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HomeMy WebLinkAboutMiscellaneous - 50 BRADSTREET ROAD 4/30/2018 50 BRADSTREET ROAD 2101043.0-0018-0000.0 � i 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c.143,§3L,the Permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed " on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an electrical permit shall be issued to the person,firm or corporation stated on the permit application.Such entity shall be responsible for the u notification of completion of the work as required in M.G.L.c.143,§3L. J Permits shall-be limited as to the time of ongoing construction activity,and may be-deemed-by.the-Inspector_of_W.ires abandoned-and.invalidifhe—. ._ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of -the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending through August 15,2012. e 8—Permit/Date Closed: '� `�/ * ;Reapply for new permit `J P rmit Extension tact—Permit/Date Closed: i Date.... .'�.Z —�.. ..... 4O oT►,1MO 3: �•„ -.. TOWN OF NORTH ANDOVER ' PERMIT FOR WIRING 7 This certifies that � . G'��� � has permission to perform A-b wiring in the building of.. ........RI P I�N.I.;Y............................................. at.. r .. f, .... ....................................... ..North Andover,Mass. Fee.':I , . .... Lic.Nov?? ' L?4........... ...:..... LECTRICAL INSPEC�OR7 it Check # j 75 8570 r. Am Commonwealth of Massachusetts Official Use Only MEM" 1)e artfl7ent Of F% Permit No. F6-7 6) P re Services BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12-:0' (PLEASE PM71NINK OR TYPE ALL INFORMATION) Date: 7 City or Town of: NORTH ANDOVER --� To the Inspector of., fires: By this application the undersigned gives notice of his or h Location(Street&Number) er intention to perforg�the electrical,woTk described below. Q '�r� ..•`�'' Owner or Tenant 5h&Gdh J-'"el PJ017 y Telephone No. Owner's Address im G f� Is this permit in conjunction with a building permit? Yes No / ❑ (Check Appropriate Boz) Purpose of Building_J;ns m \ �wP-1\c r� 9 Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Und rd g ❑ No.of Meters New Service Amps / _Volts Overhead❑ Und rd g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ` 0v, J r Completion of the followin table may be waived by the Ins ector o Wires. No.of Recessed Luminaires $ No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers I1A No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of LuminairesSwiAbove In- . o mer enc .$� mming Pool ❑ g Y Ig d• rnd. ❑ Ba. Units g -- No.of Receptacle OutletsA0 No.of Oil Burners me ., FIRE ALARMa "vo. of Zones No.of Switchesp No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Detection/AlertinD,Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal y Connection El Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or E uivalent i Heaters KW Si s Ballasts . Data Wiring: y No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent a Estimated Value of Electrical Work: Attach additional detail if desired, or as required by the Inspector of Wires. - (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 ❑ BOND ❑ OTHER I certify, ❑ (Specify:) fy,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME:�� Gcv ► E LE Licensee::C+G 7' LIC.NO.;64 � .Cc�v Signature', ; LIC.NO.-L23 (If applicable;;enter"exempt"in the license number line.) Address: 1 S\pnt R D -,;A%.A V S Bus.Tel.No.. -! 77 *Per M.G.L c 147,s 57-61,security work requires D Alt.Tel.No.: t 4-760 Department of Public Safety"S"License: Lic.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) EI ❑owner's agent. gent Signature Telephone No. I PERMIT FEE. $ i�. i�� / 1 -- � �' .� r �, -� The Commonwealth of Massachusetts Department of Industrial Accidents j _ - Office of Investigations 600 Washington Street le Boston, MA 02111 { www.mass gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le�bly Name(Business/Organizafion/individual): ?cc,,A , t C Address: city/state/zip:�e� G ,� S nnA O1 gOCp Phone #: .701 137 7 Are you an employer?Check the appropriate box: L❑ I am a employer with `� 4, Type of project(required): ❑ I am a general contractor and I b, ❑New construction employees(full andlorpari-time).* have hired the sub-contractors 2.❑ I am a.sole proprietor or partner_ listed on the attached sheet.x 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor or me in any capacity, workers, cornp.insurance. g, ❑Building addition o workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.F7 Electrical repairs or additions 3.❑ 1 airs a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No-workers'comp. c. 1.52, §1(4),and we have no 12. Roof insurance required.]t employees. ❑ repairs [No workers' 1317.0ther comp. insurance required..] Any applicant that checks boz#I must also fill out the section below showing their workers'compensation policy information. t 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 wo ••r•r�....�u.:317�air�ti. I am an employer that is providing workers,compensation insurance or i informmtian. ' 1` mJ'employees. Below is the policy and job site Insurance Company Name: Upt`G�t Sett w1(��• Vim: 1 Policy#or Self-ins. Lic. Expiration Bate: O'1_ Act09_ Job Site Address:_.s(7 t3�c J S'� City/State/Zi fl 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 thisstatement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. . I do hereby certify under the airs and penalties of perjury that the information provided above is true and correct Date: 10 9 Phone#: r71C ficial use only. Do not write in this area,to be completed by city or town ofciaL City or Towl PermitlLicense# 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 I Information and n Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an-individual,partnership,association,corporation or other legal entity,or any two or more of the'foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,empioying employees. 'however the owner-of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance'coverage required." Additionally, MGL chapter 152, §25C(7)states'Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation.affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of f insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not requimdto carry workers' cornpensafion insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not'the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy;please call the Department at the nurnberlisted below. Self-insured companies should enter their self-insurance-license number on the appropriate line. -' City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. in addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under".lob Site Address"the applicant should write"all locations in (city br town)."A copy of tine affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each c s year. When a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-8.77-MASSAFE Revised 5-26-05 Fax#617-727-7744 www.mass.gov/dia Location Z3 -ev - c� f No. 3 S Date a� y Ma�T►► TOWN OF NORTH ANDOVER 0 9 1 Certificate of Occupancy $ �SSAC11U5Et� Building/Frame Permit Fee $ Foundation Permit Fee $ r+ Other Permit Fee $ TOTAL $ Check # 1733 c,��U �C� Building Inspector a _ Town of North Andover Tti Office of the Building Department F� k, Community Development and Services Division * i 4� William J. ScottDivision Director ` °� •°• �=• " 27 Charles Street Nds�` North Andover, Massachusetts 01845 978 hone Tele 688-9545 D. Robert Nicetta P ( ) a Fax (978)688-9542 Building Commissioner F . CHIMNEY APPLICATION AND PERMIT DATE 4 ILx�U2 PERMIT # L LOCATION I OWNER'S NAME BUILDER'S NAME MASON'S NAME MASON'S ADDRESS MASON'S TELEPHONE MATERIAL OF CHIMNEY �CCi� /�4f� cam' �` �Vuy-/2._ INTERIOR CHIMNEY EXTERIOR CHIMNEY J NUMBER AND SIZE OF FLUES Z THICKNESS OF HEARTH Will chimney or fireplace conform to requirements of the code and have rules and regulations been received: DATE SIGNATURE OF MASON CONTR. LIC. # EST. CONSTRUCTION COST/CONTRACT PRICE PERMIT GRANTED FEE ROBERT NICETTA, BUILDING INSPECTOR INSPECTED REMARKS SOLID BRICK REQUIRED THIS PERMIT MUST BE DISPLAYED ON THE -PREMISES BOARD( F A 5� PPF.ALS 64R 9_-11 [3 )iL.D(T� -95 t G 68R _1., CON ' SFRV,A'1'IE?N b88-95 30 NFAL1'H 688-940 PLANNING 6$8-9535 r WOOD STOVE IN;3TALLA 0V1 CHECKLIST � `' , " Vrlo ;�� `1 Permit A building permit is required fc,'(the installation of any solid fuel burning appliance. The building permit and installation inspection are limite'd to the stove installation and not to the stove construction. ( Stove i' A. New Used B. Type/radiant ncuiating c/ C. Manufacturer Vwmom awkm( I ?b. No._ I�► Name/Model No. � ZO$�CnIlar size Clirnensions/Height L J'� w X 2-1p X 21t h _I_•�ngth Width Chimney A. New Existing B. Size(flue area) C. Other appliances attached to flue(Number and flur:!size) ._ D. -Prefab(Manufacturer—name and type) E. Masonry/Lined _ Flue liner:_ Unlined ! lype 3 manu+aciurer) _ F. Height(refer to diagrams) cap 7 Y ( OVER, ICI I I I =Zq( 'L'MIN. 2 =tlt4. {io' ,MIN. I$")�IIN. ���Gyp y1G HEARTH CHIMNEY HEIGHT Hearth(non-combustible) A. Materials B. Sub-ffoor construction C. Minimum dimensions(refer to diaoram) Clearances and Wall Protection(see stcve installation clearances chart) A. Type of wall protection provided B. Clearances(refer to diagrams) i FIREPLACE CORr1ER WALUCENJ ER 1 i I c L 1 F j 780 CMR: STATE BUILDING CODE COMMISSION Figure 2109-4 CLEARANCES FOR SOLID FUEL BURNING APPLIANCES I --CAP C; FACTORY-BUILT CHIMNEY (Dp .ROOF BU►PORT I i SU►PORT RRACNET NON-COMBUSTIBLE B _ I ✓f'' WALL PROTECTION _CONNECTOR MP[ A - CONN CTOR OVERLAP 1 1 _F a \� WOODSURNING STOVE A A 3 � AIR SPACE ' I r . ti4 L 12" NON-COMBUSTIBLE. ' FLOOR PROTECTION STOVE INSTALLATION CLEARANCES Pustible 6" Asbestos Mlllboard Concrete/Masonry „ Stove Componentsterist Spaced out 1'• ) Foundatlon Vali Brick Veneer. 369* Radiant Steve Circulating Stove—Frontr. cl,culsting ddlant Stove—Side/lack36'0 18•0 6.9 18,a Stove —Side/Sock 12�' 6.. . 600 6a. 6: Singlr Vert 2. Connector rt a l8', 1200 6" � --------------- Insulated 211 2tt Connector P1 a 211 211 C. ChlnrYer Height ada-Ver ee (3) feet above ad)Rient roof and (Metal or Masonry) two (2) fret .above an roof ridge within 10 feet -r D. pamper 1 s not nc u e n the stove construction. It Rust be Installed (n the connector Alpe. 1. Front: Fuel or ash access side. 2• Thimble required for passage through co-bustlble construction, 3• Mon-co-bustibic spacers required, 4. Clearances on. t h ac silt of a radiant stove with a heat shield shall be measured as If a circulating type. I NORTH Town of Andover No. 3 -_ a lover, Mass., O 0 - LAKE �• COCMIC NE WICK ORATED P'Pa,��(y 7 u BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR J..THIS CERTIFIES THAT C A • Foundation has permission to erect.... buildings on ...... O. ....... /.y40�s�../....�.t.....+.. .. . Rough . . •• tobe occupied as.............J...............................I.p .. .................................................................................... Chimney 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. ?vim PLUMBING INSPEC'T'OR VIOLATION of the Zoning or Building Regulations Voids this Permit. J Rough Final PERMIT EXPIRES IN 6 MONTHS ELEC'T'RICAL INSPECTOR UNLESS CONSTRUCTION ST T'S 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 j Until Inspected and ..:;Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. pi 3790 .. �� �r zDate . pORT11 oAL TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUS� This certifies that - -<-�- .." has permission to perform .t ..... . ....:.,.,,........::. . wiring in the building of. F at ............................................ ....� : l ...�...._ ..... ,North Andover,Mass. Fee` A........... Lic.Nof�.l����/ �.................. � ......................... / �'� ELECTRICAL INSPECTOR Check # C- C (/ Commonwealth of Massachusetts Official Use Only Department of Are Setvices Permit No. �® BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 2 UIW [Rev. 11/99] leave blank 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: y A 2- City or Town of: /Vo, 4�96yl�� To the Insectortof Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) ( ,8�A-0 S r. Owner or Tenant .TQN11I V4-V L=�G J<A-S Telephone No. 9 1$..(o$l.agjc1 Owner's Address 0 (3'2W b s-r A,� Is this permit in conjunction with a building permit? Yes ❑ No�-- (Check Appropriate Box) Purpose of Buildingt=S 1 04FN T(A-L Utility Authorization No. Existing Service_I CO Amps �j/ c�„Volts Overhead , Undgrd ❑ No.of Meters J New Service (G: Amps20_x /2 Volts Overhead, Undgrd ❑ No.of Meters i Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 1AIS 440-11) A)JEW 1 aO AM S�QC V lc _ NLT'W i Q Completion of thefollowing table may be waived b he Inspector of Wires. No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ In- El o Emergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatin Devices .`~ Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number ..ons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Si ns Ballasts No.of.Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. 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 ® BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Peter Manzelli II Signature LIC.NO.: A 16199 (If'applicable,enter "exempt"in the license number line) Bus.Tel. No.:-_978-589-9611 Address: 99 Main Street Westford,MA 01886 Alt.Tel.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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ a Inspection Request Peter Manzelli II is requesting a Rough / " inspection to be performed. at Name: O� w kO.vec khS Address: SO i3 RRD ST, Rt), Phone: g79'4?1- 09 4 SR#: 6-70245' Date: q 30 Thank you, Peter Manzelli II Phone- 978-589-9611 99 Main Street Fax- 978-692-8658 Westford, MA 01886 C. 143 Sec. 3L Board of Fire Prevention Regulations; Rules Relative to Electrical Wiring and Fixtures: Any person installing for hire any electrical wiring or fixture subject to this section shall notify the Inspector of Wires in writing upon completion of the work. The inspector of wires shall within five days of such notification give written notice of his approval or disapproval of said work. A notice of disapproval shall contain specifications of the part of the work disapproved, together with a reference to the rule or regulation of the board of fire prevention regulations which has been violated. 05/20/2002 13:02 9786928658 ELECTRICAL PAGE 01/02 r FAX COVER SHEET 99 Main Street Westford, MA 01886 Phone 978-589-9611 Fax 978589-5155 SEND TO Company name '`. �'�`�>t=tP.�� t€�i�Y,`.i,+.y�.,y.� -• ;:`��.' i�i������1�Q�6(�$�[dl��I From .. .. ...... . i Attention Date. aA-oa Office location ` Office location ... . ...... . .. Fax numb r Phone number i 9- gds- �s$�- 9 - s,� Urgent j Reply ASAP Please comment I Please review i For yourinformarion Total pages, including coven COMMENTS z ;.t:qr `� t"�,•.°f'r..:t5��fpi�� `itt`t ..... ... ... ..... ..... ...... ... .. ..... .. .. .... ... . .......... .. ..... . ... I ............ --------------------------------------- CJ m N m W C7 Q CL COMMONWEALTH OF MASSACHUSETTS OF REGISTERED MASTERIELECTRICIAN ISSUES THIS LICENSE TO i ELECTRICMAN INC PETER MANZELLI II 1 99 MAIN STREET y WESTFORD NA 81886-260 16199 A 07131104 327298 4 � 1 uj w w In to c CJ m k m r- (n CJ CD a--1 CJ m m N m CD t Y S' i i G \ 3 �". .: � Date . 3°,<«`° •�"o°�' TOWN OF NORTH ANDOVER' ?_ _ PERMIT FOR WIRING y' O p ` i. SACMUS rt....�."';�,'•,.+�''-: a -�° �'• 'Thls.certfies that .. .a .z ..�. .. .. .... has permission to perform ......... ^ -�' - ;. � wiring in the building of �., ,� � •: North Andover.,Mass •• Y I FeeA-P.? Lic_.:No .�..0 :;%�c`" . .... . ... .. . ELECCRICAL AVSPECTOR fi Check'# t°. t > Y PETER"WANZELLI II I99 MAIN-ST � / 53 274/113 !� WESTFORD MA 01886 v GJx�_'. Date' _ -Py to the 11 -order of ' D ; ` C_E� - � ollars 8m j ENTERPRISE BANK'AND',T COMPANY MEMBER FDIC ° +WESTFORD,MASSACHUSETTS 01886 For 2 7 a _ � T 4 2 . � n ,r.a.01 L3 02 , � u 0020:23 .TO REOROEfL1bODfb]2G�9•m+!+.O�Kks�M��°4'�^' _ '� ' i L Location No. DateOf d" ,.ORTFi TOWN OF NORTH ANDOVER 16. Certificate of Occupancy $ N14us•E1� Building/Frame Permit Fee $ �c Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 3u vy Z Check # 1647 1 Building Insp.6 for r TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING we BUILDING PERMIT NUMBER. DATE ISSUED: _c;2 ` rn aDO X SIGNATURE: Building Commissio /I for of Buildings Date Z SECTION 1-SITE INFORMATION O 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 UseLota1(0 0-4 -+/— Fronta e 0 ()(4 ' 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R red Provided Re red Provided v 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record S � / s o i3egb54ftel 'Name(Print) Address for Service I 7� 2L -a 304 Signature Telephone 2.2 Owner of Record: Name PrintAddress for Service: O Z rnIII Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ IKA Licensed Construction Supervisor: O mnS� License Number ss Expiration Date ic ature Telephone r i 3.2 Registered Home Improvement Contractor Not Applicable ❑ v I Company Name �l LjL,44(,,(— In,44th -Isk Registration Number r ;10 )ture Expiration Dae ^ Tele hone V 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 4 in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......K No.......❑ SECTION 5 Descri tion of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other Specify 6Qz-,, 1�C T I Brief Description of Proposed Work: VG SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to beY OFFICIAL;USE O1�TLr Completed by permit applicant 1. Building / (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X (b) D 4 Mechanical(HVAC) �- 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OW S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property I Hereby authorize to act on My behalf,in al tatters relative to work authorized by this bhilding permit application. Signature of Owner Date SECTION 7b OWN AU ORIZED GENT DECLARATION I as Owner/Authorized Agent of subject pe H y declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Sit of Owner/A ent Date' NO. OF STORIES SIZE BASEMENT OR SLAB RD SIZE OF FLOOR TINMERS 1 s 2 3 SPAN DMENSIONS OF SILLS DM/1ENSIONS OF POSTS DINENSIONS OF GIRDERS DIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHININEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE FORM U - LOT RELEASE FORM -INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from el Boards and Departments having jurisdiction have been obtained. This does not re,the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION APPLICANT 4le—, PHONE , 7�2 3d`( LOCATION: Assessor's Map Number-60—q-3 PARCEL 0-0,/60 SUBDIVISION LOT(S) STREETJST. NUMBER OFFICIAL USE ONLY********************** *** * * RECO FENDATIONS FT N AGENTS: /CON ERVATION ADMINISTRA R DATE APPROVED DATE REJECTED COMMENTS s TOWN PLANNER DATE APPROVED i DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS i . PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE_ Revised 9197 jm i MY-19-2003 10"46 P.02/02 MORTGAGE INSPECTION PLAN BOSTON SURVEY, INC. 02-09062 P.O.Box 290220 Charlestown,MA 02129 (617) 242-1313 MAIN (617) 242-1616 FAX APPLICANT. SESLAR&CHOCK LOCATION: 50 BRADSTREET ROAD DEEO/CEjttT. 987-408 CIT1;STATE. NORTH ANDOVER,MA PLAN REF: 409 987 r lies esioetir GNtAOe 8160+/-SF �+ . �7L TT 1-3 -- N _ i #50 2 STORY I I 70:04 BRADSTREET ROAD 1994(e)Boston Sung.Saltrere PREPARED: 10-10-2002 CERTIFIED TO: 1800 EAST WEST MORTGAGE COMPANY,INC. SCALE: 1 Inch=20 feet The permanent structures are approximately located on the GEORGE According to Federal Emer ground as shown.They either conformed to the setback gency Management Agency requirements of the local zoning ordinances in effect at C maps,the major improvements on this properly fall in an the time of construction,or are exempt from violation en- Np 4 i t" arca designated as Zone )('A& N � forcement action under M.G.L.Title VII,Chapter 40 A, 7'04 Communt:y Panel No: .7 Section 7,and that there are no eeeroaohmcots of major - rmurJtalT OG�0p $� Improvements either way across property lines except as 'i' V Effective Date: 4,3 shown and nosed hereon. _ lo NOTE:Zone C o areas of roinlmai floods//ing(no Shading).This t u designation ill not based on an elevation cartincats. NOTE:This is riW a boundary f title insurance Survey.:h;s .�was n<nnsrred in occcrdanca to p(aenourni dna rncn"trnl�slendsra_,k3f Mart. rr ri Lvan lns usedthe r rec .ertusrsus t3aatd ear Rey7ialrniinn nP[rrataanio, rr�le.e<sra nr,rt.irnq survo ars.250'CM.R S.0S.or n use lar ert char 0 peetien9 as aoapraa used for reeordino.mraoarirrr.eM,.<r<rem.<:nx,...e ,..�..-w.....r-_ f+ Y purpose is Prohlbited.This plan Is not to be TOTAL P.02 North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM 6 -a -o`3 In accordance with the provision of MGL c 40 S 54, a condition of Building Perrrrit Number S,j Y is-that-the debris resulting from this work shall be disposed 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. UY (Location of Facility) Signature of Permit Applicant SLC) ----------------- �3 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through.the Office of the Building Inspector �, I _,_____1 _.____ i _� �, , �:�{ . II The Commonwealth of Massachusetts M tl Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: Location: )D City 1i AY'eV C, t I (/l/(fl_ ©` " 3 U Phone # 2J 7tF l '-/VT I am a homeowner performing all work myself. E4I 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. Policv# 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 penalbes of,a'fine up to$1,500:00 and/or one years'imprisonment_as_vias_cbM-penaltiesin-thefmn- -a-STOPWDW-ORDER and afm�f understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for co Merage verirjcation /do hereb der the pains and peva/' of perjury that the frrformahon provA*d above is true and correct. Signature + Date__T4�o3 Print e J Av—, Pyne.# SSI `� 's Official use only do not write in this area to be completed by city or town official' City or Town Paan;&/.:—nsi D Building Dept E]Check if immediate response is required D Licensing Board E] Selectman's Office Contact person: Phone# I] Health Department Ei Other • ; �2 S„��� . j�.eS'r c,�e�n c.� s�o_ mss- �� . . _ �i�,ecQTo FIv�St. .................... a1 Mr i ly' i . i�� � l ✓/ZE°VdI7� l ABOARD OF BUILDI REGULATIONS,.-i �lticense CONSTRUCTION SUPERVISOR' ' Nu_mberC� :011756• g " � Birt�tdate 05/29x'1960 £, , icpires�og/297�QD4 Tr no <23883 *Mr GaMARTIIVOLI 22 WHTTIER tiAVERHILL MA "03Q1 Administrator 3s NORTH Tomm Of . EAndover O 1 R` 11L 0 . = -a -a 003 0�A coc-,c� ,� dower, Mass., °RAT E D P'P��_`C, BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......5. 0 V''N............. .l..�.,I lr- D •.. Foundation�3 Bio w •�. ....1� . . has permission to erect... ....�18......... buildings on ..... ..................................�.................................... . ... Rough ........... to be occupied as. .P C�,..:... .�. I! �..�.......��ifi�ll<..f/I� .................. Chimney .............................. provided that the person accepting this permit shall in every respect conform to the terms of the applic n on file in Final this office, and to the provisions of the Codes and By-Laws relatin to the Insp ction, Alteration and Construction of Buildings in the Town of North Andover. �� �� � PLUMBING INSPECTOR 30 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTIONS ART 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. Smoke Det.REVERSE SIDE � Location t No. Date r IV ". 7;,tio TOWN OF NORTH ANDOVER 4 Certificate of Occupancy $ X11 Building/Frame Permit Fee $ +ss NuSEt� F undation Permit Fee $ ermit Fee $ W Sewer Connection Fee $ Y Water Connection Fee $ t. TOTAL XD 616 Building Inspector 0,11/30/95 11:25 39.00 RnID 9439 Div. Public Works i PER311T NO.�Q_o�io APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP rq0. LOT NO. 2 RECORD OF OWNERSHIP (DATE BOOK '.PAGE yZONE I SUB DIV. LOT NO. LOCATION O PURPOSE OF BUILDING OWNER'S NAME , ` NO. OF STORIES SIZE OWNER'S ADDRESS �a BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME it s-i n 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. COSTS,30 PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 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 A n` DATE FILED 7 BUILDING INSPRCiTOR SIGt4ATURE OF OWNER AUTHO Z D AGENT r FEE QB L OWNER TEL. PERMIT GRANTED CONTR.TEL.0 V 19 CONTR.LIC.a ®S C d t( q H.I.C.# BUILDING RECORD 1 OCCUPANCY 12 j SINGLE FAMILY �• S.oRIEs `THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT'ANb DISTANCE FROM MULTI. FAMILY _ OFFICES _- LOT LINES AND EXACT 'DIMENSIONS .OF ,,BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN: j 1 CONSTRUCTION ,J , 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE d t ? I 3 � � � •� T �� ' CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ FIN. ATTIC AREA _ NO BMT FIRE PLACES _ HEAD ROOM _ MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARDVV D ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH.TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY i ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR II POOR _ ADEQUATE NONE 5 ROOF 10 - PLUMBING GABLE I I HIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES i 1` _LAVATORY _ WOOD SHINGES .� !KITCHEN SINK SLATE 'y" NO PLUMBING N TAR & GRAVEL STALL SHOWER _ `( ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST '. PIPELESS FURNACE �t FORCED HOT AIR FURN. TIMBER BMS. 3 COLS. STEAM STEEL WOODBRAFTERSOLS. = ART CONDITIONING G 11L •`r ,1 `` RADIANT H'T'G UNIT HEATERS GAS �. 7 NO. OF ROOMS OIL B'M'T 2nd _ ELECTRIC 1st 13rd I NO HEATING NORTH y FAIN + own of dOver G l rt dover, Mass., F 00 1915 1,V1-111C 111:\Nllrt 4.,�� s- BOARD OF HEALTH Food/Kitchen Septic System PERMIT T • BUILDING INSPECTOR THIS CERTIFIES THAT................ .... ....... ... ...... ................... Foundation i ..... buildings . . � has permission to r�sl........... . ., gs on ...... ........ .. ... Rough to be occupied as.................... .. �..... ... . .. Chimney f provided that the person accepting is permit shall in every respect confor 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 Inspection, Alteration and Construction of i 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 MONTHS � UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough �... et'�....... ..... Service BUILDING INSPECT�..R 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. ? ,' Smoke Det.