HomeMy WebLinkAboutMiscellaneous - 701 WAVERLY ROAD 4/30/2018 (2)r
-C
C
Commonwealth of Massachusetts
- Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
11CI.1111t No. X13
t)ccupanc\ and Fce Checked
[Rev. 9 051 11c11,,e blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All '.pork to he hcrtonlicd in Accordance I%ith the \la,'achusetts VIC01-ical Code I\11.C). i?' (AIR 12.00
PLE•,ISEPRL),TI.` INK OR TYPE. ILL L\Ft)RHITION) Date: y�flr%6 --
City or Town of: AlorA And over To llle ht.peL-Ior o 66'ires.
liy this application the unJtrsi�ned gives notice of hi or her intention to Pei -l"(4111 the electrical \%ork described below.
Location (Street & Number) 2DI (, over 1 !,,s,
Owner or Tenant &n e 0. Telephone No.
Owner's Address S a M L
Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box)
Purpose of Building &t.T;j Gn GG Utility Authorization No.
Existing Service /OD Amps /atpYd Volts Overhead N Undgrd ❑ No. of Meters %
New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of deters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: td;reyvt&iC4-S s ter
kifcken t; e "Jke.
i ,1111DIC1 imI nl !llr !r,llrnt I,Ihh, ni.n 1,.. I,.,n ..l h,: I1- 1• a • . L ,J II`.
No. of Recessed Luminaires
No. of Ceil.-Susp. (Paddle) Fans .
No. of Total
Transformers KVA
No. of Luminaire Outlets
No. of Hot Tubs
Generators KVA
No. of Luminaires
Swimming Pool :above In-
�rnd. ❑ i-nd. ❑Battery
: o. o Emergency Lighting
Units
i! FIRE ALARMS �Vo: of Zones
No. of Receptacle Outlets
No. of Oil Burners
No. of SwitchesNo.
7
of Gas Burners
INo. of Detection and
Initiatinz Devices
No. of Ranges f
No. of Air Cond. Tota No. of Alerting Devices
Tons g
No. of Waste Disposers
eat Pum
'I otal :
umber
..........................
Tons
K INo. of • el-Contame
.
Detection/Alerting Devices
No. of Dishwashers `
Space/Area Heating KW ,' Local ❑ r unicipal ❑ Other
Connection
No. of Dryers
Heating Appliances KW
Security Systems:*
No. of Devices or Equivalent
No. of Water
Heaters KW
No. o No. of
Signs Ballasts
Data Wiring:
No. of Devices or Equivalent._._.._
No. Hydromassage Bathtubs
No, of .Motors 'Total HP
Ielecommunications W ring:
No. of Devices or Equivalent
OTH ER:
.t11!li;rr,rG.Ln,:rlcr�:lr;�rrl rJlr.•;,rc,l,:u•„arr�/tnrc,l l: �. irr 1r0l. n-P,,r•I Il .:
F;timatcd V;tlue of Electrical Work: A6 6W, 00 i \t hen required by municipal policy.)
\1• ork to : tart: Inspections to be requested in accordance with \IEC Rule 10, and upon completion.
INSLRANCE 'OVERAGE: t.nless waived by the owner. no ptrnlit for the perlornlance of electrical work Ina) i":_ue uni:•,.
tilt licensee provides prooforliability insur,ntcc includim-, •',.onlplctcd operation- cover vle or its strb�tantial �quiv;rlcnt. ' h,.
AI&r.i,..nc.l certilic: th;rt' (Icll cmcra"r•c I: 111 1+:1'Cc.:111d Ilan e'.hihited prrwt 1.11 :;acne tr; the purinit i •uin office.
11 Ki)NG: lititil R.\Xa.'c 13ti�.I? [_] illll:R [� I`ih:ccily:i
,J:11%er /f!e PtiJ` s
_ice nsee:--e-
l: ..l;ii,. ���/�:. - :rel• :.. , ry.r .r, ;Lr i..:. t:. , ..:,uri�• . ,:,;c.,
+ ddress:
::')C(-Lll-ity 5y,tcm ContraLtor LJLC :;e required fOr this,,,rLxk; ifapplicable.
OWNER'S INSURANCE bVAIN'ER: I ;im mi ;u•c that tht
required by law. By my i,natLu'c bcloty, I hereby '.�aivc thi requirement.
Owner,A,gent
� ! C..' 9.:
'13us. TO. No.T
1.It. Tcl. vn'�.�gQ.-gall.
enter Lhe license number here: ___
rr,:l /idle the Nubility insurance : r.•.1a.t n, rnr,111v
,tot the lelteck unc) ❑ .n�ncr � j u�� torr:, .t�,.:i;;-
�F4.i1/T
L7
Date .. - /.......�"....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that L'4i�'r...�po� �.�'kr� / Z-Lt�-�
....................... . ....................................................
has permission to perform A-! < C' kx7' '-
................................................................
wiring in the building of ( � loL*
at ..............al... tt/.l�C,C2 f,/ ....'�-J-�.......... , North Andover, Mass.
