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HomeMy WebLinkAboutMiscellaneous - 643 SOUTH BRADFORD STREET 4/30/2018 643 SO BRADFORD STREET 210/104.D-0147-0000.0 1 Date.... . ... :...�.U.. s NORTI, of,, •° �e�do TOWN OF NORTH ANDOVER PERMIT FOR WIRING �SSACMUSf� This certifies that ............ ...............`�...... �................................ ... has permission to perform ......6,k c 2<N.(-�..T.........................:............ wiring in the building of..........20�F'.�. ... �............ at.... ... ?...... 7��..I��.X.,..f%7).KC............... . North Andover, ass. Fee.... 5......... Lic.No. Z • E�CfRICAL INSPBC'1'bR r-.� Check # �S 6 � � 9377 r . 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.01 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 ofongoing construction activity,and may be.deemedby the.Inspector-of_Wires abandoned-and.invalid.iflie—_. ._ 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 entitystated on the permit application. ❑ 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 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 puipose 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 beginning on August 15,2008 and extending through August 15,2012. 0>441e 8—Permit/D.ate Closed: /;{ /:S7— ***Note:Reapply for new permit B/ ❑Permit Extension Act—Permit/Date_Closed: \ Commonwealth of Massachusetts Official Use Only Permit No. 3� 09=- Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 9/05] (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: 4-29-2010 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) 643 South Bradford Road Owner or Tenant Rob and Kimberly Jones Telephone No. (978)655-4550 Owner's Address 643 South Bradford Road North Andover MA Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Bog) Purpose of Building 1-family dwelling Utility Authorization No. 1 Existing Service Amps 120/240 Volts Overhead ® Undgrd❑ No.of Meters 1 y New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters k Number of Feeders and Ampacity ' Location and Nature of Proposed Electrical Work: install lighting and receptacles in basement ompletion of the following table may be waived by the Inspector o Wires. i No.of Recessed Luminaires 5 No.of Ceil:Susp.(Paddle)Fans No.of Total J' Transformers KVA Y KVA No.of Luminaire Outlets 2 No.of Hot Tubs Generators � No.of Luminaires 2 Swimming Pool Above ❑ In- Elo.o Emergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets 13 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 4 No.-of Gas Burners- No.of Detection andInitiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers eat Pump umber Tons KW No.o el- ontained p Totals: ...................... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Secu oyf Devisees 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 TelecommunicationsNo.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: $1850 (When required by municipal policy.) Work to Start: 5-3-2010 Inspections to be requested in accordance with NEC 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 ® BOND ❑ OTHER ❑ (Specify:) I certify,under the pains andpenalties of perjury,that the information on this application is true and complete FIRM NAME: ONLY CONNECT LLC LIC.NO.: 12201A Licensee: Stephen F.Krasner Signature LIC.NO.: 26363E (If applicable,enter "exempt"in the license number line) Bus.Tel.No.: 617-484-2828 Address: 206 School Street Belmont MA 02478 Alt.Tel.No.: *Security System Contractor License required for this work;if applicable,enter the license number here: 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 a int. Owner/Agent Signature Telephone No. PERMIT FEE. $50.00 Check#1561 1 r / VO 16- 0-13 ' y 10 a . I Date.).b.l .... OF NORT/i.,'11 TOWN OF NORTH ANDOVER * * PERMIT FOR WIRING '$$ACHUS�S This certifies that ........... .....:......t........�=.I....... .....A........................................ has permission to perform2.................. r5..........................................................L' ptiR g ..... ry c.. � wiring in the building of.......a.!JE'S at ..:.. `T?-�......�. . ! .A AX � : rth Andover,Mass. .... ..................................................... Fee !! Lic.No�,,K94,' INSPECTOR Check# `C� i it � (� 11 . 05 . ..... w ace ne»w►raiea i a-.-ate. I. .... .0 1.ly Pemut No , �� cp2garipy aria dee ebecked BC}ARi ::DF FIRE P E1lE T�t3N RE�ULATlOi S >v 1/07) te1.av%eista%. All work to be F in accordance wP:the Masachusetfs EiecGtic i Cnde(MEG'):52 t t RR'12 00 , . I. (P�Er SEpRINT1Nr14Kr �t L 'E" Q Tf4m.` D,-... rp /:. .ty�r Tows ofv the ector oYit-es By this appi�caubtt tl�e and ed gt► gives no�ce of his ox her mtenhon to perfomi;the electrical work described below Location`(Street.Bc Nu.... ) �.Y�7 1 ... . Qwner of Tenant ��r��] 17 Tdep l`io '7 Owner's°Address Is_tuts p1.ertA it ren conjunctrnu tT�a b [dmg rnt#' 'es Na (C&ech Approg!, i x) Purpose of StitittiAg � t �t thvri oA PTa E�tist�n.i ., ce ,Amps / 'Volts` :: Qverhe�ad Uudgrd Q No of Yleters' New;3ervice A_nps: I Yo'"" bverhes� grxi No of Meters. Number of Feeders aed°Ampac ty Locatto..:and Nat.. e►f;Frogosed ElecE=rcal Work : £ometwn o tl�e table" be pawed ":theins ector o :fires No afReeassed Lamiaaires No.of Geidwap (Padciie)F%ans o.o Total Transformer% s KYA i�lo of Luuzinaire flutists f6 of.dfTAbs Geu'erators 1CYA No of ,umunaYres Swim Pont Above a a.o esgency g. .Unit$ 4 N.o%of Receptacle()rrtlets lvo ofd i3urners FItE AI. R1VlS No of Zones No of�w1 cher No of Gas Burners +. o etectron a�n :fur tiatis Devices No d Ranges Na of 63r Coad. fl 1. — A- .. ---%.%.i 1. : o.of Ale0ttu�Devices 5 No of Vi�aste Disposers`: amp :nsA r Tous o:o - oA tied 9. o S ..fto10A/I�elertiA Devices;: No.of lltshwashers4. SpaeelAr� entin Loot Q u II Other 1. CoaAectian , No o€Dryers Fleaiiug Appiiagces ICW e1.,W. stems iia of epees or nrvateut ivo o a er No of o of 1. Heaters KW.: Datas Wu iAg . % No of Devices o.r E o� alent ". i s Ba No Hyd ois►assnge Rathtufis Ido oTt l oinrs : 'I otal % . 11—a�-". ons it.g :UTHER . I�Io afDe�nees or E uivaient ,::. cit,rdi}rttrtttaT detail fdetrrr�i arms reOwr dy 4 7rtspectar aj.6. , Esdr.a. ..:Ya2�ze of Elcetricai Yor c- f-?3 l en re�uttedity A unic�pal hcy) Work to Steffi 7z�C T/ rss iu sated in aecorcfane wrtii MEC Rote 3 8,and upon completion INSURANCE CaVERAGE, Umiess1. waved IrI+tl�epvvner,uo gemutor the performance of elecfical work may issue unless the.licensee provides pmot'of. -.-ty "O�aPce tnP'N.1-g-completed-pe€at;v�°' ayecag or rts S stantaa[equivaleflt Th undersigned certifies thats4ch coverage�s u��nrce and teas exh;brt1 . ,.-- same to the pernut issuing once. CHECK(?TSE TNSURANCEOND [� QQR [j {Specify' t certefy,under thepat- and ofd rp3' xhat the rn,MQr i lintr otr thrs appl�carFan is true acid complete. F1 RiVIq.NAME A,t:Y€s 2ecf;x rca. .e=l -�ak1d Cn, r _f ILC I�IG.l iO�5 50a:.' Licensee. Not 371d =M�eTaud 9 551gnafitr� 1Y0. e. 4�' (I,,'applroablk enter'exempt'in thetAce►rse umberItn � 1. " - us,Tei TVo 9'D£3 h R 7 Q 5.44 A. dress '. 290 Broadway s�t3t 3V MaeI .. 11 m ' OI8 4 Att:Tei T+141. *t'or Iv-G L c 147,s 57-Cl,.secut r-vor .W ofpwb ;;afe "S"t.�cense . ... . Lac No OWNER S IN$I9.,: CL WA►'I'S i�- 1 ain aware t�Cat t�teLtcensee c7oernat have the Irab�ty insurance coverage normally regntred b law By my sig-a ....beit�au,I)eer�y a tfits t, tam ilt �c�e Tc,oAe [Q owner: owner's °crit- Owner/Agent % Signature': , T I.