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Home My WebLink AboutMiscellaneous - 66 EQUESTRIAN DRIVE 4/30/2018 / 66 EQUESTRIAN DRIVE 210/105.13-0141-0000.0 I i s Cif n� Date.................................. f N�pTit 1 3?;•_t;�`` :•�"�o� TOWN OF NORTH ANDOVER jA PERMIT FOR WIRING ,SSACMU`�� / This certifies that ..................... ......U� `"``................................` .,..:.......... has permission to perform Ux............... f' wiringin the building of................................................................................... at........................ .................................... �... ,North Andover,Mass. Fee�...�......... ic.No%:�b .......... . i. ... ELECTRICAL SP R � Check # 8206 Commonwealth of Massachusetts btiicial only.° Department of l=ire Services Permit No s�U�=: Ocatpanay and Fee Checked ,IF BOARD OF FIRE PREVENTION REGULATIONS (Rev 'i 1199) (teavebtank): APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Al wort to be waned in awmiar"wpm Un Mamadwsetis 8=WW Code(MEC)527 CZAR 12.00 (PLEASE PRINT IN INK OR TYPE ALL-JAfEDB N Date: I`'I L0 Y City or Town of N brt,-I'� �c�.-- To nsp totorof Vires: By this application the undersigned gives n of for her intention to perform the electrical worts described below. Location(Street&Number) �o e (��StA(U ff!1 �)LcVZ_ OwnerorTenant M t,"4A ,(�_Cj[�A L<A't\e,1—L j Telephone No. Owner's Address 1-1 Is this permit in conjunction with a building permit? Yes0 No (Che*Appropriate Box) Purpose of Building Utifity Authorization No. Existing Service Amps__L_Vohs Overhead[] Undgrd10 No.of Meters New Service ,_ Amps / Volts Overhead[] Undgrd[:] No.of Meters Number of Feeders and Ampacity di Location and Nature of Proposed Electrical Work:�P�Grv�-WV� e�c Complethn of the following table may be waived by Inspector of Vines Trans No.Of Recess Fixtures No.of Cell-Susp.(Paddte)Fans Ts Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Foxdtres Swimming Pool Above I No.of Emergency Lighting gmd. gmd. Battery Units No.of Receptacle Outlets No.of ON Burners / FIRE ALARMS No.of Zones No.Switches No.of Gas Burners 1-6 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No. Devices Tons 9 ' Heat Pum I�snft4vt Tp� KW No.of Self-Contained No.of Waste Disposers Totals: DetecticiVAlerting Devices No.of Dishwashers Space/Area Heating KW Municipal Local j] Connection ❑Other DryersNo.of Heating Appliances Security Systems: No.of Devices or Equivalent No.of Water No,of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices of Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent f� -vv I a 8ly R Attach adfilonal deta7lf desired,or as required by the Inapector of wires INSURANCE COVERAGE: Unless by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liabilky insurance including° mpleted operation"coverage orb substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of me to the permit issui�n office. CHECK ONE: INSURANCE BONDD OTHERp (Specify) Estimated Value of Electrical Work:$ 99-0,00 00 (When required by municipal policy.) (EWrddonoate) Work to Start417 4 r Inspections to be requested in accordance with MEC Rule 10,and upon completion. l certify,under rtthhe pains and penalties of perjury,that the iMornmdon on this applrcegon is true and complete. FIRM NAME: 1 li C`fL�2G D�1., t V AtJ�S h C.. UC NO: t71�6 G3 Licensee: e.S M "61"46n wa Signature QLGjr__ r,' i LIC NO: l s (ff,applicable 'euemor h the ikensejumber fne.) ' Bus.Tel.No: — C� Address: �F_rttA-v�lGl v►� � vt � �yrL IN�/� Alt Tel.No l F� .� OWNER'S INSURANCE WAIVER: I am aware that the Licermee does not have the liability insurance coverage normally required by law. By my signature below,1 hereby waive this requirement I am the(diad ne)13owner ❑owner's agent Owner/Agent Signature-, Telephone No. a— Date. . . .I.. . . NOR7M � O 0.1< •° .�� TOWN OF NORTH ANDOVER . tea„, ..."!• OOL PERMIT FOR PLUMBING �. This certifies that . . . . / . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . ' . .