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HomeMy WebLinkAboutMiscellaneous - 591 MASSACHUSETTS AVENUE 4/30/2018 (2) 591 MASSACHUSETTS AVENUE 210/045.C-0026-0000.0 14 ti y •xnP Na NORTH AMOWR ]BUR-DMG DEP"TA ENT .1600 Osgood Street • North Andover . Tel. 978-688.9545 Fax: 978-688-9542 B MESS FORM FOR TO WN CLERK DATE: ADDRESS: J ice..S-sa c c), S �-��. ��� e TYT€3F)3U8MES : tfGr"r-1c '5 �c Cc 7�elr ne, BUJILDINGL.AYODT PROVIDED.,, YES N� ZON:[NG,BYr,.E�.'4�4�'USAGE: .,.YES NO B D G INSPECTOR SIGNATURE SUSM SS FORM FOR TOWN CLERIC 2.40 Rome OccupAon(1939132) An accessory use conducted villin a dwelling by a xesjftt who resides in the dwelling as his principal address, which is clearly Recondary 10 the use-of the building for Ring pluposes. Home occupations shall -ihcIizde,"but iiot'limited to the following uses; personal services such as furidshed by an artist or instaictor, but not occupation involved with motor vehicle xepairs, beauty paxlors, animal kamels, or the conduct of retail business,or the nnanufacturiug o�goods,which impacts the residential nature of the neighborhood; 4. For use of a dwelling in any residential district or multi-fainly district for a.home occupation,tba following conditions shall apply. hOn'Ip occupation, one of a. Not more than a total of tbrw(3) peaple may em loyec{ t.th a;, , p , whom shall be lhoowner oftl d.fibmo occupation and residingg m s'aid d �elluig; b. The use is carried on sf ddly witbin.the principal building; c. There shall be no exterior alterations, accessory buildings, or display which are not customW with residential buildings; . d. Not more th=iwentyr five(25) percent of the existing gross floor area of fho dwelling unit. so used, not to exceed one thousand (1000) square feet; is devoted to'such use. In connectionwith such use,there is to be kept no stock in,trade, commodities or products which occupy space beyondthese jimits; e. Therewill be no display ofgoods or wares visible Ecom the street; f The building or premises occupied shall not be rendered objectionable or detrimental to the residential character of the neighborhood due to the exterior appearance, emission of odor, gas, smoke, dust, noise, disturbance, or in any other way become objectionable or detrimental to any residential use within the neighborhood; g. Any such building shall include no features of design not cust6mW in buildings for residential use'. ignatuxe Date s } Date.... ." /..©.7..... i VkORTI{ °`'"`D;•1"- TOWN OF NORTH ANDOVER s OL +�, p PERMIT FOR WIRING +D,ATID♦�`� SACMU'" Thiscertifies that .......... ........................ . ........................................... has permission to perform `" 'LN • '.�•................... ................................................ _ .... .........................�........................... wiring in the building of......rx: 9r ........... ,North Andover,Mass. N� Fee--131......... Lic.No.��� ....� 7 . IkIl .. '?'� ....... .... . ELECTRICAL INSPECCTT0 Check # V 7550 r Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. /6�P Ou BOARD OF FIRE PREVENTION REGULATIONS [Rev1107]y and Fee Checked 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: City or Town of: NORTH ANDOVER 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) S-q [ MA�Q, At/Q-.- Owner ✓QOwner or Tenant l fVAts P L 4lI O Telephone No. Owner's Address S km Q 3 t) z-c Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Buildingyp,,p Utili Authorization No. Existing Service )06 Amps lit /94/ Volts Overhead Undgrd❑ No.of Meters 2 New Service 99L- Amps J () / i/ Volts Overhead Undgrd ❑ No.of Meters l Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion o the ollowin table maybe waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Tota Transformers KVA ' No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- F1 o.o mergency ig ing rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.of Detection and TotInitiatin Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: I . .. c Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Sectio,oSystems:* s or Equivalent No.of Water No.of No.of Heaters KW Data Wiring: Si ns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommumcat►ons Wiring. No.of Devices or Equivalent OTHER: � 'l Attach additional detail if desired,or as required by the/nspector of Wires. Estimated Value of Electrical Work: () UU (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'nsurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ER BOND ❑ OTHER ❑ (Specify:) I certify,under th pains and penalties 9,f perjury,that the inform tion on this application is true and complete. FIRM N E: K ^ ���( � LIC.NO.: (j Licensee: ��, �A LNC tvj r✓ Signature LIC.NO.: G)-/- (/f applicable, enter "exempt"in the license number line.) Bus.Tel. No.• 3—S('o� -139'3 Address: 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 INS C WAIV : I am aware that the Licensee does not have the liability insurance coverage normally required by law. y Ci, a low, I hereby waive this ent. I am the(check one)❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No.(oD�- 0 13y PERMIT FEE. �' .,� '"�-. i �� � ' � � � a .. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/plumbers A li cant Information Name(Business/Organizatiowindividual): L 2 C_/l Please Print Legibly � v Address: City/State/Zip:, Phone.#: ) Are Y21fan employer?Check the appropriate box: 1. I am a employer with, 4. ❑ I am a general contra7and [7. ype of project(require ft_�rnployees(full and/or part-time),+ have hired the sub-co ❑New construction 2. I am a sole proprietor or partner_ listed on the attached sheet. ❑Remodeling ship and have no employees These sub-contractors haveworking for me in any capacity, employees and have workers' . ❑Demolition [No workers'comp,insurance comp.insurance.t . ❑Building addition 3.❑ required.] 5. ❑ We are a corporation and its 10-❑Electrical repairs or additions I am a homeowner doing all work officers have exercised,their myself.[No workers'comp, right of exemption per MGL 11.❑Plumbing repairs or additions insurance required.]t C. 152,§1(4),and we have no 12•❑Roof repairs employees.[No workers' 13.❑Other 0 comp,insurance required.] •My applicant that checks box#1 must also fill out the section below showing their workers'compemadon policy information. t Homeowners who submit this affidavit indicating they are doing all work and an hire outside contractors moat submit a new affidavit indicating such, =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'w rt>lr,Policy number. ram am employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: k'r –(3 7) Policy#or Self-ins.Li c.#: – Expiration Date–IV P :�v Job Site Address: City/State/Zip: 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 fine up to$1,500.00 and/or one-year ' of MGL c. 152 can lead to the imposition of criminal penalties of a y imprisonment,as well as 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 Investi ations of the DIA for insumn a coverage verification. I do hereby u er t pains d enalties o P jperjury that the information provided above is true and correct Si lure: Date: 131�1 1%. / Q Phone#: — [6. fficial use only7le' rite in this area,to be completed by city or town ofjlclaL ty or Town: Permit/License# suing Authorite): Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector Other Contact Person• Phone#• Q Location No /149 Date — 1— 97 " 011 TOWN OF NORTH ANDOVER 0. I Certificate of Occupancy $ 4L • • Building/Frame Permit Fee $ °°"'"°'Eta da}}J+�'.o Permi Fee $ ot/u SACMUS �yl'k�l�f rC F r Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building InslYe'ctor 1. ". 10 4�t97 13:32 25.00 PAID ------- Div. Public Works PER311T NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 �'.v1AP iqo.®mss, LOT NO. �, 2 RECORD OF OWNERSHIP DATE BOOK 'PAGE ZONE SUB DIV. LOT NO. —I OCATION / 1viASSl�rNG a:6- f�„L/e- PURPOSE OFA ��� }1,093 A OWNER'S NAME L! e NO. OF STORIES / SIZE N r f•,OWNER'S ADDRESS ADDRESS BASEMENT OR SLAB .sCf/ '1M 1a sS H c,�1 USc�{�s' � U 13 A Se A' ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD �BGILDER'S NAME , /� d� SPAN -- DISTANCE TO NEAREST BUILDING /"/ DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS I/SISTANCE FROM LOT LINES-SIDES REAR " " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY BUILDING ALTERATION yam. s y'^�/C5 IS BUILDING ON SOLID OR FILLED LAND W'I'LL 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 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES ES BLDG. COST 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 DA E FILED '3// A 7 7wy BUILDING INSPBCTOR SIGNATURE OF OWNER OR AUTHORIZED AGENT dd FEE �+- 11� OWNER TEL.M PERMIT GRANTEDCONTR.TEL. 6 8;� -) d 19 C TR.LIC.# �15'6 3 l-6 ��� -7s-7 t, l 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 8 INTERIOR FINISH CONCRETE d I 2 13 CONCRETE BL'K, PINE BRICK OR STONE HARDW'D PIERS PIASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ '/, 1/7 FIN. ATTIC AREA _ NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDW'D _ ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. & FLOOR (- BRICK ON FRAME CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I- I POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) _ GAMBRELMANSARD TOILET RM. (2 FIX.) _ �} FLAT I A SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR 8 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. 6 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 .� I' �i �1e T�ay�nxaruvea� a�✓�a�tae,�ivae�i I` " DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR.LI CERSE Expires: Birthdate: ; CS: 068390 08105(2000 08105/1949 Restricted To: 00 THOMAS 41 HOUDE'• OM*00' 1401 GREAT ?OND RD 18 N :ANDOVER, HA 01845 .............................................. - __--- _... .--_.---�1ee�am�xon«��✓�faaaac�uaelta ' HOME IMPROVEMENT CONTRACTOR , ' Registration 120138 a Type - DBA N•� Expiration 02/26/98 NORTH ANDOVER PAINTING & REMO THOMAS W. HOUDE G� �o '�4/01 GREAT POND RD, 018 ADMINISTRATOR NO ANDOVER MA 01845 l tAORT ovm of eAndover * 1l dover, Mass., .T444 11. 194?7 0 s LAKE '9 -COC M ICHEWICK �qA E D�`P`y S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System ;60.1w BUILDING INSPECTOR THIS CERTIFIES THAT.................... . : ::: Foundation has permission tout. buildings on • R�.......... g ........ Rough to be occupied as.............. rco ...... .. "+ - .... ... � ............ Chimney provided that the person accepting this permit shall in every respect nforfi to the terms of the applition 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 PERMIT EXPIRES IN 6 MONTHS Final ' ELECTRICAL INSPECTOR UNLESS CONSTRUCTIONeST TS Rough ............................... .. .... ................................. Service BUILDING 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 Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. 'ter/07 S-1 moke Det.