-p- su Na �:P ?' '.EES$ '; .. .. .. - .. - .. .. ... .. ✓F.... ,. .. .. ... -, The Commonwealth of Manwhusetts Deparbnent of lndus&W Acddents Office ofImw gallons 600 Washnigton,veer Boston,Masi 021.11 wwy.masLgov/dia WorkersCompensation Insurance Affidavit. Bnitders/Contractors/l�l�clms/pinmbers licant Information Please�'rint Name 'dual)=.rBBIS�;):I�CTRIC SERVICE AND CONTROLS LLC Address_ .290 ngnADMAV ori . 11.L - .� _ City/State/Zip__M`kbI,Q„ Ma 01844 Phone#; Are you an employer?Checkthe appropriate box: 1.� I am an=Ployer with 4.O I am a T ype of project(required): employees fall and/or �� tractor and I New c project ( 1�fin4 have hired the suers 2 -z ;am a sole proprietor or parum 1'tsOed on the atlached sheet. 7.0 Remodeling ad have.no erloyees 111ese yrs have worhing.fvrthe in any qty_ employees and have workers' 8.0 Demolition No workas'coup nismance, - comp.int, 9.0 Building addition 5.0 We are a cohporaton and its 3.0 I am a bomwwner doing all work officers havel�9mcetrical repairs or additions myself'(No wadmis' their P rWd of=aVdon perm MGL I L Cl-Plumbing repairs or additions inseuenoe retluired]t c.152,§1(4),and we have no 12.O Roof hairs emplayees.[no workers' comp.ittsurance:+equhv&] 13.0 Other *Any applicanttSatCbahsbox inmustalsef8l�ttbesxuoabe�show..59—W oAwe tH0MWWnmswh0a tbhx rdRVitW'WRft1hW-Wedog,11,,*.d .him Upeosom Poft rnmtion. o�thatcbecict�ls boa��stat�aa � oontts� a ne4raQidavit tbesti tradms> thesame ofoes'bsNdsWewbedwor=ttbmeumbmempbyaL if I.amoa e�loyel'thatis b#bnnadoa on bis wmwefvrAry aweyem Below is thepofty andjobMe insurance CompaMyName: - .Traveiters=-:Ins. Policy#or Self-ice Lic - - -- 5B3s;st�•r_�_ - Job Site Address: Attach a copy of the workers'eumpensation polio,declarattion page(showing the policy nwaber and expiration(date Failure to secure cx y as Section 25a of MGL 152 can lead to the imposition of c�rimirtal UP to$1,500.00 and/or one year imprisonment as y�as civil Pe»aities of a fine $250.00 a Ptahalties in the form of a STOP WORK ORDER and a fine of day against ca iitor.Bi advised that a copy ofthis statement mMyhe forwarded to the Office of Investigations of the DIA for eo a verification. 1 dotfierby eerie unde►thepaies and p1makm 0094W7 thatfhe inforavadm provided above is true and comrL • nam-- G 3 PrntAfame:. Normand Michaud Phone* 978 687 0544 V 4ffich use only Do not write in this area to be co Ided � by d&or town afficiat City or Town: permit/hcense#: Issaing Authority(circle one): G. of Beath L Building Depoi tmeot 3Other .C3ityll'own Clerk 4.Fjecb cW luspecWr 5. Plumbing Inspector Contact person: Phone#: SMT a= +� Date...1.. .. ...11-3...................... 1 OF NOA7�y,� TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION 83gC�5fc Thiscertifies that ........................ ...............................................................................:. has permission for as installation . J�14. c�. ...... . ..... . P g in the buildings of......�C� j t4 ^ ............ ................................................. at.. ....��:....C ! .::................r- ..c`�.....:.........., North Andover, Mass. tr� t�..:`........ Lic. No i.L.�........ M .................................................... Fee cam, GAS INSPECTOR Check# - %3 8909 -` MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY MA DATE v- 7-/3-_jj PERMIT# -- D!vh't9 Si' OWNER'S NAME r�c�i3 JOBSITE ADDRESS e I GOWNER ADDRESS 9-4014- r TE q'78-y9y-_&:/2 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL n EDUCATIONAL © RESIDENTIAL PRINT CLEARLY NEW:Q RENOVATION:F REPLACEMENT:IV PLANS SUBMITTED: YES F-] N 0 APPLIANCES Z FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER .- T1.:� �1 I I _ 1 I BOOSTER �( CONVERSION BURNER �� J COOK STOVE DIRECT VENT HEATER DRYER - M FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN ��- . . _ - _ F-- POOL HEATER J 1 ROOM/SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER -TER HEATER OTHER vRA)✓44 4T'T1G, INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES NO IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY BOND �]I 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 E AGENT01 ST SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this applic a and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application wi be in complia a wit all ant o sion of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME !GC//3 i24) P4 GA/4 L-%— LICENSE# 7y IG U E MP MGF[�� JP 0 JGF LPGI 0 CORPORATION F- Jj#=PARTNERSHIP®#=LLC 0# COMPANY NAME: I!=r�Si4l2� f!� ADDRESS G �?/? � lei) _ _ CITY STATE U2ZIP TEL FAX I :���- - �lCELL SU-�lo� EMAIL ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTI/ON NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES " r y The Commonwealth of liTassachusetts Department opndustrialAccidents IR Office of. Mvestigations 600 Washington Street Boston,MA 02111 www.mass.gov1d1a 'workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name,(Business/Organization/fndividual): G!�/�lZo7 /�<G�✓/,tJ`% �,��.^t��%�'� .a Address: �A�2�2�J� ✓� �2,� City/State/Zip: AJ/V Phone#: 6D 3 - b3 '<Y 0 Are ou an employer?Check the appropriate bog: Type of project(required): 1. am a employer with /� 4. ❑ I am a general contractor and I ` 6. ❑New construction employees(full and/orpart-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. y, ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.[]Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions F myself.[No workers' comp. c.152,§1(4),and we have no 12.❑Roof repairs insurance required.]I employees.[No workers' 13Other . comp.insurance required.] ❑ Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they a're doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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 1s providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: G 01 Policy#or Self-ins.Lie.#: Expiration Date: lob Site Address: G Y.3So 3/?� "�i2�� S City/State/Zip: AJ, Attach a.copy of the workers'compensation-policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. X do hereby nder the pa' d et i ofperjury Aat Elie information provided above is true and correct. r Simafore: Date: �� ^l✓� Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permlt/ucense# Issuing Authority(circle one): 1.Board of health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - - -__-_- 'D.h ,,o 44. q Information and Instruction's 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 ofhire,. 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 root 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,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)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 maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage, Also be sure to signand date the a ffidavit. 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 IegibIy: The Departdientlias provided a space at the botEom 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 refe?66"e°irumbe°: 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 maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or'-permit not related to an business or commercial venture i.e.a do license Y v n re � ( g or permit to burn leaves etc.)saiderson is NOTrequired uired to P q 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 CQM41011wealth ofmassachmotts Deputwea of fadugrial.Accidents • Q)ffce ofIn��estiga�ioavts 600 Wasbingtoxi Stroct Boston,MA 02111 TO,#61.7-727-4900 ext 406 or 1-877MASSAFF, Revised 5-26-os Faze#617-727-7749 E Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991m3)of ` r' i enclosed space. iFailure to possess a current edition of the Massachusetts f state Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS i 7 t`11.1 U%lL•.t.Cl tt?