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HomeMy WebLinkAboutMiscellaneous - 36 WOODLEA ROAD 4/30/2018U4t �am=nwra,ih of �fiar4us �,,,,,,t, °' Use °"" Etgarttntat df Puhtic *nfztq Occ,parmy A lee ChooW BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3*0 Pam �^W APPLICATION pFORd In accordance PERMIT TO PERFORM ELECTRICAL WORK withAll work to be Ine Massachusetts Electrical Code, 527 CoA 12:00 Q*(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) oats g * or Town of --NORTH -ANnn ER To the 1 epector of Wlras: The udersigned applies for a permit to perform the elec I aIwork described below. Location (Street & Number) LOT -F` 3 [�(in �.e _ 0-J. Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes _ No Lz"� (Check Appropriate Box) 119 [� Purpose of Building Utility Authorization No. 90 I1 1! J Existing Service Amps _! Volts Overhead :_' Una rho 9 C1 No. of Meters New Service Ot% Amps �J Volts Overhead _..I/"— Undgrno No. of Meters Number of Feeders and Ampactty Location and Nature of Proposed E No. of Lighting Outlets I No. cf 4ol :cs I No. of Transformers Total KVA No. of Lighting Fixtures i Swimming P_oi Accve.— on- t— Srra _ grna I Generators KVA No. of Recaotacie Outlets I No. of Od E%.rners I No. at Emergency Lighting Battery units No. of Swltcn Outlets I No. of Gas=::rrers FIRE ALARMS No. of Zones No. of Ranges I No. ct A r Czr..c. 'alai No. of Detection and :cns Initialing Oevlcas No. of Oisoosals I No.ol Heat 'o:ai .alai aUr:S ons P<W No. of Sounging Devices No. Of Self Contained No. of Oisnwasnera SOacerArea Heal rq K;J OweetloniiSounding Oevlees No. of Oryors I Heating Cevices KW L.Ocal — Munscioal Connection Other NO. OI Vu )i Low Voltage i No. of Water Heaters KW I Signs ?aitas:s Wiring No. Hydro Massage Tuos I No. of Moicrs ,alai HP OTHER: INSURANCE COVERAGE. Pursuant :o ine reauiremenls _-t '.tassacni sers ;enerat Laws I have a current Liaodsty Insurance Policy incluaing C -m„ of c Ccerauons Coverage or iia suostanlial equivalent. yE3 ;�-No = 1 have suomitteo valid proof or same., to In* Offlcs. YES It you nave cnecxea YES, pipes* Ingteate We type of Coverage OV, checking the aoprgo sato Oak. INSURANCE d aCNO = OTHER = (Please Scec.,�) Estimated Value of !est a�l•worts S 9 �/[� (Exarttttan Osat Wont to Start y Insoec:ion ,late �ac�as:ec: Rougn ` VFinal Signed unser :he Penalties of perjury: FIRM NAME I-V„ G _ UC. NO. f /9 Licensee � LIC 01 qb n "a _ n . n�/V.f� i -�j�/`[9ua. Til. No. ` / 1 �i Address • Att. OWNER'S INSURANCE WAIVER: I am aware that the Lzensee cues not nave in* insurance coverage or Its tuostantral egYtvelent as re., guwea by Massacnuselts General Laws, ano trial my signature in :^.i3 zermit s00tic2tion waives this regWrerh*M. owner Agent (Plea” check ones ireanone No. PERMIT FEE. _ (Signature of Ov ner or Agenn ■4Wl", •1 N2 1 476 Date .... ..../a °_e ppL TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that ..... LA. �.......... �.... Cv has permission to perform ........ .1,.`�.jM o......s.P_40.a..c,.le ......................... wiring in the building of (~.: .(1. 4k)., °..........o U� at ... rlt: ....9..........(c...........(,./JCS ? .lF .........,'North Andover, Mass. Fee .. .0.: O�L Lic. No..l.13CU./��-............................................................ ( � J3/12/98 ELECTRICAL INSPECTOR 08:37 50.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer This certifies that .. has permission to perform ..L...GP, plumbing in the buildings of... , , , , .. , , at ....... .. l , �f?