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HomeMy WebLinkAboutMiscellaneous - 38 WHITE BIRCH LANE 4/30/2018I 00 W row s� od= ;"I (% mom .7-r- Location 3e, No. Date 4 4 v . v 4J TOWN OF NORTH ANDOVER Certificate of Occupancy $ _ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $� t � Building Inspector Div. Public Works Location . i No. 4 i Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector Div. Public Works Z r > > > > "' > ny C [n m z to -i Q� p m c cn > m p n r n > p n O .a .. O c _. C c z > z > ro o -� cn a n a <( r '� a C cnn .� > n n H z ✓� y W O `� O z ro Q 6 n S r1 r O G O rra � n f v Uri -- W 0 ^0 F rL F rz F 7 P Z a° r O z Z z Z z Z r O cn n n o i o o ° O O � �' '= r -i �' C n C O ►ni � •n -I E Rt M ui H " n � o°Ocn O O O a a Q y c z J� cn n I a c c O. Z W W cn cn G S v n FM A Cl) M m CD 0 m _v, y — d CA Cl) 10 0 co 0 z v) fl. o 0' r c CL �; c � y O CO CD o v CDCL o Cr CD co O CD w w a. C CD y CO CL O CO) CCCID S7 O -n z 0 0 o CD a O C CD 3 ',gid n 0 z ti m n o 9• OE N -4 � °:m ti ft �a„rC O m CD O m y y •' o imm mm-CCa > > N - �O a = , .-► n o y o ny :. o �m ? 1• N cn /.-► N oca C . �y O CC, y � -C y CD A �• CO) !�L m cif � � • m CD C9 r. CD 0 cn CD z y cn cn d o rC,; t CL C. Z ' o C. CO)� O o m 70G-' d z a� � I w- o O w � o iTi � '? w G z Vi w n; G G CL n �� C C' � c 'O Cn p CL o �J rA 0 c i - FORM U - LOT 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 or requirements. FILLS OUT THIS (� APPLICANT L"ONE ` 1 LOCATION: Assessors Map Number_ PARCEL SUBDIVISION �. �-l� %e �� n- LOT (S) STREET ST. NUMBER _ USE ONLY'�`�`�``***� RESENDAT IONS RF T WN AGENTS: 71 (A CONSERVATION ADMINISTRATOR COMMENTS DATE APPROVED DATE REJECTED vJ (i m 100 1 TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING iNSPECTO Revised 919' jm (99 DATE s -11o30 WHITE WHITE BIRCH LANE 154.1 ' Lor 1 o A=45110 S.F. 0 228.3' FOUNDATION LOCATION PLAN CLIENT. IPSWICH SAVINGS BANK THIS CERTIFICATION IS MADE AND LIMITED TO THE ABOVE CLIENT. LOCATION. NORTH ANDOVER,MA. SCALE. I"=60' DATE: MAY 10,1995 Te" L A I W C N I rnI � I ci 60 - b In V � I CERTIFY THAT THE PRIMARY STRUCTURE SHOWN CONFORMS TO THE HORIZONTAL SETBACK REQUIREMENTS OF THE LOCAL APPLICABLE ZONING BY-LAWS IN EFFECT WHEN CONSTRUCTED. (THIS CERTIFICATION DOES NOT CONSIDER ANY OTHER RESTRICTIONS SUCH AS COVENANTS, WETLANDS,£ASEMENTS, ORDERS OF CONDITIONS,ETC.) THIS DRAWING SHALL NOT BE USED BY THE CLIENT FOR ANY PURPOSE OTHER THAN THAT OUTLINED ABOVE,£XCEPT WITH THE WRITTEN PERMISSION OF CHRISTIANSEN & SERGI INC. FURTHERMORE THIS DRAWING IS THE COPYRIGHTED PROPERTY OF CHRISTIANSEN & SERGI INC. AND ANY UNAUTHORIZED USE IS PROHIBITED.CHRISTIANSEN & SERGI TAKES NO RESPONSIBILITY FOR THE UNAUTHORIZED USE OF THIS DRAWING OR ANY INFOR- MATION CONTAINED HEREON. BASED ON SCALED DATA ONLY THE PRIMARY STRUCTURE SHOWN IS NOT LOCATED IN A FLOOD HAZARD ZONE AS SHOWN ON FEMA FLOOD INSURANCE RATE MAP. COMMUNITY NO.: 250098 D005C TE.6/2/93 OF MAS'T9 IN cy� MAEL 9 •� O Q LAND SURVEYORSE£RS CHRI S TIA NSEN SERGI PROONAL !ITER \oma 160 SUMMER ST. HAVERHILL.MA. 01830 TEL 508-573-0310 © 1995 BY CHRISTIANSEN & SERGI INC. DWG. NO.: 930670016 4- i -� 1 1 I I ! 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Public Works Location 38 - Ste" UaA*- L* 1 No. 105 Date 3 2 cl 0 : 1 cp 0 411. s�CHus t� n _i 7992 TOWN OF NORTH ANDOVER$ Certificate of Occupancy $ S� Building/Frame Permit Fee $ Foundation Permit Fee $CU Other= Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ o TOTAL $ Building Inspector Div. Public Works Location No. 1 6 g Date �oRTM TOWN OF NORTH ANDOVER A Certificate of Occupancy $ Building/Frame Permit Fee $ � 4 +¢ SAGMUS Foundation Permit Fee $ r, Other Permit Fee $ _ Sewer Connection Fee $ t 670 Water Connection Fee $ 7 7• TOTAL $ M 0 l g �B�jldir( Ins ctor 7003 DiY',Pu it; Works v; n Q U 0 OC LA 1 G < �C all f 8 >. 0 m I O W F > z m m F u°f a t7 ILW J M U U i L Q z O c o '9 O G7 Z � i 9 Z o. l< "� sr J a J LU U 4 I � W � z J z 6 3 o o V O U V 2 U c O G7 Z o. l< "� W CIE ui C= ui LLJ LA- O ¢ LL. LA - t� w m O ; :L16 m. 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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: Phone Y7r - O JLP-5�j C �rr_i1-- e6s-4OZ-00 LOCATION: Assessor's p Number Parcel Subdivision WOM 6U/\ Street Lots) St. Number 58 ************************Official Use Only************************ RECO NDATIO OF OWN A �/Z����'` I Date Approved fA Conservation Adm istrator Date Rejected Comments a Town Planner Comments Date Approved Date Rejected Date Approved Food Inspector -Health Date Rejected /� Date Approved6 f 9 i— Septic Inspector -Health Date Rejected Comments Public Works - sewer/water connections - driveway permit w _ i Fi e Depart�me,nt Received by Bu e � . • r Z . ✓1% �o�Om�ea� o�✓�raaocuiur�elGs z r OEM ENT OF PUBLIC SAFETY CONSTRI OEM LICENSE � - Axpires: Birthdate: p$/28/1997 03/28/1956 Res _ edia_? OO i(EIT N KILGORE PARTING BROOK LN �• �d NEYFIELOS, NH 03856 LOCUS MAP LOT 2 BM LOT 3 -CHERIS__�IR. for 4` for 5 LOT 10 "OPEN SPA Cr LOT 9 Lor 8 r 7 DRAIN EASEMENT B. M.: TOP STAKE ON 24 BEECH, EL. = 146.94 NO SCALE SOILS DATA r ENGINEER CHRISTIANSEN & SERGI INC. INSPECTOR SANDY STARR, BOB LEYLAND .TEST PIT N0. 94-12 DATE MAY 10, 1994 TEST PIT NO. 94-13 DATE MAY 10, 199 0 2 "SCRIP17ON DESCRIP17ON i 1 r r i r i I � I SOILS DATA r ENGINEER CHRISTIANSEN & SERGI INC. INSPECTOR SANDY STARR, BOB LEYLAND .TEST PIT N0. 94-12 DATE MAY 10, 1994 TEST PIT NO. 94-13 DATE MAY 10, 199 0 2 "SCRIP17ON DESCRIP17ON WHITE BIRCH LANE � y r 100.0' 7 N I � oNo C cn I ti v 0 I� 154.1 ' I nT I A=45110 S.F. Ex�sj / /FND� 228.3' / P V FOUNDATION LOCATION PLAN CLIENT: IPSWICH SA VINGS BANK THIS CERTIFICATION IS MADE AND LIMITED TO THE ABOVE CLIENT. LOCATION: NORTH ANDOVER,MA. SCALE. 1"=60' DATE: MAY 10,1995 CHRISTIANSEN SERGI PROFESSIONAL UND SURVEYORS NGINEERS 160 SUMMER ST. HAVERHILL,MA. 01830 TEL 508-373-0310 © 1995 BY CHRISTIANSEN 8 SERGI INC. I CERTIFY THAT THE PRIMARY STRUCTURE SHOWN CONFORMS TO THE HORIZONTAL SETBACK REQUIREMEN73 OF THE LOCAL APPLICABLE ZONING BY-LAWS IN EFFECT WHEN CONSTRUCTED. (THIS CERTIFICATION DOES NOT CONSIDER ANY OTHER RESTRICTIONS SUCH AS COVENANTS, WETLANDS,EASEMENTS ORDERS OF CONDITIONS,ETC.) THIS DRAWING SHALL NOT BE USED BY THE CLIENT FOR ANY PURPOSE OTHER THAN THAT OUTLINED ABOVE,EXCEPT W17H THE WRITTEN PERMISSION OF CHRISTIANSEN & SERGI INC. FURTHERMORE THIS DRAWING IS THE COPYRIGHTED PROPERTY OF CHRISTIANSEN & SERGI INC. AND ANY UNAUTHORIZED USE IS PRONIBITED.CHRISTIANSEN & SERGI TAKES NO RESPONSIBILITY FOR THE UNAUTHORIZED USE OF THIS DRAWING OR ANY INFOR- MATION CONTAINED HEREON. BASED ON SCALED DATA ONLY THE PRIMARY STRUCTURE SHOWN IS NOT LOCATED IN A FLOOD HAZARD ZONE AS SHOWN ON FEMA FLOOD INSURANCE RATE MAP. COMMUNITY NO.: 250098 0D0SC_����11TE:6/2/93 - �. ADWG.NO.:930670016 10 Location .3i_. U3fkl _ No.0 Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fe 4 $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ I> . Building Inspector 06/19/95 14:53 39.00 PAID Div. Public Works KAREN H.P. NELSON Dimror BUILDING CONSERVATION HEALTH PLANNING p =Tow_ n of ' NORTH ANDOVER F'.. DMISION OF PLANNING & CoNi MUNITY DEVELOPMENT CHIMNEY APPLICATION AND PERMIT 120 Main Street. 01845 (508) 682-6483 PERMIT DATE_ LOCATION W tit l�i ► �-a.�. .l Q �`zQs� .�— - OWNER'S NAME BUILDER'S NAME MASON'S NAME MASON I S ADDR M.nSONIS TELEPHONE M.ATE:CIAL OF CHIMNEY �lp K �r I'/-- le Ci- EA, S � s INTERIOR C:-:I.4NEYE:YTERIOR C::i_'INEY S D� %I NU:�EER A_10 SIZE OF FLLTES ii iHICiCi�Ja OF HEARTH r - e -f t require^..eats of the code and Wi" _ a:^ney or fi_�gl�c con_.._... o - c have rules and reculatic:.s oeen received: G) S DATE 3 ..T r � CONTR. LIC.=C5•-0'/OV.? SIG:+nIUR.. OF ;2ASCP1 ip. %�7 EST.. CONSTRUCTION cos T ! Co.i : RAC 7 PERi4T_T GR; TED (Q—T�"-I----- /A RO SRT NETTA, BUILD=_:G =_;S: T,._OR INSPECTED REMARKS ' T'D= REOUIRED THIS PERMIT MUST BE DISPLAYED ON THE PREIMISES 06/13/1995 14:07 6037729300 RICHARD L HESS ' PAGE ',@11 J C01qA/V0A1' ro EMANUEL ENGINEERING COMPANY ENGINEERING CONSULTANTS 62 PORTSMOUTH AVENUE STRATHAM, NEW HAMPSHIRE 03885 (603) 772-4400 FAX (603) 772.4487 Mr, Keith Kilgore Home Ownership Group Parting Brooke Lane Newfields, NH 03856 RE: Chimne}r Support - 36 Hilton -Property Bennett Road, Boxford Dear Mr. Kilgore: July 26, 1994 BILL / ItCEY x 32 Colonial MA In regards to our site visit of June 24 and recent discussions, it is our opinion that the two 3 1/2 inch diameter concrete filled steel lally columns are adequate to support the dead weight portion of the chimney above the second floor ceiling joists as well as the forces resulting from wind pressure provided the following items be performed, 1. The top of the tally colamn shall be welded to the underside of the steel base frame supporting the 6 inch concrete slab. 2. The 6 inch thick concrete slab shall be reinforced with No. 5 bars at 12 inch spacing each way. 3. Three vertical No. 4 bars, each 20 inches long, be installed at each of the masonry corners just below the steel base frame. See attached Section C -C. 4. The baste frame shall be attached to the masonry using 10 J -bolts (1/2 inch diameter) for anchorage or No. 4 bent rebar welded to the underside of the base frame. 5. The lally column splice be welded all around its perimeter. 6. Nan -combustible lateral supports shall be provided at the first floor level in two directions. see attached Detail "A" and "B". For the second floor level, see attached Section 1-1 and Detail "C". CIVIL 0 STRUCTURAL • SITE AND LAND PLANNING 06/13/1995 14:07 6037729300 Mr. Keith Kilgore July 26, 1994 Page 2 of 2 RICHARD L HESS 7. Lateral supports and the lally columns shall be covered with gypsum or equal to provide a fire resistance rating as required per the Building Code. Our assumptions for determining the dead weight of the chimney are as follows: 1. Four and eight inch thick concrete block perimeter; brick fireplace, and hearth. 2. Two tile flues with a 4 inch thick partition flue. 3. Hollow core cavity between the perimeter and partition masonry, i.e. not filled with rubble. 4. Four inch thick chimney cap and 6" thick concrete slab at chimney offset. ,PAGE 02 y � i No seismic design has been taken into consideration nor is it required as per Section 1113.1.1 of the Massachusetts State Building Code, Fifth Edition. Should you have any questions or if we can provide you with further assistance, please give me a call. Very truly yours, ;:'j Fred S Emanuel, P.E. �: FFA & t"UEL CM Nas" File:003/HmOwnGrp.Doc 06/1J/11395 14:07 5037729300 //- ?ice' r- �pTECr ,kNC; �.E 5-E=> dr, #4 MPM � 12" otc. ON W Y 1.11 411 MN, � LOW�� C�lM1�Y �A5�N1�Nr FLOOD RICHARD L HESS PAGE 03 r r� i i 1 i t NaTGCT LNUt coL S UT moo i i _.�-T�(ptC Al. All. LEVt LS •� Cry?. 'Z FL -ACG -5) 41K.. - , .. 1, M%IVUr LM 06/13/1995 14;07 6037729300 RICHARD L HESS PAGE 04 Lie / 5�A� WAY J.:A / 211 wr, O fo WC,orWAR #4 om X 20." M MR Ir 11 GC S 0l 1/2 CHMY, G�DI�i' ���r ,. 11 jil �1j _: f Vi�V1.fi CM5 ►Yllfi )yiVM rm Gom Few m r ; At RWM WCA110NI JINC�. A5 MIR �Ul I-- C "ON C 06/13/1995 14:07 6037729300 r. EMANUEL ENGINEERING CO. Civil & Structural Consultants 62 Portsmouth Avenue STRATHAM, NH 03885 (603) 772.4400 RICHARD L HESS PAGE 05 ,we SHEET NO. ,M OF CALCULATED ar � - j t �i �v DATE CHECKED By DATE A. -At r U0/Iit1y75 14:eI bb3lI2'3300 RICHARD L HESS PAGE 06 EMANUEL ENGINEERING CO. Civil & Structural Consultants SHEET NO, 62 Portsmouth Avenue l °F STRATHAM, NH 03885 Z (603) 772-400 CHECKED SY DATE 06/13/1995 14:07 6037729300 RICHARD L HESS PAGE 07 l EMANUEL IENGI UXMG COMPANY 'ENGINEERING CONSULTANTS * * * INVOICE* * *62 PORTSMOUTH AVENUE STRATHAM, NEW HAMPSHIRE 03885 (603) 772.4400 FAX (603) 772.4487 To: Mr. Keith Kilgore Date: 07-20-94 Home Ownership aroup Project No. 94-52 Parting Brook Lane Invoice No. 1 Newfields, NH 03856 For Period 06-24-94 Thru: 07-25-94 For Professional Services Rendered: RE: Chimney Design - Site Visit to Boxford, MA and Newfields, NH - Prepare Letter and Sketches for Modifications - Prepare Two Engineering Drawings - Prepare calculations and check - Prepare specifications. Retainer Received: 07-1-94 .............$ ( 300.00 Engineering: Principal Engineer: 26.5 hrs 0 $48.00/hr......... $ 1272.00 Senior Engineer; 15.0 hrs a $45,00/hr............ 675.00 CADD Drafting: Word Processing: Expenses: 28.0 hrs 0 $ 35.00/hr...,.......... 1.00 hrs a $20.00/hr............ Sub Total Engineering: 980.00 20.00 $ 2947�.00 ......— Photographs; ..................: $ 12.00 ............. Drawing � : Co ies3 $ 4.50 P 1.50 ea .... ................. Sub Total Expenses: $ 16.50il " i (bIq� _6 (J t�NY– File:Invoice/94-52-1.Dpc cLk415 � Total This Invoice: $ 2963.50 Less Retainer Received: $ =300.00 TOTAL AMOUNT DUE: $ 2663.00 CIVIL * STRUCTURAL * SITE AND LAND PLANNING os- EMANUEL ENGINEERING COMPANY ENGINEERING CONSULTANTS 62 PORTSMOUTH AVENUE STRATHAM, NEW HAMPSHIRE 03885 (603) 772-4400 FAX (603) 772-4487 Mr. Bill Lacey September 1, 1995 15 Brandley Road Watertown MA 02172 RE: William and Mary Lacey Residence 38 White Birch Lane North Andover, MA Dear Mr Lacey: Based on the stamped Engineering sketches provided to you on August 22, 1995, we have reviewed the rafter to joist modifications at the Lacey residence on White Birch Lane in North Andover, MA. and found them to be acceptable. File: MS001/95-66.Doc Very truly yours, 1 Fred S. Emanuel, P.E. CIVIL • STRUCTURAL 9 SITE AND LAND PLANNING ,""EMANUEL ENGINEERING COMPANY ENGINEERING CONSULTANTS 62 PORTSMOUTH AVENUE STRATHAM, NEW HAMPSHIRE 03885 (603) 772.440Q FAX (603) 772.4487 August 22, 1995 Mr. Keith Kilgore Home Ownership Group Parting Brook Lane Newfields, NH 03856 RE: William and Mary Lacey Residence North Andover, MA Dear Mr. Kilgore: With regards to our office discussion of August 17, 1995, the following information was given to me so that I could determine the adequacy of the main house roof system. 1. The hip rafters are 2 x 12's. 2. The standard rafters are 2 x 10's at a ten on twelve slope. 3. Ceiling joists are 2 x 8's and they span as per the sketch provided to us. 4. Rim ceiling joists are present. 5. Rafters rest over the ceiling joists. 6. Three collar ties are present on each side of the chimney located approximately one third down from the ridge. 7. Rafters rest on a 2 x 6 nailer above the ceiling joist. 8. Rafters are nailed to the nailer using 5-6 sixteen penny nails. 9. Ridge boards parallel to the flat roof rafters have blocking matching and opposite the ends of the sloping roof, rafters. Using the Massachusetts Building Code Section 1111.0 as a basis of design, the following loads were used in this evaluation: 1. Snow Load - Flat 30 psf - Slope 23 psf 2. Dead Load 10 psf CIVIL • STRUCTURAL • SITE AND LAND PLANNING Mr. Keith Kilgore August 22, 1995 Page 2 of 2 A ' !. The review concludes the following: 1) The flat roof joists are adequate as constructed to support a snow load of 30 psf. 2) The double ridge board that forms the perimeter ofthe flat roof is adequate since it acts as a conventional ridge board of typical gable construction. 3) The single 2 x 12 hip rafters are adequate. 4) The 2 x 10 sloping standard roof rafters are adequate. 5) The bottom connection of the standard rafters and hip rafters require reinforcement due to the outward thrust produced by the dead and snow loads. Sketches have been provided showing the required modifications. Should you have any questions regarding the above items, please advise. I appreciate the opportunity in providing these services. Very truly yours, Fred S Emanuel, P.E. , . •s. *.,� t+r • Ci. � C.� ,t,,, a�a� � ri0.w:v� G7ersi File:MS001 /Kilgore 1.Doc .......I�' PROOUnT 204.1 (Single Sheets)_W1 f f,8dr.aInc.. Groton, Mass. 01471. To Order PHONE TOLL FREE 1-800.225-6380 V EMANUEL ENGINEERING CO. Civil & Structural Consultants 62 Portsmouth Avenue STRATHAM, NH 03885 (603) 772.4400 Fax (603) 772-4487 JOB V ✓ — �l SHEET NO. j% /�OF CALCULATED BY—J, A, I " 1 D L-17211 DATE CHECKED BYE ! DATE SCALE l....... g , . .... 