%Jl►�`JL"1.4'i',IiL! �� i . LLSL8i hI/IO/50 ShL6 528I-L8020 HN WVHQNIM Qd02I aoomadvi 5 °! iinVN9IW d adVH9I8 :01 3SN3W 3AOSV 3H1 S3nssi.. ' 2i39WfYld )131SVW V SV 43SN3011. SH3111dSVJ 4NV 521381 nld sii3snH0.VSSVW d0 HI IVWNOWWOO P e i i E Date.6 4P. . .. .... 5 pf Np toT °,4, 3� TOWN OF NORTH ANDO 'ESR p F + • - PERMIT FOR GAS INSTALLATION . y SACMUSESS 4 This certifies that . . ./`> .`. .�`.1�'�'. : . `'. . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . . . . . . . . . . . . . . . . in the/buildings of . . . . '! . . . . . . . . . . . . . . . . . . . . . . . . . . at . .(.:c f . . . . .l�L?d .� :: . . . . , North Andover, Mass. Fee. . .3�:'. . . . Lic. No..j. . . . . . . . . . . . . . . . IGAS INSPECTOR Check# C ' S 5585 Inspection of Gasfitting MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) Mass. Date Permit # 7��0 Building Location6Y3 " rGIQ i n��Owner's Name ex u A#I(' t . ...._ _, Type of Occupancy 1 Yl q New C] Renovation Replacement Plans Submitted: Yesp No❑ V) y s W ,� w x � a vt a "0 a � i O z N .z W a. V) w O 0 ap N z a a Y 'z z ~ ¢ m of F a d O a a w W 6 'L W 6 C r rA (C W V W = N W < a O C W V H Z "r }- 2 W a a Uj 1" w U Y to a = C W J < C F. .F >. N z W I w O0 W a 'z C Uj w � 3 C U c > o a N o SUB—BSMT. G BASEMENT 1ST FLOOR 2ND FLOOR i —' 3RD FLOOR 1 s 41HFLOOR —1 STH FLOOR I 6TH FLOOR 7TH FLOOR BTHFLOOHFFFT Installing Company Name Y-( Check one: Certificate Address VP�n X Corporation Business Telephone_ �g - ,� _ �53(A Q Partnership Name 0 Firm/Co. of Licensed Plumber or Gas Fitter rl Y --� INSURANCE COVERAGE: I have a-current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have checked No Elygf, please Indicate the type'coverage by checking the appropriate box. A liability Insurance Policy Other type of Indemnity O Bond O 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: Signature of Owner or Owner's Agent Owner p Agent O 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 issued for this a ation wit a in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chaplet 142 of the General Laws. 8y Te of License. Plumber Title Gaslitter r9n a of cen or or as itter t Maser r City/Town License Numbs APP Journeyman r ' y �IN�l41NlPlC'h0�is8XITDN,E! i�EE • _ RAoo��aa.•tir��tcttoNB NO. APPL►CAT►GN'ixOR PIRMIT TO 00 I•LUMONG' • UNDERGROUND'RQUnH COMPLETE Mum y E!NAL INBPQC'ryON ' !'>EREIIT Q11�'NXE'D DAta PLUM:81 •IN>Z'ECTON 40 M /I Location ' ..,.,.! i.��•.�� .4 No. Date pORTN TOWN OF NORTH ANDOVER Of� .ao �a��00 F, A Certificate of Occupancy $ /l * Building/Frame Permit Fee $" 0 Q Foundation Permit Fee - Other Permit Fee Sewer Connection Fee �- 1gOater Connection Fee $ Z TOTAL $ �% •"� JI^ y Building Inspector Div. Public Works Location r Mo. rl Date &ORT" TOWN OF NORTH ANDOVER S Certificate of Occupancy $ %' D •i r Building/Frame Permit Fee $ Ss,,C,,,,sE� {F44hd'ation Permit Fee $ Other Permit Fee $ Connection Fee $ Q Water Connection Fee $ TOTAL $ -' i Building Inspector Div. Public Works Location Date NaR*� TOWN OF NORTH ANDOVER 3?o�t?`•D '``��OO - p Certificate of Occupancy $ Bu (ame Permit Fee $ Foundation Permit Fee $ p ��,OWermit Fee $ bl&A�� -Sewer Connection Fee $ -4-19,.Water Connection Fee $ TOTAL $ c2o o o o 0 BuildIns/p�6ctor �� j ` Div. Public Works PERJIIT Nn. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. /�/�i/ ��` PAGE I r MAP 4-40. �� Z/ LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE ZONE SUB DIV. LOT NO. �I i LOCATI PURPOSE OF BUILDING 4 OWNER'S NAME ��✓ filth /'I/J��� ,� 9r::l � / /yjNO. OF STORIES ( SIZE OWNER'S ADDRESS C.. v/moi BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS 1ST ! l(,\ 2ND C� / `3RD BUILDER'S NAME1� /� i SPAN J �/ ® C. / 'L DISTANCE TO NEAREST BUILDING .✓ DIMENSIONS OF SILLS DISTANCE FROM STREET L//�� r POSTS / ;p DISTANCE FROM LOT LINES-SIDES "'7REAR �'s G3 " GIRDERS AREA OF LOT S FRONTAGE HEIGHT OF FOUNDATION THICKNESS "+e,2 A IS BUILDING NEW J SIZE OF FOOTING rl X t1 �z IS BUILDING ADDITION 7 MATERIAL OF CHIMNEY /.- f- IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE i- IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER j Kms_ � IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES D��MMIFF� - . �, kyo'00 r EBT. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 LESS MA 4��12 10 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 DUE FRAM E Mme /) o EST. BLDG. COST PER ROOM ���w�.+���•��aa�..j� tNlf SEPTIC PERMIT NO. ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING / .5 �P — 4 APPROVED BY i ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AN APPROV D BY BUILDING INSPECTOR DATE FIL -9 BOARD OF HEALTH SIG E F OR AU ED AGENT F E E PLANNING BOARD PERMIT GRANTED OWNER TEL 0 '7,s--3 35 CONTR.TEL.ar..� --7 J,'� 19 --�- CONTR.LIC.tJ EiC y �d BOARD OF SELECTMEN i � c fU1LDIN0 INfPECTOR' BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY I STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION I 8 INTERIOR FINISH _ CONCRETE d 1 7 (3 CONCRETE BL'K. PINE -- BRICK OR STONE HARDW D PIERS PLASTER DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B M AREA _ r '/. 1/2 1/ FIN. ATTIC AREA NO BMT FIRE PLACES _ 1 HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS '1 CLAPBOARDS 00oo B 1 2 3 DROP SIDING CONCRETE �— WOOD SHINGLES EARTH ASPHALT SIDING HARDV../'D ASBESTOS SIDING COMtACN VERT. SIDING ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK N MASONRY ATTIC STRS. & FLOOR BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME + `l a"-'+ + •"^'' S - SUPERIOR POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH 13BATH FIX.) � } GAMBREL _ MANSARD TOILET RM. 12 FIX-1 L FLAT SHED WATER CLOSET ' ASPHALT SHINGLES AAVATORY WOOD SHINGES KITCHEN SINK ' E SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST IPELESS 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 i 7 NO. OF ROOMS GAS OIL B'M'T 2nd ELECTRIC 1st 13rd I NO HEATING =R LOT 28A 3� 62961,9 ± $ F u r, LOT 26A 61 , 688 ± SF l5 ± SFS pR IC 17, F is Fit rl(. F 17No � /.• O O \\\ 10 Ak _ \ v 0 V• V � � fJ �` 7 F'+ --•.� it/\ I �;i�.�4 / PROP . a FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary z , I approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or tr landowner from compliance with any applicable local or state law, regulations or requirements. ******************Applicant fill's out this section***************** APPLICANT: '// y� A0 Phone LOCATION: Assessor's Map Number ,16 /z Parcel Z---Z-7 Subdivision �/z�Gc� /9��,� Lot(s) _al Street �"b X6113 , �,/ S� St. Number D ************************Official Use Only************************ �R�ECOMMENDATIONS OF TOWN AGENTS: Date Approved �b 2 Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments kmomW Date Approved Health A4ent p Date Rejected Comments 101AM �+ Public Works - connect'sewer water / ion - driveway permit 6Z4n;,4 /d/�� Fire De artment Received by Building Inspector a, �® Date I .. 4lL'YANIMtINI VI- ruuu%.aNrtll - OF F.ALTH 1010 COMMONWEALTH AVE. 4 i BOSTON,MASS.02215 -lull ;rASSACHUSETTS I _ ENCLOSE CHECK OR MONEY ORDER LICENSE PIRATION DATE CONSTR. SUPERVISOR FOR REQUIRED FEE, 5/3011993 t~Wil,i' ILIC-'N' O.' I" MADE PAYABLE TO EFFECTIVE DATE STRICTIONS °}""� t, I: " 'QMMISSIONER OF PUBLIC SAFETY" SONE 06/30/1991 009802 , T PAUL J STHILAIRE (DO NOT SEND CASH). 66 SPRING HILL RD i * 013-30-0908 NO. ANDOVER MA 01845 PVEASE hOTE,41QNCREASE >(eudi_W4wrfl ONLY) FEE: ?" k. 100.00 EIFECTIVE � (�.�� ?, '�89 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY �.� HEIGHT: I STAMPED OR SIGNATURE OF THE COMMISSIONER DOB: 08/24/1939 D ; NOT DETACio VclASE.•STUE THIS DOCUMENT Musr 9E I SIGNATURE OF LICENSEE { SIGN NAME IN FULL WVE SIGNATURE LINE ','•` CARRIED ON THEPERSON OF {I •�� THE MOLDER WHEN ENGAG- COMMISSIONER I$ RIGHt THUMB PRM. ED IN THIS OCCUPATION.- 2b)S � ZLBEt 'ON Sal rti rte►o-� o r�o i 1b r�,Yv?��y.�Q LJ n�r`,�-L'�H� i-1-1-� n H x S c r-4 a .�^�r-i o f Ana 1,vo^J rti r---,c"S sf-I 91'V,Q"')IC1�t� !� N '3ht L mod IA .1?!-:m•7 ya1-s Q I �66I 0 I �, U 2 2 ,Z 0 � 9 � to � _►-:�•s 88� `ice •2"�•f'� '��`21 f'ti b'1d d sz -L----, Location No. Date NORTp TOWN OF NORTH ANDOVER F . p Certificate of Occupancy $ + � Building/Frame Permit Fee $ c us` '''�q,` tion Permit Fee $ Ju "• Fee Sewer nnection Fee $ Fe ; -Water Connection Fee $ $ Building Inspector Div. Public Works WFICHS()I'-: \I� I:n :,,.3:�::�'): [�1(�>��"1'�l N 1)0 VE 111 AI it I t llVV;ll IN 11 71 .17 175 I'LANNING & fq I I.P. NJ: .1 SON. I )II(I:(A ( M CHIMNEY APPLICAH014 ANO IT13111' 1'E1Z IIT. OCATION VNERIS NAME: '.II LVER'S NAME:-Slvl kSON I S NAME: J ,(�9 X1-7 , 7 L� ASONIS ADDRESS: �SON'S TELEPHONE: UERIAL OF CHIMNEY:__ ITERIOR CHIMNEY: CZ L-XIL:1z1olz diallky: IMBER AND SIZE OF FLUES: -11CKNESS OF HEARTH: i U chbiney olt. ()i/LepCace can(lout to 41te Imiubtemmt.6 u() the curie culd have "ttice-5 Mid igutatiow been aece.Zved:—kr� T.E: >2-16-,g--T --GRATURE OF MASON: --RMIT GRANTED: Z33 1*-'E E )BERT NICETTA I ILVING INSPECTOR ISPECTEO: ell :MARKS: SOLID BLOCK•11 EQU I lfl THIS PERMIT MUSF GE VISPLAYLV 014 IHE VIZU11SES CERTIFICATE OF USE & OCCUPANCY . Town of North Andover r Building Permit Number 484 1992) Date JUNE 29,_ 1993 THIS CERTIFIES THAT THE BUILDING LOCATED ON 643 SO. BRADFORD STREET (Lot #26) MAY BE OCCUPIED AS SINGLE FAMILY DWELLING W/2-CAR GARAG$N ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. MOR7q •'" CERTIFICATE ISSUED TO Andover Construction & Dev. Corp. 66 Spring Hill Rd. p ADDRESS North Andover. MA + - s rs cmus A ♦ i � Building Inspector PLA NI GOI.- ')­yz:j:INAL SEW MATER FR,N A L own or nalover NO. 48- 01 Mass —19 &i& over, op DRIVEWAY ENTRY PEI K i' te,A. C C-RT-C E C 0 BOARD OF HEALTH E R M IT T 0 THIS CERTIFIES THAT/41AWAP6001t.161004 .. k e or ...W.- BUILDING INSPECTOR, 04#ftlfbuildings on ... ..PIA000RA060 Rough 3 has permission to erect I010100 A A&.4.01V Chimney ,e A to be occupied Final provided that the person accepting this permit shall in every respect conform to the terms of the application on rile in NUL PLUM, ING.INWCTOR this office,and to the provisions of the Codes and.By-Laws relating to the Inspection, dd& RAVIffe Mu Wiff"Ly Buildings in the Town of North Andover. REGULATED BY PARA 114JL B.C. VIOLATION of the Zoning or Building Regulations Voids this Permit. in �7 PERMIT EXPIRES IN 6 MONT FEE AID ELE&RICAECTORkj--'tj- e)6 Rough 19 L UNLESS CONSTRUCTIO STARTS s Service Final PERMIT FOR FRAME/BUILDING . .. ..... BUILDING INSPECTOR GAS INSPE5:TOR DATE' FEE PNF ROW/ .3 i -/Li�)- L L L41j"114�6fPL I init Required to Occupy Buildiiig Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector