BOOK ;PAGE
ZONE
SUB DIV. LOT NO.I
LOCATION
%I�
vvO
PURPOSE OF BUILDING
OWNER'S NAME
f� !d
NO. OF STORIES SIZE
OWNER'S ADDRESS
i0 �..r•�
BASEMENT OR SLAB
ARCHITECT'S NAME . 1�
BUILDER'S NAME 'f', r�lf,—,/'
SIZE OF FLOOR TIMBERS 1ST, 2ND 3RD
SPAN
DISTANCE TO NEAREST BUILDING
DISTANCE FROM STREET
DIMENSIONS OF SILLS �•
POSTS '
DISTANCE FROM LOT LINES - SIDES
/! REA %
GIRDERS
AREA OF LOT
FRONTAGE
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW 41x
OF FOOTING X
IS BUILDING ADDITION
MATERIAL OF CHIMNEY /0ryE7
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM 10 REQUIREMENTS OF CODE
IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY
®� %
s�G
IS BUILDING CONNECTED TO TOWN SEWER „
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
SEE BOTH SIDES
PAGE 1 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
-- I®5Z59
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST / �•�
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
—/*t
BUILDING INSPECTOR
-e�
OWNER TEL. ar`
CONTR. TEL. #
CONTR. LIC. #
H.I.C. #
I OCCUPANCY
SINGLE FAMILY S-ORIES _
MULTI. FAMILY OFFICES _
APARTMENTS
CONSTRUCTION
2 FOUNDATION I_II 8 INTERIOR FINISH
CONCRETE i3 11 12 13
❑l lVK alyrvc MAKUW U
ERS PLASTER
DRY WALL
UNFIN.
3 BASEMENT
IEA FULL FIN. B'M'T'
/t /, FIN. ATTIC A
BMT ' FIRE PLACES
4 WALLS II 9 FLOORS
CLAPBOARDS B 1
DROP SIDING CONCRETE _
WOOD SHINGLES EARTH _
ASPHALT SIDING HARDW D _
ASBESTOS SIDING COMMON _
VERT. SIDING ASPH. TILE _
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK N MASONRY ATTIC STRS. & FLOOR
BRICK ON FRAME
CONC. OR CINDER BLK.
WIRING
5 ROOF II 10 PLUMBING
R
BUILDING RECORD
12
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.
2
8 FRAMING
11 HEATING
t'
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
GAS
OIL
B'M'T 2nd _
1st 13rd
ELECTRIC
NO HEATING
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Location
No. Date
TOWN OF NORTH ANDOVER a -
Certificate of Occupancy $ S
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee _ $
Water Connection Fee $
TOTAL
-®r R67
z. 10357
Building Inspector
Div. Public Works
PERMIT NO.
APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
PAGE 1
MAP h40.,,:�/
LOT NO. �� /
t�I
2 RECORD OF OWNERSHIP iDATE
BOOK PAGE
ZONE
SUB DIV. LOT NO.
LOCATION �
PURPOSE OF BUILDING �l�M/�: lahA-
!SIZE
/
OWNER'S NAME ��% ���� !1� f tiNf9
Yf
NO. OF STORIES '7
OWNER'S ADDRESS
BASEMENT OR SLAB
ARCHITECT'S NAME 1187 )Q/,/
/77-
SIZE OF FLOOR TIMBERS 1ST �C-+2•'NID�P'7 n/. 3RD
BUILDER'S NAME 5��GD
/ ra�dY
�C.��� /
SPAN
GSILLS
DISTANCE TO NEAREST BUILDING
DIMENSIONS OF
" POSTS
DISTANCE FROM STREET �Q
DISTANCE FROM LOT LINES - SIDES/5 REAR -1 �N
6 +v
GIRDERS �? •-�7
•J�
AREA OF LOT FRONTAGE
HEIGHT OF FOUNDATION �/Gd THICKNESS /�
!
IS BUILDING NEW
SIZE OF FOOTING X
/
IS BUILDING ADDITION /7,s/ �j]�
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LANDQ
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE
IS BUILDING CONNECTED TO TOWN WATER l'-'�G�yG✓
BOARD OF APPEALS ACTION. IF ANY y
Gs
IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
SEE BOTH SIDES
PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
3
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILQ'G AND APPRO D BY UILDING INSPECTOR
�/0�
DATE FILED
SIGNATURE OF OWWR OR AUTHORIZED AGENT
FEE
PERMIT GRANTED
19
4
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST /
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
WILDING INGPKCTOR
OWNER TEL. # �y -<-2.2 Z
CONTR. TEL. #
CONTR. LIC. #
H.I.C. #
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY
ORIES
MULTI. FAMILY
ICES
�FF
APARTMENTS
CONSTRUCTION
2 FOUNDATION
8 INTERIOR FINISH
3 1 2 13
PINE
CONCRETE
CONCRETE BL'K.
BRICK OR STONE
HARDW D
PIERS
PLASTER
DRY WAIL
_
UNFIN.
3 BASEMENT
AREA FULL
1/1 1/1 %
NO BMT
HEAD ROOM
4 WALLS
FIN. B'M'T' AREA _
FIN. ATTIC AREA _
FIRE PLACES _
MODERN KITCHEN
9 FLOORS
CLAPBOARDS
B
_
1
2
3
_
_
DROP SIDING
WOOD SHINGLES
CONCRETE
EARTH
ASPHALT SIDING
ASBESTOS SIDING
VERT. SIDING
_
HARD\?✓'D
COMMCN
ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK N MASONRY
BRICK ON FRAME
CONC. OR CINDER BLK.
ATTIC STRS. & FLOOR I_
WIRING
STONE ON MASONRY
_
STONE ON FRAME
SUPERIOR I-1 POOR _
ADEQUATE NONE
10 PLUMBING
5 ROOF
GABLE
I
HIP
BATH (3 FIX.)
GAMBRELMANSARD
A
TOILET RM. 12 FIX.)
FLAT
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
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
GAS
OI l
B'M'T 2nd _
Ist 13rd
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.
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FORM U - VERIFICATION 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 bout this section******************
APPLICANT: e� Phone Z9Y J_zZZ
LOCATION: Assessor's Map Number o/e_F Parcel
Subdivision Lots) lQdg!�4;
Street s,07— St. Number _ J;/ s ,j
************************Official Use Only************************
RECO ATIO SeT&N AGENTS:
Date Approved YN/1
Conservation A inistrator Date Rejected
Comments
Town Planner
Comments
Food Inspector -Health
Septic Inspector -Health
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department
Date Approved
Date Rejected
Date Approved
Date Rejected
Date Approved
Date Rejected
Received by Building Inspector Date
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0"AQQAL-"U'3rr f s UNIFORM APPLICATION FOR PERMIT TU DU Pt_u(v t11r4U ys�
(Print or Type(
R•
/71
NORTH ANDOVER, , Mass. Oats 1
Building Permit s - 33,6 /
1-1
t_ocsllofis'- r",Y r-C'r c9 r-
- Name
New 0-, Renovation ❑ Replacement ❑ Plans Submitted: Yes ❑ No. ❑
F1XTU11ES
Installing Company NameV90,
Address /'0 SCJ A' /A'J
Business Telephone
Name of Licensed Plumber _ALI 09 Gf-f 4-6—
Check one:
❑ Corp.
❑ Partnership
❑-Flrtniem.
INSURANCE COVERAGE: ecx on
1 have ■ current IlabARy Insurance p9111cy or No substantial equivalent. Yes No ❑
If you have checked yn, please Icate the type coverage by checking the appropriate box.
A liability Insurance policy - Other type of indemnity ❑ Bond ❑
Cadvicate
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 this permit application waives this requirement.
Check one:
Owner ❑ Agent Q
Signature o Owner a Owners ens
I hereby certify that all of the details and Informations I have submitted for enteredl in above appikallon are true and accurate to the best of my
knowledge and that as plumbing waft and Installations performed under the permit Issued for two appifcalfon Mn be h
pertinent provisions of the Massachusetts State Plumbing Code and Chapter 112 slue (3ersarai laws. compifana with aM
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nature
Title SCS -1,9:2-
GtylTcwn lkanaa Number
Type of Plumbing Lksnsa: Master ❑
MTrMED (OFFICE USE ONLY) Journeyman 0--�
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aTHFL00R
-
Installing Company NameV90,
Address /'0 SCJ A' /A'J
Business Telephone
Name of Licensed Plumber _ALI 09 Gf-f 4-6—
Check one:
❑ Corp.
❑ Partnership
❑-Flrtniem.
INSURANCE COVERAGE: ecx on
1 have ■ current IlabARy Insurance p9111cy or No substantial equivalent. Yes No ❑
If you have checked yn, please Icate the type coverage by checking the appropriate box.
A liability Insurance policy - Other type of indemnity ❑ Bond ❑
Cadvicate
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 this permit application waives this requirement.
Check one:
Owner ❑ Agent Q
Signature o Owner a Owners ens
I hereby certify that all of the details and Informations I have submitted for enteredl in above appikallon are true and accurate to the best of my
knowledge and that as plumbing waft and Installations performed under the permit Issued for two appifcalfon Mn be h
pertinent provisions of the Massachusetts State Plumbing Code and Chapter 112 slue (3ersarai laws. compifana with aM
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nature
Title SCS -1,9:2-
GtylTcwn lkanaa Number
Type of Plumbing Lksnsa: Master ❑
MTrMED (OFFICE USE ONLY) Journeyman 0--�
i
Date.
1 3301
A
,.oR'h TOWN OF NORTH ANDOVER
O1 ,�.c 1.10
PERMIT FOR PLUMBING g
SSACMUS
This certifies that ..13P �? ...... t-1 ............. `�
4
has permission to perform ...A: �.te�-... e4 �c! ..........
c+
plumbing in the buildings of ............
at. „ ../. ?int ............ North Andover, Mass.
Fee. �1r f,. ' ... Lic. No. /.S7. � `� 7 ............................. .
PLUMBING INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
�� Office Use Only
u4t 0MMVn r34 of �a50a r4U5kftg Permit No.
flepurtment of PubUr —Aafet9 Occupancy & Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3190 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 1
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date (/� O
(M* or Town of NORTH ANDOVER To the Inspector of Wires:
The udersigned aoolies for a Aermit to perform the electrical work described below.
Location (Street 8
Owner or Tenant
Owner's Address 6�,J�� t—
Is this permit in conjunction with a building permit: Yes El No ❑Check Appropriiaatte Box)
Purpose of Building �-- Utility Authorization No. `02 r
Existing Service Amps � Z �O Volts Overhead [D'-- Undgrnd ❑ No. of Meters
New Service 09D Amps -� ZOO Volts Overhead Undgrnd ElNo. of Meters
Number of Feeders and Ampacity�'
Location and Nature of Proposed Electrical Work
No. of Lighting Outlets
No. of Lighting Fixtures
No. of Receptacle Outlets
No. of Switch Outlets
No. of Ranges
No. of Disposals
No. of Dishwashers
1
No. of Dryers
No. of Water Heaters KW
No. Hydro Massage Tubs
OTHER:
No. of Hot Tubs
Swimming Pool Above
grnd. ❑
In-
grnd. ❑
No. of Oil Burners
No. of Gas Burners
Total
No. of Air Cond. tons
Heat Total
Total
No.of
Pumps Tons
KW
Space/Area Heating
KW
Heating Devices
No. of No. of
Signs Ballasts
Total
No. of Transformers KVA
Generators KVA
No. of Emergency Lighting
Battery Units
FIRE ALARMS No. of Zones
No. of Detection and
Initiating Devices
No. of Sounding Devices
No. of Self Contained
Detection/Sounding Devices
KW LocalMunicipal r Other
❑ Connection L
Low Voltage
Wiring
No. of Motors Total HP
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
have submitted valid proof of same to the Office. YES = NO Z If you have checked YES, please indicate the type of coverage by
checking the appropAdite box.
INSURANCE — BOND = OTHER :: (Please Specify) - (Expiration Date)
Estimated Value f Electrical Work S
Work to Start Z��% Inspection Date Requested: Rough
Signed under the Pe (ties of perjury:
FIRM NAME G/�%1✓�� �ZC/-�C���71�2 /
Final
24
LIC. NO. =sem=
��J�/fes lflsG - - — LIC. NO.
Licensee Signature U8Z-l> Z6 Z
us. Tel. No.
Address
Sle— �U,�2/nfr /%2f� _Alt. Tel. No. 37Sf-5'7Ss—
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent Agent
(Please
by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner 9
(Please check one) d V
Telephone No. PERMIT FEES I
(Signature of Owner or Agent)
x-6565
Date......7. ..
