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HomeMy WebLinkAboutMiscellaneous - 573 SALEM STREET 4/30/2018 (5) / 573 Salem Street t .tie ��,. ^� - -. _ S• Lot.& Street Map/Parcel ONSTRUCTION APPROVAL Has plan review fee been paid: YES NO Permit# Plan Approval :__' ..'Date:: Approved by: Designer: g y' Plan Date: Conditions: Water.-Supply Town Y Wel! Well-Permit. . a Driller: _ r . .Well Tests -Chemical WDate Approved: Bacteria I Date Approved Bacteraa N __ _ Date Approved Plumbing Sign Oft`- = Wiring Sign off: = "Comments: ` Form "U" Approval ' approval to Issue. YES N0 - Date Issued By _ Conditions: - w.. . Final Approval All Permits Paid? a YES NO Well Construction Approvals _„. - YES NO Septic System Construction Approva YES NO', Certification? .,YES NO Other? _ YES N0 Any Variance Needed 'SES NO FINAL BOARD OF HEALTH-APPROVAL: DATE: APPROVED BY: - SEPTIC SYSTEM INSTALLATION CONDITIONS: w Is the installer licensed YES NO Type of Construction_ NEW REPAIR .- . New Construction C:ertifed Floc;Plan -Rev' ew YES NO`f -_ Floor Plan-:Review YES N0 -, Conditions of Approval from Form U YES NO Issuance of DWC permit YES N0. - DVVq,.Permit Paid i _ YES N0. ;DWWC�Permit# _Installer: `Be9in Inspection: 5 T YES N0 } Excavation Inspection: -- Needed: _ _ : r Passed - B Construction Inspection. Needed. t As Built Plan Satisfactory .k .-Approval.of Backfill: Date �A . gy, Final Grading;Approval: Date: 8 - Y. y Final Construction Approval: Date: By: 4 Certificate of Compliance: Approval; Date:- f 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 or requirements. *****************************APPLICANT FILLS OUT THIS SECTION****************��***** APPLICANT �,'� allt �- �CN`xJ tj PHONE LOCATION: Assessor's Map Number PARCEL J SUBDIVISION LOT (S) STREET � ST. NUMBER 57_3 *****************************************OFFICIAL USE ONLY*************** S OF T AGENTS: CO?43ERVATI039 ADMINISTRATOR DATE APPROVED DATE REJECTED / i COMMENTS 6 TOWN PLANNER DATE APPROVED DATE REJECTED j COMMENTS II QQ INSPECTOR-HEAT DATE'APPROVED F �` DATE REJECTED IC INSPECTOR-1-ItA&W DATE APPROVED DATE REJECTED COMMENTS4(,//&)i4 PUBLIC WORKS -SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm tili<` 5w' t �F4'S..�'�.i" ij�+lY4"•�' iY^`M�' Date,t` . �•"f � r 4167 a" TOWN OF NORTH ANDOVER �� �- 3? e�;r ..'• ppL '4. PERMIT FOR PLUMBING SSACMus� .-.......^�".. G. This certifies that has permission to perform .. : ^ 't :': y •-; :J . . . . . . . plumbing in the buildings � . . . . . . . . . . . . . . . . . . . . at e .'r-�.. . . . . . . . . . .. . . . . . . . . . ., North Andover, Mass. Fee•'/'. � Lic. No..j ( .� . . J "'- .✓�. . . . . . . . . /!? PLUMBINGffNSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer q 3 A MASSACHUSETTS UNIFORM APPLICATION FOR RMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date �0 � C4,Building Location # Amount Type of Occupancy -5. V\ '[ v'1 New Renovation Replacement El Plans Submitted Yes ❑ No FIXTURES z � Cn F a p, F d F" Pr, W SLBBM VIV >� 21�II FIDQt 3M110OR 4M>f 5M FIOCIR 6MHf at 7M HfM six HJXR (Print or type) --�/ Check one: _ Certificate Installing Company Name l'!�4 d�� orp. Address 3�j 90�x �� El Partner. wd'Q'tc e Business Telephone (o(S�S Firm/Co. Name of Licensed Plumber:` l d 5A a r 1 Insurance Coveraize: Indicate the f insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Bond ❑ Insurance Waiver: I,the ecsi ed,have been made aware that the licensee of this application does not have any one of the above three ins e 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 jr ed for this application will be in compliance with all pertinent provisions of the Massachusetts State Plu n Code 142 of the General Laws. By: bignatUre 01 LICenSeC Type of Plumbing License Title City/Townicense Num5er - Master Joumeyman ❑ APPROVED(OFFICE USE ONLY N° 1967 Date,�l..:..:%...... :�... NORT/, o � TOWN OF NORTH ANDOVER PERMIT FOR WIRING CHU Thiscertifies that ..............:............................................... .... .... .................... I has permission to perform ..... ...........U:... ................................................... wiring in the building of....... ..........?...- :? ................................................. ti at...t-z.. t-......... �'; - -............................... .North Andover,Mass. Fee.- .".... ........ Lic.No <-_�.. ...................... ....le,� ........................... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer I� O:fice Use Only The Commonwealth of Massachusetts � = Prrcic No. Department of Public Safety I Occupancy b Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 3/90 Oea�e blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Massachusetu Electrical Code. 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date City or Town ofTo the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street h Number) ,r7_3 owner or Tenant ldx/cillw Owner's Address 1-7-3 Is this permit in conjunction with a building permit: Yes 01 No ❑ (Check .Appropriate Box) Purpose of Building /�'����-��� Utility Authorization NO. Existing Service ,Amps l / � 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 AY2&,e G le? fl7�D' No. of Lighting Outlets.. No. of Hot Tubs No. of Transformers Total . KVA No. of Lighting Fixtures Swimmin Pool Above In- 'Swimming ❑ grnd. ❑ Generators KVA. No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting 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 Disposals No. of Heats Total Total No. of Sounding Devices Tons KW No. of Dishwashers Space/Area Heating KW No. of Self Contained Detection/Sounding Devices No. of Dryers Heating Devices KW Local❑ Municipal ❑Other y g Connection No. of Water Heaters KW No, of No. of Low Voltage Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: o 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 p 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 JK] BOND ❑ OTHER ❑ (Please Specify) Expiration Date Estimated Value of Elec rical Work $ c� Work to Start `U/Z� y� Inspection Date Requested: Rough ` / f Final C✓`<l �� J Signed under the penalties of perjury: FIRM NAME i _ LIC. NOM-,?3 J` Licensee r�/'1/ &t tf/in t.- Signature e:' , LIC. NO.' 1-1V Address 1A —Alt. "&, Bus. Tel. No. Alt. Tel. No. �7fi' 37�y7 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 permit application waives this requirement. Owner Agent (Please check one) x Telephone No. PERMIT FEE S Signature of Owner or Agent M Do Not Write In Here D Cn For Electrical Inspector Only m i M M n Street and No. _n DName ........................................................... Z iElectrician .................................................... IPermit No. .................................................... Comments .................................................... 1 1� I I i j Ii I `.+P.- �..-''"`_. r-a;•4.�.a ..�.J''11ijlr.''t >t+..moi.+—`y.."y.,�%°{.-."�'ti.yrY' "•''°'L�"' r 5;.: ti Location C73 No. 122 Date Zl 9 NORTH TOWN OF NORTH ANDOVER a Certificate of Occupancy $ • -� Building/Frame Permit Fee $ ' C„UsE` Foundation Permit Fee $ Other Permit Fee $ Sewer Connection. Fee $ Water Connection Fee $ TOTAL $ E 31:f3 2.5Building Ins ec or .00 PAID 7163 Div. Public Works PEWHIT Nn. 12�� APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. t,-I-/AGE 1 MAP iqO. LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK 'PAGE ZONE SUB DIV. LOT NO. F% — i ✓LOCATION� 7 3 � � PURPOSE t OWNER'S NAME NO. OF STORIES v SIZE OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME J SIZE OF FLOOR TIMBERS 1ST 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES -REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 1 ` 3 PROPERTY INFORMATION / '�� � LAND COST SEE BOTH SIDES EST. BLDG. COST 2f/000 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 AND APPROVED BY BUILDING INSPECTOR DATE FILED lTy� BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED ENT Tf A F E E sus— e� �/ �+ OWNER TEL.Hl� / �p PLANNING BOARD. PERMIT GRANTED CONTR.TEL. #_ L219 CONTR.LIC.k 3 BOARD of, EL SELECTMEN BUILDING INSPECTOR I BUILDING RECORD i 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 3 2 I= CONCRETE Bl'K. PINE _ BRICK OR STONE HARDW D PIERS — PLASTER — — DRY VJALL — UNFIN. 3 BASEMENT AREA FULL FIN. B M T AREA _ V, 1/2 1/ FIN. ATTIC AREA _ N_O B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCFETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDW D _ ASBESTOS SIDING _ COMMGN VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 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 I HIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM, (2 FIX.) _ FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING I I_MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING .P WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 8 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 B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING a �%0RT►y 01 ' - jor� 0ownver 0 No. 122 �o w_L A EIr 4 dover, Mass., 021 19 � � COCHICHE wiCK ?A TED "1 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System 0BUILDING INSPECTOR THIS CERTIFIES THAT................. �.��-yP�........ E Foundation has permission to weePe.... Ly ��........ buildings on .....* 73........ .. ...... 7.. ..............r Rough .. to be occupied as . � /. ..�� ..� ... /��C Chimney provided that the person acce tin his permit shall in ever respect conform to the terms of the Iication on file in P P p 9 P Y P PP 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 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTOi*' �r�, »TS ELECTRICAL INSPECTOR Rough �...... ... .............................................. Service .. BUILDING INSPECTOR Final OMMKO Occupancy Permit Required t0 Occ-upy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough P Y P Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT OFFICESOF: North Andover. APPEALS NORTH ANDOVER M�chusens o I gas BUILDING DIVISION OF (617)685.4 75 CONSERVATION HEALTH PUNNING PLANNING & COMMUNITY DEVELOPMENT = r KAREN H.P. NELSON, DIRECTOR In accordance with the provisions of MGL e 40, S 54, a condition of Building Permit Number l 6?-1i' is that the debris resulting from this work shall be disposed of in a preperiv licensed solid waste disposal facility as defined by MGL c 111, S 150A. The debris will be disposed of in: (Location of Facility) Sienature of Pcrmtt Appiicant Date NOTE: Demolition permit from the Town of North Andover must be obtainer for this project through the Office of the Building Inspector. Town of North Andover BUILDING DEPARTMENT —' Homeowner License Exemption (Please print) DATE Q&2� ;9, / Ftl ��� JOB LOCATION__ Number Street Address Section of town "HOMEOWNER" Name Home Phone Work Phone PRESENT MAILING ADDRESS Sit City/Town State Zip code The current exemption for "homeowners" was extended to include owner -occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license , provided that the owner acts as supervisor . (State Building Code , Section 109 . 1 . 1 ) DEFTVITiON OF HOMEOWNER: Person(s ) who owns a parcel of land on which he/she resides or intends to reside , on which there is , or is intended to be , a one to six family dwell- ing , attached or detached structures accessory to such use acid/or farm structures . A person who constructs more than one home in a two-year period shall not be considered a homeowner . Such "homeowner" shall submit to the Building Official , on a form acceptable to the Bulding Official , that he/she shall be responsible for all such work. performed under the building permit . (Section 109 . 1 . 1) The undersigned "homeowner" assumes responsibility for compliance with the State 2duilding Code and other applicable codes , by-laws , rules and regulations . The undersigned ."'Homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements . HC:?ECt;. Z,71 c SIG: L ;AT�RE � J A- P-RCV.A.L OF BUILDING OFFICIAL `dog_ . Three fa;,,i�y dwellings 35 , 000 cubic feet , or larger , will be �o c.,,:,pi�, with State Building Code Sect,on 127 . 0 , Construe _on con zrol . n.J D,sT 0 t !`r � 3 er i � I / t• 1 Y 1 FORM U - LOT" RELEASE FORM "his form is used to verify that all necessary approvals/permits from 1.----.-.,-----.--,—,,,Fctl-,,Tientshaving.jurisdiction have been obtained. This does not relieve` the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT t�� lA N'U ' PHONE LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT (S) STREET ST. NUMBER �3 ** ** ** ***************************O F F I C IAL USE ONLY**Co "4n o c-j- RECOMMENDATIONS OF TOWN AGENTS: 2�Z CONSERVATION ADMINISTRATOR. - DATE APPROVED } DATE REJECTED— COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSP TOR-HE - ... --: DATE APPROVED DATE REJECTED J� lc INS CTOR-HEALTH DATE APPROVED I DATE REJECTED COMMENTS V PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm c i I 19(Y1 ...'h.I of ( ,' 1'l)Itut•111N1'1'1'UP:\'1?I.111`t\•IP:N'1'\tiiflt\'ll'I(S �'. I Itl Ilf A)IN(:I)I�;I'Alt'1'Nll?N'1' ' ` I Ntl(:'!Ir\t•:I.ti'lct,lllfa�. ��', Lo�:;ll 1{uiltlillj;lua{tr:l�,r � '�'• ... r(r„,. :/('Lnilr. {n,�.i•N„nL Amb,vor•A'I:,Saailpi�ctl9•ll l ti�. -p / IL... Fftlr.C. . :r it gip:-.,k�ll'JY:;a fU�::YYld�t')i�4•�Y.Ya•,9d.i. 4yd,:;.. .� Iliyli Fhuy:;tlPC ClUtuwit.t LU :;antlbltr..�Ibtg Metal ;1u0{I'Ir11in,1 1 (.:ompluo l)rymill�yolol„s l)U Coillnys All lyltc;' Z I U)<n Ilux U'IIU.'. Yrl.(YUI)0011.03 I•{:,lvA:Nhill•IvlA 1)113:12. 1{uulnn(4/0)57(;•It W$ I .,aa►, £0d Wd©£:Z 666L 9Z•6nti 8665 TZ 'ON 3NOHd OO N3ddd A3SUD woad From CASEY PAPER CO PHONE No. 21 1998 Aug.26 1999 1:30PM P02 ' I 1 . i L I i I ' t I I Prom CASEY PAPER CO PHONE No. 21 1996 Aug-26 1999 1:29PM P01 1 ' t I r 'V I �1 1 r i ' -__.._....,. ... . 111 1, � ..._. ..._._.__._..___.. ....._-.. _ �....__..._..... ........... � �r 111 . I "1 I i- I u. l Address !r2 3 S 4-J..B,M S'T' Title of File Page of Date File Open: Date file closed: Doc Document/Action Title Date of Refer to other Purpose of Qocumeont/Action and notes action Document/ document/ Num. Action Department Board of Appeals — Board of Health — Planning Board — Conservation Commission -- Building Department