1 h,y 0 Pic 3385 Y (V O S A �zs PPOOL'fT 7(Id I ISinale SAee1s1705 I IP4AAeA1 �H. Inr. f Mn M-01471 Tn ruAcr PHONF Tni1 FFFF 1.FIM.795.CW EMANUEL ENGINEERING CO. Civil & Structural Consultants • 62 Portsmouth Avenue STRATHAM, NH 03885 (603) 772-4400 JOB SHEET NO. OF jf CALCULATED BY I M Or -l- 0 V--� DATE CHECKED BY_._� DATE SCALE _... .... ..... .....:.. ... _ i C �1 0 ........ _ - 2x10,RK'TE - G (1- TL 0 LL ----.. r :- 0 m r1 -� n O m O, O Z � o c POO. �M 0 o 044 0 Z 0 61 W xr� c d � z zo d b x � x v� y y d � � �D d z � o c d � � y z � d � 0 m r1 -� n O m O, O Z � o c POO. �M 0 o 044 0 Z 0 61 cn D m z x z _v z CO) 03D � � O T'S� CO) C) 'v O D C07 Z y T r CCD O z �r n d O. �' y 70-T `-) 0 v CD CD O CL =:E 5 CD C"S CD O CD m z = CCD y Dm E v y m 0 ta. 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Sym •^ c2 o � O n o �_ S m H CD ^ O O csn n C r CMCDD N � a d y rL a _ c o cnx M < Tr mca N 42 : O m m O N =m: *. ^•n 0 0 S CD o H . r rn m m: m H m n c2 o � O n A 0 c C/) 0 Cm ^ O O csn n C r r a V ;o°� d � z o cnx M pz A 0 c No 2 L J 1 Date .....f� ... .. �l�. .. 3? 64' _. 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .......14.'. �......ii�.:.. C. rs?............................................... has permission to perform ...G .s?. ... 1,�..af. .r..` !. .1........... wiring in the building of ` 4... ....-!��1.:. � ......................... North Andover .-Mass. EJ CTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer THE Ct NRIOA E LTHOFIVL4SSACRU.SE17s DE PART1 YIE �W 0FP0BL IC&1 F= BOARDOFFIREPREVF.MOiVRE7GUL47YONS 27af?1 V Office. Use only PemifNo. ;,f v ✓ _ Occupancy & Fees Checkcd 1 `'j.L PL CA1' 1ONFOR PL:iVIff 1 O 1 FCS..('O J1L =(:z'1L WORK O ALL WORK TO BEPERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 �y (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date --Town..of.North Andover - .. To the Inspector of W ices: The undersigned applies for a permit to perform the electrical work described below. VAP PARCEL - .- __.Location.(Street.&Number)-- Owner or Tenant Pj �. Q Owner's Address SaM e— . __ Is this,permit in conjunction with a. building permit: Yes ® No (Check Appropriate Box) - Purpose of Building- - �j"2k&gN 0% Utility Authorization No. Existing Service Amps / Volts Overhead Underground No. of Meters New Service Amps / Volts Overhead Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work G 6– 'CSA -P No. of Lighting Outlets No: of Lighting Fixtures No. of l• -ceptacle Outlets No. of Switch Outlets No. of Ranges No. of Disposals No. of Dishwashers No. of Dryers No. of Water Heaters --'It No. Hydro Massage Tubs OTHER. 5 No. of Hot Tubs Swimming Pool Above. Qround No. of Oil Burners No. of Gas Burncrs No. of Air Cond. Total Tons No. of Heat Total , Pumps Tons Space Area Heating KW I No. of of Motors No. of Bailasis Total HP No. of Transformers Generators - --- _ Total -- KVA KVA ; No. of Emergency Lighting Battery Units I FTTA ' Total No. of Detection and KW Initiating Devices KW No. of Sounding Devices No. of Self Contained Detection/Sounding Devices KWLocal Municipal Connections No. of Zones )nst�noeCovaagz Plaam,rtr�thes�tstxna-dlLaws Ibmaanartlmity Pchym&xlu*C= Covaagzarilsaiski le4ivaiat YES F NO Iil�estvaiidpmcf�satvelotbe0�ce YFSNOIfyaulla�d>dYES,en�r�etbetype�ooc�agebYdtadm�gthe Ir1S[JRANCE BOND M -IR F'–j (HeaseSpa*) � \ Etmafe lVakrdE e bcalWotk $ WaktoSbrt I Ra# Final Smit mderTnP�mtieso[peg uy: Fff viNAN E Lit eNa �9 r Bumj e- o. ?'3i ' Af 3?nLj—R3 7S' AIL Te3.Na �g V L4U– Z(n l OWNER'S�CEWAIVIl2 IamawatethattheLicerneiioesmtha�etheinAuatxe aiisst>l antialec vakatasrec}medt� bssad� arq avvs andttratmy si�ahaemthis�nrta�;fi�mwaitess thisteq.titerr�>t (Please check one) Owner Agent Telephone No. PERMIT FEE S tsmature of Owner or Agent A► 3:3 Office Use Onl t 0%P Tommonwrato of Masgar4usrtto Permit No. of lRepartmient of public 3ttfEtg Occupancy ,& Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) i�k 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 — 6 20 City or Town of lvok-M &d)01/ef_ To the Inspecto of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 3? WHI * 1311204 L AIVC-- Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes ka No LJ (check Appropri e-t�icj Purpose of Building n W FLCI N& Utility Authorization No. Existing Service Amps -I Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps �, Z� Volts Overhead ❑ Undgrnd No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work &EI"i Holy L— No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above grnd. ❑ In- grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets S No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and No. of Ranges /. No. of Air Cond. Total tons Initiating Devices No. of Sounding Devices No. of Self Contained No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices Local Municipal Other ❑ Connection ❑ f/!' No. of Dryers / .. I Heating Devices KW No. of - No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: 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 ❑ I have submitted valid proof of same to the Office. YES ❑ NO If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify) (Expiration Date) Estimated Value of Electrical Work $ _ Work to Start _TV Alb % fiv Signed under the Penalties of perjury: FIRM NAME Licensee _ Inspection Date Requested: Rough W I << CAU_ 1U_ Final LIC. NO. LIC. NO. (34oy R .`,���� Bus. T N,Q, Address 179 QQI�til.' �� �� i9,af%(1 Alt. AW OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance cov a or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Own_Qr Agent (Please check one) YlQ3/ Telephone No. PERMIT FEE $ ign of Owner or nt) x-6565 c 2336 Date ..... r/ ............. .... NORT1{ °t<"� TOWN OF NORTH ANDOVER . PERMIT FOR WIRING ,S$AGMUSEt Q � d This certifies that ..... li.'j... (...I ............ .s -!..:...!.w .......................................... has permission to perform ......... �.r..4 x........1..1. �.�.:.....................................� wiring in the building of at.........:.......:.r..1.........1.......:,;%!q................. , North Andover, Mass. r Fee .". + O.... Lic. No. - ,� 7! '?/,!............................................................. ELECTRICAL INSPECTOR ^' • o4 WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File