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Home My WebLink AboutMiscellaneous - 53 SPRING HILL ROAD 4/30/2018 53 SPRING HILL ROAD - 210/107.A-0243-0000.0 J.Date.... ... ................. OF r&ORT/y • TOWN OF NORTH ANDOVER * PERMIT FOR WIRING `4SACHU56 f/ This certifies that ..............:................:`....:.. .. .1...(.4....................................... v ...... has permission to perform ........................D4.......L.......... wiring in the building of.........044&111-> .................:............................... at-�..,S�'� ( ..... ........... ,North Andover, ass. Fee..............-.~— Z ..C...........-'' c/ � ..........Lic.No. �� ... 7 ELECTRICAL INSPECTOR i Check# -3 -A „ 1�`��I i��n�c.a�.A- -�o �i e, \ C0#unoaweaA o f Vamac"Ib Official Use Only ti Permit No. 2,paetrnent WJim SerUice� Occupancy and Fee Checked %Vi BOARD OF FIRE PREVENTION REGULATIONS [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 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: i7 q — /I City or Town of: nr2.-1-14 41U t)n,)p jZ To the Inspector of Wires: By this application the undersigned gives notice o his or her h`er intention to perform the electrical work described below. Location(Street&Number) 5 Owner or Tenant WGA 10 y 1910 V, ni e(Z. Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Bog) Purpose of Building 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: W t Yr1M 1Poo A{&dVG> Q2*0 Completion of the followingtable 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 ❑ o.o Emergency Lighting rnd. d. Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.o Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pum Number Tons No.o Self-Contained Totals ..... ................ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal F1 Other Connection No.of Dryers Heating Appliances KW ecurity Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications irmg: No.of Devices or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 9 —/ Inspections to be requested in accordance with NEC 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 in urance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under thepains andpenalties ofperjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: ,C F I A jt>7 E g1opOA N L Signature i&tLIC.NO.:J,1q yg,�qgc (If applicable,enter "exempt"in the license n ber line.) Bus.Tel.No.• 1 F-29 Address: y 11') �S qLl w02-11\ o w pd e 2 Alt.Tel.No.: *Per MG.L. c. 147,s. 57-61,security work requires 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ The Commonwealth qfMaswfiusetts ,Department of1idifs€rirclAccid&f office of Investigations 600 Washington Street Boston,MA 02111 www.Mass gov/dza ' Workers'Compensation YM,Nance Af idavit:13URders/Contcact0r$) IectrlcxanslPX tbex' ADpueantlWormatio . Please Print LeObk Name(Business/OxganizationlTi&iduai). f(iGIi� KTC' !•F �2 Address: Sq M AZ 14VF-" CitylStafelZip: Phone#: 9,7? Are you an employer?Check the appropriate box: Type of project(required): 4. [7 z am a general contractor and 1.[[ I am a employer with 6, ❑New cOns fruction Aployoes (full.audlox part tame).* have Wredthe sub-contractorsm a sole proprietor orpartnex listed on the attached sheet. 7• Remodeling ship and'haveno.employees These sub-contractors have 8. ❑Demolition working forme in any capacity. workers'comp.insurance. 9. 11 Building addition [No workers'comp.insurance 5. ❑We are a corporal on and its 101]Electrical repairs or additions required.] officers have exercised.their n p ht of exemption erMGL 11. ]Plur bing,repairs or additions 3.El X am.a homeowner doing all work g p 1 myself[No workers'comp. c.152,§1(4),and wehaveno 12.QR.00frepairs insuxancexequired.�? employees.[No workers' 13.[]Other comp.insurance required.] -Any applicant that checks box#1 must also Il outthe section be16w showingtheir workers'compensationpoliGy information. i-Homeowners who sahmit this affidavit indlcatingthey ao doing allworlc and then hire outside contractors must submit anew affidavit indicating such. xContractors that checkthis box must attached an additional shect showing the name ofthe sub.-contractors and their workers'comp.policy information. I am an employer Mat ispvoviclingworkeils'corrtpe;<asationinsu�incefoz'm employees BelowisthepolicyanJjohske information. insurance Company Name:. policy##or Self ins.LIG.#: Expiration Date: • lob Site Address- City/State/Zip: Attach a copy of tete workers'comp enation-policy declaration page(showing the policy number and expiration date). �! Failure,to secure coverage as requh0cl~under Section 25A,ofMGL o.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 obilpenalties in the form of a STOP-WORK ORDER.and a fne of up to$250.00 a day against the violator. Be,advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA.for insurance coverage verification. i do liereby cert&uyide�tliepains and penalties of ertury that the info formation pYovirleciabove zs true and corxec - Simafore•&44eli� Date: :'hone 0: official use ouly. .Do not write in this area,to be completed by city or town official. City or Town: Permialcense# Issuing Authority(circle ane): I.BoardofHealth 2.Building Department 3.City/ToymClerk 4.Electrical Inspector 5.Plumbing Inspector f.Other •r17+nno�. _ f Information and Instrnctions Massachusetts General Laws chapter 152 xequires all employers to provide workers'compensation for their employees. Pursuaait to this statute,an ergployee is def fined as"...every person in the service of another under any contract of hire; express orimplied,oral or-mitten:, An emPloye�is defined as"an individual,partnership,association,corporation or other legal entity,or anytwo oxmore of the foregoing engaged in a joint enterprise,and includiagthe legal representatives ofa`deceased employex,_or the recelver or trustee of'an individual,partnership,association ox other legal entity,employing employees. However the owner of a dwelling house having not more than.three apartments and who resides therein,,or the occupant ofthe dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds orbuilding appurtenant thereto shall not because of such employment be deemedto 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 l roduced•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 forte,performance of public workuntil acceptable evidence of compliance with the insurance requirements of this chapter have b con 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-contractors)name(s),address(es)andphonenumber(s)along withtheir certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members oxpartners,arenotrequkedto carryworkers'compensationinsurance. TfanLLC oxLLP does have employees,apolicy is required. Be advised that this aftxdavitmay 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 retuned 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 xequixed to obtain a woxkexs' comp ensationpolloy,please call the Department at the number listed below. Self insured companies should enter Melt- self-insurance,license number on the appropriate line. City or Town Officials Please be sure that the affzdavitiscomplete audpxintedlegibly. TheDepartnenthas provided aspace atthebottom of the affidavit foryou to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be-sure to fill luthe peWmit/Rcamo number whichwill be used as a reference number. In addition,an applicant thatmust submit.multiple permit/license applications in any givenyear,need only submit one affidavit indicating current Policy information(ifnecessmy)and under"rob Site Address"the applicant shouldwxite"all locations in .(city or town)."A copy ofthe affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as Pr" of that a valid affidavit•is on ftle for fixture p ermits or licenses. Anew affidavit must b e filled out each year.Where ahome owner or citizen is obtaining a license oxben it not related to any business or commercial venture (i.e.a dog license or per it to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Thvestlgations would like to thank you in advance fox your cooperation and should you haveany questions, Please do not hesitate to give us a call. TaoDepar m.ent's address,telephone atAfaxnumber: - �epax�x�,e�a� QfAce 0:ffuves6gaVo:Q,% do wasi migton Street BWon,9A 42111. Revised 5-26-05 Fax#617"727-7749 ' w�v.zata�s,gov�c�a r1 <COMMONWEALTH OF MAS.S.A • • A 11 goll 559 lei AQARD O . I SSUE5 THEIT .LOW 1G. C1�EF(SE AS4RG JGURN EYP4AP ELCT81 'I �tca Z , )fRD E RINGDAHL.....JR 543 P1ASSltHtiS ETT �R1f +Ur 'ter fW 1��'.:ISi7�4FJ'�P4 ',� t�/Yf•1J i V'Ty�'�"I�� ,5+�� MON• PER11IT NO. / / L� APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP K-4O. LOT NO. 0;)�43 2 RECORD OF OWNERSHIP (DATE BOOK PAGE ZONE I SUB DIV. LOT NO. F .�-1 L/L-OCATION `� -S-PR/N/ [/f// �� PURPOSE OF BUILDING , lb OWNER'S NAME ,J, `jib �/�/1 t I le-9- e-() ` (7 (/ NO. OF STORIES SIZE OWNER'S ADDRESS f 2 �Lsl `r_ _ -c4 6 1 Li Rd BASEMENT OR SLAB ARCHITECT'S NAME J `F+Iy�V`�.(/Jl l/j SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME Frec .,L' - -- Cowk rlc�, (jyl SPAN _— DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS 4,--DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING /0!f X IS BUILDING ADDITION �� MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND �eS 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 &D IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST 3 /?D� 100 PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. 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 ANDAPPROVEDBY BUILDING INSPECTOR DAT FILED14 BUILDING INSPBCTOR SI URE OF OWNER OR AUTHORIZED AGENT FEE OWNERTEL.# �///,,,, �-��10 PERMIT GRANTED 9/ CONTR.TEL.# �7`�-87CL 19 CONTR.LIC.# os—41 QJ I H.LC.# 1 1 Za lig BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILYSTORIES 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 I RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE B t 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B M'T' AREA _ V. 1/2 3/ FIN. ATTIC AREA _ N_O B M FIRE PLACES _ HEAD ROOM _ MODERN KITCHEN I 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDIN0 _ ASBESTOS SIDING COMMCN VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I� POOR � ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) _ GAMBRELMANSARD TOILET RM. (2 FIX.) FLAT I 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. 8 COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL 3rd NO HEATING B'M'T 2nd _ ELECTRIC 1st 1 � rt 3(& , 14'-0" 3'-6" 3.-6" Y-6" Y-6- 2x4 pressure treated railing with 2x2 pressrure treated ballusters 3'-5 1/4" 4x4 pressure treated post 3'-8" wrapped in primed pine Brosco ultra view storm door Edge of existing deck. Extend framing oxer 2'-0" 12'-0 1/4" 3'-5 1/4" 3'-0" Remove existing 1x8 pressure treated decking and replace with new. Existing deck 3'-';1/4" 3'-8" Or Existing slider Miller 53 Springhill Road N. Andover, MA 01845 14'-0" T_0" / existing footing /7 0" —_l double up penmeter joist New 10"footing Eas;ting deck 12%l 3/4" new 10"footing / Miller 53 Springhill Road N. Andover, MA 0 18,15 Ridge Brosco ultra view storm door Pine soffit and facia 2x6 collar tie Screen 2x10 rafters 2x4 pressure treated hand reail Primed pine soffit and fascia 4x4 presuure treated post / wrapped in pine jU /,2x2 pressure treated balluster C e't 1 t 2x10 continuous header 4x4 post fasteners PT 4Ix4 2x6 cedar sill 2x8 PT framing Ix8 pressure treated decking 4x4 PT post 1/2"j-bolt and post base 7h u- a i pp pp dd q' ��yfi f I .t.!�h,._N Y di.l I�F.1��h�fi�n,'1.,••m .'��7?.IL.:i.?h�ih., �I." '�.. d°h -i .°"'b a 10"concrete footing r v RIDGE VENT ASPHALT SHINGLE ICE AND WATER SHETLD ALUMINUM DRIP EDGE \` \\ 15 LB FELT 1X8 PRLVIED PINE RAKE COLLAR TIE 4X4 PT POST WRAPED IN PINE 2X4 PT HANDRAIL 2X2 PT BALLUSTER 2X8 pt FRAM 14'-0" Miller 53 Springhill Road N. Andover, MA 01.845 a ' Circ FORM U - LOT RELEASE FORM , INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: ML t IF-Z- Phone �fig- 8-C)/ a LOCATION: Assessor's Map Number _ to Parcel 2--`f'a Subdivision Lot(s) Street s3 - �� ` St. Number ************************Official Use Only************************ RE NjDATIONS OF TOWN AGENTS: ` , Jqf� `"" Date Approved 1 a Cons rvati.on Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected �./---�, Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date 9 TJ r'L7 •I_ Cc •--.t -n Co Co C.F'1 Cx3 34ORWAGE I SPECTION ppletan Land R—ayful. Inc. V a +�erntet U*RZ*G Wxss� LjrM ote w {oeyeew7aso y` 1 UDRTW,()R_--_bIl-t.E.l- .[� ADDRESS OF PRINCIPAL B8 LOING o• �� , �• � _ fUOC�1?)A.nlarry6R Mr\ MM Im for merr w p em�d h rwi bs ,y, ,� �,� b�i es,o ounby,. I14S1,accepts ro ra�pani�iyt kr durtoges m �9bf 4Aw do"qn sold,omrtgamowkn MM �ya m6 dx to add Ms popobd mnigo-)e ]h Afamtlbn on Nk rna+tpapelar e{kn'a%40J rtproduol0n r MWIWom of we mobfw b d 9 o f pbr rHt4n eonwd mn Sl q obloo�ein'Ut" lAirtll AUM lac _vkev'ss5lo-C 1�6dw- r.s:a 1ICA�i �ios kn s�o Pnpond P aeeardonea do 1 SLandorW fa valgoq. 001 17- . 1 SWE TWr N WIf Pf)NUgow onmrm a 4, , - .M tiermmWdl eetaaeh ,;a„7rwb w ek A rA*Mp erdgomsa,oed ttvt Nero on m r wv%hrrotiL I /rJ� ` svw ow reran polwiv inet q .l nd badlod ofHa o Hand Nacre ter. L L7 %064 Is boa!oe W M Flood ftwd 2ww_ s' s 13 Mhrmtt M h k-tkbrd tc doUnft FbW Mgfd a t %m NOW dot r AF) CM Obrd Rxluente _Pd 7T N"� / ------ �•_ ` ♦ \ 'OL' O Dd*of&WPWSD If?•3-9(s N Pan Retererrao BL Ads d Ptan:� Jam-�f-9G c yft` i d`3 c . OR s - 6 over Town of L � � m * dover, Mass., 19 O sLA CHIC WICK E �y BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THISCERTIFIES THAT............................................. �.. 1...........0 l.l..l•• . ............................................................ Foundation . on ....... ... �.1./ .�..,� ...1.. ../......... Rough has permission to erect...........�t...S.. c .... kgs . . p to be occupied as f �... ................TC.. ..1 ........1..�. .. .............. Chimney [f es ,,l. C e 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this hermit. Rough Final PES EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST S Rough ..................................... ... Service UILDING 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. Office Use Only 0142 Tamumun# [if :ffiaS0ar4U5rftS Permit No. _ Mepartment of Ituhtic"%feta Occupancy&Fee Checked _ BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 1 3/90 (leave blank) 01 3 � 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 S—/3— 3 or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical worY, described below. Location (Street & Number) Owner or Tenant ✓ <�/ter > 5 Owner's Address S�m Is this permit in conjunction with a building permit: Yes Ifs No ❑ (Check Appropriate Box) Purpose of Building X,-5 Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps _I Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Total No. of Lighting Outlets No. of Hot Tubs No. of Transformers 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 9 tons Initiating Devices No. of Disposals Dis No of Heat Total Total p Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices 1 Municipal No. of Dryers Heating Devices KW Local ❑ Connection ❑Other No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Compie Operations Coverage or its substantial equivalent. YES e NO = I have submitted valid proof of same to the Office. YES _ NO If you have checked YES, please indicate the type of coverage by checking the appro ate box. INSURANCE BOND OTHER C (Please Specify) (Expiration Date) Estimated Value of Electrical Work S Work to Start —�3 g Inspection Date Requested: Rough l 3�9 Final Signed under the Penalties f rjuU: / e �' C ardi rc�S �zC LIC. NO. /7 FIRM NAME - A Licensee a1-/L /COzy / Signature LIC. NO. /�/�Q Bus. Tel. No. CZ F- Address _�5/� � ' � ` - ` ' O, 4�� 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) Telephone No. PERMIT FEE S (Signature of Owner or Agent) x-6565 Date.......� Ln........f. ... 41°` 931 0 — 0 TOWN OF NORTH ANDOVER ..16 PERMIT FOR WIRING Ui SSACHu Ah K�Z,2t!., J, This certifies that .... ... ................. . ....... has permission to perform .......... .............................................. wiring in the building of ............................................ at......,,,,?13...).. 4,u ....�/.................... .North Andover,Mass Fee........I. ...... Lic.N,�/(.V.f. ................. ... ....................................... V ilECTRICALINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer &Mmoaarealt4 of + alifia jusetts Permit No. Office Use Bepixrtlnent of} ubtic �ufctg Occupancy& Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM. ELECTRICAL WORKAll work to be d ( P accordance with the Massachusetts Electrical Code, 527 CMR 12j00 (PLEASE PRINT INIrK O TYP ALL INFORMATION) Date City or Town , 0rfh d� To the Inspector of Wires: The udersigned applies for a permit to perform the efectrical work described below. Location (Street & Number) ��/2/-tom —/ Owner or Tenant H,11 Owner's Address Is this permit in conjunction � witthea building permit: Yes ElNo �` (Check Appropriate Box) Purpose of Building X&i Sy Utility Authorization No. Existing Service Amps —J Volts Overhead ❑ Undgrnd U No. of Meters New Service Amps ._/ Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work rif/Z"_ No. of Lighting Outlets No. of Hot Tubs � No. of Transformers Total K VA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ I Generators KVA 1 No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners 1 Battery Uni;s 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 Dishwashers No. of Self Contained Space/Area Heating KW Detection/Sounding Devices No. of Dryers Heating Devices KWMunicipal LocalEl ❑Other Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts ------------- Wiring No. Hydro Massage Tubs I No.of Motors Total HP OTHER: w/ f INSURANCE COVERAGE. Pursuant to the requirements of Massachusetts general Laws have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES - NO - I have submitted valid proof of same to the Office. YES C NO ` If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE IX BOND C OTHER C (Please Specify) Genera l L i a h i l i t 1 2/31 /97 Estimated Value of EI ctr'ca(Work$ (Expiration Date) Work to Start Inspection Date Requested: Rough Signed under the Penalties of peri ' Final FIRM NAME Boissonneault Electric Corp. All 823 LIC. NO. (causes �1=�ts4,�i cd G Signature - UC. NO. 3 Address__ 47 al am Road MA 01 826 Bus. Tel. No. (508 ) 454-0383 Dracut, Alt.Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial qutas re- quired by Massachusetts General Laws, and that my signature on this permit applicaton waives this requirement. Owner �l At gent (Please check one) i (Signature of Owner or Agent) -Telephone NO.—_ PERMIT FEE S 4 A Date.......1..... ........7 , a 852 E NORTH 3:p�';�`�• TOWN OF NORTH ANDOVER p PERMIT FOR WIRING CHU This certifies �tY�:- �...... ... . .... ', has permission to perform .. r.._.. .(....... �... i j....,� t1 l 1 wiring in the uildinI of..........:..... . .... ... ... at L,.�. .... . ....... ,North Andover,Mass. Fee.3.0.. ... Llc.No.`�JR,'?..3....... INPECOR ... 4—"3—? r� J ELECTRICAL ST Z6 04/10/97 10:49 30.04 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer