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HomeMy WebLinkAboutMiscellaneous - 37 HAMILTON ROAD 4/30/2018N J 0 N of T Q 0 �lTAJ V Q .� s Location No. 79 Date NaR,h TOWN OF NORTH ANDOVER F w 9 * ; ; Certificate of Occupancy $ s►cNus `� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 18786 C -. a� ~Building Inspe� Y�r 1.1 Property Address: 3-7 &AIVI /Lran/ /Pa( 1.2 Assessors Map and Parcel / Map Number Number: a v Parcel Number 10\16 *1Vk) & U6 )J ��� CJ`s 37 WAl"r 1-FON 9,:1 1.3 Zoning Information: Zoning District Proposed Use ��"� I& �7�--66 1.4 Property Dimensions: I Lot Area Fronto ft 1.6 BUILDING SETBACKS ft 2.2 Owner of Record: Front Yard Side Yard Name Print Address for Service: Rear Yard ReqWred Provide Rapred Provided ReqWred Provided 3.1 Licensed Construction Supervisor: Not Applicable ❑ 1.7 water Supply M.G LC.40. 34) Public ❑ Private ❑ Zone 1.5. Flood Zone Information: Outside Flood Zone ❑ 1.8 Municipal Sewerage Disposal System: ❑ On Site Disposal System ❑ aa.,iian. A - rAVrJxi x VWf4MM,-In IAU 1nU1ciGl U Ac xxt Historic District: Yes _ No _ 2.1 Owner of Record MWI M l t < Cou(zs C- 37 WAl"r 1-FON 9,:1 Name (Printt)�)), AAddddress for Service 0, ;eZ ��"� I& �7�--66 Signature Telephone 2.2 Owner of Record: 's Name Print Address for Service: i '4 Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ b'�' Licensed Construction Supervisor. License Number Address 97 73Expiration a�-40 Date` / v Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name _, 5 p&.:f-x,q Al r S/ 11/Y, 6dae12 /V / Registration Number 6 O� E1�1rati Date Add s 737 Signature Telephone 00 rn X 3 z 0 v rn 0 z M 90 0 r v rn _r z a SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 4 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 .......0 No ....... 0 SECTION 5 Description of Proposed Work check au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ [Alterations(s) 0 Addition ❑ Accessory Bldg. ❑ Demolition 0 Other 0 Specify Brief Description of Proposed Work: SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant QCIL:.ITSE,� 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction (f 3 Plumbing Building Permit fee (a) X (b) /' ✓, 4 Mechanical HVAC 5 Fire Protection 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 1> �� as Owner/Authorized Agent of subject property Hereby authorize �Y `— to act on My behalf, in all matterRelative to work authorized by this building permit application Signature of Owner Date SECTION 7b OW AUTHORIZED AGENT DECLARATION 1, ,as Owner/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 Print Name Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1Sr2 ND 3 SPAN DINIENSIONS OF SILLS DINIENSIONS OF POSTS DIN ENSIONS 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 •s CS # 022680 HIC# 103358 A. J. Walsh & Sons t J, 55 Pleasant Street North Andover, MA 01845 ge # of pages 978-688-6737 or 1-866-AJWALSH Job Name I Job # Job Location Date ; , - Date of Plans `r Architect We propose hereby to furnish material and labor — complete in accordance with the above specifications for the sum of: 1 $ with payments to be made as follows: -~ Any alteration or deviation from above specifications involving extra costs will be Respectfully executed only upon written order, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents, or delays submitted beyond our control. Note — this proposal may be withdrawn by us if not accepted within Occeptance of Vropooai ' 'j I The above prices, specifications and conditions are satisfactory and are - "Signature ��/ lC'c ?moi hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. Date of Acceptance Signature Dollars II O NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the pEris n of MGL c 40 S 54, a condition of Building Permit at: 4�r� that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL 11, S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section