HomeMy WebLinkAboutMiscellaneous - 618 CHICKERING ROAD 4/30/2018 618 CHICKERING ROAD
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NORT1,
°tt"`° '•'"° TOWN OF NORTH ANDOVER
Oc
p PERMIT FOR WIRING
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This certifies that ....................... (/914 ..&�e.r ............................
has permission to perform �� 'cam r
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wiring in the building of.... �E.�'t.... E;�...—15..........................
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at........ .....�eLI�CMCAL
.. ,North Andover,Mass.
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,t Fee.�a..4-":.^ Lic.No.5.ff 3 �............. -��l .....`1::......,. ...
INSPECTOR
S
Check #
„ . Commonwealth of Massachusetts Official Use only
Permit No.
n Department of Fire Services
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/991
(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 W INK OR TYPE ALLIN ORTION) Date: t p(o
City or Town of: —�, To the Inspecto of fres:
By this application the undersigned gives nota e o his or her intention to perform the el�aI work described below.
Location(Street&Number) I C ki2/"7
Owner or Tenaut Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No 114 (Check Appropriate Box)
Purpose of Building_ e s,L Utility Authorization o. 7,52 0 7
Existing Service 15D� Amps J b/ Ly(�Volts Overhead❑ Undgrd No.of Meters
New Service _L—a Amps Zv/ 2 OVolts Overhead❑ Undgrd No.of Meters
Number d'Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
Completion of the ollowin 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 ❑ In- ❑ o.o Emergency Lighting
rnd, rnd. Batteg Units
LN:o �of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners o.of Detection an
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons $
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 E uivalent
No.ofWater KWNo.of No. of Data Wiring:
Heaters Si ns Ballasts No.of Devices or Equivalent
No.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 issue unless
the licensee provides proof 0'
liability i urance inciuding"completed operation”coverage or its substantial equivalent. The
undersigned certifies that such cover a is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:)
Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date)
Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
I certify, under the pains and penalties of per'u ,th t the infor tion o application is true and completes
FIRM NAME: tJ ,d LIC.NO.:
Licensee: �ei�!`iry� <143.4 Signature LIC.NO.:
(If applicable,en— ter"exempt"i the license number line.) Bus.Tel.No.•
�
Address: F /k D Alt.Tel.No.:Q-7k
OWNER'S INSURANCE A E : I am ware that the icensee 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 a ent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $
1400 A
A& �
Generators Residential& c each additional meter..$10.00
TOWN OF ANDOVER Commercial: Sewer Ejection Pump: $25.00
ELECTRICAL PERMIT FEES a) including photovoltaic& Signs: $25.00 each ballast
(Effective March 12, 2003) generating Equip Per KVA $1.00 Smoke&Heat Detectors &
MINIMUM PERMIT FEES: b)un-interruptible power systems, Initiating Devices:
RESIDENTIAL $25.00 per KVA$1.00 Residential: $1.00 each
COMMERCIAL $100.00 c)batteries over 100 amp. hours,per Commercial: $60.00 up to 10
NO SE CABLE ON cell$1.00 devices over 10-$1.00 each
OUTSIDE OF BUILDING x Heat Devices: $1.00 each Space Heaters:
Air Conditioners: $40.00 each Heat Pumps: $40.00 each area heating$1.00 each
Alarm Systems Security: (for fire Hydro-Massage Bathtubs/Hot Sub-Panel: $25.00
systems see smoke/heat detectors) \p Tubs: $20.00 each Swimming Pools:
Residential: $40.00 p Lighting Fixtures $1.00 each Residential:
I
Commercial: up to 10 Devices Lighting Outlets: $1.00 each Above Ground: $25.00
�
$60.00 additional devices over 10- Major Appliances: (not listed) Inground: $50.00
$1.00 eachj t $20 each Commercial Pool: $100.00
Carnival Equipment: $50.00 each Motors: (per hp or fractional part Switches: $1.00 each
Ceiling-Fans: $1.00 each thereof) $2.00 Temporary Service:
Oil/Gas Burners' Must have Utility Authorization Number
o:nmercial New Construction or Residential$25.00
Alterations: Residential$20.00 each
$100.00 per 1,000 Sq.Ft. of Commercial$20.00 each . Commercial $100.00
Construction S aceOffice Furnishings: per circuit$10 Transformers:
Commercial Service
(Relocatable Part -itions/Cubicles) a)capacitors,Per KVA $1.00
- Change/
Repair: Outlets&Fixture: $1.00 each b)ducts,conduit&conductors
Must have Utility Authorization Number b Ovens Built in/Counter Top Units: (Associated w/Padmount Transformers)$25J
5.
$100(first 100 amperes or fraction,one $10.00 each c)each manhole 00
meter) Panel Change/Circuit Breaker: d)each handhold$$5.00
a)each additional 100 amperes Residential: $20.00 e)per KVA$1.00 ;
capacity or fraction. $30.00 % Commercial: $25.00 f)primary feeders, $25.00 each(over
b) each additional meter$25.00 Phone Jacks: See 600 volts,non-utility o 25.0
)vaults and equip. $25.00 each
Commercial Temporary Service: data/telecommunications. Washers: $15.00 each
$100.00 Ranges$15.00 each
Must have Utility Authorization Number Receptacle Outlets: $1.00 each Waste Disposals: $5.00 each
Commercial Repair and/or Recessed Fixtures: $1.00 each Fater Heaters: $30.00 each
Maintenance Permit: (Blanket Re-inspection Fee: $25.00
Permit)up to 2 Electricians$150.00 Repair to Service Residential: *For Multi-Family &
per pair of Electricians over 2$50.00 $20.00 Large Commercial Project
Data/Telecommunication: Residential New Construction
Residential: $1.00 per port see Wiring Inspector for
(Dwelling): $220.00
Commercial: $30.00 up to 10 pricing:
(with service up to 200 amps)
devices over 10-$1.00 each Must have Utility Authorization Number Paul Kennedy (978) 623-8306
Dishwashers& Disposals: for services over 200 amps see below (Office Hours 8 am to 10 a w7
$5.00 Each --- -_ .-._.. ---
a)for each 100 amps capacity or
Dryers: $15.00 Each fraction add $20.00
Emergency Lighting(Battery Units) b)each additional meter$10.00 "Inspection Schedule:
$ 1.00 each unit c)each additional panel/sub panel I ROUGH
Feeders or Sub-feeders: $25.00 I FINAL.
each 100 amp capacity of fraction 1 TRENCH (if applicable)
thereof Residential Additions/Alterations:
Residential: $5.00 each $220.00 maximum
Commercial: $15.00 each Residential Service Change or ADDITIONAL
Gas/Oil Burners: Underground Service: INSPECTIONS "$25.00 (if
Residential: $20.00 each $40.00 applicable)
Must have Utility Authorization Number
Commercial$20.00 each a)one meter,up to 100 amp capacity
$40,00 (revised 09/04)
b)each additional 100 amp capacity
or fraction$20.00
C`i55
Date./
� �10RT1�
°`t"`° '• '"� TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
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This certifies that ........ee ............ r-c�......................
has permission to perform .........: ' :,.--c ...........................................
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.wiring in the building of.�...%�': ....................................................................
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` ::.'. ,North Andover,Mass.
Fee s ....... Lic.No:`_--( .......
J ELECTRICAL INSPECTOR
Check # j /
JIM(,U[VLY1Uty rrc.H"n yr Jyltljont,nv.u.i I L3 �••
DFPAR731EN 'OFPEX1CSAFE7Y Permit No.
i BOAROOFFIREPREVEMONRF.GUTA7YONS9702120
Occupancy&Fees Checked
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
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) 1�
Owner or Tenant A
Owner's Address 6
Is this permit in conjunction with a building permit: es No (Check Appropriate Box)
Purpose of Building �jl d Q < Utility Authorization No.
Existing Service %Q Amps {/ Volts Overhead Underground No.of Meters
New Service Amps Volts Overhead Underground No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total
KVA
No.of Lighting Fixtures i/ Swimming Pool Above 0 Below Generators KVA
'r round round
No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units
No.of Switch Outlets
40 No.of Gas Burners
Ni.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
Plumps 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 Municipal Other
Connections
No.of Water Heaters KW No.of No.of
Signs Bailasis
No.Hydro Massage Tubs No.of Motors Total HP
OTHER• -
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Telephone No. PERMIT FEE$--?,5 r
signature of Owner or gen
JIMa.virltriILArYF■I d!1va ir�xx�,uv�u.:i� �•••j ��-� ,
DEPAIRDIENTOFPUBLICSAFETY Permit No. YJ t f
BOAROOFFREPREVEMONREG VXONSS27C11a1R12:(XI
Occupancy&Fees Checked
APPLICA77ON FOR PERMIT TO PERFORM ELEC CAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00
EASE PRINT IN INK OR TYPE ALL INFORMATION) Date
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) 61C
Owner or Tenant -{�
Owner's Address f
Is this permit in conjunction with a building permit: es� No a (Check Appropriate Box)
Purpose of Building ,/ e5i JqkT( < Utility Authorization No.
Existing Service %'Q Amps 11 Volts Overhead Underground M No.of Meters
New Service Amps Volts Overhead Underground No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total
KVA
No.of Lighting Fixtures t Swimming Pool Above ci Below Generators KVA
`f round ground ri
No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units
No.of Switch Outlets
No.of Gas Burners
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 Municipal Other
Connections
No.of Water Heaters KW No.of No.of
Signs Bailasis
No.Hydro Massage Tubs No.of Motors Total HP
OTHER
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INSURANCE BOND El amm El (PleaseSpt*) ,Cll_./7� AU-17,1141 CC) /1'. 0
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(Please check one) Owner Agent *�
Telephone No. PERMrr FEE$--�5
signature or Uwner or Agent
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Location /-/"� )
No. 67 Date Zd
NpRT1y 1 TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # ! _
r
r
672
/1`'--Building Inspect(0v
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT EtM&RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PERMIT NUMBER. DATE ISSUED: m
SIGNATURE.
Building Commissioner/Inspector of Buildings Date /D -LxA &6 Z
SECTION 1-SITE INFORMATION O
1.1 Property Address: 1.2 Assessors Map and Parcel Number:
elm
Aip Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use I.ot.Area Frontage ft
1.6 BUILDING SETBACKS 00
Front Yard Side Yard Rear Yard
Required Provide Required Provided ReqWred Provided
v
1.7 Water SupplyM.GL.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System:
Public 0 Private ❑ 1 Zone Outside Flood Zone 0 Municipat ❑ On Site Disposal System 0
SECTION 2-PROPERTY OWNERSIiIP/AUTHORIZED AGENT
1L: D;strict: Yes �.lo STI
2.1 Owner of Record
.� 06 _
Name(Print) Address for Service
Signa a Telephone
2.2 Owner of Record:
0
Name Print Address for Service: z
M
Si ature Tele hone
SECTION 3-CONSTRUCTION SERVICES 90
3.1 Licensed Construction Supervisor: Not Applicable ❑
mlqma
Licensed Construction Supervrso: -
/ rn • „ feu (� �`�/ Licen umber "In
Address C� ,V v I �J
3&12 /D (a >
72 ion Date �.
Signature Telephone V
3.2 Registered Home Improvement Contractor Not Applicable ❑
Company Name _ / M
Registration Number
Addr-esss-/ C�p
9&�- Expiration Date G)
Signature Telephone
SECTION 4-WORKERS COMPENSATION(M.G.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.......0 No.......0
SECTION 5 Description of Prosed Work check aII r licable
New Construction 0 Existing Building X Repair(s) ❑ Alterations(s) ❑ Addition ❑
Accessory Bldg. 0 Demolition 0 Other Specify
Brief Description of Proposed Work:SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY
Completed by permit applicant
1. Building (a) Building Permit Fee
Multiplier
2 Electrical �j' (b) Estimated Total Cost of
v �O Construction
3 Plumbing Building Permit fee(a)x (b)
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
as Owner/Authorized Agent of subject property
Hereby authorize O to act on
My be all matte relative affthorized by this building permit application.
Si iaiueof
Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
1, as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are tn:e and accurate,to the best of my knowledge
and belief
Print Name
Signature of Owner/Agent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS I' 2' RD
3
SPAN
DM ENSIONS OF SILLS
MIENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHM4NEY
1S BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
NORTH
Town of And
�d
s : A E dover, Mass., f
COCHICHEwICK
7�ADRATED
S BOARD OF HEALTH
PER T T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT. ........................... Foundation
.... ................................. ..........
has permission to erect..... ............................... buildings on ... .. ..... ................... Rough
to be occupied as ......... ... ........ .. ...... .... ..................dow................. chimney
. . .. 7--
04 . . . . ..
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. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS
UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR
Rough
..... .... 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.
a 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
at: ,/;i/ C/--t f 44.,L,, 1� s that the debris resulting from this work shall be
disposed of in a properlylkensed solid waste disposal facility as defined by MGL
11, S 150 A.
Also, note Permits are required under Fire Prevention laws Chapter 148 Section
I OA.
The debris will be disposed of in:
(Location of Facility)
Signature of Permit Applicant
A
Fire Department Sign off:
Dumpster Permit
Date
� i7�t!�ilJ�f�t�<L wa'�lt�lfiitdfl
BpARbO NUIi.I iNGREGU TION'&
L1C+Ir m Gt STRUCTION SUPEftV1SOR
Number: CS 073476'
Birthdate; 0312711M
e4ires.0 712006 Tr.04. 17407
R�st'lcted: _
MICHAEL J PALMISANO
PO o 2fl78
MEfF UEN, MA Das 1 MAI, mis t►ner
._..
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
14e91stratIOW. 127987
Expiration ?1812007
Typ�►_t"tiMdividual
MICHAEL J.PALM.ISANO F
MICHAEL PALMISANd
1'FENWICK CIRCLE: ,
METHUEN,MA 01844 Administrator
CornmmweWth of Mass0'ehusetts
Division of Registration-,
Board of Electrical£xe*ice
MICHAE Q3jR PAV SAN{}'
�� 1 FENWIC Clf
vifil
METHt1EN�lA 0844 .
Master ElecI660 r 6,
201100-A 07/31/2107 " —""'001681
umme No. Expiration fate. Serial No,
x