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Home My WebLink AboutMiscellaneous - 418 MASSACHUSETTS AVENUE 4/30/2018 418 MASSACHUSETTS AVENUE __ 210/033.0-0043-0000.0 Date.. .- `O �a°RTH TOWN OF NORTH ANDOVER Po p PERMIT FOR WIRING ,SSACMUSEt ' This certifies that ............................... 1 has permission to perform .... _� ., ......... ` o y wiring in the building of......... . ................................................ Y �Q .,-��-C ........ ,North Andover,Mass. ;y � .�_ Fee..... .........:.... Lic.No4:�-Y.r�.......... .�.G�,G.��....... ELECTRICAL INS E Check # k 7993 �-. Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No.O «► BOARD OF FIRE PREVENTION REGULATIONS [Rev1 07]upancy and Fee Checked .2(leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 PLEASE PRINT W INK OR TYPE ALL INFORMATION) City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Owner or Tenant S Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes IT No ❑ (Check Appropriate Box) Purpose of Building 111 pb, Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Loc�a�t/ip°n and Nature of Proposed Electrical Work: Com letion�rtheollowin table may be waived b the Ins ector of WiresNo.of Recessed Luminaires No.of Ceil:Susp.(Paddle) No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ o.o cy ig g rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones No.of Switches No.of Gas Burners No.of Detection and InitiatingToFDevices No.of Ranges No.of Air Cond. Tons. No.of Alerting Devices No.of Waste Disposers Heat Pum Number .Tons KW.. No.of Self-Contained Totals _.. . ""' ' ' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local umcipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* p No.of Devices or E uivalent No.of Water No.of No.of Heaters KW Signs Ballasts . DatN of DWirinevices or E uivalent + No.Hydromassage Bathtubs No.of Motors Total HP elecommunications firing: No.of Devices or E uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify,under the Ains and aIfty of perju that the information on this application is true and complete _ FIRM NAME• L C �/_44C' LLCc LIC.NO.: A/3,l Licensee: 614 Signature — LIC.NO.: (If applicable, ler"ex t' the license number line.) Bus.Tel.No.: �5�7' f'o 9 Address: �t9 r COJZD �7% ,�,y-,—40 ;es Alt.Tel.No.:,�)r- ?7 (, *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑owner ❑owner's agent. Owner/Agent SignaturTelephone No. PERMIT FEE: � \ ..+ �, c I 1 The Commonwealth of Massachusetts k� ! Department of Industrial Accidents .. Office of Investigations 600 Washington Street Boston, MA 02111 www.naass.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A licant Information Please Print Leaibl Name(Businesss/Organiza6onlindividual); C/w I'�� ✓ L�/'''ff C' LGe/ Address:/(o City/.State/Zip: ' % ! Phone#: . �J��y�`r�—F� Are you employer?Check the appropriate box: Type of project(requires: 1.0211-am a employer with, 4. ❑ 1 am a general contractor and 1 6. Q N=emodeling struction employees(full and/or part-time).* have hired the sub-contractors 2.Q I am a.sole proprietor or partner- listed on the attached sheet.t 1 ship and have no employees These sub-contractors have 8. Q Demolition working for mein any capacity. workers' comp.insurance. 9. Q Building addition [No workers' comp,insurance 5. ❑ We are a corporation and its IO.Q Electrical required.] officers have exercised their repatrsbradditions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.Q Plumbing repairs or additions myself.[Nonworkers'comp. c. 152, §1(4),and we have no 12.Q Roof repairs insurance required.]t .employees. [No workers' comp. insurance required.] 13 Q Other *Any applicant that checks bomt#I 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 ant an employer that is.providing workers'compensation insurancefor ray employees. Below is the policy and job site information. Insurance Company Policy#or Self-ins.Lic.