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HomeMy WebLinkAboutMiscellaneous - 49 BRENTWOOD CIRCLE 4/30/2018 (2) / 79,7o: WOOD CIRCLE0000.0 I 1 Location Gam/ Date , ca EE TOWN OF NORTH ANDOVER NGRTM ptt.ao ,a1tip . F A Certificate of Occupancy $ CU Building/Frame Permit Fee $ ,Foun atio�it Fee $ t 1 Permit Fee $ c9J Sewer Connection Fee $ Water Connection Fee $ -- - TOTAL $ Building Inspector 10680 Div. Public Works PER31IT NO. o yo APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. I LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK !PAGE — �ZONE SUB DIV. LOT NO. LOCATION PURPOSE OF BUILDING OWNER'S NAME ° NO. OF STORIES v SIZE OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME Fn h l!1 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 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 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST D PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER Q. FT. PAGE 2 FILL OUT SECTIONS 1 - 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 r 1�3oI 7 DATE FILED BUILDING INSPECTOR SIGNATURE AU-THOPIZXD AGENT F E E �1� ! 2 OWNER TEL.# ��!J PERMIT GRANTED '.---� � CONTR.TEL.# 19 CONTR.LIC.# ® � Gr1 ` q H.I.C.# /2-3 (32 s r Air BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY 11 S'ORIES 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 3 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _�I DRY WALL F.UNFIN. 3 BASEMENT 11 AREA FULL FIN. B'M'TAREA _ '/, '/t °/, FIN. ATTIC AREA _ N_O E'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 COMMON VERT. SIDING ASPH.TILE STUCCO ON MASONRY STUCCO ON FRAME BRI K ON MA—S—O—NVY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER ELK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR _ 11 ADEQUATE NONE 5 ROOF 11 10 PLUMBING GABLE HIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. &COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL < B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING t dovei- i own ofAn No. 040 0 �= 19 s . dower, Mass. • Ij COCMICHEWICK LAKE T�S SRAE D 1P BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........ . ..... ............ .... .. ... . . .. ....... ..... .:..... ... ..�...- ..r.. + .... Foundation r4has permission to.�wt........ ......... buildings on ��. ,.. Rough ,. ......... Chimney to be occupied 4s ...... .... . ...}` ......................................::......... provided that tk: person accepting this permit All in every respect conform to a 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTH 'ELECTRICAL INSPECTOR UNLESS CONSTRUCTION Si Rough ...... .. .. ........................................... Service LDING INSPECTOR 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 FIRE DEPARTMENT .. Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. L Date.................................. NORTm TOWN OF NORTH ANDOVER 1 P PERMIT FOR WIRING c 4 SACMU5, �i1.,� o Thiscertifies that ..... ................................................... ...................... ........... A has permission to perform ,4 ~; ....ti ............................................. .............. .. � � wiring in the building of.....c�....!.........f................................................................. mat..............�...........................�....................�........ ,North A((Andover,Mass. � Fee.... ....... Lic.No..J.!... ,?�..............................CO..... .I......! ELECTRICAL INSPECTOV Check # S 584 ) TRE C0M10ArWE4LTH0FM4S94CHUSE7TS Office use only Yct DEPA�VTOFPUBr C94FETY Permit No. BOARDOFFbWPREVEMONREGULWONS527CMRI2:Gb Occupancy&Fees Checked APPLICATIONFOR PERMIT TO PERFORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MMASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 ;/ (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date /Y Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electricab wo, described below. Location (Street&Number) Owner or Tenant 1111-e✓/ /Al Owner's Address 419 reAl 4V60 C Lr! eje- Is this permit in conjunction with a building permit: Yes m No ® (Check Appropriate Box) Purpose of Building /Alc to Utility Authorization NO.Y'i??7— Existing Service Ave Ampky I—J1kVolts Overhead Underground ® No. of Meters / New Service o10V Amps /Xp 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 Fixtures Swimming Pool Above Below Generators KVA round M Around No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. TotalFIRE 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 Ng_of Sounding Devices No oESelf Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other' Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massae Tubs No.of Motors Total HP )THER surMMGDvaage.Ptnst>anttothe mgmementsofMassachuseZGere Lam rave aataentIlab>btyllm=PolicyiwhxhngComplete Opetaftons CoverageoritssubstanWeWNalent YES NO iawabnittedvalidptoof totheOffi�YES � c IfyouhaNekJQedYES,plea�int�thetypeOfcovetageby eckmg the x (SURANCE BOND M1I IR � (Please Spa*) ExpitationDate Estimated Value of ELc�ical Wodc$ orktoshart h�specrionD&Re �gtRough Final g)edunc]Ar eso ZlVINANIE CJ5 l� �'G C� S i' S d ©V �j'C�/S Lic WNo.jot I/V (tom sipNO 0`�09 -7 LI BUSaM Tel No. (Pf 6,7 ,5o,= lam' A1tTelNo. VNER'S INSURr1NCE WAIVER;I am aware that ttr-License does nothave the ins<uance mvetage orils su(s�Ivial egruvalent as required byMassachl>seus General Laws .thatmy s g)ahue on thispmdt application waives tlns mquimmt ease check one) Owner ® Agent Telephone No. PERMIT FEE$ rgna ure 5T Owner or Tgpnf a The Commonwealth of Massachusetts d Department of Industrial Accidents Office of Investigations w Boston, Mass. 02911 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 aI 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. Policv# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of.a fine up to$1,500.00 E' and/or one years'imprisonment-as_wellas_civil..penaltiesin-thefnrm ofa..STOP WORK_ORDFR.and_a fine.of.(.$1D0..00)_a-dayagainst.me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. !do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name P.hone.# Official use only do not write in this area to be completed by city or town official - City or Town Permit/Licensing Building Dept ❑Check if immediate response is required 0 Licensing Board F-1 Selectman's Office Contact persona Phone#: Health Department Other ,� r°