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Home My WebLink AboutMiscellaneous - 362 BERRY STREET 4/30/2018 (2)I N2../ ..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ... .............. ? �v C)' ................................................ has permission to perform ........ F �f f.. ( ................................................... wiring in the building of ........... ...... ``q .......................... at ..... ..... ................................ . North Andover, Mass. Fee... ! Lic. No...3A7� ........................................................ X O21V. ELECTRICAL INSPECTOR 9 r .19 15. 00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer (lc� Vee On lry� The Commonwealth of Massachuset Department of Public Safety lug 4c.r+«y a r.. o�aae BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 1200 3/90 (t..w •tint) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work (o be periormed In accordance wi(h the Masaachvsetu Electrical Code. 527 CMR 12:00 Q (PLF-A-SE PRINT IN INK OR TYPE ALL INFORX&11011) Date ��— % (�► City or Towu of� �, _/ y\�Cken r-c� To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street b Number) (, 1 -f rig► , A ST Owner or Tenant �L. Zc,�(� 1-�Jf�,r Owner's Address Spn� Is this permit in conjunction with a building permit: Yes ❑ No Ba (Check Appropriate Box) Purpose of Building D e _,Jt y-.< Utility Authoriution N0. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of hettrs New Service Amps / Voltz Overhead ❑ Undgrd ❑ No. of 2Seters Number of Feeders and A=pacity Location and Nature of Proposed Electrical Work k >J l :Se W G(- Py ro P . a� Po• - No. of Lighting Outlets No. of Hot Tubs No. of Transformers Tout TVA No. of Lighting Fixtures Swimming Pool Above In- rnd. ❑ 1grnd. ❑ Generators KVA No. of Receptacle OutletsNo. of 011 Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Cas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices Ho- of Sounding Devices No. of Sel Contained Detection/Sounding Devices Local ❑ lfsnicipal ❑Other Connection No. of Ranges 8 Total No. of Air Cond. tons No. of Disposals No. of Heats Total Ictal Tons. P=PNo. of Dishwashers Space/Area Heating xW No. of Dryers Heating Devices Al No. of Water Heaters KW NO, oi No. of s Ballasts Law Voltage No. Hydro Massage Tubs No. of Motors Total HP INSURANCE =ERAGEs Pursuant to the requiremoms of Massachusetts General Laws I have a current Liabili� Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES NO I have submitted valid proof of same to this office. YLS00 HO ❑ If you have chockAt YES, please indicate the type of covers:* by checking the appro7ri:ts box. INSURANCE BOND ❑ OTHER ❑ (Please Specify) (ration ate/ Estimated Value of Electrical Work $��=_ Work to Start " / LCS Inspection Date Requested: Rough 'l Z Final Signed t..:4er the penalties of perjur; t FIRM NAKE 13-a _ LIC. N0. 1=Sj2'0f- Licensee< AJAL_� Signature-, LIC. NO. - Address l %,('(r,o.cl:.c - G. tat c -.L,. bus. Til. No. -- — Alt_ Tel. No. OWNER'S INSURANCE WAIVER: I as aware that the Licenses does not have the insurance coverage or its sub- stantlsl equivalent as required by 2iassachusetts GeneralwsaZ ,and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FF-- S G (Signature of Owner or Agcntl Location :� & f.--, r' No. 5,61-5J Date ' MORTq TOWN OF NORTH ANDOVER 0 16. A Certificate of Occupancy $ s+cMus `� Building/Frame Permit Fee $ �U Foundation Permit Fee $ ' Other Permit Fee $ TOTAL $ Check # ' " Building Inspector�� t UORTFI � O tt�ao s. �O 49 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 9SS^CHU`�E1 Permit NO: Date Received: o 0 - Date Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION-��^t-- -S n K ot PROPERTY OWNER 1�ctl-` Psco 'i Print MAP NO.: 16V C PARCEL: ZONING DISTRICT: TVPF AND 1TCF. OF 1R1T11,D1Nf_ UtQ9r"D11!' me rnTnrr, X711 r n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ Addition ❑ Alteration ❑ One family ❑ Two or more family No. of units: ❑ Industrial ❑ Commercial &Repair, replacement ❑ Demolition %Assessory Bldg ❑ Moving (relocation) ❑ Other ❑ Others: ❑ Foundation only Lr„ov,ix�ir 1 iviv yr w vtuL 1 v tin rKCr VKTvlr,1J OWNER: Name: Address: 3 � Z C CONTRACTOR Name: Address: Identification Please Type or Print Clearly) P re A1!2 w Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT. $10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost x10.00=FEE:$ /DU Check No.: Receipt No.: Page I of 4 i TYPE OF SEWARGE DISPOSAL Public Sewer ❑ Well ❑ Private (septic tank, etc. Ix Tanning/Massage/Body Art ❑ Tobacco Sales ❑ Permanent Dumpster on Site ❑ Swimming Pools ❑ Food Packaging/Sales ❑ NOTE: Persons contracting with unregistered co tractors do not have access to the guaranty fund Signature of Ag t/Owner Signature of Contractor Plans Submitted ❑ Plans Waived ; Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Water & Sewer connection signature & date DATE REJECTED ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ .Other DATE APPROVED DATE REJECTED DATE APPROVED ❑ ❑ DATE REJECTED 11 Comments Comments Temp Dumpster on site yes—no— Fire Department signature/date Building Permit Approved and Issued by: Page 2 of 4 0 DATE APPROVED lki 04 W w ui E v y a y C CD 0 ar- cm c 0 m 0 CP c c N 0 I 0 Z cm g O 5 E"4 a z 0 U C� O cm i C. - CM 32_ O .� h O O 'E m m CL �3 .0 � � L e_Cv o a CMQ c c c C:jO w .5.o d O D co C Z m 0 CL C..± y O C C c U) 0 N 19 W W I% W N f� E� O W w N vi U a s Cd w w v U x W a� a x W a w w" bow w w W x v w ° z cn o cn ui E v y a y C CD 0 ar- cm c 0 m 0 CP c c N 0 I 0 Z cm g O 5 E"4 a z 0 U C� O cm i C. - CM 32_ O .� h O O 'E m m CL �3 .0 � � L e_Cv o a CMQ c c c C:jO w .5.o d O D co C Z m 0 CL C..± y O C C c U) 0 N 19 W W I% W N f� Gerald A. Brown Inspector of Buildings TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 HOMEOWNER LICENSE EXEMPTION Please print DATE: Z O 6 JOB LOCATION: a C, Number Street HOMEOWNER 4r' k3nN Name. Home Phone PRESENT MAILING ADDRESS S� xjOL -ler Telephone (978) 688-9545 Fax (978)688-9542 ,< /0 ec ) 7 Map/Lot �7.-4K3 Ss 3f /�7�.. Work City Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other Applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. /) _ . _ — - HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Raised 10.2005 Form Homeowners Exemption �3a-7 Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided DIMENSION Number of Stories: Total land area, sq. ft.: NUI LN anCI DAIA—(Por Page 3 of 4 Total square feet of floor area, based on Exterior dimensions. Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created IMC. Jan2006 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4