�.cP,,, / ,North Andover, Mass. Fee . ,��? -.. Lic. No. .. ...:�............ . PLUMBING INSPECTOR Check # "5d "1 i� MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK – y CITY 1J G' 7fJ/7 �/JJ)///�� MA DATE PERMIT # % C JOBSITE ADDRESS 3 OWNER'S NAME �!_//,/f e POWNER ADDRESS TEL AX TYPE OR OCCUPANCY TYPE COMMERCIAL Q EDUCATIONAL ® RESIDENTIAL PRINT CLEARLY NEW: ® RENOVATION: ® REPLACEMENT PLANS SUBMITTED: YES E] N!NJ FIXTURES Z FLOOR— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM _= DEDICATED GAS/OIL/SAND SYSTEM _ DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN ' FOOD DISPOSER n FLOOR / AREA DRAIN INTERCEPTOR (INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE / MOP SINK TOILET URINAL �1 WASHING MACHINE CONNECTION !NATER HEATER ALL TYPES WATER PIPING 0 .OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES NO v IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY ® BOND OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. K CHECK ONE ONLY: OWNER ® AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and to to of my kn edge and that all plumbing work and installations performed under the permit issued for this application will be in complia w' .all P ion Massachusetts State Plumbing Code and Chapter 142 of the General Laws. e PLUMBER'S NAME STEVEN J. ADDARIO JR. LICENSE # 13106 IGNATURE MPE] JP® CORPORATION# 3102 PARTNERSHIP# LLC®# COMPANY NAME ADDARIO INC. ADDRESS 228 CENTRAL STREET SUITE #1 CITYSAUGUS STATE MA ZIP 101906 TEL 339.440.8100 FAX 1339.883.3059 1 CELL EMAIL Idis atch@addarios.com - " O Q x • b r z c� z b y 0 z z 0 y m i m y r 0 'b z O C Z m < O m Cr7 -0 Cl) O M cn 4t m O m El N ri ❑ O Or z �a V O z z 0 of NORrk qti �m *4.,. •:.1.. Ria �-- �gSSq 5E� Date . '4-02 P/1'3 • . TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that. �. 1.:. .t1.. lrc. .. ......... .. . has permission for gas installation. ....... in the buildings of .. �..�.............................. at ...� . l ... �� �1 ........ North Andover, Mass. Fee .cam?O.."' . Lic. No/3/.D�,.... .'�4 ................. ... GASINSPECTOR Check # 6-61ca, 8714 Ny,, MASSACHUSETTS UNIFORM APPLICATION FORA PERMIT TO PERFORM GAS FITTING WORK CITY /i/t3 ,3� jf � MA DATE— PERMIT #. JOBSITE ADDRESS �,OWNER'S NAME GOWNER ADDRESS TE ). JFAX TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ® RESIDENTIAg-�� PRINT CLEARLY NEW:O RENOVATION: ❑ REPLACE ENT• - PLANS SUBMITTED: YES ❑ NO APPLIANCES 7 FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER i (� CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS. MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER [� ROOF TOP UNIT TEST -- — UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES Q NO ❑ I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ❑ OTHER TYPE INDEMNITY ❑ BOND OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ® AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate tolbe best of my k wledge and that all plumbing work and installations performed under the permit issued for this application will be in complian all P provisio the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME I STEVEN J. ADDARIO JR LICENSE #13106SIGNATURE MPEJ MGF ❑ JPF-1 JGF F-1 LPGI ❑ CORPORATION Q# 13102 1 PARTNERSHIP [j# LLC ❑#0 COMPANY NAME: ADDARIO'S INC. ADDRESS 1228 CENTRAL STREET SUITE#1 CITY I SAUGUS STATE MA ZIP 01906 � ]TEL 1339.440.8100 FAX 1339.883.3059 CELLIEMAIL dispatch@addarios.com Ox z z o JF W Q z a d z w ON --v ❑ a zo z o N❑ w � ~ w O w O u W 3 W rx W a a O > w w N a t7 z a Q a a � V x J F a IL a � � w x W H LL w F O z z z d 0 a d� The Commonwealth of Massachusetts Department of Industrial Accidents 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 (Business/Organization/Individual): ADDARIO'S PLUMBING INC. Address: 228 CENTRAL STREET, SUITE #1 City/State/Zip: SAUGUS) MA 01906 Phone #: 877.233.2746 Are ou an employer? Check the appropriate box: 1 I am a employer with 8 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. # ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions I I.Vlumbing repairs or additions 12. ❑ Roof repairs 13 . ❑ Other *Any applicant that checks box # 1 must also fill 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 must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: FEDERAL MUTUAL INSURANCE COMPANY Policy # or Self -ins. Lic. #: 9306944 Expiration Date: DECEMBER 29, 2013 Job Site Address: (�4.0 City/State/Zip: I I 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 up 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 certify under the 877.233.2746 of pelo jy that the information provided above is true and correct. Official 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 #: r Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and,should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 5-26-05 www.mass.gov/dia .W. C�W�AO.TMI O� LtC iS G AS AMA R RLUMBfR 11!^x: IS + QNr STEVEN J '.DDAR IO JR 331 MAIN '; t BOXFORD 1A 01921-2225 13106 05/OAI14 164821 _ 9 3342 Date. C,7-. .:�.... $, TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION A r This certifies that ..:.�'=.....-..` ......`:=.:" ...-.P..:...`... has permission for gas installation ................. /1 in the buildings of :..... "/� :��... .2 ................. • • • at�� .. . ?......a...�.. t`. ........... North Andover, Mass. I Fee./". .. Lic. Nofy/!?�7.... % GAS IN HECTO (f WHIT : Applicant CANARY: Building Dept. PI K: Treasurer s > ' MASSACH lFUM -APP11CATON FOR PERMIT TO Type or print) .PARCEL P NORTH ANDD / RT MG ,2, -a-7 19 �Gl Building Locations -3in W0,9D1£>1(moi`'�� Permit # -,33-12, Amount S ;- Owner's Name New ©' Renovation ❑ Replacement ❑ Plans Submitted ❑ (Print or type) Check one: Certificate Installing Company Name /'iS 1%1,�'d/✓�'c��i Corp. /rY/ Address_ %� ❑ Panner Business Telephone Name of Licensed Plumber or Gas Fitter ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No ❑ If you have checked ves, please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver. I am aware that the licensee 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 of Owner or Owner's Check one: Owner ❑ Agent ❑ i hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By: Title . CirviTown APPROVED (OFFICE (A -F ONLY) Signature of Licensed Plumber Or Gas Fitter LM Plumber 9� ❑ Gas Fitter License (Numoer Master ❑ Journeyman n :L r w ,n m " U C z = Q C �t C C z �• cn �i Z Z f� % �� V ` J r Z t st t `' i n = z C 7 w C Al C S L v SU B -BASEM ENT T BASEM ETF IST. FLUOR 2ND. FLOUR 3RD. FLOOR 47 It. FLOOR ST It. FLU V R 6T 11. FLOUR 7T IN. FLOUR silt.. F1,0OR (Print or type) Check one: Certificate Installing Company Name /'iS 1%1,�'d/✓�'c��i Corp. /rY/ Address_ %� ❑ Panner Business Telephone Name of Licensed Plumber or Gas Fitter ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No ❑ If you have checked ves, please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver. I am aware that the licensee 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 of Owner or Owner's Check one: Owner ❑ Agent ❑ i hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By: Title . CirviTown APPROVED (OFFICE (A -F ONLY) Signature of Licensed Plumber Or Gas Fitter LM Plumber 9� ❑ Gas Fitter License (Numoer Master ❑ Journeyman Date .cV - �-f - - - N2 4308 HORTM TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING S C04US r. This certifies that ....................... has permission to perform--.