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HomeMy WebLinkAboutMiscellaneous - 61 INGLEWOOD STREET 4/30/2018 GLEW07 / 000.0 \` 2101007 I i �I Date/C4. ./.. . .. HOR Thy Of o 64, TOWN OF NORTH ANDOVER t PERMIT FOR.GAS.INSTALLATION SSACHUSES 1 F - This certifies that �..�. . . . . .:"�". . . . has permission for gas installation . - . ./- / - •. °'. . . . . in the buildings of . ,l ." vet . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . .. North Andover, Mass. Fee . . . . . Lic. No.t!`� ,� . . . . . . . . . . . . . . . . . . . . . . . .` GAS INSPECTOR Check# 6634 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) (jpL f Z Mass. Date 2Q 4V Permit# 1� Building Location f) Owner's Name Owner Tel# Type of Occupancy' New ❑ Renovation ❑ Replacement ❑ Plan Submitted: Yes ❑ No ❑ FIXTURES o w `� a `� 1 z p z z < 0 o z w 2 rO w �WW �Q w � � Q CO W m w z x a: "a w w > z Q w J ¢ F O Z o zW o co x T o M Q i w 3 Q t7 U > Q a 1-- o w SUB- SMT BASEMENT IST FLOOR 2ND FLOOR ' 3R°FLOOR 4T"FLOOR 5T"FLOOR 6T"FLOC'' 7T"FLOOR e FLOOR Installing Company Name L/ ��� Check one: Certificate s Baa . C Address / ���� �� .� -��"`-`_ corporation ❑ Partnership Business Telephone# - _ ❑ irm/Co. Name of Licensed Plumber or Gas Fitter /—� U7 G INSURANCE COVERAGE: I have a current lia ,ility insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. Yes No ❑ If you have checked yes,ply-ase indicate the type coverage by checking the appropriate box. A 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: Owner ❑ Agent ❑ Signature of Owner or Owner's 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 the permit issu o is ap lication will be in compliance with all ertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gen I s. By Type of License: • lumber Signur} Licensed Plumber or Gas Fitter Title •-Gas fitter G r� 1 ase - License Number � Cityrrown •-Journeyman APPROVED(OFFICE USE 0NLY) .- &- o c'Date.... . . NORTH TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SSACMUS� Y This certifies that ti T`4VL ...... ............ ..................................... has permission to perform /4.r gr�� ....... .................................................... ................. wiring in the building of.....................; 1 �'...... A. '�.r . ..............`1........... ,North Andover,Mass. Fee.. G.... Lic.No.PY.W19 .......... /� LECTRICAL INSPECTOR/ Check # 6 Commonwealth of Massachusetts official Only Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS MaP&Parcel 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 INNK OR TYPE ALL INFORMATION) Date: City or Town of. /' f2T6� i��D(/ To the Inspector of fres: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) �p,/ /y�'rJ -S-7— Owner S-T Owner or Tenant _ A."4 L J. /Y— .J;4 C Telephone No. Owner's Address -.5140g, Is this permit in conjunction with a building permit? Yes No ❑ Building Permit# Purpose of Building gA `Pe!q Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volta Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: R Completion of the followin table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans o.o of Transformers ICVA No.-of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool rnd Above 1:1rnd. ❑ Batts NO.Or Units g ng No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of Detection an No.of Switches No.of Gas Burners o.Initiating Devices No.of Rankes No.of Air Cond. To. o.of Alerting Devices No.o[Waste Disposers ea Puma um er_ ons o.o elf-Contained Totals: 71i'l, etecdon/Alertin DevicesNo.of Dishwashers Space/Area Heating KW ocal ❑ c 0' Other Connection No.of Dryers Heating Appliances ICW Security Systems: No.of Devices or Equivalent No.o aterKW 0.0 o.o Data Whing: Heaters Si ns Ballasts Na of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications g: , No.of Devices or E uivalent ' OTHER: Attach additional detail if desired,or as required by the Inspector of res. 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 a BOND ❑ OTHER 0 (Specify:) 941 71D-9 Estimated Value of Electrical Work: (When required by municipal policy.) (Exp ) Work to Stam Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certi}jr,under the pains and penalties of perjury,that the information on this application Is trite and complete FIRM NAME: LIC.NO.:A 1 1983 Licensee: LOUIS CONT I NO Signature LIC.NO.:E2 8 7 8 8 (Ijapplicable,enter"exempt"in the license number line.) Bus.Tel.No978=363-5420 Address:_ 1 nnNn`rAu nu G7FCT NF'wRirRY arta olg85 Alt.Tel.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)0 owner owner's agent Ilz Owner/Agent PERMIT FEW?S 5ianature Teleehnne Nn_ i Date. . 7:. 3.!. C -L ",O RT:�4, TOWN OF NORTH ANDOVER 3? .�.r p PERMIT FOR PLUMBING SS CH S� b This certifies that . . . j.r.< <. �. . . . � . . . . . . . . . . . . . . . has permission to perform . . . ..?. .l4. �XA . . . . . plumbing in the buildings of . . . .r"d:,. c . . . . . . . . . . . . . . . . . . . . at. . . . . . . . . . . .. North Andover, Mass. PUUMBING INSPECTOR Check # 5318 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS C / NDate Building Location > J r Permit# + Amount Owner kto t///t _5/7'?r T/1 New Renovation Replacement 0 Plans Submitted Yes 0 No FIXTURES F Cr Cn F A9z w W rsa F A e STSBM B SEVENr M HiOCR • 2 D H-CM �1HIACg2, 4IH FIDCit 5II3110M 6M HDM 7M FIDCR SIH FIDCIR (Print or type) Check one: Certificate Installing Company Name / / l�ryn ❑ Corp. Address �v� h'L/e El Partner. Business Te ep one Firm/Co. � v Name of Licensed Plumber: ,Ao e ' r�4 Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 0 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 three insurance 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 ermit Issued f this application will be in compliance with all pertinent provisions of the Massachusetts State Pl ing Cod and qWer 10 of the General Laws. By igna re o icense um Type of Plumbing Licerge Title City/Town icense NUMNIT Master ❑ Journeyman APPROVED(OFFICE USE ONLY Location LIQ � �C-t F WO O ' No. 668 Date �— „pRTFTOWN OF NORTH ANDOVER C? •. • OR s i i Certificate of Occupancy $ 112 t: S'�s'•• E<� Building/Frame Permit Fee $ ICY s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 156 -- Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED: �T ` D O SIGNATURE: t �' Building Commissioner/I -or of Buildings Date SECTION 1-SITE INFORMATION Z 1.1 Property Ad ess: 1.2 Assessors Map and Parcel Number: O Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: /1�.-Vo .57r- Zoning 'strict Proposed Use Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard ReqWred Provide RegWred Provided Required Provided v 1.7 Water Supply M.Gj..C.40. A) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: D Public ❑ Private 4 ❑ Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record Name(Print) Address for Service: L�aUCS Si ature Telephone 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: 7Z— O License Number on Addr �/�7ilO 7` ('lQ Exptrahon Date Si ture Telephone r 3.2 Registered ome Improvement Contractor Not Applicable ❑Ila v Company Name z o 6 5-1 m �M J �'/ Regis ration Number r' A dre r y /9A cry Z l Expiriti n ate Sign—e— teliphone G) c SECTION 4-WORKERS COMPENSATION(NLG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Workcheck au applicable New Construction Exitin Building Repair(s) Alter ns(s) I Addition ❑ Accessory Bldg. ❑ Demolition ❑ Okber Spec' Brief Description of Proposed Work: L SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant I. Building (a) Building Permit Fee (jb Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(8)X (b) 4 Mechanical HVAC ' 5 Fire Protection 6 Total 1+2+3+4+5 p Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING.PERMIT 1, ,as Owner/Authorized Agent of subject property Hereby authorize Ito act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, K&J ^� as Owner/Authorized Agent of suttject property Herebv declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Y s Print me44t Sigr&6re tent er! ent Date / IMMO 111111 INS NO. OF ST RIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING x MATERIAL,OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE fThe Commonwealth of Massachusetts j J Department of Industrial Accidents Office or investigations ' Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: � S .Location: 40( :t' City �J n. r +/A/ M Phone e 4 6 7-70 s� am a homeowner performing all work myself. 01 am a sole proprietor and have no ono working in any capacity f am an en toYeproviding workers'compensation for my employees working on this job. company nam Address WO Cdy: Phone k 7,v t,- 6 7 "]a b Insurance . .. ✓r -L . Cyr R/ ornRM name: Address C�Ity Phone* Ins Co. Policy Pailura to secure coverage as required under Section 25A or MGL 1:522 can lead to the Ntlpos�ton d crknina!penalties.of a fine up to$1;500.00 and/or one years'imprisonment as well as civil penalties in the form d a STOP t+1►0121C Ofibt and a tine of 310000 a d understand that a Copy of this statement may be forwarded to the Office of Investigations.of the DIA for ) day against me. 1 I do herby certify under t poi and pen les perjury that the k*matfon provkted above is bue ani!correct Signature Date -z-/0 z— Print name fJ -70 oneZ7 (P� Official use only do not write in this area to be completed by city or town official' Building Dept j ©Check Yimmediate response is required Building Dept El (J Licensing Board p Selectman Is Office Contact person Phone# Q Health Department other ?fr9 WORKMAN'S COMPENSATION NO R T1y i 0" . 0f over w1 LA O dover, Mass., 13'' 0 COCMICHEWICK V RATED P'? C S BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR � 1 THIS CERTIFIES THAT.......K,4..%s `.... .�............ ....................................................................��d............................. Foundation has permission to erect.4�4%....................... buildings on ...`.�.........��.�.�.�,....,..,................ ...s.. ........ Rough to be occupied as himney .. ......... ....... �..................... ��►c............................... provided that the person accepting this permit shall in every respect colorm to the terms of the application on file in.. Final this office, and to the provisions of the Codes and y-Laws relating tote Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR aS �� VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough ........... Service BUILDING INSPECTOR Final OCC1.bpCl1lCy Permit R2qul1"eL>' t0 Occupy Bulling GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT I Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. Location z �'�" /�'w��� No. V-- Date " NORTH TOWN OF NORTH ANDOVER i y . ; . Certificate of Occupancy $ �'�s •E<t' Building/Frame Permit Fee $ swcMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ -' Check # 2J V 'i 56 U Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING a BUILDING PERMIT NUMBER. DATE ISSUED: to _a 7-n?0 oa M SIGNATURE: , -- Building Commissioner/1for of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Ad 1.2 Assessors Map and Parcel Number: Map Number Parcel Number• 1.3 Zoning LInformation: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided © go 1 2312-51- 30 a 1.7 Water Supply M.G.L.C.40. Zone 54) 1.5. Flood lnfotmation: 1.8 Sewerage Disposal System: Public Ae Private ❑ Zone Outside Flood Zone Municipal Je On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record Nam rint) Address for Service4�Z 978 : n' Si ture Telephone pp0 2.2 Owner o ecord: 1V. Name Print Address for Service: O Z rn Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supe ' or: Not Applicable ❑ �C/✓ + S r Licensed on S rvisor: 0 O License Number mn Addr J, I q 7K 1�,97 -7(2-C/ t)ta Expira ton bate E S' ature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Sf 00. Company 14ame / ��// rn Jtf{� J�'/ /—t Registration Number r Addref 3 b/� r d �� C�fi' Expiration ��49 J y Z ature Tee hone YI SECTION 4-WORKERS COMPENSATION(nG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the build' g permit. Signed affidavit Attached Yes...... No.......❑ SECTION 5 Descri tion of Proposed Work check all applicable New Construction ❑ Existing Building .ke Repair(s) [IAlterations(s� Addition ❑ " Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify. Brief Description of Proposed Work: ©r.ev— CJ SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit ap2licant 1. Building (a) Building Permit Fee 7o od Multiplier 2 Electrical (b) Estimated Total Cost of /000 Construction 3 Plumbing Building Permit fee(a) x (@) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signatur(xrOwnew9entDate NO. OF STORIrS SIZE BASEMENT OR SLAB il RD SIZE OF FLOOR TIIVIBERS is 2 3 SPAN llIWNSIONS OF SILLS DIMENSIONS OF POSTS -act DINffNSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHEVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE The Commonwealth of Massachusetts Department of Industrial Accidents Dice of Investigations ' Boston, Mass. '02111 W 'ers'Compensation Insurance Affidavit �g ' Please forint Sums Name: k eli, S Location: L i.yo n Ci am a homeowner performing all work myself. �I am a.sole proprietor and have no one working in any capacity E�krI am an employer providin workers'compensation for my employees working on this job. Com name,• � , C�,_s Address A aX Cid ;l Phone# oJ, .bar EC-L-7-0-0 CoQ 2aaf cQr►��y name: Address C-- — - Phone#- _ irtsttran�:-Crz. � � F3111106 to secuio coverage as required under 25A or MCL t,52 carr lead latus impos*on of criminal . and/or one years'imprisorgnent a$*Well as dvA pe+!�s.aratlne uP to$1:500.66 . penalties in the.torrrt of a Sloe Vt/f)F31C ottb�i and a fine of 0100 OOj a day against r»e i understand that a copy of this statement may be wwarded to the office of kwestigaft s of the PIA far co%wage veri�n: l do herby certify u d" the p aw. eX Ofpadwy that the k*mation provided aboveis true and.cwft-t Signature Date O�r Print name e .S Phone# � 0(ax Official use only do not write in this area to be completed by city or town ficial- !] Bur/ding > - (QOheck W irnmediate response is requ„ed Building Dept p Licensing Board p Selectrhan's C�c6 Contact person: phone A 0 Health Department D ofher ?Or?KMAV'S COMPENSA TION North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) ig ature of Permit Applicant /oma Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector nt o. * AV$t-, tAA V,s qs'' (q-76�4e,7 704 3� f0 6AA) fed , eAr X78 9*PbA t R . "l x - . dors �o Cxr3�rh� ?W�e-� � C 0- Ito 0� r! NORTH Town . of over y O 74 LdM6a - COCHICHEWICK ORATED S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System � BUILDING INSPECTOR .. THIS CERTIFIES THAT......... VAN ..A! .. ................... ........................................................................................ Foundation I • has permission to erect... -�f.........43 ....... uildings on .6 ... N ..A...00.0.0.41........3.C......... Rough to be occupied as... . . ... t3A chimney . M . ....� ..... ..... ...... ....... ..... . .................... provided that the person accepting this permit shall in every respect conform to the terms of the application 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. /a S ow PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ATARTS ELECTRICAL INSPECTOR Rough .................................>t .... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. DATE: SCOTT L. GILES FRANK LES 11, P.L.S. JUNE 24, 2002 � � � SH oFMgs�c SUBJECT PROPERTY REVISIONS: RANI{ S• GILES y �o Fin SURVEYIN G ss MAP 7, PARCEL 26 G 50 DEERMEADOW ROAD A 13 61 INGLEWOOD STREET sslo KEVIN J. SMITH SCALE: 1 INCH = 20 FEET NO. ANDOVER, MA 01845 ` Save AREA-=0.31 ACRES o' 20' 40' TEL: (978) 683-2645 ---� E-MAIL: FrankGilesSurvey@attbi.com K JUNE 24, 2002 DATE PLOT PLAN OF LAND PRIOR OWNER LOCATION MAP 7, PARCEL 26 61 INGLWOOD AVENUE 61 INGLEWOOD STREET NORTH ANDOVER, MA. DILENDIK TRUST C/O PETER J DILENDIK PREPARED FOR AREA=0.31 ACRES KEVIN SMITH BOOK 1473, PAGE 197 D.O.S. = 1958 PARCEL 22 PARCEL 21 PARCEL 20 135.0' EXISTING FE `CE 1 M 1 . :. MAP 7, PARCEL 26 AREA = 13,500 S.F. j 24.5' v � o #� ST_tNl C- JL ; .HSE. - n j r» ; 6. PATIO 6.5' ` 3' 23.0' PARCEL 23 13' M 71 w; DRIVE (-� a Z 135.0' H z W INGLEWOOD STREET w z zz V) THE OFFSETS SHOWN ARE FOR THE USE OF THE BUILDING INSPECTOR ONLY AND SUCH USE IS FOR THE DETERMINATION OF ZONING CONFORMITY OR NON-CONFORMITY WHEN CONSTRUCTED. 1 CERTIFY THAT THE OFFSETS SHOWN CONFORM TO THE ZONING BY-LAW OF NORTH ANDOVER, MA. C:\CLIENTS\SMITHTLAN.DRG x 3 /06 Date..... ......... NORTH TOWN OF NORTH ANDOVER t p PERMIT FOR WIRING �,SSACNUS� This certifies that has permission to perform // /'/ �' / / J ::..................... ........... ..............................1/ wiring in the building of............ �.. ........�....................................................... . .....�.. ....._ ........................ . .......... ,North Andover,Mass. at.... i' Fee...? .. J s v Lic.No.............. ..........I ..... ...... .... ,/.......... �. ELECTRICALINSPECTOR Check # 04P Tommonwralt4 of Mas.sartIntirthi Official Use Only y Department of Fire Services Permit No. F2 BOARD OF FIRE PREVENTION REGULATIONS Occupancy 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: r7A-2- 02, City or Town of: "09 —18 lJA-) LXC(Z- To the Inspector of Wires: By this application of the undersigned gives notice of his or her intention to perform the electrical work described below. lJ Location (Street& Number) 6, 11 1 1v — �--E WO©D 57— Owner or Tenant F I I!�{ S tit,i i E>� 1 Telephone N 706f Owner's Address 110 Is this permit in conjunction with a building permit? ❑ Yes ❑ No (Check Appropriate Box) Purpose of Building .TWO F4ticl f X 140 Utility Authorizatio N Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.o New Service �C,,Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity / Location and Nature of Proposed Electrical Work: S r` `fit t� R Completion of the following table may be waived by the Inspector of Wires. No:of Total No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA Swimming Pool Above In- No.of Emergency Lighting No.of Lighting Fixtures grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Gas Burners No.of Detection and No.of Switches Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KSecurity Systems: KW No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.of Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent 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 be issued unless the licensee pro- vides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such cov- erage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE EX BOND❑ OTHER[3(Specify:) xplration ate) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: CONTINO ELECTRIC & LIC.NO.: A}19$3 Licensee: LOUIS CONT I NO Signature LIC.NO.: E 2 8 7 8 8 (If applicable, enter"exempt"in the license number line.) Bus.Tel.No.: 978-363-5420 Address: 1 T)ONOVAN DR T V F WFST NEWBURY, MA 019 8 5 Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law.By my signature below, I hereby waive this requirement. I am the (check one)❑owner ❑owner's agent. Owner/Agent [PERMIT FEE:$ —� Signature Telephone No. FORM F.P.11 HOBBS&WARREN—BOSTON (REV.11/99)