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HomeMy WebLinkAboutMiscellaneous - 517 JOHNSON STREET 4/30/2018 517 JOHNSON STREET / 210/098.A-001 5-0000.0 ` r it I I Date........ ......................... HORT!{ °f,�``°:• '"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING CHUS This certifies that ............ l7t�K� (� tq/1 y�j.. ` �.................... has permission to perform ! T<f .l Tc„y„�`il/.................... wiring in the building of ��� 19f/k2D ...... ... ................................................................ at....IS.-Y.7...... ......5 ............... .North Andover,Mass. Fee...,-P'.-vu-”' Lic.NoA,.?�. �......... .. �.... fi� ....... . . ELECTRICAL INSPECi'Ol� Check # ��t t 6926 Commonwealth of Massachusetts Official Use/Only a s - Department of Fire Services Permit No. Occupancy and Fee Checked r BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),52 CMR Y.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: r 3b 1'0� City or Town of: Q1f7-Y AA1AQ0VN To the Inspectorof Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street& Number) !1! e\4 5CN �� �r✓� Owner or Tenant K eu i a a 415 Y�(f( Telephone No.(Gl`7-M-3"152— Owner's Address 512 -72,,4b5-'F{e C e'T Is this permit in conjunction with a building permit? Yes NJ" No ❑ (Check Appropriate Box) Purpose of Building kslolw- d4z Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity = Location and Nature of Proposed Electrical Work: �"uy�Od f,� �jT /7-CA11W ;w Completion of the following table maybe waived by the Inspector of Wires. No. of Recessed Luminaires �� No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above in o.o Emergency Lighting rnd. rnd. El Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o. o Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pum Nur1. Tons KW No.o Self-Contained Totals mbeDetection/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 t No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: s No.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of E ctric I Work: t> (When required by municipal policy.) Work to Start: �Y/30 (f Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C ER GE: 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 or- BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: " kv Ite LIC. NO.: S Licensee: Signature y t O� LIC. NO.: _ (ll'applicable, enter "exen "in the license number, ine.) ^, us.Tel. No.:� Address: L. A1,,EGy a-1y /1«/oAlt. Tel. No.: *Security System Contractor License required for this work; if applicable,enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By y signature below, 1 hereby waive this requirement. I am the(check one)•24'bwner ❑ owner's agent. Owner/Agent Signature Telephone No. 97+ PERMIT FEE: $ D MRnWEN 'OFP(W XSAMY Permit No. BQAIPDOFFIREP avnvnuivRhGVLATIg11 537(3,maim C9 Otxupeery&Feer Chocked APPUCATTON FOR PERMIT TSO PERFORM ELECTRICAL WORK ALL WORK To BE PERFORMED IN ACCORDANCE WITH THE MASSACLNSSTS ELECTRICAL CODE,527 CMB 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of Nortb Andover To the Inspector of Wires: The undersigned applies for a permit to perform,the electrical work described below. Location(Street&Number) J, 75pJyNvOiV 151 Owner or Tenant Owner's Address Is this permit in conjunction with a building pmu. it: Yes No (Check Appropriate Boa) purpose of Building Aa-0-M/10,Al 74� A--)(/ V-11V o geA,5IDfcNL-,0'E- Utility Authorization No. Existing Service , Amps ,0// Volta OverheadUnderground No.of Meters / New SAmps..�O �V olts Overhead BUnderground No.of Meters Number of Feeders and Ampsdty Location and Nature of Proposed Electrical Work " No.of Lighting Outten Na of Hot Tubs � No.of rr maxmsrs Toed KVA Na of Eighties Pbct m Swimming Pod' Above Betow dtamaten KVA r— No.of Receptacle Owbt No.of On Bueoas — No.of F—p-y Lighting Bwmy Uoitu No.of Switch Outlet !�C/ FE No.at gee Butean I No.of Ranges _, No.of Air Coed. 11 Toed /� FIRE ALARMS No.of Zaros�� Tom J No.of Disposds Nm of .'Hest — Total. _._ Total _ No.of Detecdoe s,,W Pkmwe Tows Kw-... bddaftes Deviow No.of Dishwashms Space Ana Heating KW No.Of �� Self CentWned Na of Dryms Heating DrAc s KW tad ° iMwdcipd Catnecdom No.of Wsw Heaten KW Na of B ^1 usigns No.Hydro Musap Idles / Na of Macau Told HP OTHER heu�aet7�eie�Plsoertbbe�itrr�atlNe�diuelsClmt�llaiM IhneaasrmtI�e6tlyhaairoeFt�,yilcldrBt t?les>be�aiiltgiivskrt YM rpEl Uwwatrr1ledvddppti9dsmciD1z0MzYM jlcud7Mpk=kdM9etyRc(wwqVg' )rb'C1RA1� am E amm 0 ��Y1 P„gislfmDwe VattafI]ectdcalwodt WodaDSW hpxAmD*F4grsted lioi�t 1� s �w, 9yzdundkrk;;iC,fPdjW- FSMNAUE LioszNa Lio3t�e ��l�G' �/7/i./�/L�/�% LiaeaeNo � � Budrss UNIa. OWPNWSMJ AN EWAtVFR;Ianmmi a dzLiame bntrianaloea m*critrstftoa}ivdnx ardthetmysg�iaaseontiapanrit tiragiimuat zc}iWbyMasaarfmcla>edLavis (Please one) Agmtt r�i c/ Telephone No. 9� �'o-7/6 pg�t�rn�FE9 3 r�51` Date. 1 1 H°R7M TOWN OF NORTH ANDOVER �: .�� --•.'• °oma PERMIT FOR PLUMBING s � • '� 'O•.r�o..'`49 ,SSACMUSfct This certifies that . . �?.o .�n� «. . . �.��.. . . . . . . . . . . . . . . . . . . has permission to perform . . . 1 Ia<' . . . . . . . . . . . . . . plumbing in the buildings of . . . .d't.N. 4--�. . . . . . . . . . . . . . . . . . . . . . . . . . . YLUMIBING North Andover, Mass. Fee/12 Lic. No. ! �?.f�.f. . . . . . . . i_� . . . . . . . . INSPE .TOR Check # 3 v r 6570" MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS _ _ Date Z C- `6 Building Location J /7 J o}• k6o 1.. S 1 ,Owners Name Permit# 776 Amount Type of Occupancy New Renovation Replacement 0 Plans Submitted Yes 0 No FIXTURES Cr 12 rX C ed SLI&EMIC BASEW NT ISIC)H CM Z� 2r-DR M 2 / �2)NIDCR f / 4II3 FLD(lt . 5M11" 6M11"- 7M M]FLOCK7M]MOCK SII3)EID(lt1 1 1114 (Print or type) Check one: Certificate Installing Company Name yr l G&-' �G Corp. Address 0 Partner. I� .e i,�c� 1 as�- /Y',� • Q t Fo.j Business"Te ep one -7 R'1_ 2,21 —ZZ ?777 © Firm/Co. Name of Licensed Plumber: insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy [a 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 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 e P in • g Code an pt e 142 of a General Laws. By: SignaLure um Type of PIU-bing License Title a I�f City/Town License 1Qum er Master ElJourneyman APPROVED(OFFICE USE ONLY Date.................................. HORTM °�<�``°:•�"� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSACMUSE� This certifies thatU.... ........... ,��.... ...... ,.................................... � has permission to perform ..................... J............................................. wiring in the building of.....' - �.7...... ......................................................... ,North Andover,Mass. '' �` ,w lGGL� r�.y� ELECTRICAL INSPECTO Check # ! {f// DEffi MYTOFPUD SUE/Y Permit No. BaMOFFBPEPIPlrMV1hOINRt7f3[1lATIg44.97CMe12, C9,/1 `od Occupancy a:Fees Checked APPUCA71ONFOR PERMIT70 PERFORM ET CAL WORK ALL,WORK To BE PEIVORM®IN ACCORDANCE W MI TM MASSACHUSSTS EL.E(MICAL CODE,S 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) 17 �0-11N,50A 5/:- owner or Tenant Owner's Address 0-1wSa/y -577 Is this permit in conjunction with a building permit: Yea No E3 (Cheat Appropriate Box) purpose of Building W/T/P/i/ 7� YL,K/ V-11V& ,e Sj0,ENG,1E- Utility Authorization No. Existing Service AmpsQ// Volts Overhead El Underground No.of Meters / New Service Ali i Volts Overhead Q Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work " No.of Uandna Outlets Ca No.of Hal Tubs No.of Tnaafamara Total KVA Na of Uahthy Fi:taa Swttamiry Pod' Above 0 Below Oett n"n KVA No.of Receptack Oudeb No.of OR Buems No.of Emergency Uahtini Battery Ueda No.of Switch Outlets �� ,.. No.of ON Barren No.of RwWs No.of Air Cad. Total ! FIRE ALARMS No.of Zmm Taos ✓ No.of Dispoule No.of Had — ToW Totd No.of Detenioo and Pun= Tons Irw Initie ft Devkea No.of Dishwahen / Space Ara Heathy Kw No.of Sounding Devices d No.of Sad Contained Deowd Devices No.of Dryer / Heathy Deviax Kw Local 0.°moi mwdcipd 0 0( Comsectio n No.of Water Heaton Kw No.Of Na of S Baikels No.Hydro Maaye Tata / No.of Moon ToW HP OTHER' }t9tiawiaetb�Pta�tbt2letec�i�rHbdNla�fi8'�G�I�r1t IhwaannLW yj==Fb .YiiditCbrr ormWbMMequiwlmt yo Np • Ihtfiesubmlledvsidptoafdsnnebh�oe Y1 4 iymimeygS,pitaitdM&-rA eefwwu;`7ym the 6aR Al�()IiANQ U BCTD� UTfFR � �Ira��c�) E�rpi�m r WakbSM rt r,na�Is�,rsba 9 va�d dwak s , �lv d LioeroeNn BudlsasTtiNrz - �. - , /�/i1O a►tmNo► OWMtSP6URANCEWA AR,Iamnmtwdzt;mwdmmt canoe its le�r�,ta9a�l:edbyM lac I a arddietrriysigriatiaeondiispemd true�i®t (Please one) Agent Telephone No. �� aS?-�Y6 pggyt�frr FEES ��� Date...................... ... ... Th TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ... .�. -A2 C-1 has permission to perform ..................................................................... wiring in the building of..A- Alt .............4...... ......0....J.................................... North Andover,Mass. 0 Fee.,fL.,f............ Lic.N&...... .... ........ ...... ELECTRICAL INSPECTOR Check # 5481 THECOMMONWEALTHOFMA.S CHUSETTS Office Usj/n Jr f DEPARTAMWOFPUBIIC Permit No. BOARDOFFIREPREVE ION ONS527CNIRI2.�10 Occupancy&Fees Checked APPLICATTONFOR PERMIT TO P RFORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH T M SACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat lql a 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) S I q ��I .S 0 J S Owner or Tenant L'-P ,4j /4 dex Owner's Address Jr� �oLcvs�.a S� itlr� a✓Pn 1144 ©18-%t Is this permit in conjunction with a building permit: Yes r7T No (Check Appropriate Box) Purpose of Building GX f%--� �i c✓��h Utility Authorization No. L.LSLL1 Existing Service /00 Amps 4 /A? Volts Overhead Underground M No.of Meters New Service op Amps/,2o Overhead ® Underground No.of Meters Number of Feeders and Ampacity a �(OT 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 ground 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. 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 Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER- 1 hiuuanXCovetage.RNR]M ttDdrmgtm =ntsofMasSactatscitGmxalLaws IfiaNeacjm=Lzhltykmm=PbhcytwhdTCmiplee0paahonsCDver,lporltswbstanWeqwmiat YES ® NO E3 IbaNembmmdvalidproofofsametodrOffice.YES YyouhavechododYES,pleasenidicatetheeArofoovmageby dleddngdle box INSURANCE BOND OTHER (Please Spa*) EVirafm Dae WodctoSfatt /s O EsttmamdValueofDearicalWotk$ IrgecfimDkReWe*d Rough Final Sigr>edurarTr ofpajtuy FIRMNAME LkmseNo. Licniisee 7 ✓! Signahue L..No BuskmTel No. fjjf✓1 X92`�G/a / A1tTel.No. OWNEl2'SWSURANCEWANIIt amawatedvitheLioawdoesnothawde' covWoritssttbsaidequwalentasmquffedbyMassahisettsC,=TJLam and tfi-Any signattue on dis penrrit application waives @lis mgtmenent (Please check one) Owner F-1 Agent Telephone No. PERMIT FEE$ Signature of Uwner or Agent 4138 Date./C...... ...... . ...... . ... ..... TOWN OF NORTH ANDOVER tP PERMIT FOR WIRING US This certifies that .................... ............................................................ has permission to perform ...................................... ........................ wiring in the building of............................. ......... ........................................... at l ................z.................................................... .North Andover,Mass. Fee"—.�.............. Lic.No.............. ............1.1. .:?...... .. ..................... ELECTRICAL INSPECTOR Check # The Common& ealth of Massachusetts ° OWY I)ePrr! "Int of Public Safety � L11 OCuFancy t FM Chwksd —�.-- BOARD OF FIRE PREVI.rvTION REGULATIONS 327 CMR 12:00 3/90 On"d.,p APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK A J work 10 be peAQrm,wl in accordance with the MassaChUmsta E*CtrieW Code,$27 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION] Date 7— CRY or Town of )J, , TO the Inspector Of Wires: The undersigned applies for a permit to Perform the electrical work described below. Looallon(Strew d Number)..'P . -- b"`Sar"�-tom Owner or Tenant---.;�=dam _ /e��►e--. Owners Address 17 —.3a6.. Is this permit in conjunct th a builain' permit. Yes ❑ No 13'-- (Check Appropriate Box) Purpose Of Building /'a(/ Utility Authorizatbn N0. Exietlng Service/ Amps... I.,Lia volts Overhead �UndWd ❑ No,of Meters f Amps _L _.__Volta Overhead ❑ Undgrd ❑ No.of Meters Number of Feeder*and Ampacity LOcanon and Nature of Proposed Flecwc;v Work_ f/?�, !� EJB' b TOW P�e�t/ fj®��-??�✓.®i:�f�G �1 No.of UgMinp Outlets a ;,:I.of Hot Tubs No.of Transformers !KVA No.of Lv"fixtures ming Poot AboveWnd. A. 0 C;ensrators KVA No.of Emergency Lighting Nck of ReoepWo Outiats ; of Oil Burners Units «- No,of Owfth Outlets ; i of Gas owners FIRE ALARMS No.of Zo _.� No.of Total No.of Doliectlon and Ranpa !a.4f Air Coed. tons Initiating Devices fVa.of Disposals - !, .� of p turps Ton KTotal IN No.of 9ou""g Devi No,of Sell No.Of owhwashera osce/Area Hosting KW Defecifon/ vices No.of 6rysre Mating Devices _ KW Local❑art ❑Other KW Iv.).of No.of Low e No a Mawr ns "8�rllaa�ts_ wwft t�ADkp No.Hydro 1aisage Tuba Motors Total HP OTHER: INSURANCE COVERAGE: f urea,ent ra rhe.f=iuirernents of 7cporan setts General Laws ,�,/ I have,a current Ustoility insurance Poiicy inc+uciaq Compistns Coverageor its substantial oQuivaMnt. YESt�INo ❑ t have submitted vali of swr+e to this of<t,.I; YES . tf you haw check YES,please indicate the tyfpe of covers"by checking tits appropriate box, INSURANCE SONO❑ OTHER[] tFt,j.wo Specify) Estimated VWuo of Electrtod Wont$ .... (Expiration Date) Work to Start Signed under the penalties of perjury: FIRM NAME LIC.NO, Ucensr L. . — Signature UC NO. 'Z Address / 4yL sus.TM.No. Aft Tel.No, OWNER'S INWRANCE WAN": I am swera u,rpt the iloer+eee Qwr not have the Insurance oowrage or IN aubstantlal equivaNnt as required by Massachusetts Generpl taws,ane tart my signature on this permit illppfteutton wain this Mquirertsnt. Owner ❑ Agerrt ❑ (Please chat, rine) `V (SlgnNure of Owner or'Agent) TMet7horte No. PERMITfrEEi ! Date. .AP : . ,aOR TIy 6.6 6 6 6 TOWN OF NORTH ANDOVER p 9 • - PERMIT FOR GAS INSTALLATION s + SACMU5Et t This certifies that has permission for gas installation .�.:aha-.n�.,! ,<< <.r._ .4.r. in the buildings of, . . ,rpt .f. .�...�. . . . . . . . . . . . . . . . . . . . at North Andover, Mass. (i Fee:-3n . .cry/. . . Lic. No. /n R./�. . ��;,° . • GAS INSPECT4SR Check# 4 : 62 MASSACHUSETTS UNIFORM APPUCATON R PERIVllT TO DO GAS HrrING (Type or print) Date NORTH ANDOVER,MASSACHUSETTS Building Locations 51 -7 .cA— 51-- Permit# Amount$ � d Owner's Name ��/�y6A.— NewElRenovation Replacement ❑ Plans Submitted ❑ U lam ? o a z p ° yyR3 to a Ow' � .P G WCA Ua aA Oa `n P UB -BASEM ENT ASEM ENT ST. FLOOR ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5 T H . 17L O O R 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR i Ch one: Certificate Installing Company (Print or type) o j]��iG� f L� Corp. i Name t /0/Z)W:5' 5i ❑ Partner. Address Llx4-ia� lyiiS. 6iP6� n usmQess Telephone one 7�/��2/-7 2�7 Firm/Co. Name of Licensed Plumber or Gas Fitter ZG A11— INSURANCE INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. YesE3 No J If you have checked yes,please indicate the type coverage by checking the appropriate box. Liability insurance policy ® . Other type of indemnity ❑ Bond Owner's Insurance Waiver: I 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: Signature of Owner or Owner's Agent 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 installationswf�rmed under Permit Issued for this a lication will be in compliance with all pertinent provisions of the Massachusetts e G C and Cha 1 o he Ge ral Laws. Signature of Licensed Plumber Or Gas Fitter Mn Title Plumber /d Fls Tit City/Town ❑ Gas Fitter tcense Number Master APPROVED(OFFICE USE ONLY) ❑ Journeyman Date..!...t s.... ... ... . iR AORTIy pf s�,ao ,°,ti0 o? TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION -.z :• SAC10 MUSEt h This certifies that . . . . . . . .'`.. 4 �" , has permission for gas installation . . . . r i-� °-�1�i/I in the buildings of . at . . .`. . . . . . . .. . . . -. . - . . . . . . . . . . . . . .. North Andover, Mass. Fee, ./%v. . Lic. No. . . . . . . GAS INSPECTOR Check# 3"/. )/' 52 . 9 MASSACHUSEITSUNNORM APPUCATON FORPERIVIlTTODO GAS HUNG// (Type or print) Date 6r,10 y/ NORTH ANDOVER,MASSACHUSETTS TT Building Locations 17 'Se Permit# 09 Amount$ Owner's Name 2' -� New❑ Renovation Replacement ❑ Plans Submitted ❑ 0 W .W.1 "Q ° � F A w ° � d a a� w .a C a z d a H o • SUB -BASEM ENT BASEMENT I IL 1ST. FLOOR ' 2ND . FLOOR 3RD . FLOOR 4TH . F L O O R 5TH . FLOOR 6 T H . F L O O R 7TH . FLOOR STH . FLOOR (Print or type) � Checkone: Certificate Installing Company Name. /G�t���I2/G� 1��� Corp. Address `' �J ' ❑ Partner. Business Telephone Z —ZZ ® Firm/Co. Name of Licensed Plumber or Gas Fitter /�LdiL d��2iGiC INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes D No❑ If you have checked yeses,please indicate the type coverage by checking the appropriate box. [3Liability insurance policy q Other type of indemnity ❑ Bond Owner's Insurance Waiver: I 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: Signature of Owner or Owner's Agent 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 Permit Issued for is application will be in compliance with all pertinent provisions of the Massachusetts S e G e and a r General Laws. Signature of nse Plumber Or Gas Fitter By: ® Plumber /6 Title City/Town ❑ Gas Fitter License Number aMaster APPROVED(OFFICE USE ONLY) ❑ Journeyman Location 617 No. Date =p — �ORT4 TOWN OF NORTH ANDOVER O f � A }co Certificate of Occupancy $ cMus<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 17650 Building Insp� r a J R ! TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVATE, OR DEMOLIIySHH••A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. / O.. DATE ISSUED: T O 10 3 SIGNATURE: Building Commissioner/1for of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: qfm Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: cS FS I/ /7i0 Zoning District Proposed Use Lot Areas Fronta e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provi4e Required Provided Required Provided 1.7 Waterly M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public Private ❑ ZOIIe Outside Flood Zone ❑ Municipal ❑ On Site Disposal System SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record U/rI C2vrr✓ 5/� JaF�vy oma/ ( /� Nc��r Name(Print) Address for Service: \ k-IL &4nn, q��1 S� -7 Y6 ,C c �G�>> ?33- 37Z-;72- a Signature T lephone d W 2.2 Owner of Record: Name Print Address for Service: O z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: �)b a6� O XA r" License Number mn Address Expiration Date ic Signature Telephone M< 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number r Address J r Expiration Date ^ Signature Telephone V I f i• y S r 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.......❑ No.......❑ SECTION 5 Description of Proposed Work check all a ticable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: X a B �y f r R S //S Conn ,�D1.21 iiV2/ 05 c-i �' T� Gt!r/s p o"`ch SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICM USE ONLY Completed by 2ennit applicant 1. Building (a) Building Permit Fee o? "f 5-0,OOH Multiplier ✓� 2 Electrical (b) Estimated Total Cost of S� DO Construction d S 3 Plumbing DU 6 Building Permit fee(a)x(b) 4 Mechanical HVAC pov 13 pZ d 5 Fire Protection 00 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTH ORIZ4tiON TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, /20/l / wAe 0 i✓ as Owner/Authorized Agent of subject property . Hereby authorize to act on My behalf, n I matters rel ve to work authorized by this building permit application. Y ems_ , ��„�_ //14)Y1,63 Signature ot 6wner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, E Ui./ IZ4 I-KC12°ti 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 (') fy!N 114/>/wy"Ai Print etom.._ f''.� Si ature of Owner/Agent Date NO.OF STORIES SIZE BASEMENT OR SLAB /3,11 t" -„i SIZE OF FLOOR TI1vIBERS 1 2ND 3RD SPAN / DIMENSIONS OF SILLS DIN ENSIONS OF POSTS t a(C DIMENSIONS OF GIRDERS y' a X HEIGHT OF FOUNDATION THICKNESS /U SIZE OF FOOTING yC/ X MATERIAL OF CHIMNEY �f IS BUILDING ON SOLID OR FILLED LAND .' o C r o IS BUILDING CONNECTED TO NATURAL GAS LINE �g �a c�nMIX ocy,pr� ,-3 y �yq�»�•�b o•,4 c .� 02 (of Oaf �- f=ns FORM U - LOTRELEASE'VORM .11-cq4_03 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. Issassee-■ssssssssssssssessasssssss.sasses.■■s■■ssssrssas.sss..sss.MEN as se an APPLICANT ZLI111zg `&o J PHONE ( G 0 ) 73 3-3?SZ e7t ASSESSORS MAP NUMBER 9U LOT NUMBER SUBDIVISION LOT NUMBER STREET �'0 SO STREET NUMBER ± I ussssasas.sssas■ass.s......WA.ss..sRoss■saesss.s■ssss..ussssssss.a.sMEN sas■ OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS DATE APPROVED CORSERVATION ADMINIS OR /r DATE REJECTED CONy'<LVIENTS DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED r •� �,. AS DATE APPROVED b SEPTIC INSPECTOR-HEALTH A, DATE REJECTED COMMENTS 0 PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMN]ENTS RECEIVED BY BUILDING INSPECTOR DATE T j North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location 6f Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector NORTH ® ® � Andover 0 to d1l,0 CO. � LAK o over, Mass., AP-/o - 0 3 COCMICMEWICK S RATED P'PF`��Gj U BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System Qf� N rV BUILDING INSPECTOR THIS CERTIFIES THAT.........1 .......... /—' Foundation has permission to erect.... ... ..... .. .......... buildings on ..... ...................................... ............................................ Rough r wv Ml to be occupied as '2 S40 h IV!�!'...`,,,,... N �A M Chimney ~ ....................... . ..��e� F...........,................................... .... ..C.3.$h... 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 Inspection, Alteration and Construction of ' Buildings in the Town of North Andover. pt a lk / SO PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTIONS ART Rough ....... .a . .............................::...: Service BUILDING INSPECTOR 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. JEFREY D. & CHARLENE A. HART DAVID A. & SUZANNE D. JIHAD & LYNN A. MAP 98A, LOT 12 WHITE HAJJAR MAP 98A, LOT 56 MAP 98A, LOT 33 150.00' NOTES: 1. MAP AND LOT NUMBERS REFER TO NO. ANDOVER ASSESSORS. 2. THIS PLAN COMPILED FROM PLANS AND DEEDS OF RECORD AND A PARTIAL FIELD SURVEY. MAP 98A, LOT 15 AREA = 44,810 S.F. OD p 3. SEE DEED RECORDED ENDRD = 1,03 AC. BK. 1196 PG. 728. 4. SEE PLAN #3696 RECORDED ENDRD. SHED STEPHEN J, & MARY T. 28.3' DERBY MAP 98A, LOT 14 Ln o JAMES BLAKE o DECK GARAGE o MAP 98A, LOT 16 46.5' 26.8' 1 STORY 46.1' WFD i #517 47.9' ` ADD/T/D I I I I I f 86.58' _ y \63.55'JOHNSON STREET PLO T PLAN OF LAND IN NORTH ANDOVER, MA. DRAWN FOR '1 KEVIN & NICOLE AHERON 517 JOHNSON STREET " I HEREBY CERTIFY THAT THE FOUNDATION IS LOCATED ON NORTH ANDOVER, MA. 01845 THE LOT AS SHOWN." DATE: OCTOBER 29, 2003 SCALE: 1"=40' 0 20 40 60 - ` 10/29/2003 MERRIMACK ENGINEERING SERVICES - � 66 PARK STREET STEPH ,, R.L.S. DATE ANDOVER, MASSACHUSETTS 01810 ull�wv-A Y.•\R 14\DWGS\5942\WS\5942-0 f.dwg x RIM .,- 04e Tammonwfulth of Masour4olletts Permit Noffice Use Only113.,,, 5 �eparttnf:nt of Public �ttfetg Fe Occupancy� e checked / BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3�so (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be - performed In accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) . Date 07/19/95 %* or Town of NORTFI ANnnvvp To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) _ 517 Johnson St. Owner or Tenant Russell DesRoches Owner's'Address Same Is this permit In conjunction with ek building permit: Yes ❑ No ® (Check Appropriate Box) Purpose of tuilding Residence Utility Authorization No. Existing Service Amps _I Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Repair Service No. of Lighting Outlets No. of Hot Tubs No. of lVansformem Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery 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 Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices No. of Dryers Heating Devices KW Local ❑ Municipal ❑Other Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP + Inc OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws 1 have a current Liability Insurance Policy including Completed Operations Coverage or Its substantial equivalent. YES 6 NO ❑ 1 have submitted valid proof of same to the Office. YES E9 NO ❑ If you have checked YES, please indicate the type of coverage by checking the ap$ropriate box. INSURANCE L$ BOND ❑ OTHER ❑ (Please Specify) ' (Expiration Date) Estimated Value o1�I�S(ic,�yVork$ Work to Start UU// ``'���7�y``�� Inspection Date Requested: Rough Final 07/19/95 Signed under the Penalties of perjury: FIRM NAME Landers Electrical Co. , Inc. r /,7 Ic. No. A5912 Licensee Vincent R. I',anders, Pres Signature O, A5912 1000 Osgood St. , NO. Andover, MA 018 .5 —686— — 3828 Address /3 Bus. Tel. No. _ Alt. Tel. No. OWNER'S'INSURANCE WAIVER: I 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 this requirement. Owner Agent (Please check one) (Signature of Owner or Agent) Telephone No. PERMIT FEE$ 15.00 x-6565 � :ter i 9 w Date.... .......:.:�.......r.. ,1 NORTH o:°est; ` o°� TOWN OF NORTH ANDOVER '° PERMIT FOR WIRING 7SSACMUSES r r This certifies that ....1.:�`. 4-'.C!.r5...... ..C.l. ..,..:.,. .......... ......... has permission to perform ....f.'�I:ftp ���z/Z.! ' ........................ wiring in the building of...................,.t f.%...:'... ..;.J....................... .......... 1 ... . I f. ........ ,North Andover,Mass. Fee.!..,....... Lic.No.—,(.!/./_2............... ............................................ � ELECTRICAL INSPECTOR 16:19 15.0 91111' WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File J AKTR S UCTURAL ENGINEERING ERK8 Coleman Street Peabody, MA 01960-4104 Tel. & Fax (978) 531-5927 September 10, 2005 Mr. Kevin Aheron 517 Johnson Street North Andover, MA REF: Framing at 517 Johnson Street, North Andover, MA Dear Mr. Aheron; The engineer made a site visit to the above address on the afternoon of September 10, 2005. He observed completed timber framing at the first and second floors built about the original structure (a one story wood -frame ranch). First and second floor framing, for the addition, are 14"AJS 25 timber joists, set at 16" on center. Stud wall and roof framing appears to be solid and well built. Enclosed are photographs of the above work. The engineer believes that the existing framing is of the best professional quality and should be approved. Sincerely, sr"amu Andrew Kuchinsky, P.E. y No..WOO h s 0 l60I J V 0SJ y s pl xA A. 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