�'� ....... plumbing in the buildings of .................... ........... North Andover, Mass. Fe—e-2 L i c. No.pl^ ............. /,C= SPECTOR PUM WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS ate _�'�� Cdl� Building Locario . 3 �� ,# Owners Name SfJy<�� C Permit # ` Amount Type of Occupancy .S �ti� %�i1i'. ��` New ® Renovation [:] Replacement 1:1 Plans Submitted Yes E] No (Print or type) Check one: Certificate Installing Company Name 10-IM5, p`v�,Gild/6 �` �. L�i� - 13 Corp. j i Address 7 Partner. I— ,ys,l /y!l�_ Business Telephoneys-r/ El Firm/Co. Name ofLicensed Plumber. Insurance Coverage: Indicate the a of insurance coverage by checking the appropriate box Liability insurance policy 1 Other type of indemnity El Bond ❑ Insurance Waiver L the undersigned, have been made aware that the licensee of this application does not, have any one of the above three insurance Signature Owner 11 Agent n I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of theMas us State hunbmg Code and Chapter 142 of the General Laws. ��. By: Signature of icenseQ rIUMDer Type of Plumbing License Title City/Town License Numoer Master �' Journeyman APPROVED (OFFICE USE ONLY N22177 Date..���C? y NpRTIi <"`°;°14 TOWN OF NORTH ANDOVER 4 * 9 PERMIT FOR WIRING This certifies that.... / Ree f J d <<9 �= ! ........................................................................................ has permission to perform ......................................................................... wiring in the building of ........ �/� �� v v "` h1 Of at ......3.a.....1 v vUG�... `i....... ...... North Andover; ...., ... , .ass. C� r �......... Fee.r�!,�.�.....:........ Lic. No. �........ .......................................................... ELECTRICAL INSPECTOR 7A WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 77JE00MM0NWF4LTHOFMAYS4CHUSE77S Office Use only 01V Permit No. �7 DFPAR730VTOFPUBLICS41UY ' < 7 BOARDOFMEPREVENWONREGULATIOAN-WCMR IZ-AO Occupancy & Fees Checked APPLICATION PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date a6 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical wo described below. Location (Street & Number) Owner or Tenant Owner's Address/t' e X417,1 e� Is this permit in conjunction with abuil ing permit: j Yes No Purpose of Building �%,�-7 ) //f' / (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead E3 Underground M No. of Meters New Service cx'l� Amps % / olts Overhead Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work , 7777;iT , No. ofs ighting Outlets No. of Hot Tubs No. of Transformers Total KVA _ N,f,Lighting Fixtures / r Swimming Pool Above Below Generators KVA Jgroundground No. o. 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 Ranges f No. of Air Cond. Total / Tons No. of Detection and No. of Disposals No. of Heat Total Total / Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW / No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW a Connections a No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER htsltratoeCo R>ts�att9�thetagtmanai�afNt>semGateallaws Iha%eam=tLiaokh uwmPotityutlxkgCaqkOpwadcmCovwdgcritssistartialegivaient YES NO IhaNeshmitaadvalidprocfofsaneot cO� LL'LJ NO YES M ff�culmedtadWYES,plemmdc*thCtypecfooaaagebydrdmtgthe INK A1� ro BOND M OTHER ftmeSPeffY) WC&IDStart , Sigrwuniz FIRM NAME ExptrdurnDaJC / �E= tedvakxdElMftidWCik $ Liot�seNa Lioerm 'Z? /Oi�L��/ Sigt rae . �` Lt0=1.1 o Br simTd.Na At �, `� // ii // A1tTeLNa OWNER'SINSURANCEWAIVET amawatetMattheLigawLaws andiximysignattseatthispemffiappfiatortwanesthis mw*mnat (Please check one) Owner F-1 Agent17 Telephone No. PERMIT FEE N21981 Date ..... feeTOWN OF NORTH ANDOVER - PERMIT FOR WIRING This certifies that ..... r: c i�— ..................................................... has permission to perform .... .................................... wiring in the building of.. ..... .................... ........................... at .......... wo ..... ....... North Andover,N2 S. ....... Fee .��**�**.*O*..,.A(). Lic. No. .......... ........ CkW 00y ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer TRE COAfffONYlEALTHOFiVL4S�r-1(.U[,SE17S office Use only DiT,qR731E7VT0FPUBUCSA= Permit No, BOARDOFFB?EPREV=ONREGM7YOAS527C,,11RIZ-00 Occupancy & Fees Checked APPL[CATIONFORPERAlflTTOPERFORM. ,LE=(�'AL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE IMASSACHUSSTS ELECTRICAL CODE, 527 cMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. iA PVJPARCEL 0 Location (Street & Number) 7" Owner or Tenant Owner's Address 4 Is this permit in conjunction with a building permit: Yes= No IV I (Check Appropriate Box) Purpose of Building P a CY U i e, G:�- Utility Authorization No. Existing Service Amps Volts Overhead Underground No. of Meters New Service -_;�5-4aS]L4�4�- Amps /Uo Yolts Overhead Underground No. of Meters I Nurnbei -of Feeders and Ampacity 75j7;7 Location and Nature of Proposed Electrical Work 674- ,p -Y ,/) i, & No. -of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of LightingR%tures Swimming Pool Above. Mand Below Generators KVA ground No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Bumcr3 F= ALARMS No. of Zones No. of Ranges No. of Air Cond. of No. of Detection and No. of Disposals No of Heat To Total Pumps Tpns KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal. Conncctoris I I Other i7. of Dryers Heating Devices KW No. of Water Heaters KW No. of No. of Sims Bailasis No. Mydro Massage Tubs No. of Motors Total HP M11,11-010 �*AF046_8:11 own, 01 , Is 1811Vas .1• 0 •W 4. , .109 all R 4 M1 0hili. 1• 19 F-11 05 Lqmp�� - �M­ 0. Vdb'brf TWIOVWM14_4_00N' : " • EstDatedVahr,dEbzbcalWcrk — Final 1611-2 Sigrialure amxnsTelrb s73ll - ,N1t OW'I\ER'SNSURANICEWAIVEI�Iamaw&r�tnttrLrmsedmnAtuwd-ru3sLr,umccmmmcr&sL±stnbaleqr4i,ilasmgmcdbyNiismdmsettsG=aiLawb (Please check one) Owner Agent = Telephone No. PERMIT FEE — �qLma[urc of owner orA,,,cnL N. E NoDate SR t;o"T.,� TOWN� OF NORTH ANDOVER p 'Certificate of Occupancy $�� o Building/Frame Permit Fee $ 1371t Foundation Permit Fee $ g� ` sACMUSt 6 ,/ i ZS3 Other. Permit Fee $ 8 WG, Sewer Connection Fee $ 60 'Water Connection Fee $ r TOTAL Ins ctor 10/09/98 1OV-51 0 3 l+421.(!0 .PAID Div. P bl c Works V;P .. :.air.. s E o �71 • �: y' �'_: "�`L ..'H'/"�Yr..„fi..a_.y'+}.+�..y✓y-i�"�''rj^-�5..r.yd,��-f�sa., -74 4(/ r'„C� y 00 ' , Date % `•' V40P ' ° __TOWN :TOWN OF NORTH ANDOVER Of�No •1,�, . F 'A p Certificate of Occupancy $# .� Building/Framermi Perm t Fee $ $ cMuSEs� . Foundation Permit Fee $ J °J0 AMJ Other Permit Fee $ o Sewer Connection Fee i $ ` V W Water Connection Fee $ TOTAL /j$��`� Bum' g7lns` ctor _ , n17 ' 10/0/5 ��:.�'/ 1,421.1)0 PAID Div. Piibl c Works ,. F, Y �I c� V c a � z Y �I w z c w J► x oc Ln �c aj a 3Z LU jl. 0 3 OC < • .. _ p J U. O O La w < ? i z z zz .. ..A Q N w Z wJ Z Z w t_ 6 _ 'L' Z Q V 1J Q — r^.r N C L- Z a C s � . _.- Q p O LU � w u J w LU z rb , w N L VIC Z 4 w Z r C Q u Z F . Q y y y Z ,y Z 4 w Z ^yy Q F V Z 7z y Q � M T� Z Z < •- N r .;jZ �JJ Z Ci m C Y �I 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 out this section***************** APPLICANT: ( JJ Phone 6 /0 LOCATION: Assessor's Map Number Parcel Subdivision (.V z-1 4- U 0 1 JIR:!�;cj Lots) Street Cyim 0�4---� JZ �- St. Number �G RECO MriE AT NS F T AGENTS Conservation Administrator Comments Town Planner Comments Food In ector-Health ep is Inspector -Health Comments Use Only************************ Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected - yl?Vlf 7 Public Works sewer/water connections - driveway permit Fire Department n 3,,&7 Sc -(i Va#n Yk e-- z 9% Received by Building Inspector Date L Qul to v z 0 149 \ 0\ y O� OQ� OOQ `nSv. \cc�x, 7A U, II tD C t w!''' a1 1 1 t4not 1 w 1a� 3 r, o�. n°, w "�oS802_090W `3 I o 4 r Z 0 p in�-Ct-3�I —o 91 11 VO OD g�'b5—•D, x\'6'6 �,D .'�- 121.67' S_85 0 1 0 0 9,8-. -T-5 5.'0 t. r t �i8Nal9 r6 T M0oOoycJ4- r n t� o't= 9 rnnu IN1 CDC 04, o*w �00 ti $g0W-TI{w oo 39 6 °'c73.92' 4 "W'79502"S7 S ' �� �• - p,p o I' IIw v 1-4 to is ��I - t 2 wor) 4.86 5 81'18 46 W " 1 0 72_74' to II v to It- 1$ r ' ry u, I_ '8j QJ0' ys cn rn IN t S7804 571``03'2,. 6� �' 6 of 4-772' !r y, OC4 AC, iu) N At is II �tn _� o tj r i A (rt w ?� p3 . , C7 0 G) N�8 o rn 0)LO : 30� x 22 ""tv e��P CO V\ 1 n r 58.81 26^ . WqmN 3 to y Cj fit WIN mb ONDNNp pN r%. YI - Oi0-t1/ Ln CqA a r ^ aMay C4 U I• D y �.. Cr Fi''S 11� Q� nII II II 1\ 3- 0. /�4 O ak 9 � f Yo O O_ .: (I! a Lnz Qj rII SLY '-i t \ j 10 Ito (P w N tD I` ' � J � k! j ,� �y. i �� 5• ,,, \t (L,\�}� y k�F,(+4�, f i.. O O WN •. ISJ kti. d ''j -'i 1"WN a� 1. �a,„ r »a All I`ac AX Y Itn + • 0 o d� U � o w N CA- uX a ch ce o U z 1�1 C w w v U x � p" coW w a w u '� x p � a z w w w c z C� o O z "S"a 0 0 o ac m : o a 3Ec D t; o, .•oc 0 3m3 w �A m� A � y .E o a v S ---� N m m 'CO3 C h IS 2CC33 z �a Q o go o c W : oz 3 a F- CD o c H W C CODN=.+�Z E -;;-ere muj h N L= COD a '0os x ccGo c ate my z $ aO m E .o N C ca IV cm CIO 0 CD c 'c N 0 Z r-. 0 Z O 911, to Ac � e ' T:"T'd ST8'011 . ;'�i�-!' -Ir rr:n:^r49talEPtfJL <'j/ �7ZdG4¢crttt:SR'� OBPARTEmST of PUBLIC SAf6YT t' „ ricr.nse: fORSTRUCTIOR SUPERVISOR 1 R inb�t 67pites Birthdate I CS 061.313 1111111991 8111711943 11165 1 KCL&A.q , '. 20 CBARROS Avg SOITB 1S i d' NASK�lA, RN 03063 RRSTBICTHM 90 [ I 08 - Bnae IA - Masonry only 1G I & 7 Faa.ily Hon"s Growth Management Bylaw Exemption Statement Town of North Andover Building Department This fort 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 an Building Permit (below) Address of Property for Permit (below) c22 , 9 C.0A Map and Parcel: P ase of Application (check below) P one Nu er 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 iq 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 existence as of the effective date of this by-law, provided that no additional residential unit is created. 