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HomeMy WebLinkAboutMiscellaneous - 67 SUNSET ROCK ROAD 4/30/2018 67 SUNSET ROCK ROAD 210/106.A-0222-0000.0 �.\ onwe use Only uhe Cfwmmwnwealth of gusadpwim Portt,tt No. at"Mcm of Dubuc %ftrq Occupaii A Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 C51R 12:00 3fso Peeve wank; i APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massacnusetts Electrical Code, 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date _ .�T, 99 ____ %* or Town of NORTH ANDOVER To the Inspector of Wlree: The udersigned applies for a permit to perform the electrical work described below. f Location (Street & Number) h 7 S6W ISL R0 4 AV D , (Z O j#I3- j Owner or Tenant r NK Am Owner's Address 7 /v 1 11a�R i Is this permit in conjunction with a building permit: Yes Noj (Check Appropriate Box) Purpose of Building _ /1 eAl f IA10i° fW A/G y jr�le.`jlf4 , / ' Utility Authorization No. V'7 j Existing Service Amps —J volts Overhead Undgrnd Q No. of Meters __ • New Service ROO Amps a dye Volts Overhead _ Una rno � 9 No. of Meters I !j Number of Feeders and Ampacity Location and Nature of Proposed Electrical Warx _A114%NU OF lllPgl_rjA4/- 2&/Z yAY1fZZ;,vZ- I No. of Lignting Outlets I No. of Hot ',.cs I No. of Transformers Total KVA i'• -t No. of Lighting Fixturesi Swimming P:or abcve— in- r I gma. _ grno. '_ I Generators KVA f No. of Receotacte Outlets I No. of Oil corners No. of Emergency LightingBattery Units No. of Switch OuuatsI NAr o. or Gas =urgers FIRE ALARMS No.of tones No. of Ranges I No. of Air C-r..c. oiai No. of Detection and :Cris Initiating Devices No: of'Oisoosals I No.ol Heat 7b:ai -otai : Pur•.Cs :ons No. of Sounding Devices i t I No. of Soil Contained No. of Oisnwasners SoacerArea rieatiro KIv OetecttoruSounalnq Osvtcy No. of Dryers I Healing [�evices KWLocal -7 Municibai ,•.•Other ` Connection NO. or Vo �r Low Voltage ; No. of Water Heaters KW I Signs ?adas:s Wiring I I ' i No. Hydro Massage �uDs ' I No. of Motcrs -oiai HP ;, r• OTHER: I INSURANCE COVERAGE. Pursuant ;a the reouirements at Massacr.Lsecs ;eneral Laws / .. I have a current Liability Insurance Policy incluaing C„m ec Ocerations Coverage or its substantial equivalent. YES NO _ I have suontineo valid proof or same to the Office. YES' 7VO tr= It you nave checxec YES, please indicate the type of coverage i checking the abp Hare box. P / //Z° 1111177J.41" INSURANCE 1�80ND = OTHER = (Please SCec:"�l I P/`fZ°// 0 �i Eattmateo Value of E!ec cal work S t ( uon oast Work to Stan 6 Insoec;ton Mata Aacues:ec: Rough IN��t/ CLL • Final /�j//`< <4lL ; Signed under the mes�oil perjury: " FIRM NAME IL r J T /11V ( %�w Licensee A/ r UC. N 1 L/oM '/ �? D dj�p D Si //r�eJ�J //� 461 UC.NO.. Addnia 2d .IIT/"R 7 /I�L , g � �` 141 OfIft Bus. Tel No 7.F7 y' r Alt. Tel No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee cces not nave ins insurance coverage or its suostanual equivalent as to- qutreo by Massacnusetts General Laws, ano that my signature �n :n.s Zermir aopiication waives this requirement. Owner Agent (Please checit one(' t i :eieonone No. PERMIT FEE S (Signature of Owner or Agenn , i RdSf6 � '1 - Date../ 2 1259 t HOR71�, TOWN OF NORTH ANDOVER �. lift PERMIT FOR WIRING SSACMUS� e r This certifies that!t�J t -� A T...............7...G............../. ......:.................. has permission to perform ......W.tw........ � .... ..... ......... wiring in the building of 6?c n 12.uicew........................................... v at.....lr. .... .c {:.:.5?. .....kL.C..AA......................North Andover,Mass. 15. Fee....� �.: Lie.No...J..�. �� � ~ . ...... ............................................................. t ELECTRICAL INSPECTOR C� �10LO z WHITE:Applicant CANARY:Building Dept. PINK:Treasurer ' Office use Ofdy Ucfam unwini h of IBB S Permit No. EtITIIY$I rat of Public gafttV Occupwcy A F«Choclted BOARD OF FIRE PREVENTION REGULATIONS 521 CMR 12:00 yso Pam Nw*) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK { All work to be performed in accordance with the Massacnusetts Electrical Code, 527 CMR 12.00 (PLEASE PRINT IN.INK OR TYPE ALL INFORMATION) Dats �, Iff7 %* or Town ofNORTHANDOVER To the Inspector of Wires: ,.; The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 6 7 akfPT IO gyp. LOl#�.S Owner or Tenant l'4#Nl 4 O SSI xo(ff Owner's Address idelJv Is this permit in conjunction with a building permit: Yes _ No C (Check Appropriate Box) Purpose of Building Utility Authorization No. 71) 06 Existing Service Amps —J Volts Overhead '_I Undgrnd L7 No. of Meters I New Service Amps _J Volts Overnead Undgrnd r' No. of Meters .'m,. kI' Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work ��� Y12 Ike No. of Lighting Outlets I No. of Hot ' cs I No. of Transformers Total •'; KVA No. of Lighting Fixturesi Swimming P^oi Above — In- grno. _ grno. I Generators KVA No. of Emergency Lighting, No. of Recebtacie Outlets I No. of Oil Eurners I Battery Units No. of Switch Outlets ( No. or Gas Burners FIRE ALARMS No. of Zones ' No. of Ranges I No. of Air C nc. 0131 No. of Detection and :cns Initiating Devices Heat To:ai .otai No. of 0isoosaks I No•of Pur-. ::s :ons K1V No. of Sounding Devices No. of Sell Contained iF ii No. of Dishwashers , SoaceiArea Heatino KW Oetection/Sounotng Oewws Dryers I Heating — Municipal No. of D s. ry g Devices KW Local , Connection � Other ,7 No. of 140. it Low voltage No. of Water Heaters KW I Signs eailas:s Wiring +. t}. No. !-lycro Massage Tubs � ' I No. of Motcrs Total HP I " OTHER: k INSURANCE COVERAGE: Pursuant to the reouirements of Massacnusers general Laws 1 I have a current Liability Insurance Policy inclucing C-rn c Ocerations Coverage or its substantial equivalent. YES Y NO = 1 have suomitteo valid roof of same to the Office. YES J 710 — If nave h Ic t ' 1 p _ you a e c ec ed YES. Weare moieaa the type of coverage oy., , checking the appropriate cox. INSURANCE = SONO = OTHER = (Please Scec:�r1 G_Z4 (Expiration Oatet Estimated value of E!ectncal Work S j Work to Start Insoecvon Oate .;ecues:ec: Rough Final Signet Unger;he Penalties of peau off { FIRM NAME d c � C / _46 UC. NO: 67� I' Licensee ` Ave /4 o Sig,a::re �C. O. 6 x;. Address /.(OK „✓ - �y M6� �% !i�Lf1L`�Y Sus. Tet. No. . Alt. Tel. 40. I OWNER'S INSURANCE WAIVER: I am aware that the Licensee ^_oes not nave the insurapcs coverage or its substantial equivalent as rer', quires by Massachusetts General Laws. ane that my signature an :nis cermn application waives this requirement. n r Agent P• (Please check oner l :eiecnone No. PERMIT FEE ' (Signature at Owner or Agenti Y Date. f - 1225 t NpR7M q TOWN OF NORTH ANDOVER PERMIT FOR WIRING A �,SSACMUS S� O This certifies that ... Pa/1o! ......5 )-ea.N.......1 � t f,/1 t C a ............ ....... has permission to perform ...aL..'—7�e.... .. .............................................le V` .... � • 1 wiring in the building ofco� � �d S S � i�cK;.. �°u( fid Al4n. . .....................L......................�'........ RNs ofat..�P...�...ti?.................. ........��.�............... ,North Andover,Mass. Fee... Lic.No. ........... ............................................................... ELECTRICAL INSPECTOR C � WHITE:Applicant CANARY:Building Dept. PINK:Treasurer O OT NO. 2 RECORD OF OWNERSHIP IDATE (BOOK jPAGE Z E E SUB DIV. LOT NO. • 1 LOCATION /J PURPOSE OF BUILDING a �� OWNER'S N ME ,N` O. OF STORIES SIZE V '` OWNER'S AtmawE 8 O, 19 -7 �/ BASEMENT OR BLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS 2NDvjX/� 3RD BUILDER'S NAME `tel SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF BILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES —SIDES REAR GIRDERS AREA OF LOT s/6 FRONTAGE + HEIGHT OF FOUNDATION 8 THICKNESS IS BUILDING,NEW /�-„iJ��/ 1 SIZE OF FOOTING a Si/�X �/ X . 18 BUILDING ADDITION ...wR/ MATERIAL OF CHIMNEY .yyr�•[_ IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY If BUILDING CONNECTED TO TOWN SEWER 18 BUILDING CONNECTED TO NATURAL GAf I--NT INSTRUCTIONS 2 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EBT. BLDG. COST 7 &L / PAG[ 1 FILL OUT SECTIONS t - S EST. BLDG. COST PER SQ. FT. (�� PAGE 2 FILL OUT SECTIONS 1 12 EST. BLDG. COST ran ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED B ILDING INSPECTOR OIGNATUR OF OWNER AUTHORIZED AGENT Co FEE � .#OWNER TELC PERMIT GRANTEDti Asa /0 CONTRA. TEL.# \ 1° --, -4.e�• CONTRA. LIC. # HIC# .•:, ., :�..:>'L :: .:. ,.._ s '+r,:.. -...l.`i+ �_sa-;; - ��.'.)�` ,.r.;, i A"}. .;:+r�Lr ti.. -Y.. :„rx _ .• �{-. WHILE: BuildingDept. CREAM:`Assessors M:CANARY �� �.1OR Tey Town of - IVAndover Ty �-- �� = LAKE A dover, Mass., .19 '94,COCMICHE WICK .iY,'`• •� ORgrE6 PP 3 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System Q BUILDING INSPECTOR fHiSCERTIFIES THAT............................. ..�!�./.�,.5��...�/�..�.�.�...........�1... ...... .......................................... Foundation ias permission to erect....................f.................. buildings on ....6..7........�(�.1�(.,� ........(�` .�C,/AL Rough o be occupied as.......................................... f/tl.�G.�L-. .......... "S''�.��. . Chimney )rovided that the person accepting this permit shall in every respect conform to the term of the application on file in Final his office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of 3uildings in the Town of North Andover. PLUMBING INSPECTOR 110LATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST T ELECTRICAL INSPECTOR Rough ................................. :.... . . .................................. Service �UIL G INSPECTOR Final Occupancy Permit Required to Occupy Building FFinal S INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. o - over/01" . dover, Mass., S 19 / O - LAKE ��y: '9��COCMICHEW ICK '9 A�qA rE D S BOARD OF HEALTH PER Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........................... f4sE.r .....R.oC.�..........J.Q.. ...... .......................................... Foundation has permission to erect.................... .................. buildings on ....6..7........ .........R.OGh',' Rough to be occupied as.......................................... .......... 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST T Rough .............................. . . Service UIL G 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. FORM U - IAT 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 local or state law, regulations or requirements. ,03 ****************Applicant fills out this section*******T********** APPLICANT: �.el/j� 055 4/ (_zY Tib ��Phone LOCATION: Assessor's Map Number Parcel Subdivision ,J Lefib 7Lz1Ce� -��- Lot(s) Street St. Number /— ************************Official Use Only************************ RE DAT ONS OF TOWN AGENTS: k4�_ Date Approved Conservation Adminigtrator Date Rejected Comments Date Approved ow lannef Date Rej ected Comments Date Approved Food Inspector-Health Date Rejected Date Approved1197 Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections w - driveway permit ��� 1 9 7 Fire Department Received by Building Inspector Date ,i �;1. _: Restricted To: 00 48318 DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE 00 - None Nuaber: Expires: Birthdate: 1A - Masonry only CS 018403 0410111998 04/01/1951 1G - 1 & 2 Faaily Mow Restricted To: 00 Failure to possess a current edition of the Massachusetts State Buiilding Code W 44w , FRANK A ROSSI is cause for revocation of this license. CER DR L - ANRENCB, MA 01843 r The Commonwealth of Massachusetts - Department of Industrial Accidents �� /Ifl�dl �Utos 600 Washington Street !� Boston Mass. 02111 Workers' Compensation Insurance Affidavit name locati city , Lam/yc%'� phone# 7� Iam a homeowner performing all work myself. 0I 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-. Db one"#. insurance co poiicv# - I am a sole proprietor, general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company-name: . address: city: thane"# _. . insurance co. - .,-..'.. "--::- - :. : pohCy companny name• address- city phone#. ... .. - - ............ . . insurance co 4}' a$�t on*15 to necessary Failure to secure coverage as required under Section 25A of NIGL Ir-can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of MOM a day against me. i understand that a copy of this statement may be forwarded to the Office of Investigations of the DU for coverage verification. 1 do hereby certify under the pat and penalties of perjury dt�the inforntadon provided above is true and a rreM Signature Date � �eIF7 Print name ,�P a 1'1 6 SS / Phone# official use only do not write in this area to be completed by city or town official city or town: permitIlicense it rlBuilding Department CLicensing Board 0 check if immediate response is required ❑Se[ectmen's Office C]Heslth Department contact person: phone#; 171Other (nviised V"P1A) " Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of Applicant on Building Permit(below) Add r ss of Property for Permit(below) Map and Parcel : Purpose of implication (check below) Phone Number of A licant: ✓Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the Building Permit. Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building Department and is only officially accepted when the Building Permit is issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement,restoration,or reconstruction of a dwelling in existence as of the effective date of this by-law,provided that no additional residential unit is created. The lot(s)were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning Bylaw. This application is for dwelling units for low and/or moderate income families or individuals,where all of the conditions of 8.7.6.c are met and/or represents Dwelling units for senior residents,where occupancy of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this Section"senior'shall mean persons over the age of 55. This application is a part of a development project which voluntarily agreed to a minimum 40%permanent reduction in density, (buildable lots), below the density, (buildable lots),permitted under zoning and feasible given the environmental conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently designated as open space and/or farmland.The land to be preserved shall be protected from development by an Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism approved by the Planning Board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for building permits,(i.e.all other permits from all other boards and commissions have been received and the project is in compliance with those permits),and the Development Schedule does not accommodate issuing a building permit in that Year,one building permit will be issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate information, or the checking off of an above item which does not comply,whether done to my knowledge or s grounds for refusal by the Building Department to issue a Building Permit. Signature Owner or Authorized Agent who signed the Attached Building Permit Date This form must be attached to the Building Permit upon application for such permit. CERTIFICATE OF USEI OCCUPANCY Town of North Andover Building Permit NumberW/VDate THIS CERT S THAT THE BUILDING LOCATED O G2...-A2.z. MAY BE OCCUPIED A IN ACCORDANCE WITH THE PROVISIONS OF TH MASSACHUSETTT ATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. +04 ' CERTIFICATE ISSUED TO S ADDRESS 3��� 04.0 e G�� oil/o jJ "U'� Building Inspector ::a t4O R Tti ® ® _ _ Andover No. . i= ° h. m Ju * s LAKE dover, Mass., 19 0 � .'1r�'� '94_COCMIC Mf WICK '9 �Aq TE p S BOARD OF HEALTH PERMIT T D Food/Kitchen p� Sep 'c Syste D I4 BUILDING INSPECTOR THISCERTIFIES THAT................. ... (R... .......... .. ...... .......................................... Foundation has permission to erect.................... .................. buildings on ....6..7........ EJNS6r...... �oGi(,' ou to be occupied as..........................................S f/tl.�C.,L-,> .......... f" .�•./ ............................................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in , this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. 11i�?1a7��i PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ST : ;'� ELECTRIC AL INSPEC R :Eogh .....................................=. . .r' . .. .................................. Secy � s BUIL G INSPECTOR to Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough ` If— � �,, r No Lathing or Dry Wall To Be Done FRE DEPARTMENT Until Inspected and Approved by the Building. Inspector. 1 Burner Street No.