895
NORTH
+
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
u
This certifies that ..... oa.�)A ........ ........
has permission to perform ....... Z. e. ez. 'i a Y -Q-
... ... ... ... AK 0� ...............................
wiring in the building of ....... i c 0
.................................................................
at .......1-3...... ............................. . North Andover, Mass.
Fee... �0—dO. Lic. No.. .............................................................
ELECTRICAL INSPECTOR
C50, 00 PAID
1
WHITE: Applicant CANAR A3-55
uilding Dept. PINK: Treasurer
I
LL /� !�� ..0 ..�F,, office use only
uUE L11ritInIIIIM231th LL 'sadmift� Permit No.
Eepa tmeat of 1juhlic $afctq 0=pancy & Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS 527 CS1R 12:00 1 3/90 (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) Date4-l- Z/7
(%K or Town of NORTH ANDOVER To the Inspector of Wires:
The udersigned applies for a permit trform the electrical work described below.
Location (Street & Number) �� �/ r .7
Owner or Tenant toLL2Ar&-x9- -s'
Owner's Address �-
Is this permit in conjuncts n with a buiI in permit: Yes _ Na C (Check Appropriate Boxy 1�4
Purocse of Suildinc ����61 - U ility Authorization No. T/
Existing Servic4§�)� Amos _��Veits Overhead - Undgrnd � No. of Meters 17—
New Service Amps Volts Overhead ' N' Unogrne No. of Meters
Number of Feeders ane Am�actty
Location and Nature of Preoosed Electrical Work 3l p A7�010 7� D/71aA)
No. of Lignting Outlets /0 i
No. of Hct T ---s �,
I
No. of Transformers K`JA
No. of Lighting Fixtures `�
9
Swimming Pool Above.—
Swimming
grno. —
!n -
cmc =� I
Generators KVA
No. of Emergency Lighting
No. of Recectac:e CutletsZ I I
No. of Cil 'turners
Banery Units —�
No. of Switch Cutlets ti
I No. of Gas Surners
—
FIRE ALARMS - No. of Zones
ection
Ninitiating rOeviicesna
No. of Ranges
No. c! Air C:.nc.
I :ons �°--
No. of Bouncing Devices
of Seif Contained
Detec::on/Souneing Devices
Heat T,:al T,tai
No. of Disoosats I No.of Pur-cs _ v ;Cv —
1No.
I
No. of Dishwashers `�"
Soace/Area Heatina
KN—
Local - Muntcioat ^- Other
_ Connection _
No. of Dryers Heating Cev:ces JV �--
No. of No. t
Low Voltage
Winnc
No. of Water Heaters KW
Signs Baiias:s
AYd
C6761t
No. Hy,ro Massage Tues
No. of Motors
P
OTHER:
INSURANCE CC`✓ERAGE. Pursuant ;o the recu:rements ct MassaCt. sets general Laws
I have a current Liaoiiity Insurance Policy inctucng Cemc:eiec Cceratiens Coverage or its substantial eauivaient. YES NO - I
have suomittea valid proof of same to the Office. YES = NO = If you nave checitec! YES. please indicate the type of coverage Cy
checxtng the aoF rate Cox.
INSURANCE 3CN0 - OTHER = (Please Scec:`-�)
_ (Exoirauon Date)
Esttmatea Value Etec:ncat Work 5 *��W
Worx to Start Insoec::on Date Racues:ec: Rough
Final
Signe, under ; Pena a of ,pegu�:�
FIRM NAME
Licensee -tJJSignazure 1C. NO.
�z2 s. Tel. No.
Address Alt. Tei. No.
OWNERS INSUR NCE WAIVE : I alaware that 4te Lcensee tees not ve the insurance coverage or its suostant:al ecutva t as re-
quuea byVMasusetts Ge s. an, ;h signature cn :ns cermtt aopticauon waives this reaurrement. Owner Agent
IP!easenes , ! / ��Z2Z
Tetecnone No. tj PERMIT FEE 9 CJ
/Aianature-oTCsAler or Agents ti -55o5
4oRT
Date... - h7
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ..... //(. at1f. V ......... ......................
has permission to perform ....... ..... .................
wiring in the building of .............. 72 ..
at ..... I..- f .. a. le. rd ....... North Andover,
Fed-2.�? ......... Lic. No . ............. ................ .......... ......
EUCTR&NIL INSPECTOR
04/29/97 14:54 c- 1 1715.;—..
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer