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HomeMy WebLinkAboutMiscellaneous - 58 COUNTRY CLUB CIRCLE 4/30/2018 (3) W r.. C7 6`, I t c gORTp Of tNo y1'40 0 M % TOWN OF NORTH ANDOVER M. ,r: APPLICATION FOR A4� ATION 3 SACH Lj 7Sg^CMUSE� i C Permit NO: / e Received: _ Date Issued: - v IMPORTANT: Applicant must complete all items on this page LOCATION S�F Print PROPERTY OWNER ✓� lrmt MAP NO.: (.� PARCEL: 16-6 ZONI G DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential New Building ❑One family ❑ Addition ❑Two or more family ❑Industrial ❑Alteration No. of units: ❑Repair, replacement ❑Assessory Bldg C7–A"6-6�' ❑Commercial ❑Demolition ❑Moving(relocation) ❑Other ❑ Others: ❑Foundation only ?SCRIPTION OF WORK TO BE PREFORMED Gil / C, �2 6��Ogvevl� ✓s /-Z' Ori —��� � - // � Identification Please Type or Print Cleaply) OWNER: Name: 4/sr aA/Xe/ Phone: —� 19`57 Signature Address: CONTRACTOR Name: ePhone: Address: I�d ✓i/ c� /41� Supervisor's Construction License: Exp.Exp. Date: Home Improvement License: �LY Exp. Date: ARCHITECT/ENGINEER 1G.�2� Name: Phone: x: 14 K-10 Address: aa►2 14)54 LI,5goeg. No. (7,;gzo ;E SCHEDULE.BULDING PERMIT:$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PE SIo,otal ProjectCost :$ x10.00=FEE: Check No.: { 7t) Receipt No.: Page 1 of 4 Town of North Andover 01t,,ORT„ 3 ` Office of the Planning Department Community Development and Services Division M i •; n 1600 Osgood Street ",y+��=--•.` ' Bldg.20,Suite 2-36 ,ssACNU5� North Andover,Massachusetts 01845 ht!p://www.townofnorthandover.com P (978)688-9535 P (978)688-9542 TO THE LAWRENCE EAGLE TRIBUNE LEGAL AD FOR PUBLICATION TUESDAY,DECEMBER 19,&DECEMBER 26,2006. CLIPPINGS TO BE MAILED TO THE PLANNING DEPARTMENT AS ADDRESSED ABOVE TOWN OF NORTH ANDOVER PLANNING BOARD NOTICE OF PUBLIC HEARING,TUESDAY,JANUARY 2,2007 @ 7:00 P1VL In accordance with the provisions of M.G.L. Chapter 40-A, Section 11,the North Andover Planning Board will hold a public hearing as follows: Purpose of Public Hearing: Application for Watershed Special Permit under section 4.136.3 (c);(1),(2),(5),(6)and 10.3 of the North Andover Zoning Bylaw. The Applicants seeks to construct a 3-stall garage at the end of an existing driveway in the Non-Disturbance Zone of the Watershed Protection District within the R-1 zoning district. Applicant/Petitioner: Donald D. Stanley&Debra M. Stanley 58 Country Club Circle North Andover,MA 01845 Owner: Same as above Address of Premises Affected 58 Country Club Circle,North Andover,MA, 01845 i Assessors Map and Lot: Map 64,Lot 150 Public Hearing Date&Time Tuesday,January 2,2007. Location of Public Hearing North Andover Town Hall, 120 Main Street,2 d floor conference room. All interested persons may appear and be heard. Persons needing special accommodations and / or those interested in viewing the application materials should contact the North Andover Planning Department at(978)688-9535 Richard Nardella, Chairman BOARD bF APPEALS,688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 NORTN p ^=CE IVCD TO SACHU 2001 FEB 23 Fil 1: 18 PLANNING DEPARTMENT Community Development Division I 1600 Osgood Street NORTH Ai` `o ( '_ii North Andover,Massachusetts,01845 tiASS; Phone:978-688-9535 Fax:978.688.9S42 NOTICE OF DECISION Any appeal shall be filed within(20)days after the date of filing this notice in the office of the Town Clerk. Date: February 27,2006 Date of Hearing: January 2,2007, February 6,2007 Date of Decision: February 21,2007 Petition of: Donald D.&Debra M.Stanley 58 Country Club Circle North Andover,MA 01845 Premises Affected: 58 Country Club Circle, North Andover, MA 01845, Map 64, Parcel 150, within the R-1 zoning district. Referring to the above petition for a Watershed Special Permit from the requirements of the North Andover Zoning Bylaw, Section 4.136.3(cii),(1),(2),(5)&(6). So as to allow: to construct a proposed detached 24'x 36' garage and underground drainage structures within the Non-Disturbance buffer zone of a wetland of the Watershed Protection District. After a public hearing given on the above date,and upon a motion by John Simons and 2nd by Jennifer Kusek to APPROVE a Watershed Special Permit as amended and based upon the following conditions. Vote was 5-0 unanimous in favor of the application. On behalf of the 14orth AndoverlSming Board Richard Nardella,Chairman John Simons,Vice-Chairman Alberto Angles Richard Rowen Jennifer Kusek cc: Town Departments Applicant Engineer Abutters Assessor • 58 Country Club Circle Map 64,Parcel 150 Watershed Special Permit-Construction of 24 x 36 Detached Garage The public hearing on the above referenced application was opened on January 2, 2007 and closed by the North Andover Planning Board on February 6, 2007. On February 6, 2007, upon a motion made by John Simons, and seconded by Jennifer Kusek to GRANT a Watershed Special Permit as amended in order to construct a 24'x 36' 3-stall detached accessory garage within 120' of a isolated wetland resource area within the Non-Disturbance Zone of the Watershed Protection District The proposed 3-stall detached garage and underground drainage structures are located at 58 Country Club Circle,North Andover,Massachusetts, 01845,Assessors Map 64,Parcel 150 and is located within the Non- Disturbance and Non-Discharge Zones of the Watershed Protection District under the requirements of Section 4.136& 10.3 of the North Andover Zoning Bylaw. This Special Permit was requested by Donald D. and Debra M. Stanley, 58 Country Club Circle, North Andover, MA 01845. The applicant submitted a complete application, which was noticed on November 7, 2006, and reviewed in accordance with Section 4.136 of the Town of North Andover Zoning Bylaw and MGL Chapter 40A, Section 9. The Planning Board voted on the motion by unanimously in favor of the Special Permit. A special permit issued by the special permit granting authority requires a vote of at least four members of a five- member board. The applicant is hereby notified that should the applicant disagree with this decision, the applicant has the right, under MGL Chapter 40A, Section 17,to appeal to this decision within twenty days after the date this decision has been filed with the Town Clerk. In accordance with 4.136 the Planning Board makes the finding that the intent of the Bylaw, as well as its specific criteria, are met. This decision specifically stated by the Planning Board makes the following FINDINGS OF FACT: 1) That as a result of the proposed construction in conjunction with other uses nearby,there will not be any significant degradation of the quality or quantity of water in or entering Lake Cochichewick. The Planning Board bases this finding on the following facts: a) The proposed detached 3-stall garage will not require a connection to the Town sewer and water systems from Country Club Circle; b) The topography of the site will not be altered substantially. The construction of the garage and installation of the proposed stormwater management structures will use Best Management and Engineering Practices and not substantially alter the topography of the site; c) The limit of clearing and impact is restricted to the minimum necessary to construct the proposed detached 3-stall garage;and d) The construction of the proposed detached 3-stall garage and drainage structures have been reviewed by the Town's outside consultant,Town Planner,and Conservation Department and determined that there will be no degradation to the quality or quantity of water in or entering the isolated vegetated wetland or Lake Cochichewick. 2) There is no reasonable alternative location outside the General and Non-Disturbance Zones for any discharge,structure or activity. 2 58 Country Club Circle Map 64,Parcel 150 Watershed Special Permit-Construction of 24' x 36' Detached Garage In accordance with Section 10.31 of the North Andover Zoning Bylaw, the Planning Board makes the following FINDINGS OF FACT: 1) The specific site is an appropriate location for the proposed use as all feasible storm water and erosion controls have been placed on the site; 2) The use will not adversely affect the neighborhood as the lot is located in a Residential 1 Zoning District; 3) There will be no nuisance or serious hazard to vehicles or pedestrians; 4) Adequate and appropriate facilities are provided for the proper operation of the proposed use; 5) The Planning Board also makes a specific finding that the use is in harmony with the general purpose and intent of the North Andover Zoning Bylaw; Upon reaching the above findings,the Planning Board approves this Special Permit based upon the following SPECIAL CONDITIONS: 1) Final approval of this Special Permit by the Planning Board is conditional upon the Zoning Board of Appeals granting a Variance from Section 4, Paragraph 4.136(3)(c)(ii)(3) of the Zoning Bylaw to allow the construction of 3-stall detached garage(permanent structure) 120' from an isolated wetland resource area within the Watershed Protection district's Non-disturbance Buffer Zone. 2) No impervious surfacing shall be used in construction of the driveway expansion. The applicant shall use pervious pavers (or similar application) for the proposed driveway expansion to the 3-stall detached garage. 3) The Town Planner shall approve any changes made to these plans. Any changes deemed substantial by the Town Planner would require a public hearing and modification by the Planning Board. This Watershed Special Permit may only be used in conjunction with the Site Plan Special Permit for these same premises: a) The garage will not be connected to Town water or sewer. b) The garage will not contain an established living area nor will there be any expansion allowed. c) Roof gutter drains be connected to infiltrators as shown on the plans. 4) Prior to issuance of a building permit: a) A performance guarantee bond of one thousand dollars($1,000.00)made out to the Town of North Andover must be posted to insure that the construction of the garage,erosion control measures,and performance of any other condition contained herein will take place in accordance with the plans and the conditions of this decision and to ensure that the as-built plans will be submitted. b) All erosion control measures as shown on the plan must be in place and reviewed by the Town Planner and Conservation Department. 5) Prior to release of the Performance Bond: a) The applicant shall submit an as-built plan stamped by a Registered Professional Engineer in Massachusetts that shows all construction, including storm water management services and other pertinent site features. This as-built plan shall be submitted to the Town Planner for approval. The 3 • 58 Country Club Circle ' Map 64,Parcel 150 Watershed Special Permit-Construction of 24' x 36' Detached Garage applicant must submit a certification from the design engineer that the site was constructed as shown on the approved plan. b) The Planning Board must by a majority vote make a finding that the site is in conformance with the approved plan. 6) No open burning shall be done except as is permitted during burning season under the Fire Department regulations. 7) The Contractor shall contact Dig Safe at least 72 hours prior to commencing excavation. 8) The provisions of this conditional approval shall apply to and be binding upon the applicant, it's employees and all successors and assigns in interest or control. 9) This special permit was issued on February 6, 2007, however,this Special Permit shall be deemed to have lapsed after a two(2)year period on February 6, 2009 unless substantial use or construction has commenced. 10) This decision must be filed with the North Essex Registry of Deeds. The following information is included as part of this decision: Plan titled: Proposed Site Plan At 58 Country Club Circle in North Andover,MA Prepared for: Donald D. &Debra M. Stanley 58 Country Club Circle North Andover,MA 01845 Prepared by: Atlantic Engineering&Survey Consultants Inc. 97 Tenney Street, Suite 5 Georgetown,MA 01833 Scale: 1"=20' Date: November 9,2006,Revised 1/4/07 Sheets: 1 4 MASSACHUSETTS UNIFORMAPPUCATON FORPERMITTO DO GAS FITTING (Type or print) Date 9— NORTH ANDOVER,MASSACHUSETTS// /' n Building Locations •S� (fzy til r'1/ C c)b C��!�`p Permit# L Q Owner's Name Amount 7 o New Renovation ❑ Replacement ❑ Plans Submitted ❑ U Z CG vi wa W O 001 F Z j p z W 1 Date. �G ..�. .. c u c y =1w C > a F O „ORTN TOWN OF NORTH A14IDOVER ' PERMIT FO G INSTALLATION ,SSACN . . . . . . . . . . . USE This certifies that has permission for gas installation . . ,� �,� i L ..� he k on Certificate Installing Company in the buildings of . . .T4? �' orP• at North Andover, Mass. ❑ Partner. Fee. ' �:. � Lic. No.fi.� 1 ,�_,, ❑ Firm/Co. GAS INSPECTOR r Check# j 6126 Ick one- s 1:1No❑ LiaDUrty msurawo Num y r, Bond ❑ Owner's Insurance Waiver: 1 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 u der Per h Issued for this application will be in compliance with all pertinent provisions of theMassa efts State G an r 142 of the General Laws. By: Signf�ureicensed Plumber Or Gas Fitter Title ❑ Plu1//S2 City/Town ❑ Gas Fitter License Number HS3 Master APPROVED(OFFICE USE ONLY) Journeyman 5 Date. .?.:G. ....... NpRTM TOWN OF NORTH ANDOVER pf «•o ,"1't'O 3? '� • O PERMIT FOR GAS INSTALLATION 9 4 • • o � a This certifies that . •"l f/. . . . . . . . . . . . . . . . . . . . . . has permission for gas installation .��. `.`.: . / . . . . . . . . . in the buildings of . . .� � . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., L at North Andover, Mass. Lic. . ... . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Y MASSACHUSETTS LTINVORM APPLICATON FOR PERMIT TO DO GAS FITTING ype or pnnt) Date Z r `1— 19 d NORTH ANDOVER, MASSACHUSETTS --�-- P Building Locations 62) Ovk ermit L t J� r c— Amount S Owner's dame JOt,tn �C :J`f'a w /�d St"c.�f'c New Renovation ❑ Replacement ❑ Plans Submitted ❑ Z. �n y _? z 'si — — — su a-a :ksErt ENT — BASE .M ENT 1sT. F L 0 0 R 2.N D . FLOU R JR D . FLOC) R 47 it . FLOG It 5 T I[ . FLO G R 6'i Ii FLO G R 775 . FLOOR 3 T 11 F L O O R Name— Address .— type)� 1� // Check one: Certificate Installing Company me otP- Address ❑ Parmer. 3 Business Te ephonr ❑ FirmiCo. Name of Licensed Plumber or Gas Fitter 16J,,sC Lt-1 Z irk f1CLC1-1 - INSURANCE COVERAGE � Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ Ifvou have checked ves, please Indic to the type cove .e by checkI ,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 ,gent 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 oFmy knowledge and that all plumbing work and installations per-formed under Permit Issued For this application will be in compliance with all pertinent provisions of the.lassachusetts State G s 5aeoteh r 142 of the General Laws. 113v: Signature icensed Plumber Or Gas Fitter Title ❑ Plumber CirviTown ❑ Gas Fitter LIcense74 umoer Master APPR0VED)OFric:=USE!)NI-Y) ❑ Journeyman o ./ o 2 U "�v Date... ... . Of,NC°rM 1tiC TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ��SS�cMu Est`' This certifies that ......... ...........+ .... �...�...�.:.�........................ has permission to perform ie v. ..l...:..r....... .0......:c:...................... wiring in the building of......... .............................................. at. 5. .....C..S u..::..�...{l...C.1+.{ ... �,North Andov_er,.,Mass: Fe�......A9 ..... Lic.No..11'....... ......... .!....... ........... / ELECTRICAL INSPECTOR Check # / ✓/ WHITE:Applicant CANARY: Building Dept. PINK:Treasurer "r,W1Yl1YLV1VFrl.!l l11Vl'LUelta %-dll/luil111 DEPARTMFNfOFPUBLICS41WY Permit No. Ut BOARD 0FFIREPREVEM70NREGUL4TI0AN 527CMR 120 Occupancy&Fees Checked �l WORM WORK APPLICATTONFOR PTD PERF ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat 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) 5- Owner or Tenant 0 lJ T 13,j L e y Owner's Address Is this permit in conjunction with a building permit: Yes�No (Check Appropriate Box) Purpose of Building R e s i �/�Prig * i �� rr Utility Authorization No G4��G' Existing Service Amps Volts Overhead 1:3 Underground M No.of Meters New Service 410© Amps/L�Wolts Overhead UndergroundLL No.of Meters Number of Feeders and Ampacity Z4- ; r, El /1710 H �' Location and Nature of Proposed Electrical Work 'o.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA Jo.of Lighting Fixtures Swimming Pool Above 0 Below rl Generators KVA ground ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Bumers 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 a Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP (ITHER htsurartoe Rasuat�bt}tteetegtmartiatsafM�ad� Gaul Laws Iha-veaametLmhlityhmxanoePb yutdt>d'rtgCaTo& * CuxrdWatsakst3Mo4mWatt YES NO Iha,,eabn&dvalidpUofofsMrebthe0ffW-YES lfjwhmdiedWYES pkme the�Wofoaaagebydtedkwgtfie CE M BOND OU-IER ��ftweSpo*) �:2 a Z Esfim*d Vahte ical Wak$ WaktoStm InspeaimD*ReWe ted Rotgh Final SigrWunderTrRri 6mofp*y. p �c 7 /` FIRM NAME Y �� C 5 L C Lioa>seNa L; r /0; C I� C t-- She Br&mTel.NV y;>,- 3 ?5' 3 o e o ertac �ir' r;� 49V.e f�,�► cS(�Ufy ����: ��`��3 Alt.TeLNa F 2 � OWNER'SMJRANCEWAIVFR;IammmthattheL'a wdocsnutt ethe instraroeaaerag✓orAsst>bst laltrivalattasrt tmadbyMssad»ttselfsGataralLaws andditmysiginA OnIhspMnitFPpka6'ottwairesthistegmancri (Please check one) Owner AgentC L5 Telephone No. PERMIT FEE p� Location ),4 3 S g �.��;^�( W Cf 1^ No. 12 L Date MOIfT1r TOWN OF NORTH ANDOVER O?0•�•`•O '•,�OOs ►. A i • Certificate of Occupancy $ ��S'•• E<�' Building/Frame Permit Fee $ s�cHus —' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ J CID/, Check #-Lao, -� Building Inspector 6 �5 m w SCq 78 F - w m 0 75622• \ J On # cn LOT 3 � �/ o 0 f Z 87,121 SF ��; o c -- oo rn 00 C0, C�7�7>CC t 4 ?S1� LIMIT OF 150' ONEISTURB J rn o o w w COUNTRYco N88132-38" 1 � m CLUB CIRCLE 136.95 O w N w � d m to io tO � r*i PLAN OF LAND A 7LAN nc ENGINEERING & m IN SURVEY CONSUL TANTS INC. 97 TENNEY STREET — SUITE 5 N N . ANDOVER , MA GEORGETOWN, MA 01833 W N DA TE- OCT 10, 2000 SCALE 1" = 40 FT. ON THE BASIS OF MY KNOWLEDGE, INFORMATION AND BELIEF, I CERTIFY THAT THE INDICATED STRUCTURES cn ARE LOCATED AS SHOWN, AND THAT rn 46 THE SETBACK DISTANCES SHOWN 4. HEREON WERE THOSE RECORDED AT `'- o THE SITE. JOB NO. A0007-10 m OF M� : U THIS IS AN INSTRUMENT PLOT PLAN ON a SHOWING THE LOCATIONS OF EXISTING o 1725 AND PROPOSED STRUCTURES FOR OBTAINING A BUILDING PERMIT. LOT o o� LINES HAVE NOT BEEN STAKED 9 SUAS PART OF THIS JOB. AS SUCH THE SETBACK DISTANCES w SHOWN ARE NOT TO BE USED BY THE OC 10, 2000 CLIENT TO ESTABLISH LINES FOR N8732'01 0 FENCES, SHRUBS, LANDSCAPING, ETC... o 01 J U n f*1 Date. 1? -:w�2 a,r No <i X77 T:�4, TOWN OF NORTH ANDOVER O0 '° PERMIT FOR PLUMBING ��SSACNUS� _ ✓ " This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . • . . . • . . . . . . . . . . . . . . • r. plumbing in the buildings of -- .;. . at ' •! -PN�rth Andover, Mass. C�vt Fez�ro. . . .Lic. No.. . . . . . . . . �- .. . . . . . . . . . P�B�PECTDR Check #V 12,7T WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS _ 45d Date Date Building Location / me � / S it# CDJ✓lT�'t/ Cl� ��-���Ow�ners Amount `�- Type of Occup ancy 2 S New Renovation Replacement Plans Submitted Yes No FIXTURES r E-0 rA W a W x z H a a F A a �' 40 A A 9 E• d St$B1VI)C R�cIIVIIVT o2 M FLOM M FIOCIt 3M FLO(32 4TH RaR SIH RfM 6IH HIM 7IH Hf= M FIDQt (Print or type) p Check WWI, Certificate Installing Company Name �( ��' lit G orp. IAddress ' � Partner. a3��3 E Business Telephone 7 Fimi/Co. - Name ofLicensed Plumber. r 44 ` c Insurance Coverage: Indicate the insurance coverage-5y checking the appropriate box: Liability insurance policy Other type of indemnity Bond ❑ Insurance Waiver. I,the undersigned,have been made aware that the licensee of this application does not have any one of the above ti three insurance ignature Owner F1 Agent D 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 Massa setts Stat P d Chapter 142 of the General Laws. By: i s Type ofPlu g License Title City/Town icense INUMOer Master Fzq---,Joumeyman ❑ APPROVED(OFFICE USE ONLY r) Date.....?.... No . ..%.... .... t NORTH °ft •�"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING SSAC14USEt/(`, This certifies that ........... ................................................... has permission to perform :........... ............................... .................. wiring in the bwlding of...................................... ............................................. at......................................... .....................(�......... ,North Andover,Mass. Fee..,.`..... .... Lic.No................ ...................................�...........I.............. ELECTRICAL INSPECTOR Check # WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Commonwealth of Massachusetts official Use only ::... -------- M. Permit No. Fi'�(�/ Department of Fire Services Occupancy and Fee Checked 3�S BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] leaveblank 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 1N INK OR TYPE ALL INFORMATION) Date: 3-2G-0 City or Town oh 14. RN aoI(E(z To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Owner or Tenant ST*,"L Telephone No. Owner's Address K,4- Is this permit in conjunction with a building permit? Yes [✓] No ❑ (Check Appropriate Boa) Purpose of Building '/?c-Sr or-N CF— 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: F2c .�c�ornw t JEC�� fys;zc�y Completion of thefollo-King table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ - ❑ o. o mergency Lightmg rnd. arrid. Battea Units No.of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones j No.of Switches No. of Gas Burners No.o Detection and 17 stooks i Initiating Devices 9 be,ars �b No. of Ranges No. of Air Cond. Total No. of Alerting Devices Tons g �� No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/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 40 No.o Water IAV o.o o.o Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: l No.of Devices or E uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. 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 []� BOND ❑ OTHER ❑ (Specify:) 9/0, Estimated Value of Electrical Work: f 3 .00, (When required by municipal policy.) (Expiration Date) Work to Start: 3-IS-o/ Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify, under thepains and penalties ofperjury, that the information,on this application is true and complete. FIRM NAME: LIC.NO.: 9SC- Licensee: Signature LIC.NO.: 148 (If applicable, enter "exempt"in the license tKumber line.) Bus. Tel.No.: 97.e Z3 $Sfo Address: 28 1'PF.ayE:rrF � -CAL 5/1 f-f-4-- o 1-9-5z Amt.Tel.No.: 97,6 3Bs 4r6Pb OWNER'S INSURANCE WAIVER: I am aware diffthe Licensee does not have thediability 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 PERMIT FEE: $ � Signature Telephone Na. o Town of North Andover Of pORTN q 1LE0 1 I�/ Building Department �? gt, �b'6 o0 27 Charles Street o North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 [O[RIC IWHR ED APPLICATION FOR CERTIFICATE OF OCCUPANCY/ INSPECTION ADDRESS LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING `' CONSERVATION DATE PLANNING DATE D.P.W. —WAR ME�4/ DATE D.P MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED RIO TO INSPECTION QUEST DATE. SIGNATURE/DPW AUTHORIZATIO r .• CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number '�� -1/ Date ��`�� -a00/ THIS CERTIFIES THAT THE BUILDING LOCATED ON �p� #� �G�U2i�/ Club e/r 6 le-- MAY BE •CCUrIE) AS l/U /Ain/ i df`A&IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. ROOMI 6 P4,41- 2-- /a ,(3 717 S CERTIFICATE ISSUED TO �oN�► / S 7d.v�� ADDRESS �� C'vv�u�hY 0Ud L ''sACHO Buildin Inspector Town of No, rtover No. North Andover, Mass.,_ 91'8 BOARD OF H Food/Kitchen PERMIT TO B�' UILD Septic System 7�4� #0!4 (�rD BUILDING INSPECTOR THIS CERTIFIES THAT.1940... par"f� ...... . ............ Foundation has permission to erect... ' .......... buildings onWO-1*55.....�,w1�N.fry.., QY. CfMle Ro 3to be occupied asj4 PCOMa ...$ 4.11...AlkChimney . ................... .V.. provided that the person accepting this permit shall in every respect conform to the terms of the application on fire in Final It- this office, and to the provisions of the Codes and By-Laws relating to the Inspe Alteration and Construction of 1 Buildings in the Town of North Andover. now Us oil, PLUMBING'INA,� VIOLATION of the Zoning or Building Regulations Voids this Permit. 2- C" ELECTRIC INS R ON 5'�! 1�1 w�s Rou c3/�7 �� 100 44 *)rt.AA&J*&%,1 A1404 OP4 ................04o.. ........................... 064ft*^W4% BUILDING INSPECTOR 6/// x * GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Fi No Lathing or Dry Wall To Be Done Now Until Inspected and Approved by the Building Inspector. Burner FIRE DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det.)