HomeMy WebLinkAboutMiscellaneous - 64 BOSTON STREET 4/30/2018 64 BOSTON STREET f
210!107.6-0060-0000.0
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Location
No. / Date 46
MORTp TOWN OF NORTH ANDOVER
oA Certificate of Occupancy $
Building/Frame Permit Fee $
.r3 cmuse t Foundation Permit Fee $
s�cMu
Other Permit Fee /app 1 $ a
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
Building Inspector
I
3 5 664/99 11:39 25.00 PAID
Div. Public Works
PERMIT NO. O2 APPLICATION FOR PERMIT TO BUILD********N($RTH ANDOVER, NIA
NIAPNO. /D� /3 LOT NO. O 2. RECORD OF OWNERSII III DATE BOOK PAGE
"LONE [ / SUB DI\':LOT NO.
LOCATION / �os^�p� �-4-- PURPOSE OF BUILDING � S �8�C�33�
(D /1! Ab,o a r9 n� /moo l m-,
�(
OWNER'S NAME � ,��,�J 7 t��� �� /���,,` / NO.OFSTORIF.S SIZE
OWNER'S ADDRESS s` ✓ (J G BASEMENT OR SLAB
ARCIIITECT'S NAME SIZE OF FLOOR'IINIBERS ISI 2ND 3RD
BUILDER'S NAME SPAN
{ DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS
{ DISTANCE FROM STREET DIMENSIONS OF POSTS
DISTANCE FROM LOT LINES-SIDES O f REAR O Of DIMENSIONS OF GIRDERS
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW SIZE OF FOOTING x
I
IS BUILDING ADDITION MATERIAL OF CIIININEY
IS BUILDING ALTERATION x +��, IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER
s
BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEVER
'Se��I C-
IS
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTUCTIONS 3. PROPERTY INFORMATION LAND COST
� `_ EST. BLDG.COST
PAGE 1 FILL OUT SECTIONS I-3 1\�G I V EST.BLDG.COST PER SQ. FT.
,e 3a EST. BLDG.COST PER ROOM
ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING ( SEPTIC PERMFF NO.
ATI:ACIIED GARAGES Ni UST CONFORM TO STATE FIRE REGULATIONS 4. APPROVED BY:
C
PLANS NIUST BE FILED AND APPROVED BY BUILDING INSPECTOR BUILDING INSPECTOR
DATE FILED OWNERS TEIN
CONTR.TEL#
SIGNATURE OF O\VN F.R OR AUTHORIZED ADEN�FXCONTR.LIC#
FEE $ t ILLC.#
PERMIT GRANTED c
(� 19 /
Revised 5/5/99 .IM
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NpRTH
Town of over
Y.., .. ti,.`.:,.r., 1
dover, Mass.,
DRATED o`P .(5
BOARD OF HEALTH
PERMIT T D Food/Kitchen
I
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT.. ........-�....1��.a�.�...................a 6 h Int
/ ' .......
' ' """"":" Foundation
. ........ ..... . . ...
has permission to erect... ..x g tD...y........8.0-6 CN IS buildin son......... .................... ........................ .. Rough
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to be occupied as A4..........................&%ow") P&O I N r..0 r • Chimney
....................................... .............. .. . . . . . . ................
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.MA INrA W V • Fr• A •f 4. 1 At E s PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
VQp G � PERMIT EXPIRES IN 6 MONTHS Final
� '� UNLESS CONSTR>*p N S ELECTRICAL INSPECTOR
Rough
S40
. ............................. .............. Service
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal
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.
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
*****************************APPLICA-NT fiLLS OUT THIS SECTiON*'`********************* i
T q?S-- 1 11
APPLICANT ��1-�IzUc Z�r L'e- PHONE *r 9� �� 6
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LOCATION: Assessor's Map Number_ D r_ PARCEL_ (�
SUBDIVISION LOT (S)
STREET ST. NUMBER
**** * ** ** *********** *****OFFICIAL USE
RECOMMENDATIONS OF TOWN AGENTS:
CONSERVATION ADMINISTRATOR DATE APPROVED T141119
DATE REJECTED
COMMENTS
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENTS
FOOD INSRF-CTOR-H LTH DATE APPROVED
/ / DATE REJECTED
(/ LTH DATE APPROVED
SEP,�T1C I ECTOR-HEA
DATE REJECTED
COMMENTS �-C� .Li�.�- 7L
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE
r
Revised 9197 jm
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AS BUILT PLAN
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SU00%c-.%)URFACE DIS-POSAL SYSTEM
LOCATED IN
AS PREPARED FOR
P1A17.Y LOU 12AL. .l '5
DATE: q Io , { '19 -7
SCALE: I 4o ,
MERRIMACK ENGINEERING SERVICES, INC.
PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS
bb PARK STREET • ANDOVER, MASSACHUSETTS 01810 a TEL (617) 475-3553, 373-5721
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TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that . . . . . . . . . . . . . . . . . . . . . . . .� � . . . . . C
has permission to perform . . . 5 !!�. . . . .. ��—
wiring in the building of . . . f . . . _ . . . .
at . . . . . . . . . . .. , North Andover, Mass.
Fee . . . . . . . . . Lic. No. 5�5—ifz . . . . ��. . l, . .
ELECTRICAL INSPECT®
Check# Q j
10903
❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c.143,§3L,the
permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed
on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an
electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the
notification of completion of the work as required in M.G.L.c.143,§3L.
Permits shall-be limited as to the time of ongoing construction activity,and may be_deemed_by-the.Inspector-of Wires abandoned.and.inYalid_if.he—_. ._
or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written
application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written
request of either the owner or the installing entity stated on the permit application. . , Mo.
f 1
❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of ` J
the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this
purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With
limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was
"in effect or existence"during the qualifying period beginningonAugust 15 08 and extending-through August 15,2012.
[Rule 8—Permit/Date Closed: Lz& / ***Note:Reapply for new permi
0 Permit Extension Act—Permit/Date Closed:
l
Commonwealth of Massachusetts Official Use Only
Department of Fire Services Permit No.
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. l/07] (leaveblank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Co e(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ) 1-.)42/ -21
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) 6?1V 8 p511-U/) 5-f
Owner or Tenant z57 I) 6;tq h r,-f? Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service 1,170 Amps i JL) /ayt j Volts Overhead [� Undgrd❑ No.of Meters L_
New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: RefekS� 4e_rvl CQof 5 I I hly� �
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil: No.of Total Susp.(Paddle)Fans Transformers KVA
No.of Luminaire Outlets No. of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ ITo—.o-f Emergency Lighting
rnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
g Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
p Totals: ....... Detection/Alerting Devices
~ No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other
Connection
1 No.of Dryers Heating Appliances KW Security Systems:*
Y No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs 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.
Estimated Value of Electrical Work: (Jo (When required by municipal policy.)
Work to Start-qq-J.vI 2 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 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 (g BOND ❑ OTHER ❑ (Specify:)
I certify,under the ams and penalties f perjury,that the information on this ap lication is true and complete.
FIRM NAME: . Q L,,e '-4Q 'tr[ L LIC.NO.• U SW
Yl') C c�,e tpPUC-e- Signature LIC.NO.: 3V,08-
Licensee: E
(If applicable,a er "��,xx�gmpt"in t e licelise nzlmberline.) Bus.Tel.No.: 7 /
Address: d lS t1 tC L/I `y t 1 V►'1 t n c,fic*l /1 Q le�7 Alt.Tel.No.: 775;-- u`>'-L-14.Z
*Per M.G.L c. 147,s.57-61,security work requires Depaftment of Public Safety"S"License: Lic.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
Signature Telephone No. PERMIT FEE: $
�'�sset�•-,j � --�,afleB-�j � �e-xuspactzox,Xet�uzxet�'{$�O.QQ)�j �
�ns,�ec#oxs'cop�mte�ats: '
(Cnspec oxs'Szgnatu�re• o t aXs) Pate,
�.'asse��j � •�`aile�.--� � � ate�n.speetio�.xer�uixec�($�O.OD)-•[ � .
TnS;�ecfa�rs'comm.eWs:
(Cast dors'gignatuze•-)io iniflals) Slate
�assec�-j j azlec�--j Xte-•xnspectiop-xegi&ea($SO.OD)-j
lnspectozs'coinm.ents: ,
{lnspectoxs'�xgnatuxe- o?nfaTs) ]ate
asset.--[ ) �+'afIe�.--j � �e�7nspectzoxtxequixe�(�50.OD)-•j � '
ispectbxs'eomnm.eufs:
( ttspectoxs',�zgnatuxe� aini{ials} Jlate
sser�--� � �'azleDf--•j �- 'ate�nsp ectzo7a xe�uixed($SD.OD)-•[ �
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�L�sp ectoxs'Szgnatoxe-no 7iuitf als) Trate
aOR TACO AM TOEE FAIND PDT"LEFTONROUNTMAMA TO EE WSPECTU S NOT
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The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
UV. www.mass.g ov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Le-eibly
c
Name (Business/Organization/Individual):
Address: R) 90K �y
City/State/Zip: l.Ul'M tyyUn Phone#:
Are you an employer?Check the appropriate box: Type of project(required):
1.NJ I am a employer with�_ 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7. ❑Remodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. workers' comp.insurance. 9. ❑Building addition
[No workers' comp.insurance 5• ❑ We are a corporation and its
required.] officers have exercised their 10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs
insurance required.]f employees. [No workers'
comp.insurance required.] 13.❑Other
*Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information.
f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
*Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: �� (f
Policyj#or Self-ins.Lic. #: y'7 S� Expiration Date:
Job Site Address:/V ,)S�,yo City/State/Zip: IV C,('f� n r
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 of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year 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
Investigations of the DIA for insurance coverage verification. I
1 do hereby cert' under he n _and penalties of perjury that the information provided above is true and correct.
Signature: Date: — / o c f,2
C )
Phone#: /Q 719?
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
LOther
uthority(circle one):
of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
erson: Phone#:
1
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,b checking the boxes that apply to your situation and if 1
necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
Tel. #617-727-4900 ext 406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 5-26-05
www.mass.gov/dia
Date l..!r..o-: ..............
Ot NORTI{,�
O0 TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
CH
This certifies that ...... ................... ...........................
has permission to perform ......../��-E:.- � .............................................
wiring in the building of
..............................................................
at... `........... ,North Andover,Mass.
.0
Fee.7-�?:.......:..... Lic.No..!/GiJG
............... J......... ...........................
� ELECTRICAL INSPECTOR
f
Check #
f67G
Commonwealth of Massachtlsetll-
Deparlment of Fire Services
BOARD OF FIRE PREVENTION REGL11)*1'F'0,'\i'S
APPLICATION FOR PERMIT TO
e,,1 0 1
All wcr, t)be j)crform.-d in accordance w in i1ric Mnsa:h j.c.i- FaQC n,.1 C')-c
(PLE,-i SE PLWT JAI 1:\'K OR TYPE,ILL INFC/UfA TION/ 1).11 C'
Citi' or Town of:
By this application the undc!signed—gives nonce of his or her IMe"1!10 1 !)(":07 11 ( "'.r Ca' C'.'S(r
Lo c 2 t I o in '(S f I-e e t & IN u m b c,r)
Owner or Temint
'Owner's Address
Is this permit in conjunction Nvith a building permit'? Yes—_^----.N'0
Purpose of Building AtId
b
Existing Sen ice Amps Volts O\erlm•c U:1 I,,
--
NewService Amps Volts O"erhei.c __j U:I I c
Number of Feeders and Ai;ipacity
Location and Nature of Pr.)posed Electrical Work:
Con:9.e:iw!of:r(
No. of Recessed Fixtures IN 0. of Cc i 1.-S u s 1), (1) d 1 1,:. C T,
No. or Lighting Outlets No. of Hot Tubs
1\ ove
No. of Lighting fixtures Swimming Pool b U.I:
No' of Receptacle Outlets No. of Oil Burners
A I-, :j 1
chin No. or'Switches No. of Gas Burners 1 C
INO. o': Ranges No, of Air Cond,
nuns ."or 0:
No. of`Paste Disposers
Totals: c'!i D fly 1e F:-i "'.'e
o. of Di511v1asIiur5 Space/Arco lfc:,dno Kb
\'o. or Dryers lie:ltillg Appliances
No. 01 Vater K\Y
Heaters
ISigns N 0. D C S
\'o. Hydrumlssabv 133ilItUI)s No, of IM o to 1 5 TU t:l I HI-----
e-
OTHER:
7
eti. i
INSUR,kNCECOVEI"GE:
the licensee provides ptoofo'hability insurance including "c3nin�)1e:ec cp-:—; I o) 1,: :"r .:3 5 a:
undersigned ccnifies that such coverage is in force) and 'r1as exh!'O.tcd LI I- t D'I'll I ss�-i o:
CHECK ONE: INSURANC;--IS&OND [I OTH:--R [] (Specif
Estimated Va]ic ol'Electrics Work: 'cqm-1
Work to Stz!r-i: Inspections to be reclucs,ed )I.
I certif) under the ,niers a ln!penalties ofpeijury, thou Mc o u 15 It owp: r
F I R-N-I N A M E:
Licensee: I I I r C,
LIC
Of Opp 11:a b le, enter "e.celupt"it tl,e(ice.ns mimber '.e.)
Address:
Irl,
-c-
OWNER'S INSUI C E I I,: I am aware tn-i( the L.ic(n;,,e d&(3
required by law, By my si,gn:ture below, I hereby wai/e th,s recu.i
Owner/Agent
S iv n 2(u re _(J I
7
N° _ 4 7 Date............. .
. O� No o7N,ti
�0 TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
�SS�cHusE�
This certifies that ( �AJ!...... -
has permission to perform �' 1' v v '
........ ....... ....... .....................................................
wiring in the building of.......
at ......1.5?.�.t oN 5 r
r .............`�.. ............ . ............`..........,o,North Andover, ass.
Fee....?.f...l/.v.. Lic.No. C a2�: .l....,\���� ��j`�e,
ELECTRICAL INSPECTOR
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer
r IQ�TH0FAf4-SS4CHV:5 Office Use only
d DEPARTM %T0FPUBLICSA= V Permit No. 1 -747
OFFIREPREYEYI70NREGMTIONS527CMR 12:1X1
JEPARCEIL D Occupancy&Fees Checked
PERART TO PBUORm aE=CAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACI-IUSSTS ELECTRICAL CODE, 527 CMR 12:00 _}, ,
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date, 114, "%_i
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) 6 1/ &S 10 V ST,
Owner or Tenant EO 6-
Owner's
Owner's Address sAme
Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box)
Purpose of Building S'wimm l,IV 6 POOL (4bo,t GRG(<ND) Utility Authorization No.
Existing Service Amps / Volts Overhead Underground No. of Meters
New Service Amps / Volts Overhead Underground No.of Meters
Number of of Feeders and Ampacity
4-ation and Nature of Proposed Electrical Work W1g[ry( - Q F /4161/10 6I 4; 17) solfolmilyk 1900L
No.of Lighting outlets No.of Hot Tubs No.of Transformers Total
KVA
No.of Lighting Fixtures I Swimming Pool Above Below I Generators KVA
ground ¢round
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
Pumos Tons KW Initiating Devices
No.of Dishwashers Space Area Heating KW No.of Sounding Devices
No.of Seif Contained
Detection/Sounding Devices
No.of Dryers Heating Devices KW Locala Municipal � Other
Connections
rNo.of Water Heaters KW No.of No.of
signs Bailasis
No. Hydro Massage Tubs No.of Motors Total HP
OTHER
Ir>arar>ce Cb-,u- .Rasuare to the rix imiffz ot-rv�11s Coiaai Laws
IhaveaarcriiLiability Irara=Pchcyind=igCcmpl�te Cpm=Cowiecritsabstnimie;trva YES Eff NO
I haNeabTa edvaliddproo fmmiotheOffie YES = NO If whavechecke3YES,please
irrdia� ty�ecf Irydt arzgtt�
N3AINC>✓ BOND mHI R pimseSpecify) AleFeael-2 I�MliFWi-
Expratin Der
Esti Vaheill1em-L-al Wad,S
Wade aD Start T h>speclin Late Re4ieszed Raigh Fuel Z P f
F�NAME12L0i r, jr,, f/y z7eCmie9` L eNa a6 ��y'
L �agf—�� Lz eNo
j,2 n »Td.N ��� frT _SJ�y
d ti�� e�of�lir,
y� Al Td.Na ��Ni
OWNER'S INEURANCE WAIVER;I am,,,,,= 11 J r Li M to nc t tstve the rtsu3> a�aaeetTvs ahzi=egtmrafflas rei e byNlamd-�Cx�Lawg
aod thatmy aernth pima,war CS tics rtz rt:r u
(Please check one) Owner Agent 55 d0
Telephone No. PERNfIT FEE S
Location
' No. Date
NORT„ TOWN OF NORTH ANDOVER
`9 Certificate of Occupancy $
41J
• i
Building/Frame Permit Fee $
Foundation Permit Fee $
s�cMust
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $ _
0
TOTAL $
Building Inspector
Div. Public Works
Location & Aes;lox)
No. Date A 8Im
A
NOItT1y TOWN OF NORTH ANDOVER
p Certificate of Occupancy $ Q
Building/Frame Permit Fee $
Foundation Permit Fee $
s�CMUSE
Other Permit Fee 1��,- $
Sewer Connection Fee $
Water Connection Fee $
TOTAL o�St o
V60/ n� Building Inspector
1 ( `� V 0 Div. Public Works
Pl RM IT NO.___q ) 9r APPLICATION FOIL PERMIT TO 13 LU********NORTH ANDOVER, MA
M%PNO. a1107-3
07.-3 LOT.NI)oo&o 0000,0 2. RE('ORDOFO\1'NERSIIIP DATE ROOK PACE
.^
Z()NE SUB DIV. LO'I NO.
I
(AMON ` /Vj /+/,OOv / PI)RPQSEOIB(JBDING � 'Y` � p o S �C! E �aS ` �J ONO.CN STORIES SIZE
VNER'SNAnfE / NVNER'S ADDRESS S LI�� BASIinIENT(1R SLAB
ARCI IIT ECI'S NAME SILL•Of:FLOOR IIMHERS 1 2 3
RD
BHII DER'S NAME SPAN
DISIANCIi IONEARESI BUILDING DIMENSIONS 01:SILLS
DIS I ANCE I RO.1 S1 REE I DIMENSIONS O:POSTS
DISI ANCE FROM LOT LINES-SIDES REAR DIMENSIONS Of GIRDERS
AREA OF I-OF FRONTAGE tIE1G1ITOF FO(JNDATION THICKNESS
IS B(JILDING NEW SIZE Of-F(k)TING X
IS B111LDING ADDITION MATERIAL.OF CHIMNEY
IS BUILDING ALTERATION IS BUILDING ON SOLID OR FII LED LAND
\1'11.1.BUILDING CONFORM TO RE"JI REMEN FS OF CODE IS BUILDING CONNECTED 10"TOWN WATER
BOARD OF APPEALS ACTION, IF ANY IS BUILDING CCNJNECI L'D TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTUCTIONS 3. PROPER7TY INFORMATION LANDCOSF
EST. BLDG.COST
PAGE- I FII.I.OI I F SECTIONS 1-3 EST. BLDG.COST PER SQ. FT.
EST. BLDG.COST PER R(XN.1
EI EC-TRIC ME'[ERS I\#JS F BE ON OUTSIDE OF BUILDING SEPIIC PERMIT NO.
AI-1ACI IED GARAGES MUST CONFORM*TO STATEFIREREGIILATI(NJS a. APPROVED BY: ;'y "�l M
PLANS MUST BE FILED AND APPROVED BYfit)ILDINGINSPECTOR / BUILDING INSPECTOR
DAFL=1111:1) O OWNERS'FEI.N
CON FRA EtN
Lo
i
CONI R.LI('/I
SIGNA Il IRI;(1111\\'NE111 R A(I I't IURIZII ':N'T
III: 0� J
IlRnnrcRANn:D I) -
1
t4ORT
t e
Town of over
o m
No. A179 - -_-
* z dower, Mass., -19/8
O iLAKE A
COCHICHEWICK,lY A.
'9 SAA T E D�
S BOARD OF HEALTH
Food/Kitchen
PERMYT T D Septic System
............................. BUILDING INSPECTOR
THIS CERTIFIES THAT....... ....... .. .. .................................................................. Foundation
has permission to erect..I ' gs on ........... ...� ...... ...... ......... ... Rough
P F
/to be occupied as ! � . V� ................ Chimney
.. ....... . . . . . .. . . . . .211
......... ... . . . . . .
. . .. . . . ... ... . . .. . . .. .... . . . . . . ........ ............ .................
provided that the person accepting this permit in every respect con for o 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 EXPIRESIN 6 M THS
ELECTRICAL INSPECTOR
UNLESS CONSTRU T 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.
Smoke Det.
.WOOD STOVE INSTALLi N CHECKLIST
�4i Q
Permit
A building permit is required for the installation of any solid fuel burning appliance. The building permit and
installation inspection are limited to the stove installation and-not to the stove construction.
Stove A J e IoN
A. New Used
B. Typeiradiant r(A v1-5 1W1271-1-PILS Circulating
C. Manufacturer Lab•No.
Name/Model No. `1 9'/2 Conarsize
Dimensions/Height X J'7,X�Length Width
Chimney /
A. New Existing r/
B. Size(flue area)
C. Other appliances attached to flue(Number and flue size)
D. Prefab(Manufacturer—n�cne and type)
E. Masonry/tined I� Flue liner
cyp•8 manWacturerl
Unlined
F. Height(refer to diagrams) cap
OVEZ IC
At t
2I WK Z `•tI•�•
3'M19 o �.I,�. �',,ttrf. t2"
— MIN.
bttNhurl..
�L�c Y .:ICt
n, HEARTH
CHIMNEY HEIGHT
Hearth(non-combustible) t�
Qr)Cu
A. Materials .
B. Sub-floor construction C c�N C
C. Minimum dimensions(refer to diagram)
Clearances and Wall Protection t.see stcve installation clearances chart)
A. Type at wall protection provided
B. Clearances(refer to diagrams)
mom
II
r
i
FIREPLACE CORNER WALLICENTER.
13
REGULATIONS
l
After obtaining the permit,there are three major areas in the stove installation process to
r
consider. First, the stove; second, the chimney; and third, the actual installation.
First: All new woodburning stoves installed in Massachusetts must be tested and
approved to U.L. 1482-and/or U.L. 737 as appropriate. Used stoves may be approved by the
building department or the fire department. Every solid fuel-burning room heater shall bear a
t permanent and legible factory-applied label containing at least the following information:
1. Manufacturer's name and trademark
2. Model and/or identification number of the appliance
3. Type of fuel(s) approved
4. Testing laboratory's name or trademark and location
t 5. Date tested
6. Clearance to combustibles
a. Side
b. Rear
E 7. Test standard
t
8. Label serial number
Second: Existing chimneys should be. checked for the presence of a flue liner and
general structural condition. A smoke test may be used to determine if the draft is adequate, if
r_ the flue is without obstruction and if there is any smoke leakage. A visual inspection of the
Y chimney is needed to check for creosote deposits, surface cracks or breaks, and if the damper
is in good working order. The following two areas related to the chimney are important to
t inspect. The area where the chimney penetrates through the floor of ceiling joists should be
checked to be sure that there is at least two inches clearance between combustible materials
and the chimney.
Third:Chimneys and chimney connectors shall be installed with the required clearances
(see installation clearance table). The connector should be sloped upwards toward the chim-
ney and the connections overlapped upwards to prevent creosote leakage. A two inch clear-
ance shall be maintained where insulated pipe penetrates a combustible wall,unless it is tested
and approved for lesser clearances.
A non-combustible hearth must be provided. Most stoves have legs and allow air to pass
below; if the legs are not present, an air space below the non-combustible hearth must be
provided. Clearances vary with circulating and radiant stoves. In general, a non-combustible
shield should be installed with ventilation behind it for lesser clearances, no protection for large
clearances, and if the wall is a concrete foundation wall, a minimum distance may be allowed.
The following systems have been approved by the Construction Material Safety Board:
Permaflue,Air Krete, Smi Exterior Insulation and Finish System, Supaflu,Thermo Crete, and
IsoKaern.The code requirement for two inch air space is exempted from this type of lining
because of its high insulating and refractory qualities.
5
STOVE INSTALLATION (CONT.) PAGE 7
l STOVE PLACEMENT REQUIREMENTS
HINT: Clearances may be reduced by methods specified in NFPA 211, listed wall shields, pipe
shields, or other means approved by local building or fire officials.
• Stove must be placed so that no combustibles are within, or can swing within (e.g. drapes,
doors), 36" of the front of the stove
• If the stove is placed in a location where the ceiling height is less than 7', it must follow the
requirements in the section "Alcove Installation Requirements"
• Must maintain the following clearances to combustibles (drywall, furniture, etc.):
745 790
Minimum Clearance Singlewall Reduced Singlewall Reduced
(See the illustration below) Connector Clearance` Connector Clearance`
A Sidewall to stove 10" 1 1" 10" 11"
B Backwall to stove 19 1/2" 13" 16 1/2" 8 1/2"
C Cornerwall to stove 9 1/2" 7 1/2" 9 1/2" 7 1/2"
D Connector to sidewall 19" 19 1/2" 19" 19 1/2"
E Connector to backwall 17 1/2"** 9""' 17 1/4" 8 3/4"
F Connector to cornerwall 16"** 11 17 1/2" 15"
STRAIGHT CORNER
c; INSTALLATION INSTALLATION co
Q) �6
' OX
i
3 O O bcOs/��
E L
3 F �
DOC\41
foo
�
to
i
E
U
NOTE: On the 745 the clearance to
Measure clearances from connector must take into account the ••
the convection jacket. 451 elbow directly off of the stove
Reduced clearance installations require one of the chimneys below:
DURAVENT model DVL with DURA-PLUS chimney •AMER[-TEC model DCC with model HS chine,
•SECURITY nmdel DP with SECURITY model ASHT or S2100 chimney •METAL-FAB model DW with model TG chimney
•01-1 VER MAJCLEOD provent modelPV connector with model 3103 chimney •GSW model Super Chimney Twenty-One connected directly to appliance
SELKIRK METALBESTOS model DS connector with model SSII chimney I.C.C.Excel 10-,HT Chimney with Ultrablack HP Double-wall connector
•Sumclard Masonry Chimney with any one of the above listed connectors
These are minimum clearances,not installation dimensions. Connector position will vary depending upon brand. First
establish the stove clearances.install the 45°connector to the stove.then determine the position of the connector.
NOTE: Standard residential installations with reduced clearance connector may use the clearance determined by the manutacturer of
the connector for the connector to wall clearance or the clearance listed in this manual. Offsets must he used to maintain the
stove to wall clearance.
NOTE: Reduced clearance connectors may not connect to the flue collar—order an appliance adapter for the connector being used.
FLOOR PROTECTION REQUIREMENTS 6"Minimum
(from stove top)
• Must be non-combustible and at least .018" thick (26
,gauge) 6"Minimum
• Must extend 6" to the side and rear of the appliance (from stove top)
(measure from the top panel of the stove)
• Must extend 16" from the front (measure from the
faceplate)
• Minimum 37 3/4"deep for the 745, 38 3/8" deep for 16°Minimum Floor Protection
(from faceplate) (Minimum .018"thick)
the 790. by 35 3/4" Wide
UU NUI RLIVIuvr; Ill)Llwt:u Serial Number
Wn,wtocic Haney Listed Solid Fuel Burning Appliance
Suitable for use in conventional residential installations,mobile homes,
alcoves and as a masonry fireplace insert or hearth mount stove.
M ��® MODEL:
aVLONm E 7451A550 Flue) ■ 790 (Top Flue)
Tested to:UL-148=L-907.737 Report Na 5905 (May 199 1)
ZPREVENT HOUSE FIRES-Install and use only In accordance with the manufacturer's Installation and operating InslrucilonS.Contact your local
O building or fire officials about restrictions and installation inspection in your area.Rater to local building codes and manufacturer's
Instructions for precautions required for passing a chlmnay through a combustible wall or ceiling.Do not run a chimney connector through a
2 combustible wall or selling.Do not connect this unit to a chimney flue serving another appliance.Use a minimum 2A MSG black or 26 MSG
Q
blued steel chimney connector,connected to a lined masonry chimney,or a factory-built chimney suitable for use wilh solid fuels.Minimum
C clearence between horhnntal c ilmney connector and combustible materials•18 in.Clearances may be reduced by methods specified in NFPA 7 Seel NO
6 2f 1•listed waa ahlolda,pipe shields,or other means approved by local building or fire officials Report
Report e
310
0 aWARNING.ppliance In a slleeping alLE OME-An outside sit mom.The structural integrity of the mobile homemust be provided or combustion air,*flow,walls and caltinghoof must be maintained.and be unoblIn use.Do not install
strucLed 1 l
OMinimum Clearance to Combustible Materials•Freestanding Installation ,
Z U."7•s(es•Flu.) .1 74S(u•FI ) y,ryl 790 flop Flu.) Aka",U06""",VO r.Flu-dvoe0 Avalonm
ShgkvW oo.vwtlar Akovb P,Wle neeoe,WWr%&;"d 6h101eMaa tonMNOF yueney o.m.nva+,n•lb,nblINTERTEC
Comelhl.ner mlbn'W Cl.ef•Ks w'u.uon neldenWl Wmrt1 IneWWkn
InNen.lbn •.
Me LL11.0 h
LDA In. 11.01n.
Z A.Skied ie ur 196 ht ma ir. THWEST.INC.
103 74 k • 1 1 Oregon
c.llaetwlD b a 9-5 iLINDUSTRIES,
ri,nr le Uel 9S bL 19t h 1901n t O Ie_ , ,
D.61d,�J b
IS
I& to In 17S In. s0 k10850
F e ft,.atoC.• do• ftSla 1fAln.- 17.s IN 15AIn. Fireplace •Accessory 98033
F.Cax1+r b ConnMbr 16 0IR
JTESTED TO: 1111-1127.UL 907 Starter pipe must penetrate beyond
Freestanding Clearance Diagram Alcove Specifications Floor Protection Diagram TYPEOF , Wood •
nly the smoke shelf for all installations.
(,/ aACKsI'ALL AOJACElR*ALL t.ppAf11=11A now 9fbwdjm mwt be a noncan • Replace
Mu.Ncow.O•gh�91r� bwawbam th dw
r secured
E 9 rs• f WtiAbove,Yl9n'fii In. a nNOW IM Is U iW$Me bell' •• ' • '" '
Q D it e 1 u h,dtcd.d.E..Ow,✓e It•t.ul kl` "PREVENT I • in the open position.
USE FIRES"
s actor plate must be 1:
O SIITt: ,�y�. MITI.Alcove VPOIN 1611E 11 r#OM7 IIW epi be vai a ,Im4 RMIII►r1
m A `fir C r use only in accordance A metal del I
M , It the Ilue collar is not
^LL instructionsoperating your
• local Completely
Y. cOWPONEM REQUIRED FOR MOBILE HOKE.ALCOVE AND REDUCED CLEAJUNCE CONVE"OKILL Insert Clearance Diagramfireplace
smomtML atsmu.cw-Creon b,f wowr,e'low cft"*cwlwt fl Wtl CemDellpll cNOVwy.ysl.mr.
rance to Combustible Materials(in inches) --I
WIwvcNTm9"DVLv"vndww0DURA USehhnrr WHEA;RTHjg_XTEN9I0N
/
6eCUMTY1nod.1D7'ea'n.emrwltlr6ECURfTY'waIASHTaszlw n truly • 1
SF LXM YLTAlAM=mbi Ob oa..oEr.itl,model bbll d11m,+rOIrYEtYACl.EOD PRITYENTredd PV mlrvdwrbb mod71is7AMMWTEC•10•.1 DCC Coneele•f weh ntedH H9lManf/ J6SW-IAKES EVENS sUPEAPI M n 00 d /
11UWAa m.bi OWD coleww whh w=64 TO cNmnlV rnMinimum Clearames to Combustible Materials-Fireplace Insert Installation 1 790(ToPFlu.) A■Model"ras(es•F'u.) Model'K.UW4* U0IN non
To M41100V Shwd WIN ILS UL
wTbp0A 91 N II&SOIn 1113 It1 (tool fb ;ll.
M. SiO..fefl 10.0 in 10.0 h 9k•e IA In.
R F.chq 9.0 h, 9.0k11,
,
COMPONENTS REQUIRED FOR MASONRY FIREPLACE INSTALLATION:Surround Paneis-
Combustible floor beyond hearth must be protected by a minimum 025 inches thick insulating board•having a thermal conductivity of K=0.72
BTUs INRt-hr°t at lifff,or equivalent.(See Owners Manual for examples)Direct flute connection is optional.Do not remove bricks or moria-
from masonry fireplace.
Note:Replace giata with 5mm neoceramlc or ceramic glass only.
For use with solid wood fuels only.operate only with feed door closed-open to feed fire only.Do not use a grate or elevate tiro-build fire directly
an the hearth.
Manufactured By:
Travis hick nates,Inc.
10850 117th PI, N.E. Kirkland,WA 98033
STOVE INSTALLATION (CONT. PAGE 9
CHIMNEY TERMINATION REQUIREMENTS
• Must have an approved cap (to prevent water from entering)
• Must not be located where it will become plugged by snow or other material
• Must terminate at least 3' above the roof and at least 2' above any portion of the roof within 10'
Slanted Roofs Chimney must extend 2' ,
above any portion of the roof
Chimney must within 10'of the chimney
extend 3'
above the roof
Chimney must extend 2'
above any portion of the roof
Flat Roofs within 10'of the chimney
::.
Chimney must
extend 3'
above the roof
OUTSIDE AIR REQUIREMENTS
• Required for mobile homes & in certain localities (check with building officials)
• Must not be drawn from an enclosed space (garage, unventilated crawl space)
• Requires the option,-:l pedestal or outside air boot with legs (installation instructions are in the
optional equipment section at the rear of this manual)
When using outside air,find a location where the chimney and
outside air hole do not interfere with structural members of the home.
I A hole must be cut
-'
Pedestal (with insulation) through the floor Outside
directs air to the stove.
protection and Air Boot
floor and the
rodent screen
€ nailed in place
Asx here(see the
� s
optional equipment
instructions for
exact sizes)
...........
Optional Air Duct(must not be
longer than 15'and at least 16
square inches in cross section)
Air may be drawn from a ventilated Outside air entrance must be placed so
crawl space or use an air duct. it does not become blocked by snow.
HINT: When using outside air find a location where the chimney and outside air inlet avoid
the structural members (i.e.: floor joists and roof beams) of the home.
Location
No. Date
NORT►, TOWN OF NORTH ANDOVER
Certificate of Occupancy $
t Building/Frame Permit Fee $
• i ;
� o ;
Foundation Permit Fee $
ss�CHU
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
Building Inspector
Div. Public Works
• ********NORTII ANDOVER, MA
1'I•:RMIT NO. � < _APPLICATION FOR PERMIT BUILD
hl\1'No . 10? LOT.NO. 0060 2. RLC0RDOFO\1'NLRSIIIP DATE BOOK PAGE
ZOhE SIIB DIV. LO"F NO.
LO(-.MON �(� �O PURPOSE OF 131311 DING
ON'NERS NA1,IE �d �b��/ NO.(X S (N(IES �tib� Sq-I-'
OWNI:RAS ADDRESS BASEMENT OR SLAB
AR(I It I ECI'S NA),IE SIZE OF FLOOR 1 IMBERS I 2 3
81111 DER'S N.MIE / SPAN
O� O
DISIANCETONEARESI BUILDING DIMENSIONS OF SILLS
INS FANCE FROM STREET' DIMENSIONS OF POS IS
DISI ANCE FROM I.OT LINES-SIDES REAR DIMENSIONS OF GIRDERS
AREA OF LOT FR(NJ FAGE I IEIGI IT ON:FO(JNDA11(NJ THICKNESS
ICKNESS
IS BUILDING NEW SIZE OF FOC Yl X
IS BUILDING ADDI TI(NJ MATERIAI.O=CI IIMNEY
IS BUILDING ALTERATI(NJ IS BUILDING ON SOI-IDOR FII LED LAND
Wit 1.BUILDING CONFORM TO REQl31REMENTS OF CODE �S IS BUILDING C(NJNECI ED'I O TOWN WATER
tiJ IS BUILDINGC(NJNECIED 1O1OWNSEWER
BOARD(N=APPEALS ACTION,IF ANY -
15 BUILDING CONNECI ED TO NATURAL GAS LINE
INSTUCITONS 3. PROPERTY INFORIIIATION LAND COST
ESI. BLIX1.COST .SOU. '
PAGE 1 FILL CN II SECTIONS 1-3 ES F. BI.D(i.COST I'LR SQ. Fr.
ESI. BI.IXi.COSI K'ItR()()tV1
ELECTRIC METERS MUST BE ON(XITSIDE OF BUII DING SEIrI IC PERMI 1 NO.
AllACI IED CiARAGESMUST C(NJFORM'FOSTATEFIRE REGIII.AII(NdS a. API'ROVEDBY:
PLANS MUST BE FILED AND APPROVED BY BIALDING INSPECT(Nt BUILDING INSPECTOR
DAIE FII ED Z�8 OWNERS'I1:I.N
C(NJIR.IELH �,rBC
;�2z "I - CCN'fFR.1.ICH /0`l SYYt�?y�
SIGNAI-IIREOFOW R(WAir]�T-�.N})qR_IZI_DAGEFfi ILLC.H ! T�Q
FI:I. ��Q�'�Y
PERMIT GRANTED
19
x
�olyct
v
a
EXIS//N� �j2���.'Gr j�oo2 d/v�.a✓i��/
'2- z wo
.............
............... .........
........... . . . . .
................
........ . ........
. . . . . . .. . .... . ... ..........
... ............
... .......
. fid04
A&iiii:A
:XX
0I. 4
..........
. .. ..........
TR.................
....... . . .
-6
- 771-
customer
ED Gabriel
YBoston St.
North Andover Mass. 01845
Job`:
Convert garage to living space.
I. Main house back wall.
2. Remove two existing window units and add new L.V.L. header.
3. Install two new window units.
4. Remove existing basement door unit and *install new header.
5. Install new steel door unit.
6. Replace first floor rear door unit with a 32" steel door unit.
1.Garage space
2.Open wall to main house for 60" cased opening
3.Extend landing to match opening.
4-*Fr-am-e--1110 Or
5.Frame in garage door opening for new picture window unit.
6.Remove existing gable end wall window units and reframe wall for
double mullion window unit.
Unstall double mullion window unit to gable end wall.
8.Frame double closet and stairwell in rear of new family room.
Unstall 1x3 strapping to ceiling
IO.Insulate walls and ceiling and add 3" Of cellulose to main house attic.
I LE lectric al,install all recepticals,switches,lights as required by code and
one fan light box in ceiling as requested by owner.
121.1iistall blueboard and plaster to walls mid ceiling.
13.Add new hot water heat zone to existing system.
14.Patch vinyl siding ,and trim on exterior of house.
15.Supply and install wall to wall carpet in new family room. Allowance
$1000.00 material and labor.
16.Paint new walls,ceiling and trim owner to pick color.
1. Main house.
.2. Add two GFI outlets to kitchen.
3. Change existing livingroom window to a double mullion window.
4. Remove carpet from livingroom ,sand and refinish existing floor.
S. Install new kitchen floor allowance $700.00 installed.
6. Add deck and stairs to back of garage, size 6'x5'
7. Remove all construction trash from site.
/ . F�uf..._C �✓lLG �ah7� /GCGLCIG ��4W/u/.QWiW A � .�
OEPARTNENT OF PUBLIC SAFETY
i
CONSTRSUPERVISOR LICENSE l l
Jlp — E�►pires: Birthdate
�J18/2110 11/1811955
Q RUNIt ... E `
112 ADANS hVE�
N ANDOVER, NA 11815
t +
Typi _ 06-
.
a
00414{_ ' �y +(► of ;[ a €,
� ,as�..�C�r aha
a.. G07�7 tq /7
ADUN!STRATOR AndOVer MA 01845
y
�"'\ �..'�?. '� 'J`,tti,�•4l r 1,n� ,,bit+i v'� '{'' �Ap .a'�,vr�'� ir�`�''l�" � v 4.; �.
yy r
NORT
Town of over
* Z z dover, Mass.,4.5 19990
A.000HICHE WICK
V
'9S CRATED
(G BOARD OF HEALTH
P. ERMIT T D Food/Kitchen
Septic System
ci
�� . / BUILDING INSPECTOR
THIS CERTIFIES THAT ilii.. !....................... Foundation
....... ........
has permission to erect........'-........... buildings on ��... A?t.... Rough
/� -
..... ..... .....
to be occupied as..�i.4 .U. � � �... q�o 0.... Chimney
provided that the person accepting this permit shall in eAtspect conform the terms of the applicatio 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 ON
UNLESS CONSTR N ST ELECTRICAL INSPECTOR
IV
Rough
O ....... ...... ................ BUILD....IN.N G....... Service
IN
Final
Occupancy Permit Required to Occu ilding
GAS INSPECTOR
Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To BeDone FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector.
Burner
Street No.
Smoke Det.
O/r
Date.......
No ........ ... ..
0 TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
.N
�SSAcNUS�
This certifies that ...... ........ ....................................
... .... . .... ....
has permission to perform ........pf.� t�Ad................................................
wiring in the building of......F.d.... ........................................
at...... ....... .......... ,North Andover,Mass.
Fee......1;!A . Lic.No........... ...............................................................
ELECTRICAL INSPECTOR
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2�
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
Rough Service Final
t>� 014c OOI1 manwtalt4 Of i simar4twe is Office Use Only
Q�
Department of Public Safety Permit No.
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
Occupancy 6 Fee Checked
3/90 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 9
(PLEASE PRINT 1N INK OR TYPE ALL INFORMATION) Date
City or Town of Ml—w / _To the Inspector of Wires)
The undersigned•applies for a permit to rform the electrical work described below.
Location (Street & Number) �' / 6 S Mf
Owner or Tenant (21 , If -2-
Owner's Address
Is this permit in conjunction with a building permit: Yes No ID (Check Appropriate Box)
Purpose of Building �G J ' Utility Authorization No.
Existing Service I&ID'A Amps /Zo / 2�J 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
2 TOTAL
No. of Lighting Outlets �.J No. of Hot Tubs No. of Transformers KVA
Above In-
No. of Lighting Fixtures
Swimming Pool rnd. ID
No. ❑ Generators KVA
No. of Emergency Lighting
No. of Receptacle Outlets No. of Oil Burners Battery Units
No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones
Toi7a No. of Detection and
No. of Ranges No. of Air Conditioners Tons Initiating Devices
Heat Total TotalNo.of Sounding Devices.
No. of Disposals No. of Pumps Tons KW No. of Self Contained
Detection/Sounding
No. of Dishwashers Space/Area Heatingmunicipal unDevices
ci
Municipal
Local *
Connection ❑
❑ Other
No. of Dryers Heating DevicesKW
No. of No. of Low Voltage n
No. of Water Heaters KW Signs Ballasts WiringG
No Hydro Massage Tubs No. of Motors Total HP
OTHER:
�R
INSURANCE COVERAGE: Pursuant to the requirements of Massachusttes General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent.YES O NO❑1 have submitted valid proof
of same to this office. YES U NO IJ
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE BOND ❑ OTHER❑ (Please Specify)
(Expiration Date)
Estimated Value ofElectricalWork $ 6�
Work to Start < �!d✓ Inspection Date Requested: Rough Final
Signed under the penalties of perjury:
FIRM NAME /D `4f— —22 LIC. NO. Z '
Licensee �� s�l Signature LIC. NO.
Address 5Z 7::j Cfy0e> Bus. Tel. No. �L'b 2 6 2
Alt. Tel. No. �7�
OWNER'S INSURANCE WAIVER:1 am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required b Mass0-
achh�usetts
General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one)
Telephone No. PERMIT FEE $.
Cianawre of Owner or Aaent)