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HomeMy WebLinkAboutMiscellaneous - 453 FOREST STREET 4/30/2018 (2) I �� �` � (}J i I i I I ' ' i i i f r I i i i 1 r � c 9649 Date........�_��. pORTM TOWN OF NORTH ANDOVER .indoft PERMIT FOR WIRING CHU This certifies that ..................(-;,moo,-,e7i ........6.z ..................... has permission to perform ........... ...... .............. wiring in the building of..................R6�.Iuz.e)...................................... at.............. 7- S.. .......... . dover,Mass. ....................................................... No en .... Fee Li .c.No..5.0 72.4........ ELE*C*'T*R*I-/-z�PECTOR ci Check # 4 %.d U111t"Uff1VVWQto6AA Uff A'A�A.9�S88�AA6d�CS166� _— --� _, Permit No. � Department of Fire Service Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leaveblank) 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 IN INK OR TYPE ALL INFORMATION) Date: 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) o lr-eS l Owner or Tenant 12,4 Telephone No. ni �— Owner's Address -s'-7- ST Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service, ( Amps /&4,4�14Volts Overhead❑ Undgrd No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑� '7r-C of Meters Number of Feeders and Ampacity /�e5,CC r-r 52r1J/G¢J f� % -C 1���/�CKM c/I Location and Nature of Proposed Electrical Work: Completion of the following table may be waived by the Inspector of Wires. No.of Total No. of Recessed Luminaires No'.of Ceil:Susp.(Paddle)Fans . Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above El In- o.o raergency ig mg ' No.of Luminaires Swimming Pool rnd. rnd. Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of hones No.of Detection and No. of Switches No.of Gas Burners Initiating Devices Total No.of Alerting Devices No.of Ranges No.of Air Cond. Tons g No.of Waste Disposers HeaTot Is Number Tons KW No.ofSelf-Contained Detection/Alerting Devices Municipal No. of Dishwashers Space/Area Heating KW Local❑ Connection El Other Heating Appliances KW Security Systems:* No. of Dryers No.of Devices or Equivalent No.of Water .KW No.of •No.of Data Wiring: Heaters Si ns Ballasts No.of Devices or Equivalent Telecommunications Wiring: I No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent 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/ o BOND ❑ OTHER ❑ (Specify:) I certify,under the aims and enalties fperjury,that the information on this application is true and complete. FIRM NAME: eo t- e c /C IN LIC.NO.: Q Licensee: o Signature —''" LIC.NO.: c j (If applicable,-enter "xempt"in the license number line.) Bus.Tel.No.:41 7 92 YO Address: r<- 4Ct. D 60 Alt.Tel.No.: *Per M.G.L c. 147,s.57-6T,security work req ' s Department of Public Safety"S"License: Lie.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 Owner/Agent PERMIT FEE: $ Signature Telephone No. -j The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 �� s•• www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): G r--7;1 C 1,4 Address: City/State/Zip: z rn b Phone#: 6 7 F-2 lc ZN�1. Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.�I am a sole proprietor or partner- listed on the attached sheet.# E]Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i 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 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. J Insurance Company Name: 4&�/1,4 Policy#or Self-ins.Lic.#: 3��0 Xto 2A`7 Expiration Date:,> Job Site Address: %'3 ii r S City/State/Zip:A4N JV/ ; C�1 � 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 lead to the imposition of criminal penalties of a fine up to$1,500.00 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 under the pins and penalties of perjury that the information provided above is true and correct. Sign e: Date: - C� Phone#: /c,/ ) 7 f 7 7J Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i r%ve " Town of' d v. 4, P 0 �/ No. oz s 6kh,"Ahdover, Mass., E BOARD OE HEALFH Food/Kitchen r Septic System RMI Q BUILDING INSPECTOR . THIS CERTIFIES THAT.............................. . )..1 ... .. .4�.L..�..........1.\:��.ffr... .Q. 7� Foundation has permission to erect:................ ..................... buildings on ..... .7. .......FO.&. .Z7. ......... .... ..Rough to be occupied as .�............. ,�t/. o ,. .......... e.l Chimney provided that the person accepting this permit shall in every respect conform to the ter of the application on fiie in . Final d� this office, and to the provisions of the.Codes and B Laws relating to the Inspection, iteration and Construction of � 1 / P Y , 9 P Buildings in the Town of North Andover. n PLUMBING INSPECTOR VIOLATION of.tho ZoningY or Building Regulations Voids this Permit. Rough PERMIT EXPIRES ELECTRICAL INSPECTOR t y ------Rough .........................................s:... .......... ............:......... Service BUILDIN -.1..SPECTOR Final 'errriit Required to (�?�':�,ct y Buil Ad GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rou h n No Lathing or Dry Wall To Be Done Until inspected and Approved by the Building Inspector. EIRE DEPARTMENT Burner Street No. Smoke Det. —©� .� : � n : ,i _ • ; CERTIFICATEF USE OCCUPANECY Town of North Andover d C/ Building Permit Number a 9� ®eIe /oZ C/ THIS CERTIFIES THAT THE BUILDING LOCATED ON 4, Pm 6� MAY BE OCCUPIED AS QSl N q fe- // IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. f AORTh CERTIFICATE ISSUED TO �'`��G �1 y✓/ �t��! ����� . . ADDRESS a 1 P*W dl saw e r u d/, s ""'` Building Inspector w ; • PERMIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 ' MAP y�0. I LOT NO. �% 2 RECORD OF OWNERSHIP DATE BOOK PAGE — ZONE SUB DIV. LOT NO. �•----I I ,LOCATION / - I I l.� (J �(/,� PURPOSE OF BUILDING OWNERS NAME 7 NO. OF. iTOR1EB I SIZE I OWNER'S ADDRESS BASEMENT OR SLAB a ARCHITECT'S NAME T � - `�� SIZE OF FLOOR TIMBERS IST -'x)Q 2ND 2x10 3RD - BUILDER'S NAME J SPAN j[�",� DISTANCE TO NEAREST BUIL ING (�� „/^,— /V;/ Ile 0� DIMENSIONS OF BILLS x'4p DISTANCE,FROM STREET /(a _ -����� �� - " POSTS DISTANCE FROM LOT LINES -SIDES la a iT REAR 2(jai 7cr GIRDERS � nj .) sal `; L� (2-)( 12- AREA OF LOT 7 /I_ FRONTAGE QjQJQ f-pcl' HEIGHT OF FOUNDATION �j ✓.i, THICKNESS n t5 BUILDING NEW •iC% A t"( /U�•{ SIZE OF FOOTING1r1 Z x � IS BUILDING ADDITION U MATERIAL OF CHIMNEY F IS BUILDING ALTERATION Q CL IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE )!ef IS BUILDING CONNECTED TO TOWN WATER _ BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER Nv IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION SEE BOTH SIDES LAND COO rg p UUD EBT. BLDG. COST PAGE t FILL OUT SECTIONS 1 - 3 - -- EST. BLDG. COST PER SQ. FT. - PAGE•2 FILL OUT SECTIONS I - 12 ¢ EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS - PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE F LED p� - 01 .GNATUItE OF OWNER OR AU RIZED AGENT BUILDING, INSPECTOR FEE AV OWNER TEL 1 0 - D r f7pt PERMIT GRANTED CONTR.TEL i9fi'-41s- 67,9 61t h CONTR.UC. 4� IfPp � i d.s >_ y ��rr. • .- _._._a- -. fig,. � � { . , '� ,�, � � Y t ��' �� + tfORT Town of _ Andover No. iia. ° m dover, Mass., COCHLAX ICHEWICK �.95 �q-4 E D�pP�y E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System Q THIS CERTIFIES THAT.............................. .LJ..0...Y-3.t�l..........1.\.FG4.. 1L Y... BUILDING INSPECTOR.G{S Foundation has permission to erect..................t..................... buildings on ......�.Y..-3........ Q� ..,, 7�+....... ..7;'. Rough to be occupied as....................................................�.1.rtf...C4..J,c...........40.::.:'4Af ............................................ Chimney provided that the person accepting this permit shall in every respect conform to the ter of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Iteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST -_--- Rough ......................................... .... ...... Service RILDIN SPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT .. Burner Street No. __ Smoke Der- Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of Applicant on Building Permit(below) Address of Property for Permit(below) Map and'Parcel :/0/ Purpose of Application (check below) Pho�pe Nu�m�1ber of Applicant: Single Family _Two Family CTrJll -V6_0-'703_5' I. the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the Building Permit. Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building Department and is only officially accepted when the Building Permit is issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. Ve-L This is an application for a building permit for the enlargement,restoration,or reconstruction of a dwelling in existence as of the effective date of this by-law,provided that no additional residential unit is created. /st The lot(s)were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning Bylaw. This application is for dwelling units for low and/or moderate income families or individuals,where all of the conditions of 8.7.6.c are met and/or represents Dwelling units for senior residents,where occupancy of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this Section"senior"shall mean persons over the age of 55. This application is a part of a development project which voluntarily agreed to a minimum 40%permanent reduction in density,(buildable lots),below the density,(buildable lots),permitted under zoning and feasible given the environmental conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently designated as open space and/or farmland.The land to be preserved shall be protected from development by an Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism approved by the Planning Board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for building pennits,(i.e.all other permits from all other boards and commissions have been received and the project is in compliance with those permits),and the Development Schedule does not accommodate issuing a building permit in that Year,one building permit will be issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate information, or the checking off of an above item which does not comply,whether done to my knowledge or not, is grounds for refusal by the Building Department to issue a Building Permit. Signature o wner or Authorized Agent w ed the Attached Building Permit Da This form must be attached to the Buil ' g Permit upon application for such permit. ;,ux1 21997 t uL)ILDLNG DEPARTMrs- 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 local or state law, regulations or requirements. ****************Applicant fills out this segtion***************** APPLICANT: Phone I LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) Street St. Number 4"53 ********--*--***************Official Use Only************************ RECOlrllriENDAPIONS OF TOWN AGENTS: Date Approved J f Conservation Administrator � Date Rejected Comments Au IS f A /,Y Date Approved n Planne Date Rejected Comments Food Inspector-Health Date Approved �- Date Rejected fSStic Inspector-Health Date Approved Date Rejected Comments . Public works - sewer/water connections driveway permit Fire Department � �.7, nq ; ... s Received by Building Inspector . 1k r i IG ;NG DaEPP5 m, sr' 8�4 { • `.02'27-41 '� •171�[<':� -�, r r ADM CROWLEY STEPHEN P 83 BURNHAM RU LOWE" MA 71 "=•_'-_, DB4I�gNBN4 OY BllBLIC SBYBSI '� a `= _�, CON54NUCSION SUQBRVBIXp R es CBNSB � Nueber @21?111998 0212111961 i' CS 058114 09 Restricted Ta SSBQNBN CNONI,BY 1 , 138 VIRGINIA 0152 I HOME IMPROVEMENT I Registration CONTRACTOR TYPe _ 114187 r a ExpirationDIVIDUAL 1 08/11/91 CROWLEY CONSTRUCTION I STEPHEN p L38 VIR6INIA AVEEY 1 �MINISTRA70R LUWELL MA 01852 1� t � 1 2 1997 i 1 € �►1L.f ING DEP: .! p--�a ib The Commonwealth of Massachusetts ' ti" `'S` w'1' ' �••rrlt \n, I Department of Public Sofety mar, BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 12.00 3/90 Dc`vl'ancv s ree CheCked (leave blank- APPLICATION ) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Massachusetts Electrical Code,-S27 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date City or Town of ^/Q,e ,¢NOdVE.E' To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) _/313 ie'G�2 7' p7- 0--•ner or Tenant .STE eAE Cl/Po(,�/L Owner's Address SAME (478-) YS3 - ya5' Is this permit in conjunction with a building permit: Yes ❑ No © (Check Appropriate Box) Purpose of Building Utility Authorization 110. Existing Service _Amps_ / Volts Overhead ❑ Undyrd❑ No, of Ya ter^ _ New Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters_ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Installation of Alarm System No, of Lighting Outlets No. of Hot Tubs ' No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Batter Units No. of Switch outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond, Total No. of Detection and tons Initiating Devices No. of Disposals No. of Heat Total Total Pum sTons KW No. of Sounding Devices No, of Dishwashers Space/Area Heating KW No. of Self Contained Detection/Sounding Devices No. of Dryers Heating Devices KWLocal E] Municipal ❑Other Connection No. of Water Heaters KW Signsf Ballasts w o tag rin 2M No. Hydro Massage Tubs Y g 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 this office. YES[] NO El If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ❑ BOND ❑ OTHER❑ (Please Specify) ' Estimated Value of Electrical Work S �O Expiration Date Work to Start /—.30-4f� Inspection Date Requested: Rough Final _2-3 - 98 Signed under the penalties of perjury: FIRM NAME A.D.T. SECURITY -SYSTEMS NORTHEAST INC. If Al LIC. No. 12310 Licensee DONALD A BROOKS Signata No 12310 gg&a Address 60 William Street, Wellesley, 8 s. el. No. 413-732-4400 Alt. Tel. No.617-431-5831 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that mysignature on this permit application waives this requirement. Owner Agent (Please check one) 00 Telephone No. PERMIT FEE S S%5- (Signature of Owner or Agent No- 1451 Date TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .... . ................................. ................... /- ..... V has permission to ............... ......... .............................................. wiring in the building ................................ ................................. ...... ....... ............. ...................... I North Andover,Mass. Fee-, .......... Lic.No. ............................................................... ELECTRICAL INSPECTOR 02/26/98 10:45 35--00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer ; Of&*Use U E Crom unwealt 1 of 14w5arkimn Permit No. Ee>pInttntM of Public *tdztq Occupancy Fee Chucked 3190 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 peays blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ` All work to be performed in accordance with the Massachusetts Electrical Code, 527 R 12:00 . .. pit••. (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date T& or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) L Owner or Tenant C1 mw -7 Owner's Address Is this permit in conjunction with a building permit: Yes 0 No El (Check Appropriate Box) Puroose of Building Utility Authorization No. Existing Service Amps Voits Overhead '-1 Undgrnd C No. of Meters New Service00 �* .�_ Amps t� I ayo Volts Overhead �' Undgrna � . No. of Meters,�_ Number of Feeders ana Ampacity 'd? Cl/ C&,Jkt .1"wu v_ /044* /0 Location and Nature of Proposed Electrical Workwxrorarf/,Sewtce f- !S�-Lo�• k' otal .,c No. of Lighting Outlets I No. of Hot ' �s I No. of Transformers TKVA No. of Lighting FixturesSwimmmq P^oi Above.— In- grr.a. — grnc. Generators KVA y No. of Emergency Li 9 Y 9 htin9., No. of Receotacie Outlets I No. of Oil curners I Battery Units < No. of Switch Outlets I No. or Gas Eurners FIRE ALARMS No. of Zones + No. of Ranges I No. of Air C,:nc. 'otai No. of Detection and :ons Initiating Devices ,..; Heat Total Total No. of Disposals I No.ol Purncs :ons Kw No. of Sounding Devices &; No. of Self Contained No. of Dishwashers SoacerArea r4eatmo KW Detection/Sounding Devices ( MucibalNo. of Dryers Heating Devices KW Local Other r r+ _ Connection No. of Vo. t Low Voltage No. of Water Heaters KW I Signs ?a casts Wiring 4:. � No. Hyaro Massage Tubs No. of Motors Total HP h..-. t f, OTHER: i; INSURANCE COVERAGE. Pursuant ;o the reawrements or '.tassacr:users general Laws ,• I have a current Liability Insurance Policy incluaing Come:.etec Ccerauons Coverage or its substantial equivalent. YES NO = 1 have suomtttea valid proof of same to the Office. YES = NO = If you nave checked YES. please ,naicate the type of Coverage py " x he approonate box. INSURANCE SONO = OTHER = (Please Scec:h,v) 's p� (Exoirauon Oatel " Estimatso value of E!ectncal Work S Q52 Work to Start 9�a51Y� Inscec;ton Date Recues:ec: Rough Final , Signeq unser ;he Penalties of per)ury: _ ',n � FIRM NAME 'Fkk'C Gn/rt W -YN rflq- uc. No.-rT ( ./1I(-ua Lice a� S gnature UC. NO. r�� > a /�J� �21 �e Bus. Tel. No. � •��+-�—''" �°;f, Address•25/jG1s6wS•h�.UIIL ,A a nk-.OM69- Alt. Tel. No, L OWNER'S INSURANCE WAIVER: I am aware that the licensee cues not nave the insurance coverage or its substantial equivalent as re- ourrea by Massachusetts General Laws. ana that my signature on :his -,ermit application waives this requirement. Owner Agent ` (Please CheCx Onei• weonone No. PERMIT FEES (Signature of Owner or Agenti ..Jesse Date.f—'-�Q.....(� ... €; 119E NORTH TOWN OF NORTH ANDOVER F PERMIT FOR WIRING ,SSACMUSEt , This certifies that ^-'--: �^�^� ............... .. ................ ................................... ..... .... ..... ..,.... i. n has permission toperform wiring in the building of....................:.......... ..... : . ...... .. ,North Andover,Mass r Feed.................. Lic.No"!&.�...�A2-- ELECTRICAL INSPECTOR 9/29/97 13.14 ggapy�� Fz WHITE:Applicant CANARY: Building Dept. PIRI�``Trea�eu} i ,tk Th q O �t�eo 6y NO 6 0`y Argo [OC [M.RrKR V APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS/LOCATION OF PROPERTY : �� "Fofc sl- DATE S� REQUESTED FILED/READY FOR INSPECTION CLOSING DATE ON PROPERTY: S FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNED ROUTING l CONSERVATION PLANNING DPW -WATER METER NOTE DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST DPW oi afj ky j Signature I a File: OC form revised 618198 I �r uhe LFDatuwnw alth of Muliar#srtts Por,,,a, Etvzutntttt Itf Public: $afttq boat 3 ad ptancy d lye CAecksd__ BOARD OF FIRE PREVENTION REGULATIONS 521 UR 12:00 yso euve WMN APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK . ..; ; All work to be performed in accordance with the Massacnusetts Electrical Code, 527 CMR 2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date " S' t* or Town of NORTH ANDOVER To the h4spoctor of Wires.* The udersigned applies for a permit to perform the electrical w5?,rk described below. Location (Street & Number) Are ej Owner or Tenant 1 ' I Owner's Address !' Is this permit in conjunction with a building permit: Yes No C (Check Appropriate Box) Purpose of Building II Utility Authorization No. Existing Service mps 'I Volts Overhead ;_� Undgrnd L.: No. of Mears • New Service c900 Amps Dn Volts Overhead '_ ��^^� Undgrna tL**'- No. of Meters Number of Feeders ano Ampacity :,c d( Location and Nature of Proposed Electrical WorK �� nada No. of Lighting Outlets I No. of Hot I No. of Transformers Total KVA t 4 No. of Lighting Fixtures Sb i Swimming Pco, Abcve— tri- r „ Brno. _ rna. KVA f~ No. of Emergency Lighting No. of Receotacts Outlets No. of Oil Eurners 88hery Units No. 01 Switch Outlets I No. or Gas ?_rr.ers FIRE ALARMS No. of zones No. of Ranges I I No. cf Air Ccrc. "1 'dial No. of Detection and 4, O( 'chs Initiating Devices i No' of pis00sais I No.of Heat ?o:ai -otat aumcs :ons K%V No. of Sounding Devices No. of Soft Contained No. Of Dishwashers I SoaceiArea 4eatiroat 0 ectioniSounding Devices No. of Dryers Heating Devices satin � v. — Municioai e KW Local � ,Diner " Connection �1a No. of ., , ] ° Low V No. of Water Heaters KW Si ns a ouagJ,j ' 9 ailasa d Wiring occ No. Hyaro Massage Tubs I No. of Motcrs ,otai HP cl OTHER: ' INSURANCE COVERAGE: Pursuant :o the reouirements ar t.tassac user ;eneral Laws I have a current Liability Insurance Policy mctuoing Ccm,,:e c Ocerations Coverage or its substantial equivaient. YES = NO have suomiing in tea valid proof of same to the Office. YES 7O _ If you-nave checKed YES, please indicate the type of coverage,oy{ `, Checxing the ip�pro/qjhate bOx. �1 � ,. INSURANCE r/80NO = OTHER = (Please Scec:��1 >c :• Estimated Value 9t Electrical Work S 1 C).00' ov jiu�ae� firV (Exoirauon oatel • � ,R'J� Wont to Stall Insoec:ion Date Aacues:ec: ougn Final Signed under the Penalties of penury. FIRM NA�E, iJtGr�r —1nT.gAlb@ �`u((�QuJ�.A G1�j UC. NO. 'j j,-�/� LicenasR- ���'N0 UC ^I1 a Signa:tie C. . -%ff-,I t t y' i Addrgtr �/o.'ltti.t� ►]Lt���1 ig f��i'GIL i (jus. Tel. No. Alt. Til. WO.. � �' OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee coes not nave the insurance coverage or its substantial Squivelent As re• 1 quires by Massachusetts General Laws, ano that my signature on :nis ,ermit aopncauon waives-this reou+rement. Owner Agent j (Plesse cnecic onel• eieonons No. PERMIT FEES ' (Signature of Owner or Agents . ad6M 1,TDate%. '.! .".. .. pp �_ f 1285 f �aORT1,1 TOWN OF NORTH ANDOVER PERMIT FOR WIRING SSACNUS� This certifies that ..................................................... .......,..... r has permission to wiring in the building of.....:�-L-'..;+..........—• .; �........... at.......�k)...........:..../�z `--'?................... ........ ;North Andover,Mass. FeeAx. E' ELECTRICAL INSPECTOR ° l+` � 11114/97 17:04 423.00 PAID . ti WHITE:Applicant CANARY: Building Dept.: PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING .. ��1.. (Print or Type) �I ,,��yy��� � T _� N OW f - , Mass. Date ,�2�1 19 _Permit# �S � •1., c le,Io�_ ,V Building Location -4 or ___ OrE'fiS� Owner's Name ,�"G�� "Ng. _ ype of Occupancy. New Renovation I& Replacement ❑ Plans Submitted Yes 0 No ❑ FEATURES z z z inCn co Y to Z W to (� } U Q C 0 Cn Y Q fCL - p z cn H W ¢ V = in R Z Z Z F=- 0 w W cn rn = ¢ w cn Y = d ¢ U Z Cc Q W Q C .tn z Q rA Z ¢ a- � O U. WL! .!Z 2 G z i' ��.Y p� Fes- < Y' Q..W I � Y = ¢ = a_ v7 07 Z z W H O U = IV_- Q = cn C3 D ¢ p zQ 0- 0 Q ¢ ¢ ¢ ¢ O ¢ F- 3 Y g m u) o o g = F .W u_ c7 = 0 ¢ a: m O SUB-BSMT. BASEMENT I 1 1ST FLOOR 2ND FLOOR 3RD FLOOR I I I I I I III 4TH FLOOR I I I I I I I I I I 5TH FLOOR I I III 6TH FLOOR I I I I I I I I I I I I I I 7TH FLOOR I I I I I I I I ITTF I I I 8TH FLOOR I I I Installing Company Name I�`0 /��//�/' J pzi_ Check one: Certificate Address G1�� � -,�,�,, I�orporation R19 d/d1Z ❑ Partnership Business Telephoner._ � �. _ C Firm/Co. Name of Licensed Plumber___ � �/'j/� �J41e, `y INSURANCE COVERAGE: I have a curren 'Pidbility insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142. Yes No ❑ If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy M/ Other type of indemnity ❑ Bond ❑ OWNERS INSURANCE WAIVER: I am ay are that the licensee does not have the insurance coverage required by Chg9terJ42 of the Mass. GenerallLaws hd that my signature on this permit application Waives this requirement. Check one: SirnTature�Owner or Owner's Acen; 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 the permit issued for this application will be in compliance with all pertinent provisions of the M achus�e'ttss ate lumbing ode and Chapter 142 of the General Laws. Ey _ G���=�' _ ignature r icensea f w.,oer Title Type of License: Master ICY Journeyman [te City/Town License Number_ —g_2A3 Date.� . . . . . . .� `1 �' Q H 40RT►j ..•f ..-... .. •° TOWN OF NORTH ANDOVER t as Q c41 r .? . o� PERMIT FOR PLUMBING This.certifies thaw .G. , , , . . . . . . . . .(-5� has permission to perform:....-a, A-- : . . . . . . �'lec!� ' c.. f plumbing in the uildings of . . . . . . :. . . . . at.,. '! , , , . . , , . . , North Andover, Mass. Fee .Lie. NO—0115&. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer