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HomeMy WebLinkAboutMiscellaneous - 61 RUSSETT LANE 4/30/2018 (2) r 61 RUSSETT LANE / 210/104�g.0000.0 Date. . . . . . . . . . . �'.".O R':��a TOWN OF NORTH ANDOVER 3r 0 p PERMIT FOR PLUMBING,., �1SSACMUSE� /J This certifies that .: . . . . . : !:z has permission to perform plumbing.-in the buildings of .. . .. c . .. . . . . . . . . . . . . . . . . . . . . . J at .'. . �..'. . - ?-?-- . . . �`` '. ; . . . . .... .. ., North Andover, Mass. Feed?s- . . . . .Lic. No/.!.!�� PLUMBING INSPECTOR Check (� /. 0 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING CitylTown: N67Aa7/ MA. Date:�TI7T Permit# / Building Location: lD� dS��T�/�t/� Owners Name: Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Plans Submitted: Yes❑ No FIXTURES z z y O Y (n Cn = H W to d co z H `1 a N _i V (� a z_ z _ .U) 9 a W ~ W Z v~i Y cn OJ a x a� o ca a W o I- Z W o ag W z w �, c� v IL ul v '9 0F- = a O W � v z Q W 3 a z Z UY LU) W w oo = ° a a a a ~ 3 o SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3 Ru FLOOR 4 1H FLOOR 5 FLOOR FLOOR .—'FLOOR 8 FLOOR chm47ee D1-s y/J Ys It/1 Check One Only Certificate# Installing Comp ny Name: Corporationoration 6-1 , r. Address: CityRown: State: [IPartnership Bu6ess Tel: 0-"Q Fax: ,222 -36-2/ ❑ Firm/Company Name of Licensed Plumber: r'. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch. 142 Yes No❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. 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 Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. �Rv Type of License: ,e PI ber Signature o Lic7,u,,-- City/Town Plumber aster License Number: / APPROVED OFFICE USE ONLY ❑Journeyman City/Town: s � Date: 3 Plumbing & Gas Inspector: I 45-+T�s 1)44(would like to cancel permit# For the installation of G c In my home/address Q-j S L c�r\q) Ny ��nt, Climate Designs, LLC has completed the installation under the existing permit. Work to be completed under the new permit will be the final inspection. Sincerely, Date. .,/ . . -`.. . . .1.. 'i Of NO STN 1ti of TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION o•••"th �9SSACMUSE� This certifies that. . ....... ... .. . . . . . . . . .`.�. `.. has permission for gas installation . . . . . . . . . . in the buildings of . . .:`��`J J, . . . . . . . . . . . . . . . . . . . . . . . . . . . at f. . .'_ ... '." . . . . ?. '=. . , North Andover, Mass. Fee:: iS'ci Lic. No. . . . . . . . . . . .� Y GAS INSPECTOR Check# � 70ti MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING s . City/Town:.;w/1�Q�i Date /� _ qqk Permit# S Building Locatta .. ._:.. Owners Name Type of Occupancy: Commerciale A Educational Industrial„ Institutiona[ Residential,, r_— New:e Alteration: Renovation, � Replacement:' Plans Submitted:. Yes H No 'Y. 1 FIXTURES W IY w N U Q WWW O MX 0 W W O Cn ~ to w w W z z Z O w w W 0 IQ— to Z � �A w w w g m O a o. I— O W OO a X W > W Q Z W W (7 W y O a D:CL LL H W W � Z 2 W H W 0 > V W Z O J I— H O Z J O W j FX W FW- FW- IW- WW ~ H W toy o u=. _ _ > oO w z w a a a g o o. > > 3:1 1 3 0 SUB BSMT. BASEMENT 1ST FLOOR 2 N u FLOOR 3 FLOOR 4 TH FLOOR 6"' FLOOR FLOOR FLOOR 8 FLOOR eSt r � �° 5 I vt5'r U 1 rvl c . - --- •. - \� r( Check One Only Certificate Installing Company Name:; , ... � ...Y ✓ rpo n � , ._ ...ti. ratio . Address:, ?Cit /Town Corporation t State 'MA� _._ . Partnership > •�mneFax sis Tel x� ��� � i _ .. F rm/Company'. . .b ., ... of 1 �u��,, � ame of Licensed Plumber/Gas Fitter: INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch. 142 Yes ;Nd ,„%Al If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policyOther type of indemnity I BondLj OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner Agent ' M Signature of Owner or Owner's Agent By checking this box❑;I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. pe of License: Byiar.� .� ,x:,> I Plumber V Gas Fitter ignatur of Licens Plumber/Gas Fitter Master CityfTown _ Journeyman License Number: LP Installer APPROVED�OFFICE USE ONLY 3.-�- ✓V " Date'�?. : f . . J; T WWOF~NORTH ANDOVER PERMIT FOR PLUMBING �SSACHUS This certifies that . . . . . :: . . . . . . . . . . . . . . . . . . has permission to perform . . . - '� . . . . . . . . . . . . . . . plumbing in the buildings off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... . ` . . North Andover, Mass. Fee . . . . . .Lic. No. .. .. . . . . . . . . . . . . PLUM811fG INSPECTOR Check # 3 Q a U tq" of co X. yy a U, OUT al A Z f a, UJ rar0sar 10 = g:- < > 1 2- z .us j I I � PA� 0 0 _j SMTT. BASEMENT IST =LOO 2RD FLOOR 2817 FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7,2� CLIMATE DESIGN HEATING and AIR CONDITIONING, LLC Installing Company Name 5 South Summer Street Address Bradford,MA 01835 Check one: (_ertificate 978-372-9999(phone) uL Corporation 978-372-0882 (fax) 'El Partnership Business Telephone ber: lil-9l , - P, .///I - 7 ��n) Name of Licensed Plumber W-S.LMANCE COVERAGE: I have a currl'_ fiablIfty insureance policy or Its substantW e0uhralerd which Meets ffia re-q Yes 2T No 0 Uirc-Ments of PVGL M, 142. tr Yclu have Checked Ye.s. please indicate the type coverage by cN!ckjry the appropria-te box A liability insurance policy Other type of Inderrinfty ED o Botts OWNEWS MISUPIANCE WAWER: I am twrare ttlat thr. Chapter _ licensee does rint h;t-e the Insurance coverage requlre� ter 142 of the Mass. -eneral Laws, and that my Zl gnature ®n this permlt&pp, d by I=tlQn WatVes this requirement. ChecV, one: ::Vnature of Owner Ni—ner-,r�ent Owner E] Agent 0 I 6ereby oaroi,;y that —--------- _11ation I have subraitted(or arjje�,ed)innbo 0 Of the details and info„ est; ,and thzt sit plurnbing Wrk aW installation 110 to u der ve aPP"c2ticln W8 trUa Va-)d rate.to Nftinisnt Provisions of the ma­achL, cc, U 3 o 'n isstiz ate plum 1r, trydrmit is.w�d for this appli,�atin vAll a. j She b, st f i y nd 1 14 the Goneral Lakys. t'�Oil 00mPli&r-.oa with all Titlo ature t cen 0er —-------- pa of.Ucensa: h&star Licon se:Humber /V L cx� 30o Date Of NO .. aM'" o= TOW Of NORTH ANDOVER MIT FOR GAS INSTALLATION �,SSACMUSE�t This certifies that . . . .:.:����. . .-. has permission for gas installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . in the buildings of . . . . . . . ..... . :�^ . . . . . . . . . . . . . . . . . . . . . . . . . . . at North Andover, Mass. Fee. . . . . . . . . Lic. No.. . . . . . . . . . ,./ '--GAS INSPE�CTTOR�i/ Check# 5365 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) 'n4fao e� Mass. Date 1�� /3 � Permit # — _ >> ` Building Location .sSc Owner's Name Pit e Type of Occupancy,S'r.� New Renovation �. Replacement P Plans Submitted: Yes NoAff O N 2 y W ti Y Z uj " W W ¢ O U0. c7 J 2 W ~ >- Z Z O r- Z O u a ¢ ¢ O O w 0 — a E- N aW Q = Z ~ u7 > w N U W N W a O 0 Q �, _ W yr Of "J z a = C7 Q WW � Q C7 F Z J I z W W O 7 LL t U J 2 O '_ W H W a w i w z. a a � o o u� o nu ►_- _ O u. 3: 0 d -j U e > Q a F- O SUB'=aSMT, BASEMENT 1ST .FLOOR 2ND FLOOR 3RD FLOOR I 4TH FLOOR I STK FLOOR 6TH FLOOR 7TH. FLOOR CLIMATE DESIGN HEATING and AIR CONDITIONING, LLC Check one: Certificate I n s to(l i n g 5 South Summer Street Address Bradford MA 01835 " Corporation 978-372-9999 (phone) Partnership 978-372-0882 (fax) 'Business Telephone Lic. Plumber: rhA; "� ���r ct = Firm/Co. Vame or Licensed Plumber or Gas Fitter INSURANCE COVERAGE: I have a current liability insurance policy or fts substantial.equivalent which meets the requirements of MGL Ch. 142. Yes 9 No G If you have checked Vis, please Indicate the type coverage by checking the appropriate box. A liability insurance policy C' Other type of indemnityE] Bond ❑ OWNER'S INSURANCE WAIVER: lam 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: OwnerO 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 n - knowledge and that.ah plumbing.work and installations performed under the permit issued for. this app i "tion will be in complianc3,,vith all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of Zener La T of Ucense Plumber na use of ce . Plum or Gas Fitter Title Gas.fitte� Master., Lcense Number e�Q 20 G:ty/7own !o u rn e ym a n APPROVED (OFFICE USE ONLY) 4 Date... ........ ....... ,&ORT#1 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING �7SS,,CNUSEt Thiscertifies that ......................... ................................................................. has permission to perform ................. :...........:................................................. ............................................. wiring in the building of......A� ...... at..... .�-/.................... . .........................................................,North Andover,Mass. Fee....................... Lic.No.............. ........................ .......� ........................ ELECTRICAL INSPECTOR Check # 0 Official Use Only Permit No. Det ?�a6ltc S Occupancy&Fee Checked' BOARD OF FIRE PREVENTION REGUL;RFORM ONS 527 CMR 12:00 APPLICATION FOR PERMIT TO ELECTRICAL WORK All work to be performed in accordance with he ,assachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Date To the inspector of fres: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number Owner or Tenant Owner's Address Is this permit in conjunction with a building permit Yes '8, No 0 (Check Appropriate Box) Purpose of Building &,S-r_ Utility Authorization No. Existing Service 2 C] U Amps Voits Overhead 0 Undgmd 0 No.of Meters New Service Amps Voits Overhead 0 Undgmd 0 No.of Meters Number of Feeders and Ampacity. Location and Nature of Proposed Electrical Work k-- Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above 0 In 0 No.of Lighting Fodures Swimming Pool gmd 0 gmd 0 Generators KVA CI / I No.of Emergency Lighting No. f Rece cles Outlets No.of Oil Bumers Battery Units Nc of Switch Outlets 2 No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges / No of Air Cond Tons Initiating Devices Heat Total Total No.of Diposal C No. Pumps Tons KW No.of Sounding Devices / Nol of Self Contained No.of Dishwashers ( Space/Area Heating KW Detection/Sounding Devices 0 Municipal 0 Other No.of Dryers Heating.Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES= NO - have submitted valid proof of same to the Office YES= NO If you have checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE - BOND - OTHER - (Please Specify) 91Ao l (Expiration Date) Estimated Value of.Electrical Work$ Work to Start Inspection ate Resquested Rough Final Signed under the P Ities of jury: FIRM NAME f i LIC.NO. Licensee SignaturelLIC.NO. Bus.Tel No. Address Alt Tel.No. OWNER'S INSURANCE WAIVER: 1 am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE �� (Signature of Owner or Agent) 2; The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: Location: City Phone am a homeowner performing all work myself. F-1I am a sole proprietor and have no one working in any capacity aI am an employer providing.workers' compensation for my employees working on this job. Company name: Address City Phone# Insurance Co. Policv# Company name: , Address City Phone.# Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of afine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone# Official use only do not write in this area to be completed by city or town official' Building Dept ❑Check if immediate response is required Building Dept p Licensing Board p Selectman's Office Contact person: Phone#. Health Department Other FORM WORKMAN'S COMPENSATION PERMIT NO. 7 b APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 AP 4-40. i/ LOT NO. �© C� 2 RECORD OF OWNERSHIP DATE BOOK PAGE — ZONE 7 I SUB DIV. LOT NO. LOCATION 1 PURPOSE OF BUILDING OWNER'S NAME CP �{ C NO. OF STORIES SIZE OWNER'S ADDRESS /_I / / Ki7,u-S+S�-1- �^��� �J,p BASEMENT OR SLAB ARCHITECT'S NAME B.` L SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME AK e (f,,h m o SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET / Il POSTS DISTANCE FROM LOT LINES-SIDES REAR V ' GIRDERS AREA OF LOT F NTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATIONX f BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OFC DE A/I I2R L!✓/� IS BUILDING CONNECTED TO TOWN WATER IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST � f.9 00c) F COST PER SQ BLDG. . PAGE 1 FILL OUT SECTIONS 1 - 3 EST. ' 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 �/ �'�L� liGJ�' BUILDING INSPECTOR SIGNATURE OF OW ER OR AUTHORIZED AGENT G FEE OWNER TEL.# PERMIT GRANTED CONTR.TEL.# �� 0 19 -- VO mac CONTR.LIC.# H.I.C.# BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY ,,,,#lSiORIES 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 I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE B 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY VJAII UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ '/. 1/1 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 CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARDVJ'D _ ASBESTOS SIDING _ COMMON VERT. SIDING ASPH.TILE STUCCO ON MASONRY _ STUCCO ON FRAME 41� 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. (2 FIX.( FLAT A SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &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 OI l B'M'T 2nd _ ELECTRIC Ist 13rd H NO HEATING tAORTH own o g Andovi LA E o dower, Mass. COCMICHEWICK DRATED OPa `lb PERMIT T Food, Septic THIS CERTIFIES THAT (� I Founc has permission to wed...... .. ...... buildings on (;.i le.k S,yam V�..... Rougl to be occupied as A p ......... ... ..N..>ta-l.....5�✓..�/.N.G�/alil6ln �.�,J.�.n��.Q!�.�... .....�'1��/.'.C.�c�..........�e� ��16..0'`+ provided that the person-cce tin this permit mChim thisoffice, and to the provisions of the odes and By-Laws elating to the Inspection, Alterat on andConstruct Con on onstruction of e in Final Buildings in the Town of North Andover. VIOLATION of the Zoning or Building Regulations Voids this Permit. P: Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST TS EL Rough ... ... .............................................. ServiC( .. . ...... . DING INSPECTOR Final Occupancy Permit Required to Occupy Building . Display in .a Conspicuous Place on the Premises = Do Not Remove Rough! No Lathing or Dry Wall To Be Done Final Until Inspected and, Approved by the Building Inspector. 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