I OA. The debris will be disposed of in: Fire Department Sign off: Dumpster Permit (Location of Facility) Si nature of Pe it Applicant '/'/&. - J'-- " k � � �-%-os Date The Commonwealth of Massachusetts Department of Industrial Accidents Ofte of /nvesdgadons Boston, Mass. 02111 Workers' Compensation Insurance AtFrdavit I am a homeawrter performing all work myself. I am a sole proprietor and have no one working in any capacity Please Print QR 3 513 0,2/ L I am an employer providin g workers' compensation for my employees working on this job. Company name:' ,,-�RxwaglyT sr Company name: Address City Phone # f —� F? _4::� Falkwe to secure coverage as required under Sedan 25A or MOL 152 can lead to the impos" d criminal pensM a d.s flne up to $1,500.00 andlor arse yean' lmprlsorrnentaa wag.as.cbA pwa ies 3n ba h= dA ST.oP Y.VDRK.ORDER.end,a.flas d_(.$1W.00)AAW apalnat.ma. I understand that a copy of this statement may be farwarded to the Office of Investigations d the DW for coverage veriflcadon. ! db hereby certNy u the Ins an penalties of ped at the InfiwmaBon provided above is true and coed. Signature � G��ii �, /f�r/ _ Date If v2l C%5 Print name A -wp— k •/ /Z Phone e �� 7 Oftw use only do not write in this area to be completed by dty or town official' CIty or Town P ens$ []Check f immediate response Is required ❑ Building Dept [I Licensing► Board Contact person: C] Selectmen's Office Phone❑ Heath Department ❑ Other i b. 0 z cd ui J � •a a b � 'fib G Uw c� a°' w a a a°' c w w�' w W o z V) Q x � l)— ui g 0 . C/) 21 O O CD L O CD Z Q, O h o c cocm CA G> 'FCDC2 CD m m F— = .0 O.a CL.) CDL m o a, o- S a o I--@ � ev CD C Z CD O c. CO* O C CA LLI N W W 19 W C4 o c� o � c Vo V O.G �p O m C O m N • Ea CDs o a ECA m c$ vo ... C"m c m m o Z' VJ 3 cm m V) C Cc E go m o m� H m -aa cn CO i co ev ' c ao Q C CA o c = m o CLILu COD Cc a:.0 •dt A cc �... H _G •a 10 OLU r•. if co m CO) co 'o Z a V ti•7 .� 06 m g 0 . C/) 21 O O CD L O CD Z Q, O h o c cocm CA G> 'FCDC2 CD m m F— = .0 O.a CL.) CDL m o a, o- S a o I--@ � ev CD C Z CD O c. CO* O C CA LLI N W W 19 W C4 N° 2413 ,tORTM r Oft«ao �•,tiO O D Date ... l...ZL/................ TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that.............................................:............................................... has permission to perform ................................. .............r.....:.... 4I wiring in the building of.......................:........................................................... t . fat ......... ................................................................... r North Andover, Mass. Fee.=?r1................ Lic. No..... ....................... .... .......................... ELECTRICAL INSPECTOR J 1 Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer THECOMMONWF.UTHOFMV"CUMETIS Office Use only DEPARTAfi2VTOFPUBUCS4FE7Y Permit No. �{!� a BOAROOFF7REPREVEMOIVREGUTA7YOAS527©VfR12-M Occupancy 8t Fees Checked APPLICA TION FOR PEI?AIRT TO PERFORMELEC (T 'AL 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 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. AP PARCEL Location (Street & Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes Q No (Check Appropriate Box) Purpose of Building � Utility Authorization No. 0 0 S Existing Service �� Amps ldi/ / ��fJ Volts Overhead Underground No. of Meters New Service Q O Amps�Volts OverheadUnderground No. of Meters_ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above M Below Generators KVA ground ground No. of 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 Nos of Ranges 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 Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER - I• I 'W, 140 1 91 MO/AlIVA EsIir&dVahrdE1earxal Wcik $ - —�� Rout Firm �j ilw ii 1,11i so Im 1.0= Li0=111b imTeLNa t Telephone No. PERMIT FEE $ 6ignature of Uwner or Agent