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HomeMy WebLinkAboutMiscellaneous - 57 HITCHING POST ROAD 4/30/2018 57 HITCHING POST ROAD J 210/0380000.0 Date...... �. HORTM °�<�``°;•�4, TOWN OF NORTH ANDOVER ? '• °G PERMIT FOR WIRING CH This This certifies that "0 �`�U` n....................................................... has permission to perform ...........d!g��'.. 7�'........................... wiring in the building of......... ��...vS� ............................................................. S yiT« «� /�ST at............7 ..........e�..... ..................................... North Andover,Mass. • dl .. Lic.No..-3....... Z... ��1.� Fee.�O........ 3 � off........ ;... . . .. . ...... �- E ECCRICALINSPECTOR Check # 89u1 Commonwealth of Massachusetts Official Use Only J Department of Fire Services Perm"No. 1?11�?r1 BOARD OF FIRE PREVENTION REGULATIONS Occupancy 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 ElectricaLInector (ME ),5 7 CMR 12.00 (PLEASE PRINTW INK OR TYPE ALL WORA"TION) Date: City or Town of: NORTH ANDOVER To the By this application the undersigned gives notice,of hi or her intenti n to perform the fW l�electrical work Wires: described below. Location(Street&Number)—S-7 /Y�7C11 ,- P40 Owner or Tenant Telephone No. Owner's Address 7 R; fat,, PO-S/- Is this permit in conjunction with a building permit? yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service X?00 Amps Volts Overhead ❑ Und r g 6]-' No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and.Ampacity 'A Location and Nature of Proposed Electrical Work: �S�n r ego e V Co- , lion of the foilowin 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 AboveIn- o.o mergency tg g d• ❑ rnd• ❑ Batte Units --. No.of Receptacle Outlets 7,3'- No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 140..of Detection and Ranges No.of Ran Total Inifiatiri Devices g No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers eat Pump Number ons KW o.of Self-Contained Totals: _ _.....__.. _..__...__.._. _._. _._. Detection/Ale-rd—ng Devices No.of Dishwashers Space/Area Heating KW Local❑ Cmunicipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* • o.of No.of No.of Devices or Equivalent No.of Water N Heaters ICS Signs Ballasts Data Wiring: No.of Devices or Equivalent Total HP No.Hydromassage Bathtubs No.of Motors Telecommunications Wiring: OTHER: No.of Devices or E uivalent Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Elec 'cal Work: (When required by municipal policy.) Work to Start: 7 Z! 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 E3--BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties oinformation p ��) f perju ,th t the in ormation on this application is true and complete. FIRM NAME: o rr f D�CIu L ��r C�h,C Licensee: �iow+as /�, it3c(t��c � LIC.NO.: Signature LIC.NO.: 3 36.204 (If applicable, enter"exempt"in the li nse nu ber 1' e.)/ Address: ©�( C3! C n ctoKct r�r D3 0.t Bus.Tel.No.:603 RGr= 6?yP *Per M.G.L c. 147,s. 57-61,security work requires D „ „ Alt.Tel.No.:/"s 5'37^6�3� ep ent 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: $ �r f The Commonweutfh of Massachusetts kj )1 Department of Industrial Accidents -1 ! Ogee of Investigations �31 600 Washington Street Boston, MA 02111 www.nzass gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/piumbers Applicant Information Please Print Le-oibly Name (Business/Organization/Individual): / Address: City/State/Zip: /c', �es�c� ��•^/ �/l �3Ph ne#: . 6L �- Y3 Are you an employer?Cheek.the appropriate box: I.❑ I am a employer with 4, FF� ject(required): ❑ I am a general contractor and I imployees(full and/or part-time).* have Eared the sub-contractors Elconstruction 2. arts.a.sole proprietor or partner- listed on the attached sheet= deling ship and have no employees These sub-contractors have 8. [J Demolition working for mein any capacity, workers' comp.insurance. .insurance 5. 9• El Building addition [No workers'comp. ❑ We are a corporation and its required.) officers have exercised their 10•0 Electrical repairs or additions 3.❑ i am a homeowner doing all work right of exemption per MGL 11.[] Plumbing repairs or additions myself.[No•workin,comp. c. 1.52, §1(4),and we have no 12. Roof insurance required.]t employees, ❑ repairs [No workers' 13.❑Other comp. insurance required_] 'Any applicam that checks bo>L'#l 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. 4conuactors that check this box must attached an additional shear showing the name of the sub-contractors and their workers'comp_policy i^.yrs Wdar. lam an employer that is.providing:workers'compensation insurance er a to eeL Below is the policy and•ob site information. �' niP Y P hey. ! Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/Statemp. 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 tis 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 this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify under the pains and penalties of perjury that the information provided above is true and correct Si tune: Date: Phone#: FE71ciaeD only. Do not write m this area,to be completed by city or fawn ociaL n. Permit/License# hority(circle one):Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing inspector son• Phone#: t Information and Instructions " Massachusetts General Laws chapter 152 requires all emp)oyers 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 tho 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,employing 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,MOL chapter 152,§25C(7)states"Neither tine 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-contractors)narne(s),address(es)acid phone number(s)along with their certificate(s)of Y insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not requiredto cavy workers'compensation 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 Accident's. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,pleasccall the Department at the nurnber.listed below. Self-insured companies should enter their self-insurance license number on the'appropriate'line. City or Town Officiais 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 lnvestigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which NviIl be used as a reference number. In addition,an applicant that must submit multiple pennitAicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of'the 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 year. Where 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 bice 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 CommonweEdth of Massachusetts Department of Industrial Accidents Office of 1mvestigations 600 Washington Street Boston, 1viA 02111 Tel.4 617-7274900 ext 406 or 1-8.77-MASSAFE Revised 5-26-05 Fax 4 617-727-7749 www.mass.gov/dia T° Date....��.. .. ...L......� r 4 4 9 5 k f NORTH 1 4,ppL TOWN OF NORTH ANDOVER PERMIT FOR WIRING i SSACNUS� This certifies that .... ..'� ..... .. ' has permission to perform ........ . . wiring in the buildi g of.. .. l/Y� . ........ .. .. . .. . /,��/ 11 ..... at...... ...... .. . ' U.1. .. E�- riFi"A dove Fee... Lic. �. 6 .................. ........................... i ELECTRICAL INSPECTOR w 10/03: 0- 10/0 PAID �'1� C `k WHITE:Applicant CANARY: Building Dept. PINK: reasurer 1 �� f t Uc , (. -A ff- office u.e o., The Commonwealth of Massachusetts Permit No. 7 '/ Occupanvy & Pee Checked ly Department of Public Safety 3/90 Oe ve blank) !�/ BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 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 INR OR TYPE ALL INFORMATION) Date��4//�6 City or Town of IW2T`/ 4,1/R,0t,�/Z To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) e(LT"#/Z= �}/TL1fl1Y2L IrMZ' /2,2 Ocher or Tenant A . T, IQ4 /L ,�77- k Owner's Address -3 /2 D 14 N7>0 u Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building HC-1-.0 F-41-tIL Y 140,44 E' Utility Authorization NO. 1�_O Yy3F Existing Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters New Service & Amps /ZO' /2Vo Volts Overhead ❑ UndgrdEl No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Ay C_ /�� titrG!> &Q/ t E: No. of Lighting Outlets No. o£ Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Pool Above in- Swimminggrnd. ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets 190 No. of Oil Burners Battery Emergency Lighting Units No. of Switch Outlets No. of Gas Burners '�/t/Zt� FIRE ALARMS No. of Zones No. of Ranges Q H—r No. of Air Cond. Total Ntons I of Detection and `Up Initiating Devices No. of Disposals 0 HE No. of pumps TTons Total No. of Sounding Devices No. of Dishwashers �! Space/Area Heating KW No. of Self Contained Detection/Sounding Devices No. of Dryers Heating Devices KW Local❑ Municipal ❑Other Connection No. of Water Heaters KW Not of No. o Low Voltage 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 Completed Operations Coverage or its substantial equivalent. YES(@ NO❑ I have submitted valid proof of same to this office. YES®• NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ® BOND ❑ OTHER ❑ (Please Specify) 9/16/9.17 Expiration Date Estimated Value of Electrical Work S Work to Start Inspection Date Requested: Rough /O Final Signed under the penalties of perjury: FIRM NAME CONTINO ELECTRIC & CABLE INC. LIC. N'71_A11983 Licensee LOUIS. CONT I NO Signatur LIC. NO.E 2 6 7 8 8 Address 1 DONOVAN DR. WEST NEWBURY, U 19 8 5 Bus. Tel. No. '508 ) 3 54Z0— Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this peTsyit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S Signature of Owner or Agent roti.,,-���Fro.- " v `r'�+-l' x'Y•... Date....../ J. .... .� .. � .- 442 f NORTI� 3a;•;r`'°-:'�"�o� TOWN OF NORTH ANDOVER - ' PERMIT FOR WIRING • O� �`�`qqb� f -2 CMUSE� This certifies that . ..............>r. .. . . . J . - has permission to perform .....�. v C ...... � ..............yI wiring in the building of.....:.t�..:. . ..:...... ...................... at....... ..V...a / .r.4-1,:.. ..... ......<.-.'�!(.......... ,North Andover,Mass. t Fee..6.�...-:...... Lic.No..? ... ..p............................................................... R ELECTRICAL INSPECTOR �f 4 Ll I y i WIlw96-1QM 35.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer office Use Only /� u t Liln1M11nWt Elf _ag6ar Uuftg Permit No. "/" Mepartmrnt of Public —Aufetu Occupancy& Fee Checked 7� - BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 390 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CM a12:O (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date (X!.)Q or Town of NORTH ANnOVF.R To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) J � S Owner or Tenant 6 T 7- Owner's Address ��/ Is this permit in conjunction with a building permit: Yes l� No ❑ (Check Appropriate Box) Purpose of Building I-PS/deo-) f/, I Utility Authorization No. Existing Service Amps _J 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' re-611 Yi T4 Total No. of Lighting Outlets No. of Hot Tubs I No. of Transformers KVA No. of Lighting Fixtures I Swimming Pool Above In- grnd. ❑ grnd. LJ I Generators TVA -i 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 Total No. of Detection and No. of i~anges i Nc. of Air Cond. .,.ns _— !nitiatinc Devices No of Heat Total Totpi No. of Disposals Pumos Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area !•eating KW_ Detection/Sounding Devices 1 I - "�nicipal El Other Ne..of Dryer:> D:r:ae°t KW Local- ,_ Uonnection No. of No. of Low Voltage No. of Water Heatsrs K1N I Signs Ballasts Wiring No Hydro Massage Tubs No of Motors Total HP i Y OTHER:f (or I��I !'T� ��`'�# %• INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a cu" nt Liability Insurance Policy including Com�ol2pci Operations Coverage or its substantial equivalent. YES ±-__N_0_ have submitted valid proof of same to the Office. YES 2' NO - If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSU,fANCE �BOND ` OTHER - (Please Specify) (Expiration Date) Estimated Value of Electrical Work S Work to Start Inspection Date Requested: Rough Final Signed under the Penalties of perjury: // /J FIRM NAM f, 1 - f �r�/ Lam' LIC. NO8 . 7 y Sol �{ �' Signature ��_V v� Licensee f Bus. Tel. No tjUhe'69-.- 2- 6 Address t11lnfe )U1 y 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 applica#on waives this requirement. Own Agent (Please check one) Telephone No. PERMIT FEE S (Signature of Owner or Agent) x•6565 LocationsY01 S 6 No. 9 Date 1 TOWN OF NORTH ANDOVER L F p Certificate of Occupancy $ Building/Frame Permit Fee $ <7 Foundation Permit Fee $ N s�CHus Other Permit Fee $ > Sewer Connection Fee $ Water Connection Fee $ TOTAL $ �'� • ' o - '" B 6!ng Inspecto 00 9 Div. Public Works Location ! No. 91 Date 7' !I NORTH TOWN OF NORTH ANDOVER s V „ Certificate of Occupancy $ _ l i r Building/Frame Permit Fee $ c»ustt Foundation Permit Fee $ /0 ~ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $CO � Q Building Inspector 07[22/9593,3 150.00 PAIL} d Div. Public Works %cation WG/ tio. 3 Date NpR7" TOWN OF NORTH ANDOVER • p Certificate of Occupancy $ Building/Frame Permit Fee $ GMUs Foundation Permit $ sAt it F , Other Permit Fee $ i Sewer.`Connection Fee $ 1 /tfd �3d Water Connection Fee $ // 7�. t TOTAL $ aL� �' U Building I e for2/% 09:03 1,000.00 gLA Div blic Works PER"MIT NO. , ci APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4.40 , LOT NO. 70 — 2 RECORD OF OWNERSHIP DATE BOOK :PAGE ZONE I SUB DIV. LOT NO. LOCATION ! / PURPOSE OF BUILDING OWNER'S NAME ,f-- NO. OF STORIES IZEy OWNER'S ADDRESS ARCHITECT'S NAME •CI SIZE OF FLOOR TIMBERS IST �1��� 2ND 3RD BUILDER'S NAME SPAN /��• Of DISTANCE TO NEAR ST BUILDING ry` DIMENSIONS OF SILLS +7 y/ �7 DISTANCE FROM STREET / r J POSTS DISTANCE FROM LOT LINES—SIDES Xf—//„L o-e- REAR /�,D " " GIRDERS AREA OF LOT / FRONTAGE Lf -�� HEIGHT OF FOUNDATION / THICKNESS J i IS BUILDING NEW SIZE OF FOOTING D� X l' IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR VILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE A IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY %'✓ IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LIN INSTRUCTIONS 3 PROPERTY frNFORMATION LAND COST SEE BOTH SIDES (s, rf - EST. BLDG. C O - EST. BLDG. T PER fQ. FT. PAGE 1 FILL OUT SECTIONS 1 - 3 � _ EST. BLDG. COST PER R PAGE 2 FILL OUT SECTIONS 1 - 12 j795 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING I[ 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS j PLANS MUST BE FILED AND AP ROVED BY BUILDING INSPECTOR DATE FILED i 44 NUILDIN43 INGPKCTOR SI ATURE OF gWNER OR AUTHORIZED AGENT �L --7�r� FEE OWNER TEL. ` r 7� d V y.Sr PERMIT GRANTED m m o-zCONTR.TEL.it 7 19 FM 1 s[ J�Fi1AUE Fl=, �o Ll 7 NTR.LIC.N H.I.C.# BUILDING RECORD r • 1 OCCUPANCY 12 SINGLE FAMILY I STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILYOFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE I 2 13 CONCRETE Bt K. PINE _ BRICK OR STONE HARDW-D PIERS PLASTER F-^' _ DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ V, 1/2 '/ FIN, ATTIC AREA _ N_O B M T FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 22.J 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARDW D �✓' _ ASBESTOS SIDING _ COMMCN VERT. SIDING ASP..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. 12 FIX.) L FLAT A SHED WATER CLOSET s ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER 7- ROLL ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. — TIMBER BMS. b COlS. STEAM 49=0 STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING /� RADIANT H'T'G ��:•LZnm iwwl in UNIT HEATERS •'�"'�'.•''-.! 7 NO. OF ROOMS GAS OIL 12nd ELECTRIC 1st 3rd NO HEATING NORTH Town of ove r 0 No.539 dover, Mass., 7- / 7 -19 ?C 0 L A E COCHICHEMCK RATED BOARD OF HEALTH Food/Kitchen Septic System PERMIT T D THIS CERTIFIES THAT..................................A.......11..........1(4...Ef... ................. BUILDING INSPECTOR Foundation has permission to erect.............6..AJ E........... building"n ......... .T..-2........ ......... Rough S� Chimney tobe occupied as.................................................................... ........... ........................... thea provided that the person accepting this permit shall in every respect conform to the terms o e plication on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST T Rough ................................ ... ..... ... . ......... .............................................. Service UILDING INSPECTOR Final Occupancy Permit Required to Occupy Building . GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. 1 FORM U - VERIFICATION 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***************** a c� APPLICANT: e G/ p/ i,�l` /�2 / / J7,TOS Phone 75 - ;V T" 7 LOCATION: Assessor's /Map Number 3 Parcel Subdivision l�Gh / yl Lot(s) o Street St. Number ************************Official Use Only************************ RECO DATV OF NTS: Date Approved Conservation Administrator Date Rejected Comments Date Approved 3 Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved 3 91, Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections1�^ �'�/ 7- : `-/ - driveway perm' 1, W 7- ��%Fire Department �t e, .amu` C�y- Received by Building Inspector Date PROPOSED PLOT PLAN LOCATED IN NORTH ANDOVER, MASS. . Scott L. Giles R.P.L.S. SCALE:1"=50' DATE:7/9/96 50 Deer Meadow Road North Andover, Mass. y/jC LOT 12N. A os i �\ 0 acD A 90. 0 •,�'Scc a° LOT 12 43,560 S.F. LOT 11 h� yam. N �a t s I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE THE OFFSETS OF THE BUILDING INSPECTOR ONLY ~' SHOWN COMPLY AND SUCH USE IS FOR THE N WITH THE ZONING DETERMINATION OF ZONING BY LAWS OF CONFORMITY OR NON-CONFORMITY NORTH ANDOVER WHEN CONSTRUCTED. 19 lfk -vil R w r Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of Apppliiccant on Building Permit(below) Address of Property for Permit (below) Map and Parcel ;�$ o2,13urpose of Application (check below)' Phone Number of Applicant: /_/Single Family —Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPT70N section 8.7.6 of the North Andover Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the Building Permit. Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building Department and is only officially accepted when the Building Permit is issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement, restoration, or reconstruction of a dwelling in existence as of the effective date of this by-law,provided that no additional residential unit is created. ,0---The lot(s)were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning Bylaw. This application is for dwelling units for low and/or moderate income families or individuals,where all of the conditions of 8.7.6.c are met and/or represents Dwelling units for senior residents,where occupancy of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this Section"senior"shall mean persons over the age of 55. This application is a part of a development project which voluntarily agreed to a minimum 40%permanent reduction in density, (buildable lots),below the density, (buildable lots),permitted under zoning and feasible given the environmental conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently designated as open space and/or farmland.The land to be preserved shall be protected from development by an Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism approved by the Planning Board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for building pprmits,(i.e.all other permits from all other boards and commissions have been received and the project is in compliance with those permits),and the Development Schedule does not accommodate issuing a building permit in that Year,one building permit will be issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Appiicaof must supp+y approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate information, or the checking off of an above item which does not comply, whether done to my knowledge or not, is grounds for refusal by the Building Department to issue a Building Permit. �222� A .'Signaturer6f Owner or Authorized Agent who signed the Attached Building Permit Date This form must be attached to the Building Permit upon application for such permit. — 6 P43_�g CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MA. R SCALE:1"= 40' DATE: 7/27/96 Scott L. Giles R.P.L.S. Frank S. Giles 50 Deer Meadow Road 122.65, North Andover, Mass. NOTE: THIS LOT IS ON PUBLIC SEWER. 138.23, 23.14, LOT 12 43,560 S.F. 00 EXISTING FOUNDATIO NO SEPTIC SYSTEM fes~ ti 56•x, 4 .7P LOT 11 60.6' LOT 10 150.00' HITCHING POST ROAD I CERTIFY THAT THE OFFSETS OFFSETS SHOWN ARE FOR THE USE SHOWN COMPLY OF THE BUILDING INSPECTOR ONLY WITH THE ZONING AND SUCH USE IS FOR THE BY LAWS OF DETERMINATION OF ZONING NORTH ANDOVER, M CONFORMITY OR NON-CONFORMITY , ��cistEa�g WHEN BUILT WHEN CONSTRUCTED. CERTIFICATE OF USE & OCCUPANCY - Town of North Andover Building Permit Number 339 (1996) Date APRIL 16, 1997 THIS CERTIFIES THAT THE BUILDING LOCATED ON 57 HITCHING POST ROAD (Lot #12) MAY BE OCCUPIED AS SINGEE FAMILY DWELLING IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO A. J. Ma i l le t & sons Fj '` ` 0 3 Wescott Rd. ADDRESS AnAgver. MA r� S�CMU Building Inspector ar . o o ortiAndover No. 33 4 North Andover, Mass., 19 BOARD OF HEALTH PERMIT TO BUILD Septic System� _ s� �J / BUILDING INSPECTOR THIS CERTIFIES THAT .... . / / / �f' ' �s sy ............ r(. ......................................................................... 6Rough : .. �-, has permission to erect........................................ buildings on... . .. ,..,................... 7.................... ... �'- ✓� / /�� �' 7 lj"C :Fin himney to be occupied as..................................................................................................... ../....1............:............. ...................... provided that the person accepting this permit shall in every respect confor to the terms of the a0plication on file in ��Z this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration ani' "onstruction of biz Buildings In the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. u r r�{ ELECTRICAL INSPECTOR =G l9 -v Rough ............................................................................................................. Service BUILDING INSPECTORR GAS INSPECTOR RouDisplay In a Conspicuous Place on the Premises — Do Not Remove 0 q'°''�Aw14?� No Lathing or Dry Wall To Be Done �"`�` Until Inspected nd proved by the Building Inspector. FIRE DEPARTMENT Burner Street No. IL Smoke Det. —D �.��r ti 274 Date. .. .. .... NORTH , TOWN OF NORTH ANDOVER pf ,ao ,cti0 .0� o<p PERMIT FOR GAS INSTALLATION •ySy C� SACH SES This certifies that �.,/. . . . . . . . . . . . . _. CJ has permission for gas installation . . A A n t.". . in the buildings of . .�'-!. h. .,f??fI1. �. . X`. . . . . . . . . . . . . . 710 ��— at . .�! �. . . f�i f.� ir (�,�.� ` er,, Masi'; Fee. h�. ' Lic. No. 'L°�' . �� t7Zj "GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File 4{ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO 00 GASFITTIN' G t (Print or Type) NORTH ANDOVER Mass. Date — 2 ' q -� = Building Location S 7 ZOLL Permit # -* Owners Name New Renovation II Replacement 0 Plans Submitted D as to LUGO C F- < Z m 0 r Q o Q o t-ii s ur -.4 = N Q V L K O V l• 2 J 1-' Z t,,.,, LY O T to 93 Lai O r3 W UA t. tJ SUTd-3S1.1T. I I1 I I 1 f1 1 I i i t i1 ( fi I tt ( I �I1 i 1 'IST- FLOOR Z'40 FLOOR I i l l l I l I f ! i l i l l l l ► ► I I ! I i f 3 R n FLOOR I I{ I L I I Itt { 111 1 1t 1 {1 1 I I f 1 1 I I ( I{ ( ! f 4TH FLOOR STH FLOOR 6TH FLOOR TTK FLOOR a-H FLOOR ` i I I ( I I I (Print or Type) Check one: Certificate Installing ompany Name—9(f- /q a6Y / y Q Corp. Address 0 - - Partner. Zgd'�U -,�-21,42 =—<Firm/Co. Business Telephone: 25 7 Name of Licensed Plumber or Cas =fitter Insurance Coverage. Indica-.e t~e type of insurance coverage by checking the appropriate box: Liability insurance policy Eff Ot^er type of indemnity = Bond Insurance Waiver: 1 , the undersigned, have been made aware that the licensee of this application does not have anv one of the above three insurance coverages. Signature of owner/agent of property Owner U Agent Q I hetcby certify that 311 of the devils and information I have submitted (Cr entered)in above xapration are true and a, ate to the best of mY $aowtedge and that all plumbing worst and installations periorae: tinder Pur-mit iuuzd for this sppiiation will be in compliance with ad patiaeat provisions of the WAslachusetts State Gas Cade and chapter I4'-of ma Cca=i Lwa. av TYPE LICZENS- p,saber Title :; itlet Gasiitter Signature of Licensed Master P � ��r Gasfitter City/Town: JourneymanK APPROVED (OFFICE USE ONLY) _ Lice i15e Number