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HomeMy WebLinkAboutMiscellaneous - 55 FERNCROFT CIRCLE 4/30/2018 (2) 55 FERNCROFT CIRCLE 210/10304-0000.0 ----------- i Date...../f...7..n ,IORT of TOWN OF NORTH ANDOVER PERMIT FOR WIRING S CHU5 Et This certifies that ............ .................... .............................. has permission to perform .....!.5&) ........ 12.eAx.4 wiring in the building of......... ....................................... at.......1r...... ..... orth Andover,Mass. ........ ... 400 40� 7 Fee..-SV...... Lic.No.. .......E. . ......... .. . /CTRICAL INSPECTOR Check it 10434 Commonwealth of Massachusetts Official cUss/e Only NEW Department of Fire Services Permit No. T� Occupancy and Fee Checked r 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: lobi I i City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or►Ther intention to perform the electrical work described below. Location(Street&Number) SS Ftry%CCOa�4 CtcC(C Owner or Tenant ,A Iyh � irlKts? Telephone No. 9-18-4(2-0-D$ Owner's Address J5 m ' 4 Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building *R0,.;AeUtili Authorization No. Existing Service Amps Igo /_t(p 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: (�tn h "ice A(CDO �0 \pC'sKA ty a c.c�►wlY rl4 42� rC S�c�r�d a � �r�t:£r��y ucA �� n.�� 53at�6� Completion of the ollowin table may be 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- 110.o mergency 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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Dis osers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local❑ ❑ Other Connection No.of Dryers Heating Appliances Kms, SecNo.of Devi es or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Tel 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: 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 i urance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such covege is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. e.'�' s LIC.NO.: FIRM NAME: %J140ti is A(rla'13 Licensee: rR iL\,-ti'-X..JJ, hC12Z0.• Signature LIC.NO.: (If applicable,enter "exempt"in the license number line.) AA'',�� Zus.Tel.No.;-7A1-3�i4'S1 Address: % j)Way M Alt.Tel.No.: *Per M.G.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: $ K� J>. 6 M I �: A Location. �� No. Date NORTH TOWN OF NORTH ANDOVER p Certificate of Occupancy $ i Building/Frame Permit Fee $ �'�b^�°•'��' Foundation Permit Fee $ ssAcm Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ �C y l Building Inspector 044/121% 11:44 185.25 PAID ya 9678 Div. Public Works PPRJtff 1V 0. ` V ` _ PAGE 1 APPLICATION FOR HERMIT T1 �ULL� NORTH ANDOVER, MASS. � MAP+40. / LOT NO. / 0 42 RECORD OF OWNERSHIP IDATE BOOK 'PAGE ZONE L b SUB DIV. LOT NO. i LOCATION r��^� ��� Q PURPOSE OF BUILDING ��pR OWNER'S NAME N v v NO. OF STORIES , ,r CSIZE OWNER'S ADDRESS L� Gerocr� l clrTC e BASEMENT OR SLAB ARCHITECT'S NAME ' i 1 SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME V ,?rk t7a zvl -off /^c ` SPAN --- DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES—SIDES K�Z REAR GIRDERS AREA OF LOT eKl(Z7 FRONTAGE ZJ/ HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW 77 77 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 �ir BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER J IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST 10 0 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 FII,/L/EE A/J►/1p APPROVED BY BUILDING INSPECTOR DATE FILED " BUILDING INSPKCTOR SIGNATURE 00 OWNtR V91, UTHORIZED AGENT G� FEE gS OWNER TEL.# Q PERMIT GRANTED CONTR.TEL.#(Og<!(Y-M6?� V 19 7 CONTR.LIC.# F H.I.C.# !6r " : 7 BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY _ STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE d 2 I3 CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B M'T' AREA _ 1/1 1/1 FIN. ATTIC AREA _ N_O B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS ' 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING NARDw'D _ ASBESTOS SIDING _ COMMGN 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- I POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE MIP BATH Q FIX.( GAMBREL MANSARD TOILET RM. 12 FIX.( r FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING ' North -Andove -'e . North Andover, Mast- , _. REEDm BOARD OF I-IEA1_-'}-1 f BUILD Food/Kitchen Septic System i BUILDING INSPFI'l-T'OR. THIS CERTIFIES THAT .................... .............. >g� r..-(................................ . . ......... . . ... ... . ....... .......... . ... ..... Foundation has permission to ys#./�,. ... r�jf . buil( :gs „+ ............... ... ... !e G!2 d ... -<. Rough to be occupied as ..s.`� .........7f/?�1..1..!�- . Chimney provided that the person accepting this permit shall in evor,, respect conform to the terms one applicatioit on file in Fine; this office, and to the provisions of the Codes and By-Laws .,plating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. VIOLATION of the Zoning or Building Regulations Velds ti.'- Permit. Rough Final ELECTRICAL INSPECTOR Rough .............................. ......... . .... . .... .. ................................... Service L ING INSPECTOR Final GAS INSPECTOR Rough Display in Cnns,,icoous rig-, or, she Premises -- Do Not Remove Final N Ladhinu ur 0,,-- 'Mall To BeDone _ U i it )ec :nd � ���� �' `v the Building Inspector. FIRE DEPAR'I'i�( ?�?'s Burner i Street No. Smoke Det. WJME INPROVENENT CONTRACTOR Reyistratioe 106877 Type - DBA Egiratien 07/28/% Blackdoa Builders ���•-�� a�' K. Was ADMWISTRAMRZ L�Mreace Road Derry NN 03034 i z OEPARTNENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Nuaber• Expires: Birtbdatr: " "M? 10/3e/1"? OS/10/1961 Restricted To: if OAVIO 9 BRYAN 37 LANRENCE RO DERRY, IN 03038 So MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type _ 't ,( - 7i1 � Mass. Date - , building Location .�� �plj C t-0 Permit Owp6rs NameA4 -F/a,25ZZ R Y • New Renovation D Replacement Plans Submitted �] FIX TLIP,-- ' N dl W to >< x cc03 cc 0 of v N 0: 4 a Of tat 1r0.. V m ~ t S N _ .- O W ~ 4 a 0 = O It F W Z 02 N N to Wcri 0 C a CC Wcc U1 oc 4 V) CC W Z V W ` Or j 4 CC Q D y W tc a t7 F- Z j 1•' Z 1. YW+ N O .7'. 0 hW' W 2 Q W d rt: .r rtl O 2 0 (a = i Q to > C WO o W ¢ 0 W N j ¢ s O t7 Y aL Q ra .t U 2 y c! 0. SUR—BSI.IT. BASEMENT { IST FLOOR 21,10 FLOOR 3RI3 FLOOR 4TH FLOOR STH FLOOR ¢ 6TH FLOOR TTH FLOOR i 8TH FLOOR (Print or Type) Chec one: Certificate 'I Installing Company Name ANDOVER PLG. & HTG. CO. INC.' Corp. 1051 Address 5731 SO. UNION STREET Partner. LAWRENCE MA. 01843 Firm/Co. Business Telephone: 508-685-8383 Name of Licensed Plumber or Gas Fitter Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond Insurance Waiver: I , the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner Agent I heteby certify that aU of the details and information l have submitted (or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and tnscAdations perfomted under Permit izrt:ed,fo. this application will be in compliance with all pettincnt Provisions of the Massachusetts Slate Cas Cade and(3upter 142 of tho General Laws. Aw By TYPE LICENSE: , Plumber " Title Gasfitter Signature of Licenstd Plumber or Gasfitter tylaty�' bwn`= , }. r; " „ Journeyman APOACIVED (t» tci USE ONLY) License Number 4 TQDate.. . .. J... � , `. -��98 s yORTH TOWN OF``NORTH pANDOVERlo � - a PERMIT FOR INSTALLATION a a s p gs�SSAC'HUSE�S`', 'tyy k s� This certifies that .4�- - . . has permission .fdr' i allation in the buildings of . . . IA-). . . . . . . . . . . . . . . . . . .o. at�,-.r.� .� ��2s' . .�. . . . . . . ., North Andover, MA. Fee. :-t'�ic. NoO ' . . . . . . . . . . . . . . . . 1003 I=INSPECTOR s WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD:File f r Office Use Only - 01 4e LfUMMUtlUlt# of fagga#gefto Permit No. t department of Vuhik t6ufetg Occupancy& Fee Checked - BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 1 3/90 (leave blank) yn APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 8 All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:09 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date (X* or Town of NORTH ANnOVER To the Inspector of Wires: The udersigned applies for a permit to pe�rfor�mf the electrical work described below. " Location (Street &` Number) S5 Owner or Tenant Owner's Address SSM Is this permit in conjunction with a building permit: Yes No ❑ (Check Appropriate Box) Purpose of Building �— Utility Authorization No. Existing Service 12a Ampslr2,e� 2—Volts Overhead Undgrnd ❑ No. of Meters New Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters Its Number of Feeders and Ampacity �`��� 2 Location and Nature of Proposed Electrical Work Total No. of Lighting Outlets No. of Hot Tubs No. of Transformers KVA Above In- No. of Lighting Fixtures I Swimming Pool grnd ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners I Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones Total No. of Detection and No. of Ranges No. of Air Cond. tons Initiating Devices No.of Heat Total Total No. of Disposals Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices I Municipal [:]Other No. of Dryers Heating Devices KW Local ❑ Connection No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: INSURANCE C-OVERAGE: Pursuant to the requirements of Massachusetts general Laws I 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. YE NO If you have checked YES, please indicate �type 1 age by checking the kppropriate box. 1 INSURANCE X BOND OTHER —_ (Please Specify (Expiration Date) Estimated Value f leo rir�I Work S i� Work to Start CC�j Inspection Date Requested: Rough Final Signed under�enalties of per u _ LIC. NOZ FIRM NAME Licensee ignature LIC. NO. 7S Bus. Tel. o. Address �J Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Lic see 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 Scrce.ne� a'twipm. YrxW aa•x o' Yr No' m - i 64Y1'91�d' 31. 9'A' 3'636• B3�o 31. 3,�.� d' � O x 1/Z rs" e"]q sp o� Y'fr�° 2'11�a° Id'3yi" 2a" --------- - �a�a. 5° B Lundin Kitchen -,as built 1 r r US ReC-0•an it i On r.1794221r P, G_,2, MORifABE I N 8 P C C T 1 0 N PLAN cicy/Town:.u��:FN v = stittI iVl ti Wei_ �� z�'- --�9 4___ Scsllr 1 � ' cp 0 FSI' r11D. A ^-------------------- �------------- (tllylf l----..._._--^-•--•- Need Alf. 1 (3 -15// 2z) 6 Plan No. ------4. ------- bravo pet City/Tovo of -----t�,lP Tax Assessors Map. -- - -------- to Jo ,0 4 J, Tr C. c� o ,9 b Pry , l � N 70.o F io: -- 1 hereby certify that the abort liott#aoe pe Insction'Plan vas pr#par#•for '" in connection with a nw Portia## and is not intended or reOrtstnted to be a property line or land survey. It cannot bt used for lstablishin# feacer hod#e r walls or Wilding lines. No responsibility is extended herein to the land owner or occupant. Tht location of tht,orlginal bmildin#(s) as shorn herein was in complianct with tht local applicable toning bylaws in effect been cowsttuctNr with respect to horizontal dimensionalothergvisaatots� t„lit lin's-or is,#%empl-floe violation enforcement action under Maes I.L. Title V11, Chap. 10A, sec.