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 I allowed an EXEMPTION as ' e ove. Further I understand that the submittal of misleading and or inaccurate information, or ecking off of an above item which does not comply, whether done to my knowle r not S g;A ds for refusal by the Building Department to issue a Building Permit. ignat r€ o ner or Authqhzed Agent who signed the Attached Building Permit Date Thi o ust be attache to -*,e Building Permit upon application for such permit A . O wP J L } 00 zF-cD ZCy- 0 F - Z Z J > Co C14 O�Zw Q QN wO }may= WW wN�pZ _ W%" W C-) F- SIV �m Q�WU � J z U LLJ Q U) FM QZJ Z!w 0-0)Q- W W(D OLLHW �O>- E'm 0m`- M W V- 00 JzL-F- O > U0W O�'��- �p �w -UDOQ W<o �m. Qr}►�.Q� ��¢ 00ZWz pia V) -j a°°Q0 20 QZa i=-WZQ —1 ix QQMOM _J m m,QZ ww 0OG]VWNF- F- o F- (new >mq p W wp ZOO L-WJ ow -0- z OU ZZ� pJ �z L- CO Z Z (!) Z W Q a 5 Q U o LL cn a� OC�F- Liol< l W wa�a aW� =ZZ W- 10 OZw WI,z 0 Qo 2.06 Np MwW =p Y. I I QOp pz 0 - . z0� w ZUpp F-QQZo zN~ pwMQ W Q (f) V) Zm-z z`�rn OF oO� U0O0 UF - ML) �wJ 0�r- F-HNwwT Q L'- cn a Li Z z w Z Z• �- Z W O >- U J I F- U �- � w z y w M W�,I w Q c� Q�- z LL n. Q F- iYi O J 0 Q w?N CD J z q J O F-pwZ LL. I I 1 J J w p l- w a. 0) W Z >- = F- p 0 0 Q(-) Z=x Lj--1p0Z� Oym 0 W Q UU)(I)QZ ZOO Jam= � QZQ.� U� pQ () QZ p r w� W F- W M C' z a= W O J. m w -Q-J Q 0 LL1 p Q (n V 1 F- MV)CL Z F--�lpi Q �X.0 Z M0CL ) a - w -Cr wwww I � pz� wv, �Q w = N �.-ZW-� N�� 1'M�p O pELINEp,�14N LINE VIE DRAINAGE EASEMEN' ALJ CD Q `r � J z 04 $ _ W > o < W 0E- Q� wwo Q �w LLJ wQ W(= Q z --J C) Vz P Z � o w � sC O� �<D O 4� �- Q 00 z M m Q 0-) D �— O o w�� LU Q� Q z `- J L LLJ Q U � V)Ua_ O 01 -0 n C ui N 3 .0 (o Z U- M 0) ° : rn 000 a N'Zo, o z ALJ CD Q `r � J z 04 $ _ W > o < W 0E- Q� wwo Q �w LLJ wQ W(= Q z --J C) Vz P Z � o w � sC O� �<D O 4� �- Q 00 z M m Q 0-) D �— O o w�� LU Q� Q z `- J L LLJ Q U � V)Ua_ 301M og aboa b3�oo OM O O O O O O z i w U j p 000 a N'Zo, F - Y) o 3z F- N o �o a, vi aI N z .cgc�o Qo g z 0) N Lf) N F=- O fr-Q LLJ z \S o 301M og aboa b3�oo OM O O O O O O i U j p a N'Zo, Y) o 3z F- N �o a, vi aI .cgc�o g 0) N Lf) N ci C �o CERTIFICATE OF USE & OCCUPANCY. Town of North Andover Building Permit Number-- i yc� Date -,3--30-06 THIS CERTIFIES THAT THE BUILDING LOCATED ON ,�a� �3�� 000,b[£A0i//A9 Z ;�a� MAY BE OCCUPIED AS s5t j 4''� �A "+� 1 r a d�a�� 7Ta � IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO AS ADDRESS 8 y La �� 54- SACH"' 174Buildin Inspector Qo WD s. O Art. w_c.7 �� ;aac Cc M s CD O m 1Q .D c eSm o c. a 7 'o to cm c CL, m m 3 m 3 CA. yJ C � -: E N m a� a� mor • � :waw O aoC CD ui_W C to MD is O C = 0- N uj •® V � m V m C403 C. � O� S CA 100='3 H C .$ a w m g 0 F. Cn O C/) W 6-111, 6 O C •r.a a� a� 0 E O o O y O C CD cm i O CD L CL CMCX ca C O L C cc C _.3 .� O C CD C.3 ca CCL C H 0 o x � Iz- z U o \\\\\\ 1+..11 cn a v fr o a w° Cf) 7 COQ+ U x W to o .Yi o a�' c� iS.J go cn c/) O Art. w_c.7 �� ;aac Cc M s CD O m 1Q .D c eSm o c. a 7 'o to cm c CL, m m 3 m 3 CA. yJ C � -: E N m a� a� mor • � :waw O aoC CD ui_W C to MD is O C = 0- N uj •® V � m V m C403 C. � O� S CA 100='3 H C .$ a w m g 0 F. Cn O C/) W 6-111, 6 O C •r.a a� a� 0 E O o O y O C CD cm i O CD L CL CMCX ca C O L C cc C _.3 .� O C CD C.3 ca CCL C H 0 4 NORTH q Q Os-ILu ;6'e O COC-•< wta V C-1 ACHUS , APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS/LOCATION OF PROPERTY Gye""Z1,6c, 6le 1�w_ O DATE REQUESTED FILED/READY FOR INSPECTION CLOSING DATE ON PROPERTY: 5 w x� FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK'AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNED ROUTING CONSERVATION li CONSc 2C PLANNING DPW - WATER METER a `' NOTE DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUE ITTAL OF THE OCCUPANCY/INSPECTION REQUEST " � I \.1 I DPW 1�w S' nature File: OC forth revised 618/98