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HomeMy WebLinkAboutMiscellaneous - 46 BEECHWOOD DRIVE 4/30/2018 -YSBEECHWOOD DRIVE 210!034.0-0051-0000.0 I I AP N°- 2 v 0 0 Date::... ...:..rf� r!...... AORTA °ft"`°;•�"a TOWN OF NORTH ANDOVER = p PERMIT FOR WIRING �,SSACMus� This certifies that - has permission to perform. wiring in the building of ' `.:`.: ,North Andover,Mass. Feel//'...I...... .... Lic.No. ............'. ........ ................................. / ELECTRICAL INSPECTOR Check # �' 7 �' WHITE: Applicant CANARY: Building Dept. PINK:Treasurer IL7f'l.C.U14dL4'1ULVWI:fdd.LL'L UL" 113 vcn_causeontY� DEPARTA&NT0FPUBLFC'AFL7Y Permit No. BOARD 0FFIREPREVFN770NREGUTATI0N,S52701R 12.DO ' Occupancy&Fees Checked APPLICATION iT FOS PIJZMU TO PERFORM ELECMICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) y z 5 F C44LA.)U o E Owner or Tenant Owner's Address � M Is this permit in conjunction with a building permit: Yes=><l No ® (Check Appropriate Box) Purpose of Building C-024. - F_V_CL A,L —r,'fJ 1- AJ_ Utility Authorization No. Existing Service Amps / Volts Overhead 0 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 No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting FixturesL/, Swimming Pool Above Below Generators KVA ""�' ground oumd No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units 3 No.of Switch Outlets No.of Gas Burners 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 Municipal Other - E] Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER InstrarreCo�aa�Pumsuart9�themtttuarte>Ls�G Laws Ihmaa=tLiabtkhmram=Pdicymdu zb gCarViete Comawcrgsstbqxttdegmal YES ® ND lha�esthnkedvandpoofofsatre1othe0ffm YES 0 NO ® Ifjwha�,edrdcedYESyplasemdic&the wofmwm_ebydmkrtgttte bCDL INSURANCE f 7711 BOND F-1 alliER F-1 (PleaseSpecrfy) E#attort Daie dc>oSta<t Z-1Z ,,� E IValuedEkc 2lWotk S Wo hg)eaiomlDakR�� Z_. Fhal Signedu -.da iePetvdWsofpetjtay: FIRM NAME 1� t l...l.l YkP� 3' �l.�'�> � Li=mNo. /�� 1_6 G=p 1 Z— Li=> W u. i t .��QMNSSigna n �. Kerb t-'t (3 2— n ,� 1 BtnarssaNa LF K� a �1 )OOVE- - M AA1tTUNa OWNER'SDWRAIMWANESI.amat=ffiatt cLi:edmnctt thecstr eoo t s r iei<as.tegtmt bylvfas eitsGetealIaws a®d�atmys�taecufhispeQ�te'tt�ppfir�anwai�esttgs mt�mgr�stt (Please check one) Owner r7 Agent ® a� Telephone No. PERMIT FEE$ m. TOWN OF NORTH ANDOVER BUELDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING T OTHER THAN A ONE OR TWO FAMILY DWELLING /v Section for l OC�C1RI Use 0� BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: ✓/ O Buildin Commissio r/I or of Buildings Date LI Property Address: 1.2 Assessors Map and Parcel Number: X1r. 63 40 00S/ Al. �n�v /'A wA Map Number Parcel Number 1.3 Zoning Information: ,++ 1.4 Property Dimensions: -r e G .j I'll /,Y-, `VI 6L Zoning District Proposed Use Lot Area Fronts ftm 1.6 BU LDING SETBACKS(ft) a(.t,L axe . s lG Front Yard Side Yard Rear Yard Required Provide ReqWred Provided Re red Provided 1.7 Water Supp M.G.L.C.40. 54) 1.5. Flood Zone lnfotmation: 1.8 Sewerage Disposal System: Public Private ❑ j Zone Outside Flood Zone lay/ Municipal On Site Disposal System $— 2.1 Owner of Record NaW(PPnt) Address for Service:a V/ _/ _.v�_s�i � 1--c, s—.3Gc, M Si r Telephone aa_� 2.' uthorized Agent Name Print Address for Service: / O 97�- Co �l—�GoG �X— i�l z Signature Telephone m 90 3.1 Licensed Construction Supervisor Not Applicable ❑ 9 4oA,�/, . Ka etr,—,W. 0 2-1? 3 7 G Address License Number O Licensed Construc'on Supervisor: Z Z O L Expiration Date7 ic_ Sign re Telephone r 3.2 Registered Home Improvement Contractor Not Applicable D-- Company Name Registration Number M r Address r Expiration Date Z^ Signature Telephone u, •f .�.+ Yea„�i�� as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed un r the pains and penalties of perjury Ohl Print Name Signature of Owner/Agent Date Item Estimated Cost(Dollars)to be #s a Completed by permit applicant 1. Building (a) Building Permit Fee Jro4 Multiplier 2 Electrical (b) Estimated Total Cost of 5ov Construction from(6) 3 Plumbing r Building Permit fee (a)x(s) 4 Mechanical(HVAC) 5 Fire Protection r. 6 Total (1+2+3+4+5) fF ,L 70 o — Check Number 1111 `� Y.. e ,Yx tr s( � a ('�Y k x S N 7 i'�"f.�}`'�� �;a, t��.� )\'� ray F.t l.h s j�\ rs � a "� 9 _ j ; t: ✓ ' ..t •'��,;.> �a;'� ry ,�Y� �,.f C�4cb ai" i;�+ ��.�,, r !.��F3`�, 3+�;�5:.,�r s ,t � ,�.,,fir, ;5.--�,.,��°;��?.>1 �rt;� ,�}r � �' ,Yi>, a .,�:h. NO.OF STORIES / SIZE °e v°.o BASEMENT 6 SLAB SIZE OF FLOOR TIMBERS iST2 ND 3RD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS f SIZE OF FOOTING X / MATERIAL OF CHIMNEY < IS BUILDING ON OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE y".r k .RN sa Location No. r Date �ORTM TOWN OF NORTH ANDOVER � 9 Certificate of Occupancy $ ♦ e� � ' a ;ACHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ - Check # f., r Building Inspector r `"CTION4-W- 0910MC-OW, S , 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 Yea ..... ❑ No ❑ li s>zco» s-rl�a ©lt,DOM r; Ccsi�s &xvn;s>xv�Cssxt> Tstcra CON5TitIIC IAIST CO 1CROL P AI Tia , 11 �C©I�IT�1 i MQ) E'`I D 35,1 C F.^_Oii CT;�15141d 'ACE) 11 5.1 Registered Architect: Name: ' Address Signature Telephone 5 2 Reistered:IPr+aYessnal > )" Area of Responsibility Name: Registration Number Address: Expiration Date Signature Total Not applicable ❑ Name: Registration Number Address I Signature Telephone Expiration Date i Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date ' Name Area of Responsibility Address Registration Number iSignature Telephone Expiration Date Not Applicable ❑ Company Name: Responsible in C of Construction FORM - U - LOT RELEASE FORM a A INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT PHONE ASSESSORS MAP NUMBER �7 LOT NUMBER SUBDIVISION ,,! LOT NUMBER STREET �(� i/-�0JX(1 Dtrl VC • STREET NUMBER OFFICIAL USE ONLY RECOA4NIENDATIONS OF TOWN AGENTS DATE APPROVED CONSERVATION ADMINISTRATOR DATE REJECTED CONRVIENTS 1 f' DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR—HEALTH DATE REJECTED /I IJ7 A DATE APPROVED SEPTIC INSPECTOR—HEALTH DATE REJECTED COMMENTS PUBLIC WORDS—SEWER/WATER CONNECTIONS D AY PERMIT 2//X/,,;,/DATE APPROVED FIRE DPIPARTNItistr DATE REJECTED CONDIMENTS RECEIVED BY BUILDING INSPECTOR _ DATE The Commonlwealth'of�llassachusetts - Department of Industrial Accidents Aviv/f&rrstlgstlias r. 600 Washington Street a Boston,Mass. 02111 ' Workers'Compensation Insurance Affidavit name: Dutton & Garfield, Inc. location: 54 Beechwood Drive city North Andover, MA 01845 2hone4 978-681 -8600 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. :Dutt011 $i: e3r -3>e . .61 address: 54 Be`echD°rive.: ciNorth` A1dyE .�. Rhone#= 978 6'8`1 $5..00 insuranceAcadia IrYSurance policy# WCA0057532<-1.0.. :: F1 I am a sole proprietor, genera!contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name* .. address:city-phone#.. insurance co: Delict'#. company name: address. : . city: ... phone#: . .:....... insurance co. ... llorki a ona ee neceysa Failure to secure coverage as required under Section SSS►of NIGL IM can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of SI00.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Iuves igations of the DU for coverage verification. I do hereby certify under the pains anddpenhalties ofperjury that the information provided above is true and correct Signature °Lx/ 6 `� V e' Date Print name Jane I. Armstrong Phone# 978-681 -8600 official use only do not write in this area to be completed by city or tows official city or town: permi"cense# r)Buil:di. epartment E]LiceBoard 0 check if immediate response is required C]Selc 's Office oHeapartmentcontact person: phone#; n0tb (revised 7195 P1A) ;l he Larn�vr�taou.��eaGU2• a���.il�Laavacfzu6e%�6 BOARD OF BUILDING REGULATIONS p License: CONSTRUCTION SUPERVISOR Number: CS 029376 Birthdate: 02/28/1953 Expires:02/28/2002 Tr.no: 15184 Restricted To: 00 STEPHEN E FOSTER 48 MEADOW LN N ANDOVER, MA 01845 Administrator Dutton & Garfield, Inc. CONTRACTORS 54 BeechwoodDrive • North Andover,MA 01845 109 Hillside Avenue Londonderry, NH 03053 TeL(978) 681-8600 Fax:(978) 681-7570 Tel.:(603)425-2600 Fax:(603)434-9568 LETTER OF TRANSMITTAL DATE: 02/13/01 TO: Town of North Andover Building Department 27 Charles Street North Andover, MA 01845 ATTN: Mike McGuire RE: L-Com, Beechwood Drive WE ARE SENDING YOU x Enclosed _ Under separate cover COPIES DATE NO. DESCRIPTION 2 24 x 36 Floor Plan 2 11 x 17 Enlargement THESE ARE TRANSMITTED aS checked bellow- X_ For Review/Approval _ For Your Use —AS Requested _ For Review/Comment _ For Your Information _ For Quote For Bids Due _ For Completion _ For Execution REMARKS: SIGNED: Stephen E. Foster BUTLER BUILDER tAORTH Town . of E RAndover 100 - - -_ y T �O - LA E o dower, Mass. -a nn vZ—�L � / COCMICMEWICK AERATED P �(C S G BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........... .►.. ........IC�' . ............ ... ............................ ............................................. Foundation has permission to erect.....�Q**$040#...... bd dings on ...."7... ! 64. `v01 0 Rough �� t �� Chimney to be occupied as........................................... ..................................................................................................................... y provided that the person accepting this permit shall in every respect conform to the terms of the application on fk 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. /" I q P jo/ PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARS ELECTRICAL INSPECTOR Rough ....... .................... . .. ... . Service.... ...... ..... ............ BUILDING INSPECPOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal 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. �',Mi�I{t��0,�,1G7W ,�i#.,!'�Wl'T�[4'9!� �,�a.• �VtiRil£Qii Spp�WLtVlt�i�,'•',. - New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: �' rr.£ mss..c� <i�' d7 �.. /la .r/7— USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ lA ❑ A4 ❑ A-5 ❑ 1 B ❑ B Business C3' 2A ❑ C Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C C� H High Hazard ❑ 3A ❑ IInstitutional ❑ I-1 ❑ I-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ °S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: ,t BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels / I Floor Area per Floors Total Areas d u _ If Total Height ft f ' Independent Structural Engineering Structural Peer Review Required Yes ❑ No SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT l dzvne�s I, as Owner of the subject property QQFi)4 Hereby authorize ���,p e� j�S}Cpm--_ to act on My behalf, in all matters relative two work authorized by this building permit application Signature of Owner Date as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed un4er the pains and penalties of perjury Print Name Signature of Owner/Agent Date ,��� 111�-; ���• t s Item Estimated Cost(Dollars)to be Completed by permit applicant 1. Building (a)^I Building Permit Fee �l�00 Multiplier 2 Electrical ¢ (b) Estimated Total Cost of Construction from(6) 3 Plumbing Ir Building Permit fee (a)x ) C 4 Mechanical(HVAC) 4 5 Fire Protection 6 Total (1+2+3+4+5) ftp ,L 7` — Check Number (i x r` .r✓d. "' i-S� t•; .a s� 4 ", y .F z Y t -� ,tst F-- vra ✓-: '1 } ':7 1 y��.'x $ *F... ;-. s v]t' „5,:;y��i ,4 `✓F,-...r1 ?�k i'.'i F.., .i�. NO.OF STORIES / SIZE BASEMENT e SLAB SIZE OF FLOOR TRvIBERS lST 2 ND 3RD SPAN ter/ /'St DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS a SIZE OF FOOTING X / MATERIAL OF CHIlv1NEY < IS BUILDING ON Z5D OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE ,.r moi. r+u`