#:. CM se Expiration Date: �� — !)� Job Site Address: � � i'�7 City/State/Zip- 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 Iead to the imposition of criminal penalties of a fine up to$4504.00 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, der ins d penalties- perjury that the information provided above is true and correct Si ature. Date: C:r v1 Phone#. — [[6.Off cial use only. Do not write in this area,to be completed by city or town official th6r or Town: Permit/License# ng Authority(circle one): ard of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector act Person: Phone#: 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 ownerof 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 numbers)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cavy 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 numberlisted 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 permittlicense 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 office 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 bum 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 Investibations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-8.77-MASSAFE Revised 5-26-05 Fax#617-727-7744 www.mass.gov/dia i Date. •HORT: do TOWN OF NORTH ANDOVE a PERMIT FOR PLUMBG �' , SSACMUSE� This certifies that . . . . . . . . . . . . . . . . . has permission to perform .. . .V,4C. --. S's . . . . . . . . . . . . . . . . . . . . k" plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . at . . . . North 'Andover, Mass. CI Fee Lic. No.. . . . . . . . . . . . _ PLUMBING INSPE60R Check # t� 7646 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS / Date / . ' R O O$ Building Location 1r M f S S' A u�- Owners Name 'Permit# 0'� 1� Amount ? 7 Type of Occupancy Vice S New rl Renovation Replacement ® Plans Submitted Yes No rl FIXTURES a w � 0 o w x cc cc U rn O a w E � � � Q O �' ,•� O � W .01W rx oa J 7 SMME BASEVESIr ZD FLOM M FLO R 4IHFLOCR M FIACR 6IH HJDC]<t - 7IH HjOO t SIH FIj0Qt (Print or type) Check one: Certificate Installing Company Name bou vS c"JS A"C/ Aj SHG ® Corp. Address b �o � ��Ho(9�! �� Partner. 'r-/-' SS b'c a 1�) Q / 7 f Business 711'e—phone 2j, _ $ - 7 Firm/Co. Name of Licensed Plumber: 9 kfu '-se.!1 Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy R Other type of indemnity ❑ Bond ❑ Insurance Waiver. I, the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature 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 Mass chusetts tate Plumbing Code and Chapter 142 of the General Laws. By: igna ure 51 OcEnse- Fuer Type of Plumbing License Title City/Town APPROVED(OFFICE USE ONLY ice se um er Master Journeyman ❑ PPR Date. : . 7. 2 4, TOWN OF NORTH ANDOVER 3r '� •� OCL PERMIT FOR PLUMBING At , ,SSACMusE� This certifies that . . . . . . . . . . . ` . . . . . . . . . . . . . . . . . . . has permission to perform . . . .11 c k .q . .`r ` ' plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . at . . . .V.1. /v. . . . . .. North Andover, Mass. Fee. yU. Lic. No. . . . . . . . . : 1•_.,., - -1:. . . . . . (� 3 <{�j PLUMBING INSPECTOR Check # 5259 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Building Location MA Z�7y t`�. --.—,P' e mit# Amount Owner ��1��` New �/ Renovation Replacement Plans Submitted Yes No FIXTURES Fcf 0-0 Pq a P�1 A H A IASvr ]S>C)uLOCIt '� 21\Ll)HIOOR 9 ��IOCR 41H E OCR 5M HOCK 6MIUXR 7II3)HIOOR gm HJOCR (Print or type) � /{{ Check one: Certificate Installing Company Name [/ /�� %�llCl� vt t`C ) ❑ Corp. Address )VI /9 l A6�� >� Partner. ^l Business Te ep one 11 r EK-Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature 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 Massachu et Esta Plu in- Code an h er 142 of he eneral Laws. BY igna e of Licenseumer Title MyePf umbing License City/Town .License INUTWDer f Master ❑ Journeyman APPROVED(OFMCE USE ONLY f Location 411e No. \s Date Z, 1401tTM TOWN OF NORTH ANDOVER F R t s s ; b Certificate of Occupancy $ Building/Frame Permit Fee $ s�CHU Foundation Permit Fee $ Other Permit Fee $ } TOTAL $ � Check #Y 15512 ` -Building Inspecto/rr ` TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: b -- O � ic SIGNATURE: Building Commissioner/1for of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: (-9, 0 Li 17G Map Number Parcel Number Q� 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District li osed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R 'red Pr4- qovided 20 AT FR 1.5. FI Zone Information: 1.8 S e sal S tem: 1.7Water S IyM.G.L.C.40. 54) �8 ��o Public Private ❑ Zone Outside Flood Zone Municipal On Site Disposal System ❑ J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Nam Address for Service: 1 gnature Telephone QO' 2.2 Owner of Record: , s A 11 ame Pn Address for Service: r - -3 191 Si na re Tele ho 90 SECTION 3-CONSTRUCTION SWAVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor. 1 053 --1 O /1 / License Number rens , J s��e/V� � . .ol ic Expiration Date lSigna'fllre Telephone r 3.2 Registered Home IIm-provement Contractor 1 ( Not Applicable ❑ Company Name i p Registrationshon Number r r � d Z Expiration Date ^ Si nature Telephone i�I j tier SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 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 th u'din rmit. Signed affidavit Attached Yes...... No.......❑ SECTION 5 Description of Proposed Work check au applicable) New Construction ❑^ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be t`1FFICiE4L USE ONLY Completed by permit applicant �. 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X (b) _ 4 Mechanical HVAC !� l� 5 Fire Protection �J 6 Total 1+2+3+4+5) 7 Check Number „r SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT t " I, �(�.�, /�,,�,y� C 1 z�.�..,,� �-�:.... .X as Owner/Authorized Agent of subject property Ldl r' He eby authorize ,�,. � ,��'�i to act on behalf,i 41atters relative to work au o d by this building permit application. nature of wirer Date SECTION 7b O NER/AUTHORIZED AGENT DECLARATION I, 5L 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 C J I P e Si ature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB MD SIZE OF FLOOR TIlVIBERS 1 2 4U - SPAN 1 DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION — THICKNESS "2,5 SIZE OF FOOTING ( xzf MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND lel✓r IS BUILDING CONNECTED TO NATURAL GAS LINE The Commonwealth of Massachusetts • Department of Industrial Accidents Office of Investigations ' Boston, Mass. 02111 Workers'Compensation Insurance Affidavit OWN Please Print Name: Location: CjjY, y Phone - 3 3 Am a homeowner performing all wo&myself. DI am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. company name: Address City: M-pm Phone Insurance Co. 6 oli # L., Company name: Address City: Phone# Insurance Co. Policy owl Failure to secure cave as required under Lection 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'impnis t as well as civil penalties in the form of a STOP WORK ORDER and a fine of $100:00 understand that a cop his statement may be forwarded to the Office of Investigations 1 1 a day against me. t gations of the DLA for coverage verification. I do herby miry d the pains pen aif" ury that the infort►ration provided above is true anis correct ff Signature Date Vel ` Print name I"� Phone# k �6 S-3 7 5 Official use only do not write in this area to be completed by city or town official' I] Building Dept QCheck if immediate response is required Building Dept p Licensing Board Selectman`s rice Contact person: Phone#. Health Department p p t C7 Other YORKMAM'S COMPENSATION 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. *****************************APPLICANT FILLS OUT THIS SECTION*********************;*—] APPLICANT HONE a LOCATION: Assessor's Map Number_- (� PARCEL-0-- ,PJ/y3' SUBDIVISION LOT(S) STREETT� ST. NUMBER_�'� *****************************************OFFICIAL USE ONLY*********************************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS 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 DRIVE Y P RMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPEC40R DATE___ Revised 9197 jm MORTGAGE INSPECg'ION PLAN B o s,r o N 99-08797 SURVEY, INC. P.O. Box 220 Charlestown, MA 02129 (617)242-1313 MAIN (617)242-1616,FAX APPLICANT HARDY LOCATION: 498 MASSACHUSETTS AVENUE DEED/CERT. 5547-44 CITY, STATE: NORTH ANDOVER, MA PLAN REF: 00 `Z o 2 l Oi 5' R i C 4- 100.00 LOTS 37 & 38 PORCH !r7f m 1.5 STORY m D m 100.00 - MASSACHUSETTS AVE I 1994(c)Bosion Survey Software PREPARED: 09-29-1999 CERTIFIED TO: BARON MORTGAGE CORPORATION SCALE: 1 inch = 201 feet OFM11q �. The permanent structures are approximately located on the According to Federal Emergency Management Agency o ground as shown. They either conformed to the setback JOWNGN^ rn:aps, the major improvements on this property fall in an requirements of the local zoning ordinances in effect at o EUSSELL area designated as Zone f(—iU0 FLtD the time of construction, or are exempt from violation en- .o Q��3r�' forcement action under M.G.L. Title V11, Chapter 40 A, #3971 Cgnmuncy Panel No: ,1 rQO%� Section 7, and that there are no encroachments of major Ef ca ve '!Date: 6- 0—j3 improvements either way across property lines except as - ' Np SUR NOTE:Zone C is areas of minimal flooding(no shading). This i shown and noted hereon. designation�;not,based on an elevation eertifical:e. NOTE:This is not a boundary or title insurance survey.This plan was prepared in accordance to proce_.dural.arid fechnical.standards for Mortgage Loan.lnspections as adopted by the Massachusetts Board of Registration of professional engineers and land surveyors,250 CMR 15:05,a.ndluse for any other purpose is prohibited.This plan is not to be used for recording,preparing deed descriptions,or construction. I I 1 I ,IRT, Town of ED over 0 No. 0 C 0 r "T;"Q dover, Mass.,— 340 ORATED C H BOARD OF HEALTH Food/Kitchen PERMIT T D . Septic System BUILDING INSPECTOR .......... THIS CERTIFIES THAT .........................I...............V ................................................................................. Foundation has permission to erect....a!4.0 ... buildings on ........411.9......./n,466.....A0.4......................... Rough Y Ro'o At3,4 Y-4 A�y le-../ A. * f.�� LAS tt Chimney to be occupied as.A. .......&........................................................................................... ....... ...... AV ........... provided that the person accepting this permit shall in every respect-conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 331-'e13 � ,5WO, — PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises '— Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. 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III 11 11 1111111111111111111111 � � , 111�f1111111111111111111111111111111111111111111 ': ' � 111 f1111111111111111111111111111111111111111111 111•f1111111111111111111111111111111111111111111 ' : � 11111111111111111111)11111lIIIt1111111t1111111t111t11 � � � i1i111i1i1i1i1i1i1i1i1i1i1HiSHUMISHIi1i111i1I IIIIIi1111111111111111111�■■ ■■ ilililil ■■ ■■ 1i1i1i1i1i111i1i1i1i1IIINONE I NONE H! No■■ ■■ NONE 11111111111111111111i1lllt 111illlilllliillltlltill)llllltitltitilllillti111t111 1111111)IIIlIl1l11Ii1111111Illlilililllilllllilililll r .�� 121t�G� VENT • I I • I I 12 ►0 I I __ --------------- I r�1"TIC ASPNA_T 5HINGL�S v I I I CI X PLYWOOD SNrATHING 7 I I I I POUr3LF� TOP PI-ATr X I I I I �} AVCS P;TAIL: i MATCH EXISTING FASCIA & 50FFI1- L;lrTAII % CONTINUOUS SOFFIT VENT TYPICAL- WA.-L-: 1 / /I_ /.` �� META_ P121P F-PGF: HO121ZONTAL WOO1� SIDING / �� 1/2"60ONIX5 ICE/ WATF-12 M�Mf3P�AN� AT EAVES —i r3UILPING WPAP FIRMING AT 16"O.C. GUTTER AS NOTE1� 1/ 2'' CPY, PLYWOOD SNEATING �N 2 X 4 STUDS AT 16'' O.C. 12-I� I'113F=F2GLA5 INSULATION / / 11\�� POLY VAPO12 13Al2F'_IE12 / / I I - 2 -2 ?6�O�I�EAt�E12 TYPICAL 1/ 2'' GYPSUM WALLf3OAPI� UNLESS T�1�TL12 OTNEI2WISE FIN15H 2NU FLOOP r� ! AT, ' 1" s G-a I�I_`MJt:'�C?C% C,%F=C-K I r 1Ca / ` ------------------------- — ------------- J �-F: X1"��Nt% �-.Xi��rIP\I<.""� L''�'I<_�K �✓�Nk ��', MINI, 2 - 2 x 63 HEAr:;'-F; � LJSC F?!CKS Sf�l_\/f�!i�-CJ �'��?1\/1 C V,I,r ,) `' CSN 51-1 C: � `�T-F'UCTIJK'F TC:;� F' MAI N FIN15H 15TFI.00r ------y ---------------- fl MAI r,J I 51-OK I5H an nI {� I I EXISTING POUP-r1P IN PLACE TWIC& CI?O55 5rC11ON CONCRETE POUNI�ATION & wl� L PM5 FOP JFANNINF NAPPY 418 MA55ACHU5FfT5 AVF NOPTN ANPOVFP, MA, f7A1�. �/ I/02 P-C?OI' TfT�I Lot n wi'J.�L- �I'�'C=!'v10VtJ C.=xl S1"I NC�s II II :. FINISH �L ----------- - - ------ ----- I I I�.IF-,w f=� CE=ILING VI✓I�JC= -F� `�> �'r 1V1,�.IN -rL% kl_ MAI:N F IN15H 15t FLOOD l� 1 �.�` N !` \ 1 6 AV N1�,1 N I ti 'e 4� I i 1 .` + 1 1 ^' � .. l� __ i i 1 f � � r I i � ` __ -. ___ _ _. _ _.. 3844 4 Date... NOR7M TOWN OF NORTH ANDOVER PERMIT FOR WIRING s i �a� • �,SSAC11u5� This certifies that ��e K ' � C D r l ........... ............... ................................................ CD has permission to perform ....fl*--id .... .N............................................ wiring in the building of........ . .. ........................................................ ....... No h Andover,Mass. at............ .�.5..... ...................................... Fee.... .QS...... Lic.No. :/e10. .- . 1..".'.:`�C .. ELECTRICA�.INSPECTOR Check # Official Use Only Permit No. amort Occupancy&Fee Checked BOARD OF FIRE PREVENTION REGULATIONS.527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 1271,9 �k 00. (Please Print in ink or type all information) Date O To the Inspector 6f Wir Town of North And The undersigned applies for a permit to perform the electrical work described below. G h� Location(Street&Number Owner or Tenant Owner's Address Is this permit in conjunction with a building permit Yes No ❑ (Check Appropriate Box) Purpose of Building t ^S`le C cl- Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgmd ❑ No.of Meters New Service 0-bo Amps XA6voits Overhead ❑ Undgmd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ No.of Lighting Fixtures Swimming Pool grnd ❑ grnd d Generators KVA No.of Emergency Lighting No.of Receptacles Outlets No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Di sal No. Pumps Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers Space/Area Heating KW Detection/Sounding Devices ❑ Municipal ❑ Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts 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 = If you have checked YES please indicate the type of coverage by checking the appropriate box. INSURAICE = BOND = OTHER =.(Please Specify) (Expiration Date) Estimated Value of Electrical Work$ Work to Start Inspection Date Resquested Rough Final Signed tVider the Penalties of perjury: FIRM NAME`` t LIC.NO. Lkensee I ( /�-� 1 Signature �� ✓� LIC.NO.c3�vq��F 1 cBus. za- Tel No. 1715 S— Address`-A vC l( e V� (d Aft Tet.No. r iY L�(– 7 / OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have:the insurance coverage or its substantial equivalent as required by Massachusetts General Laws.And that my=signature on this permit application waives this,requirement. Owner Agent (Please Check one) Telephone No. PERMITTEE $ (Signature of Owner or Agent)