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Home My WebLink AboutMiscellaneous - 46 PINE RIDGE ROAD 4/30/2018 46 PINE RIDGE ROAD ] 210/065.0-0125-0000.0 f II� Location ,7 No. Date ��9 U NORTH TOWN OF NORTH ANDOVER Of No ,•,'ti'O . ►O- p ` Certificate of Occupancy $ �'�s',•^° Building/Frame Permit Fee $ swcNus Foundation Permit Fee $ a�J Other Permit Fee $ ° TOTAL $ t Check # 15025 (:�/LBuiiding Ins6dor TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED9-i9- M SIGNATURE: Buildin Commissioner/I for of Buildings Date —/ -tJ/ SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map'Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.5. Flood Zone Information: 1.8 1.7 Water Supply M.G.L.C.40. If 54) Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Name(Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3-CONSTRUCTION SERVICES go 3.1 Licensed Construc� Supervisor: Not Applicable ❑ V Licensed Construction Su rvisor: License Number Address ( � ` � it Expiration Date ' Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name M � Registration Number M Address Expiration Date z Signature Telephone G e 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 the building permit. -Signed affidavit Attached Yes.......0 No.......❑ SECTION 5 Description of Proposed Work check all 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 ?BIAL ISE�ONLY Completed b f W pe a licant 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 5 Fire Protection - Ou 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 I, as Owner/Authorized Agent of subject property Hereby authoriz�(-,Ir4.tt� l Sf?(.?'�Wykw2 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 and belief Print Name Signature of Owner/A I ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIlv1BERS 1 2 ND3 PJD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE C� ��. : TieCommorrweaCth of Massachusetts '• ► Department of IndustriaTAxidents Orfsce ofInvestigations �►�.:a �- 600 Washington Street Boston, 551�A 02111 Workers'Compensation Insurance Afndavit APPLICANT 1 ORMATION Please PRINT Lesibiv Name: Location: City: Telephone#: ElI am a homeowner performing mself.g all y ❑ I am sole proprietor and have no one working in my capacity. ❑ I am an empl er providing workers' cpipensation for my employees working on this job Company Name: Address- City: Telephone#: fi/ Insurance Company: Policy#: P ❑I am(circle one) sole proprietor,general contractor or homeowner and have hired the contractors listed below who have the following workers' compensation policies: Company an Name: Address: City: Telephone#: insurance Company: Policy#: Company Name: Address: City: Telephone M insurance Company: Policy#: I Attach additional sheet if necessary A of MGL 15B can lead to the imposition of criminal penalties of a fine up to$1,500.00 Failure to secure coverage as required under Section?S and/or oneP Years' im risonment as well as civil penalties in the form of a STOP WORT:ORDER and a fine of S100.00 a day 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 underthins and penalties of perjury that the information above is true and correct Signature: Date: Print Name: Phone# _ Official Use ONLY-Do not write in this area D Building Department City or Town: Permit/License#: 0 Licensing Board o Selectmen's Office o Health Department 0 Check if Immediate response'is required 0 Other NORTH Town of E over _ t O ;_ YV� A No. _ �� o��,� y dover, Mass., — • ADRATED PPp��S S H � BOARD OF HEALTH PERMI D Food/Kitchen Septic System � �. F BUILDING INSPECTOR THIS CERTIFIES THAT... .::...`�.......( , ................ ................ ........ ; Foundation . .... has permission to ere g g ildin son .... ............... Rough to be occupied a .. !e... ............................................................ Chimney provided that theperson accepting this pe*and n every respect,conform to the terms of the application on file in Final this office, and to the provisions of the Coy-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North A dover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION T S ELECTRICAL INSPECTOR Rough ................................................................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in ,a Rough 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. 3405 Date..�/ *6.".. G ..... co f ,ORTH ,� TOWN OF NORTH ANDOVER c do PERMIT FOR GAS INSTALLATION 9 ♦ a SACHUSES This certifies that . /�.cf r- `—r 4- . . ./. � . � . . . . . . . . . has permission for gas installation . . L C. J��. . . . . . . . . . . . . . . . . . in the buildings of . . . . . ... `` . . . . . . . . . . . . . . . . . . . . . . at . . . �. .�1)`!�.f�. `�4.'. . . . . . . . . . . .I North Andover, Mass. Fee. . 1.>r ' Lic. No..Cn :J . . . . . !.`'t—, . . . . . . . . �AS INSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer Dater/. N° 4391 p� MD°*stip TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING ,r SSACHO This certifies that . . . . . . . . . . . . . . . . . has permission to perform . . . . . r. . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . ��` �. .`- . . . . . . . . . . . . . . . at. «f . . 1.j1.'`. .l . .5 . . . . . .. ; . . North Andover, Mass. Fee . Lic. No..61 S . . . `— L. �. . . . . 9 ✓PLUMBING INSP CTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer ,•••:tPilnt a TJ c+ r J v 111-V 11 M �''�. .41jon- X1.110 �'LLtAdJiJ�lll a ype) NORTH ANDOVER, Masa. Date T BuIlding PwmR ' Location _H 6 Pine 'Ki jQe- Rcy=cl ars ' ame efe�nn,�er eenokn New ❑ Renovation ❑ ReplacemerA Plans Submitted: Yes❑ No.p FIXTURES P at w M w s W r J w X 1A 44 at o v s 43 w N ■ s t3 at lb O X ':� ,s ■ X 19 Y ar { v y O w w s� M H s p $ .` ,. .� O V r 1rt r M O O .1 i M ■ ■'. al. s. O .• la o s i« s ■ o sus-2I11T. aAGUNINT 1sT FLOOR IND FLOOR c D OR R 0 � FLOOR 4TH FLOOR ITH FLOOR ITH FLOOR. TTH FLOOR ITH FLOOR — Check one: Cerifitcate Installing Company Name ANDOVER PLBG. & •HTG. CO. INC. • 81 2122 Address 20 AEGEAN DRIVE UNIT# 10 13-Partnership METHUEN MA. 01844 ❑Firm/Co. Business Telephone 978:685-8383 .Name of licensed Plumber r,FnRrF LAROSF INSURANCE COVERAGE: ec owe I have a current liability Insurance policy or Its substantial equivalent. Yes L9" No ❑ If you have checked yqj, please Indicate the type coverage by checking the appropriate box A liability Insurance policy U Other type or Indemnity p Bond ❑ OWNER'S INSURANCE WAIVER: l am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass, General Laws, and that my signature on this permit application waives this requirement. Check one: store of of or O nen a Mont Owner ❑ Agent ❑ I Mreby eerily that r<It of the details and hfortnai".1 have submitted.W enteredl In above applkatloef.ate burs and.aoarrate to the best of my knowledge and that a1 phrmb(nq work,arii�hstaliAU0hrper{oiniod on"tht+'p hit lasu d tforYtfltt plkatlon tsfi be In convilance with aA p.rtMent provtskna of the Massachusetts Stale'PiixnblrO Mode and Chapter 112'of the Girwral.. This na usSod Jmbw Ctty frown hien:*Number 9983 IlMICl'IED (OFFICE USE ONLY) Type of PkrrnbIhg License:Master Journeyman 0 i5 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO 00 GASFITT111G j (Print or Type) NORTH ANDOVER Mass. Date I uilding 'Location pta Permit # . wn s Name 'jg»nr�-er lLe2nc,n New 77 Renovation Replacement Plans $trt r #,ltited. n FIXTUR=S (L' v Cz 0 cc LU 0 97 W a1. W V7 GS O W 1- C a x O N tas. a m y t- W w o o=, o urt t- . Q w e yt x y K N t= H a o „� w " -c c: o a w W z w LU is 1— x tw- x 1-14' z m w a > W t- o _s -� tact a ,u > C W ; < ¢ m x o 2 O us ,S x x o is x U. a tx .`tt s y a a. r o SU>L—BSPdT. BASEMEMT 1STFLOOR T� 2ND FLOOR 3RD FLOOR i 4TH FLOOR 5TH FLOOR . 6TH FLOOR 7TR FLOOR 8TH FLOOR (Print or Type) Check one: Certificate Installing Company Name ANDOVER PLBG. & HTG. CO_ IN ..d Corp. 2129 _ Address 20 A-EGEAN DR. UNIT ` 10 Partner. METHUE_N, MA. 01844 Firm/Co. Business Telephone: 978-685-8383 Name of Licensed Plumber or Gas Fitter GFOR(;F 1 Ago4;F Insurance Covera e: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy E� Other type of indemnity D 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 coverages. Signature of owner agent of property Owner Agent Q I hcicby ccrtify slut all of the dcuils and information 1 have submitted (or cntcscd)In above applieatioa are true and accurate to the but o[mr 'knowlIdge and Utat all plumbing work and lnstitiations pcsformcd under'Permit iuucd for this application will-ba in compliance with all pertlaent prorisions of eho Massachuscus State Cas Code and Chaplcs 14:of Lha Genccal Laws. — By YPE LICENSE: rGasf lumber - Title itter Siq cure of Licensed City/Town•_ aster plumber or Gasfitter APPROVED (OFFICE USE ONLY) ourneyman 9983 License Number • Office Use Only v Permit No. ;,� !rt } �Q� }} Occupancy & Fee Checked 011e &111111p111Uraltll Ut �ilk�) adllloetW 3190 (leave blank) lucttilutllielit of 1lulllic I&IIretu ward BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Area APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 i (PLEASE PRINT IN INK OR TYPE ALL INFO ATION_)- Dale City or Town of— ��` h�0%V To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. I' Location Street & Number) t� ` Floor - ( sn -�S9 162 Tel. No Owner or -fbnant Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building ;-1iiii1y Authcrization NO. — Existing Service Amps —J VOlts Overhead ❑ Undgrnd ❑ No. of Meters v rhead ❑ Undgrnd ❑ No. of Meters Its O e New Service Amps _J Vo _ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Total i No. of Lighting Outlets .. No. of Hol Tubs No. of Transformers KVA Above In- No. of i-lghting Fixtures Swimming Pool grad. ❑ grnd. ❑ Generators I<VA __ - ---' No. of Emergency Lighting it No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch rn Outlets No. of Gas Buers FIRE ALARMS No. of Zones Total No. of Detection and No. of Ranges No. of Air Cond. tons Initiating Devices No. of Heal Total Total No. of Sounding Devices No. of Disposals Pumps Tons KW No. of Self Contained KW Delection/Sounding Devices No. of Dishwashers Space/Area Healing Municipal Other No. of Dryers Healing Devices KW Local ❑ Connection 0 No. of No. of Low Voltage �+ r.lc, cr Healers KW Signs Ballasts Wiring gec-tx;ctA A5tP.14or:,_. No. 1'7dro Massage Tubs I No of Motors Total HP I `— OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liabilitylnsura4rce Policy inciud Ing Completed Operations Coverage or its substantial equivalent. YES V NO 1.1 1 have submitted valid proof of same to the 011ico. YES NO l'J 11 you have checked YES, please Indicate the type of coverage by checking the appropriate box. INSURANCE Ail' BOND rill" OTHER L7 (Please Specify) (Expiration Dale) Estimated Value of E�le--c��trig�al Work $ I Final 3 "�� `7 Work to Start L— 7 Inspection Dale Requested: Rough Signed under the Penalties of Perjury: �+_ ^ ' 11511(' G'Stn.fri.t3�a��-�t�,}StPrn3 LIC. NO. 1=IRM NAME 11 �,�a,,��_�— LIC. NO. 1154 Ci Licensee 1 ice:. �g Signature 800-g6t-DOgZ Bus. Tel. No. fS`� �Qot! 4-��il—I`2�l w0.1��t1�m I�H�� ►51J Alt. Tel. No. Address,Y357_ OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the Insurance coverage or Its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives tills requirement. Owner Agent (Please check one) Telephone No. q��q PERMIT FEE $s� --- (Signature of Ownar or Agent) l4olily Inspeclor for rough and/or final inspsclion. Permit roust be obtalnod before commencing any,and all work In compliance with G.L.C. 141 &all applica- bin laws&ordinances is required and understood. X•6796 v-'`ti� y.,.Y�-..r -_Y..J^_'_ +��`:_ .s7F�•"'-�ice...+�-..ss^v+yMrc+----,,.,J ss v��-s:.�.--..-r-� q.^'.�^�rY-r*.a^�.y N2Date.... I. ...1.....7 836 - TOWN OF -NORTH ANDOVER � PERMIT FOR WIRING ,SSACMus� This certifies that r ..... ......�.P..c .........J - has permission to per ,~. . gCU wiring in the building of .......,.C)..C( . ...C . k.................... ... North Andover,Mass. o E. Fed' 5...,.UX).. Lic.No.A.Ul . ............................................................... ELECTRICAL INSPECTOR � �1 (3( 7 f WHITE:Applicant CANARY: Building Dept. PINK:Treasurer > MASSA€: USETTS UNIFORM APPLICATION FOR RMIT TO DO PLUMBING (Type or print) �– NORTH ANDOVE A CHUSETTS (� Date Building Locations f�+, t1 d1� �0��-� � Permit # 37a/3 V90-'Ar--Owner's AmountrN1 EX�ie Name New Renovation Replacement Plans Submitted I l FIXTURES z > w z Z z a s d z F w O W d p Q a O F d d w w W F. VO CL O F, E, d SLSBgV� B��IT sL` 1SC FLOOR V0 FLOOR 3REk FLOOR 4IH FID(R STET FLOOR 6TH FID(R 7IH FIO R SIH FIDO2 (Print or type) Check one: Certificate Installing Company Name C`l�� Corp. Z� Address '^ Partner. Business Telephone 21a 66 4— ❑ Firm/Co. Name of Licensed Plumber: LD►J 1'..A� Insurance Coveraee: Indicatet 7etype of insurance coverage by checking the appropriate box: Liability insurance policy El" 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 h e sub ' ed or enter d)i n abo a application are true and accurate to the best of my knowledge and that all plumbing work and' stall, s pe rf ed der Pe it Issued for this application will be in compliance with all pertinent provisions of the Mass bus P bi ode a Chapter 142 of the General Laws. By: Sigoture ot Mcenseau er Type of4er Li ense Title City/Town kens u Master Journeyman ❑ APPROVED(OFFICE USE ONLY v > MASSACHUSETTS UNIFORM APPLICATION FOR PERMITY,TO DO PLUMBING ."` (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Building Ldcations Permit # Amount Owner's Name New Renovation 0 Replacement 0 Plans Submitted n FIXTURES conz x a z p. 0 O W FW z �a x a drA z o d W Q W W" W U x E" Q a pG O d EF d a A A d F "� I= d Fa CC O SLSBM &4SEMM 151;RDOt 2M FIOCR IM FIDQ2 4M FILM 5M FIDm 6TH FUM 7IH FLOM SIH FWR (Print or type) Check one: Certificate Installing Company Name` Corp. Address �}Partner. Business Telephone Finn/Co. i i Name of Licensed Plumber: ' Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy n Other type of indemnity a 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 El 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 Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By: NignatUre ot Licenseaum er Type of Plumbing License Title City/Town License Number Master ❑ Journeyman ❑ APPROVED(OFFICE USE ONLY �.,,�{r,.�.:_::.-r,C...�,�,,,,.r.r.��-..- --'-...1,,.,�+`v�i�^.;rail::�-a..a►+��...,s""-'----^,�''L=-+-�.�°.�,. Date.$ T cr N2 3713 F TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING SS/1CMUS - p o This certifies that (r. . . . . . . . . . . . . . . . . . . . . . . . . . o CU has permission to perform . . . 9. . -. . . ..' C> . . . . . . . . . . . . . . . 6 plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . at. . . el, / t . , .�.c' .r.. . .�.� . . . .. North Andover, Mass. Fee. 1:�. Lic. No.Cl't�z�' . . 't�Orr.'. . . . . . . . . . . PLUMBING INSPECTOR q WHITE: Applicant CANARY: Building Dept. PINK:Treasurer