` . . . . plumbing in the buildings of�'. . .`.?. . .. `.�. .. :� . . : . . . . . at: ''. . . . . . . . . . . . .(. . . . . . . . ., North Andover, Mass. Fee"'�.�. �- .Lic. No�S'34?�'. .�/ ::.._•. (� .1_� . .� . . . . . . . PLUMBING TOR Check # 1`131 7760 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Building Location__4��'f �-O �Owners NameDate -� Permit#_ 7 &d Type of Occupancy //C� > Amount — �c New ri Renovation. � Replacement ❑ Plans Submitted yes ❑ No FIXTURES o 0 H m A . to to o � �R4V1� .a A � A � B.aiSF11M1�II M FLOCK M FLOCR 3M FLOM 4IIiROM SM FL OOR 71�Y ji_+7'ilJ� d SIFT bLOCit (Print or type) Check one: Installing Company Name Certificate Corp. Address ❑ Partner. Business Telephone �Fitzn/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy JU Other type of indemnity Bond El Insurance Waiver: I,the undersigned,have been made aware that the license three insurance e of this application does not have any one of the above Signature Owner ❑ Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massach is to Pl g de and Chapter 142 of the General Laws. By: Tli—gnatureoliicense Title Type of Plumbing mbing License City/Town tcense APRum er APPROVED(OFFICE USE ONLY Master Journeyman ❑ 1 � 1 Date ..... ................... f NORTH 1 ``°-1'_�."°O� TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACHUSE� { This certifies that %1 s.1n--c�-cr......................................t, � has permission to perform ..................:................................................ wiring in the building of ` ...... , ..f........................................... at...........................::....................: `°' ,North Andover,Mass. Fee--k. ..... Lic.No. � N � � �v .......� . ........�. .........�. .. ..... .\�:...,-r..... Q ELec[R[cnt.INS E 8060 # 13l°/ 8060 Date.. .. . ... HORTM , TOWN OF N04TH ANDO PERMIT FOR GABS IN JkLLATION 1 S-A This certifies that . . . . . . . - '�-�. . . . . .. . . . . . . . . . . . . . . has permission for gas installation in the buildings,-cif . . . . . .... . . . . . . . . . . . . . . . . . . . . . . i at . . . . . `- . - R --�-- �., North Andover, Mass. Fee: 11c. No./'S 3.... . . . . . . . . . . . . . . . GAS INSPERTOR Check# /y 6451 MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GASG (Type or print) 7 � ¢— NORTHAN R, MASSACHUSETTS Date 0 Building Locations Permit Amount$ Owner's Name New D Renovation D Replacement Plans Submitted ❑ Ed ZCn • � m F w a pp O � p z F F Z F Q x w Z a C O W > 7W.' GZ < w Q W F F w O > tr. A U O x zZ 3 U z > o a F o SU B-BASEM ENT BASEMENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) / Name Check one: Certificate Installing Company 77-Gj v / El Corp. Address _` Partner. Business a ep one A Firm/Co. Name of Licensed Plumber'or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance"policy or it's substantial equivalent. Yes If you have checked es please indicate the type coverage by checki13 ng the appropriate box. Noo Liability insurance policy Other type of indemnityBond 13 Owner's Insurance Waiver: [,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. Signature of Owner or Owner's Agent Check one: Owner 13 Agent I hereby certify that all of the details and information I have submitted(or entered)in abopl best of my knowledge and that all plumbing work and installations performed under Permve apto the it Issued for this application will ication are true and accurate be in a compliance with all pertinent provisions of the Massachusetts St e Gas ode and Ch ter 42 oSf4he General Laws. By: Signature of Licensed Plumbej-Qr Gas Fitter Title Plumber City/Towrr, D Gas Fitter ice e u er Master V _ APPROED(OFFICE USE ONLY) 'Journeyman sa ckc �g v 1, .1 I Ise Only--- ftoo Departmen;: of Fire Sery ces Permit No._ -- ----..---- OCCL :. ov BOARD �� FIREPREVENTiON REGULATIONS ,cv alxl Fu C;h� :h.cr 1?n y t,� ,,:tiinnk)- - -APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ,,l1 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: City or Teen of- AV\C6JeYL. To the Inspector ofWires: Tay this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) r( eq()e._s+o fly iii� ` uc_ Owner or Tenant M. t[+ Ae.+�`�tM"G t Ne... U Telephone No. d Q� Owner's Address e— lu Is this permit in conjunction with a building permit? Yes No (Check Appropriate Bos) Purpose of Building 5i) yy` Utility Authorization No. Existing Service Amps / 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: 0 N 1-tyo M Camlesion tine .pilaw table be waived b the etor R'ir -- -No.of Recessed LuminairesNo.of.CeiL-Susp.(Paddle)Fans 0.0 ata Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool rade ❑ rnd ❑ 0.°BatteryUnimergenry mg ts No.of Receptacle Outlets No.of OR Burners FFA A,;,ARM5 No.of Zones v No.of Switches No.of Gas Burners M ]<nihfie tion and ft Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices d Ptu No.of Waste Disposers ceTotaLcP am r ons Detection/Ale n' Devices No.of Dishwashers Space/Area Heating KW LocalpA ❑Connection ❑ Other No.of Dryers Heating Appliances KW Security wys s:R No of Devices or Equivalent N5.of Water Heaters KW o.o signs Ballasts Data Wi No.of Devices or le Te uivant i No.Hydromassage Bathtubs No.of Motors Total HIP mmanucatious of Devices or ni t OTHER: r7/ 60 Attach adc&tioxai detail tr&shrA oras regWred by the Inspector of imm Estimated Value of Electrical work: CCS (When required by municipal policy.) Work to Start: (0 6 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 1 the licensee provides proof of liability#12111181100 including"completed operation"coverage or its substantial equivalent. The undersigned certifies that sucha is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER [I (Specify:) 1 I certify,under and ptnahies of perjutq,that tke information on�applleat ion is trace and complete FMM NAME: l n.6 �V)l �.I(� LIC.NO.: 10156 Licensee: X01 A Fin �ow Signature -7).Gr=r-^v�LIC NO.: O(S Q (/fapplicable,enter t"in the ficense nonbe�rFvr ) Bus.Tel.No.-Q72 - 4!1---2906 Address: _ YII,d�i/�Lc-t )�'�n}e ' _ Alt.Tel.No.: 1? -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 requited by law. By my signature below.I hereby waive this require crit I am the(c eck one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. G� l�>ZF/ PERMIT FEE. 3 rr•ry nP RAVFRLY R01 RIM —P Location � � �yi✓ S4 P (A No. c;2 Date l� 6 HQRT1y TOWN OF NORTH ANDOVER F • Q9 ` Certificate of Occupancy $ NuBuilding/Frame Permit Fee $ skst Foundation Permit Fee $ Other Permit Fee $ TOTAL $ //0 Check # b 592 /� Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING sor owmat use fl� BUILDING PERMIT NUMBER. DATE ISSUED. ic SIGNATURE: C Building Commissioner/Inspector of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: -,s D )y Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sf) Frontage R 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided v 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Owner of Record j lose 1' ///C//GZ s G � �(F/6/67-5 T/�'/s�/lam �/�' Name(Print) Address for Service: r Signature Telephone qj /v 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ 0 -� 2-,2 j /2) icensed Construction Supervisor: C/ > C O License Number / Address ,,,l Expiration Date S' re Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name m Registration Number r Address r Z Expiration Date ^ Signature Telephone Y, 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.......❑ No.......❑ SECTION 5 Descri tion of Proposed Work(check au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Mterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: -ec �C SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed b permit applicant 1. Building / (a) Building Permit-Fee- Multiplier eeMulti lier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X (b) 4 Mechanical HVAC �- 5 Fire Protection 6 Total 1+2+3+4+5 Check Ntunber SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owne Authorized Agent o subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. -Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST2ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS lI] IGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 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. *****************************AP/PLICANT FILLS OUT THIS SECTION******,***************** APPLICANTG �/GPHONE LOCATION: Assessor's Map Number �-� PARCEL SUBDIVISION LOT(S) STREET �G/(/`P S ( 4,0 / LCv_ ST. NUMBER ************************************OFFICIAL USE ONLY*********************************** RECO ENDATION OWN AGENTS: CONSERVATION ADMIN IST TOR DATE APPROVED DATE REJECTED COMMENTS h0 Qx c Ava44 n Ur5fn 6 /� U TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm • MORTGAGE PLOT PLAN 13 z' 85f tA r Loi 19 75 '0 88 S.F,± • . N i J \ r o ' t OF S RT yN �`A ESS\0 / IY1R '�MO.SIiRVE`l/ STREET ADDRESS 1&t4 OWNER: P{+,1(. L-toI+1 En\ QTY BUYER'aLlr.µo� MARICW, t K141t 5, DEED REFERENCE:--Z9?9 / 6 SCALE:__I" it'50' PLAN REFERENCE:-9,8s'? r-or 19 DATE: 17--7 -1993 TO: RAY 8AtA S MO?,rm6E ccrt�, I HEREBY CERTIFY THAT THE ABOVE MORTGAGE INSPECTION PLAN WAS PREPARED FOR USE IN CONNECTION WITH A NEW MORTGAGE AND IS NOT INTENDED OR REPRESENTED TO BE A PROPERTY LINE OR LAND SURVEY. IT CANNOT BE USED FOR ESTABLISHING FENCE, HEDGE, WALLS OR BUILDING LINES. NO RESPONSIBILITY IS EXTENDED HEREIN TO THE LAND OWNER OR OCCUPANT. THE LOCATION OF THE ORIGINAL BUILDING(S) AS SHOWN HEREIN WAS IN COMPLIANCE WITH THE LOCAL APPLICABLE ZONING BYLAWS IN EFFECT WHEN CONSTRUCTED, WITH RESPECT TO HORIZONTAL DIMENSIONAL REQUIREMENTS, OR IS EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER M.G.L JITLE VII. CHAP. 40A. SEC. 7, UNLESS OTHERWISE SHOWN HEREIN. SUBJECT BUILDING(S) UE(S) IN A FLOOD.ZONE] DESIGNATED FLOOD ZONE G AND SHOWN ON FIRM MAP COMMUNITY PANEL #250C,9 8-"S 9 DATED: MEISNER BREM CORPORATION ATTORNEY Dod1ERT` W-;`I-AwiE 151 MAIN STREEL SALEM,NH o3o7q . 603 893-3M MORTGAGEE: 190 LIMUON ROAD,WWESTFORO,MA x1886. (5D6;692-2505 PLAN NO.: -'lQ 30, 9 North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: J (Location of Facility) KignatofVrmit plicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector z a The Commonwealth of Massachusetts "` = d Department of Industrial Accidents Office of Investigations w~ Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name Location fo �`�i�/c�s,T' �1/�i D/f City 4 X��// Phone # F7 I am a homeowner performing all work myself. E' I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. Company name: Address City Phone#: Insurance.Co. Policv# Company name• Address City Phone# Insurance Co. Polio(# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of.a fine up to$1,500.00 and/or one years'imprisonment_as_well_as_civii.penaltiesin theformnf-aSTOP WORK_ORDER and..a.fine_ofJ.$1110.00)-a day.againstme. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 I do hereby certify under a pains and penalties of rjury that the information provided above is true and correcDate Signature Print name T��l� ✓� /i �`t/ Phone.# Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing Building Dept []Check if immediate response is required Licensing Board [] Selectman's Office Contact person: Phone#: [] Health Department [] Other TNvn � h ED - ovm of - . No. 0� dover, Mass., �� 6 ORATED S H � BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....... .�... ... ......... ..... C... .o./. ............ .......................................... Foundation has permission to ere t...� ..� ..�... buildings on .4.A......S.q!V!4'401AN �//�Y ................................. ......... Rough to be occupied as.......kftr/d R� pI.,�c4 rn"�........:.:............................................ 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 r lating to the Inspection, Alt ration and Construction of Buildings in the Town of North Andover. I PLUMBING INSPECTOR / VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION START ELECTRICAL INSPECTOR 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det.