HomeMy WebLinkAboutMiscellaneous - 440 MARBLERIDGE ROAD 4/30/2018 (2) 440 MARBLERIDGE ROAD
210/038.0-0094-0000.0
Date.y ... �Q........
pORTN
,N TOWN OF NORTH ANDOVER
.1T? ' O�
p PERMIT FOR WIRING
: � �
SSACNUS�
This certifies that .� '..........: ...'...... -�.. ice.............................
has permission to perform ..... -r
wiring in the building of........ �- ?;..::.." !- .................................................
at North Andover Mass.
t ` Fee i�P............ Lic.No. `�` f S 1 ...�--... l :.A.,.........................
ELECTRICAL INSPECTOR
Check #
4725
THE COIYMON{ EALTH OF AAS,SACHU,SETTS Office Use only
DEPARTAR 0FPUXJCSAFM -4
Permit No.
BOARDOFFNEPREVEMONRWUTA770NS527CW 12M t
Occupancy&Fees Checked
APPLICATTONFOR PERMIT TO PERFORMELECTRI®R12.:COL WO
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 C
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat_ ����
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location(Street&Number) L 2'
Owner or Tenant 2
Owner's Address
Is this permit in.conjunction with a building permit: Yes No (Check Appropriate Box)
Purpose of Building 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 Am acit
b p y
Location and Nature of Proposed Electrical Work �4 1 ire 1 .isv. ;! 9 t (,i 11�► r3ts�ihl e,C.x c�"� �uha...Ot z [ %
No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total
KVA
No.of Lighting Fixtures Swimming Pool Above Below Generators KVA
ound round
No.of Receptacle Outlets Ll
No.of Oil Burners No.of Emergency Lighting Battery Units
No.of Switch Outlets
No.of Gas Burners
.f No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones
Tons
No.of Disposals No.of Heat Total Total No.of Detection and
Pumps Tons KW Initiating Devices
No.of Dishwashers Space Area Heating KW No.of Sounding Devices
No.of Self Contained
Detection/Sounding Devices
No.of Dryers Heating Devices KW Local MunicipalOther-�
Connections
No.of Water Heaters KW No.of No.of
Signs Bailasis
No.Hydro Massage Tubs No.of Motors Total HP
OTHER- I r$ll,)1 ;LJ 60 (nl.i,1 ar lL 1/44 Y' /Sou—1 b/J
u � �
htstuar=Com age.Pui<a><vittothetegmmie NsofMa%adiwtsG=!dIaws
lbawaamatli"tyknwmwPbhcynrkxbrgCc)mpleD--OpaabonsCDmnWcritsabsMaleqLuvalert YES NO
IhavesubmittedvandptoofofmwtotheOfce.YES i 1 � If)ouhays;dl�dYES,pkaseir thetypeofoov�tagzby
checking the box ��11
INSURANCE BOND r GII-IER r7 (PlewSpe*) 3/0 t/
Expita>iot'Dal-,
EValueofTllectricalWodc$
WotictoStatt u It>SpearortDateRegttestea Rough Final
signed under iieFruitesofperjury.
FIRMNAME LicenseNo.
S
Iio� �U,✓1'1�?5 f c...lu( Sigl��hue - +�t/�� J LKffwNo 3-j6
1 v Busiim'fel.No. 6�fl M 3 ml
��' /' } ( AIt�T No. 4 y 7S –:
OWNER'S INSURANCE WAIVER;I am aware that thelicer re does not have the mirance coverage orits sttista iM equivalent as taquaed by Masswx�General Lam
and that my signature on this permit application waives this recMement
(Please check one) Owner ® Agent
Telephone No. PERMIT FEE$
tgna ure ot Uwner or Agent
z The Commonwealth of Massachusetts
Department of Industrial Accidents
of Investigations
Office
Boston, Mass. 02111
Workers'Compensation Insurance Affidavit
Name Please Print
Name:
Location:
City Phone #
I am a homeowner performing all work myself.
I 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 Phone#:
Insurance.Co. -_ Policy# -
Company name:
Address
City: Phone#:
Insurance Co. _-----Policy# ---
Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penatties of.a fine up to$1,500.00
and/or one years'imprisonment.as wA-as-civil.penaltiesinlhelnrm-ofa_STOP WORK_ORDFR a.fine-cf_($1DO-0A)-aAay.against-me. I
understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
i
do hereby certify under the pains and penalties of perjury that the information provided above is tare and correct.
Signature Date
Print name Pbone#
Official use only do not write in this area to be completed by city or town Wiiciar
City or Town Permit/Licensipg
D Building Dept
E]Check if immediate response is required 0 Llcensinq Board
p Selectman's Office
Contact person: Phone#. E] Health Department
Other
Location
No. �-�` S Date
NORTIy TOWN OF NORTH ANDOVER
i Oft . o '•1.{.O
` Certificate of Occupancy $
�SSACHU Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
16874
Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAI RENOVAT5 OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PERMIT NUMBER: DATE ISSUED:
s- 1/_7�
ic
SIGNATURE: l---
Buildin Commissioner/ft-dor of Buildings Date z
SECTION 1-SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map and Parcel Number:
g iq (AJ
Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
i
Zoning District Proposed Use Lot Areas Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard
Required Provide ReqWred Provided Required Provided
1.7 Water Supply M.G L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System:
Public 0 Private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0
SECTION 2-PROPERTY OWNERSILIP/AUTHORIZED AGENT Historic District: Yes No m
2.1 Owner of Record ` (� ' t
UlD Y-77-1 `i'4C) 1 t I.a 6'a 1(i '
Name(Print) Address for Service: V
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Z
M
Si afore Telephone
SEC ON 3-CONSTRUCTION SERVICES 90
3.1 Licensed Construction Supervisor: Not Applicable ❑
Licensed Construction Supervisor: O
License Number
Address
Expiration Date ic
Signature Telephone r
3.2 Registered Home Improvement Contractor Not Applicable ❑
Company Name
Registration Number r
r
Address r
Expiration Date �1
Signature Telephone Y,
SECTION 4-WORKERS COMPENSATION(KG.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 the building permit.
Signed affidavit Attached Yes.......❑ No.......❑
SECTION 5 Description of Proposed Work check au a livable
New Construction ❑ Existing Building 0 Repair(s) 0 Alterations(s) 0 Addition 0
Accessory Bldg. ❑ Demolition ❑ Other 0 Specify
Brief Description of Proposed Work:
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be Dollar x
( � �� �FFICIA��tTSE�NLY ��
Completed by permit a licant � w >
1. Building 4 O 'OC) (a) Building Permit Fee
Multiplier
2 Electrical (b) Estimated Total Cost of
Construction
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
r
as Owner/Authorized Agent of subject property
Hereby authorize to act on
My behalf,in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
I, ,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 k
and belief
t
Print Name
Signature of Owner/Agent Date
NO.OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR THVIBERS iST2ND 3
SPAN
DIMENSIONS OF SILLS
DUv ENSIONS OF POSTS
DIIv1ENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHIIVINEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
1� 12c�
1
tic-
North Andover Building Department
Tel: 978-688-9545
a1
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54, a condition of Building Permit
Number is that the debris resulting from this work shall be
P
dis osed of in a properly licensed solid waste disposal facility as defined by MGL
c 11, S 150 A.
The debris will be disposed of in:
(Location of Facility)
Signature of Permit Applicant
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector
JL V rr ii Vi 'Vif� J.Tionr
�ss�.av Y www AL
No.
yy
O -- LA o doverMass. _
T
COCMICM WICK >
ADRATED PP9. C�
S H �
BOARD OF HEALTH
PERMIT T Food/Kitchen
D . Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT....MAIN............$:dR.21 . . .
........ .... .... ... Foundation
.. . . . ....
AJhas permission to erect.....%S a �...�....... buildin s on 4 t......... Rough
r�0 �`S� Chimney
to be occupied as............... ...................................................................................................................................
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 nspection, Alteration and Construction of
Buildings in the Town of North Andover. 3's ION _ PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
PERMEXPIRES IN 6 MONTHS Final
IT
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.
SEE REVERSE SIDE smoke Det.
t
Location,
No. 40 Date
°"TN, TOWN OF NORTH ANDOVEF 4
A .
Certificate of Occupancy $
Building/Frame Permit Fee $ 3
,ssACMUSEt� Foundation Permit Fee
i
Other Permit Fee $
Sewer Connection Fee $ Ln
Water Connection Fee $
TOTAL
Building Inspector
i.j /�
k. ' ' 9 5#0 Div. Public Works
PERMIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. i/ PAGE 1
MAP 4-40. I LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK PAGE -
ZONE SUB DIV. LOT NO. �—
LOCATION �Q[6(�1 PURPOSE OF BUILDING e,U
�i FRI D
OWNER'S NAME ,e Oen NO. OF STORIES SIZE
OWNER'S ADDRESS Vt BASEMENT OR SLAB
ARCHITECT'S NAME T 7 V /ii/7 �J cuf SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME , tl dN� ���I I Yti�AI SPAN ---
DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS
DISTANCE FROM STREET POSTS
DISTANCE FROM LOT LINES-SIDES REAR " " GIRDERS '
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW SIZE OF FOOTING X
IS BUILDING ADDITION MATERIAL OF CHIMNEY
IS BUILDING ALTERATION ✓fe� < IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS �! n,q 2 3 PROPERTY INFORMATION
LAND COST
SEE BOTH SIDES f �/�
2a ��/� „19G� it. (o f'1! C�•v (N r wEST. BLDG. COST
PAGE 1 FILL OUT SECTIONS 1 - 3Re- o�� �Q�r'�` EBT. BLDG. COST PER 8Q. FT.
rx .v 6 C S,
PAGE 2 FILL OUT SECTIONS 1 - 12 /�C! ` / d�'� EBT. BLDG. COST PER ROOM
1 G+ /T SEPTIC PERMIT NO.
ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING 41, A' If k/
-,0-
� 4 APPROVED BY
�ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATION
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR �1
DATE FILED
WILDING INBPZCTOR
SIGNATURE OF OWNER OR AUTHORIZED AGENT
FEE OWNERTEL.#
PERMIT GRANTED CONTR.TEL.# �03 $Vg
CONTR.LIC.# ir'V-f!596
• H.I.C.# Ac 7-Y612-
I z
I
e
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY _ STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
MULTI, FAMILY OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA-
APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION \
2 FOUNDATION 8 INTERIOR FINISH
CONCRETE a 1 2 13
CONCRETE BL'K. PINE
DRY WALL
BRICK OR STONE HARDW D
PIERS PLASTER
_
UNFIN.
3 BASEMENT
AREA FULL FIN. B'M'TAREA _
1/1 1/1 FIN. ATTIC AREA _
NO B M'T FIRE PLACES _
HEAD ROOM MODERN KITCHEN
4 WALLS I 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH _
ASPHALT SIDING HARDW D _
ASBESTOS SIDING _ COMMCN
VERT. SIDING ASP-H.TILE
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STRS. & FLOOR _
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME
SUPERIOR I-� POOR _
ADEQUATE NONE
5 ROOF 10 PLUMBING
GABLE HIP BATH (3 FIX.) _ {
GAMBRELMANSARD TOILET RM. (2 FIX.)
FLATI I SHED WATER CLOSET _
ASPHALT SHINGLES LAVATORY
WOOD SHINGES KITCHEN SINK
SLATE NO PLUMBING _
TAR & GRAVEL STALL SHOWER _
ROIL ROOFING MODERN FIXTURES _
TILE FLOOR
TILE DADO
6 FRAMING I 11 HEATING
WOOD JOIST PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. &COLS. STEAM
STEEL BMS. 6 COLS. _ HOT W'T'R OR VAPOR
WOOD RAFTERS _ AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
GAS
7 NO. OF ROOMS OIL
B'M'T 2nd I_ ELECTRIC
1st 13rd NO HEATING
i
j NORTH
' F
Town of 0 over f
No. 0
. y T
1 "
rt ." dower Mass., �i4t� 3 19
COCniCr�tw�Cn �
7� ADRATED Pl?�' C
5 BOARD OF HEALTH
Food/Kitchen
Septic SystemPERMIT T
R
t
BUILDING INSPECTOR ,
THIS CERTIFIES THAT.. l Kr,,.......1,TA� .... ...................................................................................� Foundation
has permission to erect./�q- .,..................... buildings on ..' 0..�.+ COUP6.*.........Q'D...................... Rough
to be*occupied as�I A�....Ck .Q!!!+�.... F.....�rr...��.sv" .. �...... .......... ... .. . Chimney
provided that the person accepting this permit shall In eve respect conform to the terms of the application on file in
p P P g P �Y P PP Finalt : t }
this'offlce; and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of }a; ia.
Buildings In the Town of North Andover. PLUMBING INSPECTOR j�'
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit.
PERMIT EXP 6 MONTHS Final
UNLESS CO STR C ST S ELECTRICAL INSPECTOR
Rough s
Service
BUILDI SPECTOR s
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
'n Conspicuous Place on the Premises — Do Not Remove Rough
Display' in a C pFinal , � 5
No Lathing or Dry Wall. To Be
Done
FIRE DEPARTMENT {
J.
;n ¢ Until: Inspected and Approved by the Building Inspector.
Burner
Street No.
Smoke Det. i ;•
E
0G..)
�„kx.....-,. .,.... _ '` �.. .,may...v.....G�,'w ., _. w�„-��««w-•.,'taw wsa«.w.a'�ur�R �:+tikJ�te. .�a..a+�s•a�ea.�e>ki�.. .c�.�zrP-*5t�r��.r�•k._:t&x .,
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�, �•�. _��_��.-tet- -� y�ep JI�ME$
'
NO BOX 14
NH 03073 `
oos12-05.39,im 12FMJ3
�t 1�$. c i VY51
UP.�� S99i -01
12 1s9 � .CLASS OPERATW<
SEX M WT
,rwl.-'..`o"' { '4.a.*'^f^+"`uXu^ . ''.^�'"p ° re^( "uti °++" iw*h'3 ✓ 'v..��� j ' �f j",,
" .,TVyy ".r .�y7r�F
.. ..�n .. /f 389-38-11
a
RGIfdIA C.BEE
.OR OF TOR
. ,� '✓ire Lc�romarouxal�r a�.ilfaua�uve!!.i
HOME IMPROVEMENT CONTRACTOR
Registration 109462
E Type - PRIVATE CORPORATION j
. ! Expiration 09/16/94
i
J F CONSTRUCTION INC
JAMES R. FRAHM
f 28 CORINTHIAN DR P 0 BOX 14 ( Z ?
ADMINIS—IRATCR N SALEM NH 03013 �0
41
-._ COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY _ `—` Falleretopossessacurrent
OF ONE ASHBORTON PLACE Massachusetts State Balld/n
I V MrASSACHUSE T TS ^� BOSTON,MA 02108 '�� o�,lecaarsior r�aartc l .
JLC.av LICENSE 211cense.
EXPIRATION DATE CONSTR. SUPERVISOR CAUTION
12/05/1995FOR PROTECTION AGAINST
RESTRICTIONS EFFECTIVE DATE LIC-NO, THEFT, PUT RIGHT THUMB
NONE 06/3011993 005156 PRINT IN APPROPRIATE
° ° 1 BOX ON LICENSE.
JAMES R 'FRAHM E
g25 CORINTHIAN DR PO BOXzi* E
0 0{, ____ BLASTING ERIMS.
SS Al 389-38-1153 m NO SAtE�1 NH 03073 m MUNCUI�E
PHOTO NG OPR ONLY) F
V O.00 NOT VALID UMI.SIGNED BY LICENSEE AND OFFICIALLY JUL t t
HEIGHT: tl STAMPED-OR-SN3a'MTURE OF THE CO�IONER t �JUL. 2 6 1793
f DOB: {j}
12/05/1939-' /L.
THIS DOCUMENT MUST BE _ TURE OF LICENSEE NMiE N FULL ABOVE SIGNATURE LINE 4
CARRIEDONTHEPERSONOF�,
7I
. GAGAGEDINTUSOCCUPATIOK .> R
GNA
THE HOLDER WHEN EN-
IONE
i
b.- 17..
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