SS '. as
l
Fee ..................... Lic. No
ELECTRICAL INSPECTOR F
Check # I ` l
615 7 B
F13
M
.y
Commonwealth of Massachusetts
Department of Fire Services
,l
7"k, BOARD OF FIRE PREVENTION REGULATIONS
Permit No. ( 5-7y
t)ccupanc% and Fee Checked
[Rcv. 9 051 I Ieavc blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All %%w -k to he Ixrt niied in acconhllCe with the \Ia»achusetts Flcctl-ical Co& t\iFC). i' (AIR 12.00
I'LL ISE PRLN T I.N' INK OR TYPE, ILL INFOR.I L I TION, Date: q/1 6 _
City or Town of: 9?r-4 , Andover TO dle 117SpVOW O/ li hT.S.
13y this application the undersi-ncd ,Ives notice of his ur her intention to perform the clech ical tNltrk tiescrihcd hrluw.
Location (Street & Number) 7pl Wave r I N RZ ,
Owner or Tenant 2nn : e 0. Telephone No.
Owner's Address 9 a M e
Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box)
Purpose of Building ZSR Gn Ce Utility Authorization No.
Existing Service /0,0 Amps /040 / v?Yd Volts Overhead Undgrd ❑ No. of Meters
New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of deters _
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: tire. oyde4-s t7_4 11 4--r i-er
k tck" re owAk6.
( IM11.lclinn ul thv ';,U,n, ,,,; r„hl•, , 1,., , h,, 1.., n --
No. of Recessed Luminaires
No. of Ceil.-Susp. (Paddle) Fans
,r
No. of TWA
Transformers KVA
No. of Luminaire Outlets
No. of Hot'Tubs
Generators KVA
No. of Luminaires
Swimming Pool 'kbo,,e ❑ In- ❑o.
�rnd. grnd.
of Emergency Lighting
1-Batte-ry Units
No. of Receptacle Outlets
No. of Oil Burners
d FIRE ALARMS �No. of Zones
No. of Switches �.
No. of Gas Burners
.,No. of Detection and
Initiating Devices
No. of Ranges
g f
No. of Air Cond. Total
Tons No• of Alerting Devices
No. of Waste Disposers
Heat Pump
_hotIIIS:
Number
Tons
KW No. of Self -Contained
Detection/Alerting Devices
No. of Dishwashers `
Space/Area Heating KW
Local ❑ Municipal ❑ Other
Connection
No. of Dryers
Heating Appliances KW
Security S litems:*
No. of Water
No. of No. of
No, of Devices or Equivalent
Heaters KW
-Suns Ballasts
Data Wiring:
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No, of .Motors Total HP
I clecommunications Wiring:
No. of Devices or E uivalent
OTHER:
Illurh.... V;norur” ,a'nt'i I/J, ;marl• ,;r as ,l ht. ,ilr N„
F.,Aimatcd VJuc of Electrical 1VInk:
S QO, 0(/ (A hen required by municipal polic,,. j
kk urk to Start: Inspections to be requested in accordance with \•IEC Rule 10, Lind upon contpletiurl.
INSLIZANCE •OVERAGE: l.rlless waived by the uwncr. no perntit for the perlorrllancc ofcleUrical work may i :Auc tulle',
III(: licen';ee pruv ides proof of Iirlhility in urancc includim, ",_ontplctcd operation•• coveraee of, its ,tlhtitantial �:cluiv,llcnt. a !1,.
:ndec.i .,ner.l ccrtille: that ' ucli Cu�era",l' I', III It)1'CC, ,Illi) ha, c hihitcd proot cl ,aro to the perntit i! .Elia : oltice.
IIta�Kt>�E: li�`il R.\�.l'1�� 13t;�-I) �] !ift!I•.R ❑ Itih:ccily:;
r 'r'!'!l�)7, I;1Jrr Nee purls ,1.710 JCRt.1//1rt'`' 1 JC'I' .111", Irl fll ?( a rr
• 1 I/ ./ I .Af.'lI�111'.l1�.l1►,,;1.1f.1• r/.7�)llC(1/,(NI!J/l'!r<'r!,°1(�t.'li.'!/)��`/t•.
t ilt,til NAM C:n G LOInE'��L� v�
+_icensee:
4e-y-C._A.__LJAAe,__ •:r, ltatu►ee-a�� r ---_ + d(. rt1.: � ,
1,`,;;'j;ri,.',r.lr:. -:✓r ..'rlal.t .r.i,. Li.t.:, ..r,nti,. ,„�., i�11S. Tel. �O.�Q�83-���.
Address:
Security Sy,tem Contractor License reyuircLi tui (Itis t> t,rk, if applicable clltcr ahc license number here:
1.)WNtF.R'S INSL R,kUCE �bY,kivER: I am ,tvv.ue that the I.i ;en<ee Jr,,.-' 1Ird have the liability insurance c•r • rn'. c 11 f -mall'.
acquired by law. 13}' my below. I hereby '.valve this, rrquir01101t. 1 ;1111 the (cllcck unc) ❑'.>vvnur L] u��ner':, a'l.;nt.
Owner,/Agent---
;rt:itut'c.tfIT 1,W
i
i
e Location 0
i
No.
5!..Date
„ORT„ TOWN OF NORTH ANDOVER
p Certificate of Occupancy $
Building/Frame Permit Fee $
Fou da
�CNtion Permit Fee $
sUSE _
ermit Fee $
Sewer Connection Fee $
Water Connection Fee $
o
TOTAL $ ,=alif
JW Building Inspector
�� l
6811 Div. Public Works
PERJiif NO. r APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
6q
i
AGE 1
MAP 4-40.
I LOT NO.
2 RECORD OF OWNERSHIP IDATE
BOOK PAGE
ZONE
SUB DIV. LOT NO.
LOCATION
PURPOSE OF BUILDING
OWNER'S NAME
NO. OF STORIES I SIZE
OWNER'S ADDR
BASEMENT OR SLAB
ARCHITECT'S NAME
SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME
SPAN
DISTANCE TO NEAREST BUILDING
--
DIMENSIONS OF SILLS
DISTANCE FROM STREET
POSTS
DISTANCE FROM LOT LINES - SIDES REAR
GIRDERS
AREA OF LOT FRONTAGE
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW
SIZE OF FOOTING X
IS BUILDING ADDITION
MATERIAL OF CHIMNEY
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
IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
SEE BOTH SIDES
t PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
/DATE FILED y 6
OF OWt*" OR AU HORIZED AGENT
FEE
G
PERMIT GRANTED
OWNER TEL. #
CONTR. TEL. #
CONTR. LIC. #
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST oO
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
G( G
mulWlNa INuruiumn
1 OCCUPANCY
SINGLE FAMILY 11 1 STORIES
MULTI. FAMILY OFFICES
APARTMENTS
CONSTRUCTION
2 FOUNDATION II8 INTERIOR FINISH
CONCRETE a I 2
CONCRETE Ell. K. J PINE IJ_ _
PLAbI[K
DRY WALL
3 BASEMENT II
AREA FULL FIN. 8'M'TAREA _
y, 1/2 1/1 N. ATTIC AREA
NO BMT
HEAD ROOM
HIP
FIRE PLACES
MODERN KITCHEN
_
GAMBQEL
PIPELESS FURNACE
MANSARD
4 WALLS I 9 FLOORS
CLAPBOARDS
FI ATT
B
_
1
_
2
—
3
_
_
DROP SIDING
WOOD SHINGLES
_
CONCRETE
EARTH
ASPHALT SIDING
ASBESTOS SIDING
_
_
HARD",' D
COMMON
VERT. SIDING
ASPH. TILE
STUCCO ON MASONRY
TILE FLOOR
STUCCO ON FRAME
BRICK ON MAS NRY
BRICK ON FRAME
ATTIC STRS. & FLOOR
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
5 ROOF II 10 PLUMBING
GABLE
I
HIP
BATH 13 FIX.)
WOOD JOIST
GAMBQEL
PIPELESS FURNACE
MANSARD
TOILET RM. 12 FIX.)
FI ATT
SHED
WATER CLOSET
_
ASPHALT SHINGLES
WOOD SHINGES
LAVATORY
KITCHEN SINK
_
SLATE
TAR & GRAVEL
NO PLUMBING
STALL SHOWER
_
_
ROLL ROOFING
MODERN FIXTURES
_
NO HEATING
TILE FLOOR
r
TILE DADO
BUILDING RECORD
12
THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA-
RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
0
6 FRAMING
11 MEATIN{i
--
WOOD JOIST
PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. & COLS.
STEEL BMS. & COLS.
_
STEAM
HOT W'T'R OR VAPOR
WOOD RAFTERS
_
AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS
B'M'T 2nd _
1st 13rd
GAS
OIL
ELECTRIC
NO HEATING
r
W4
Fli
W
0
s•.
o
A
x
m
v
u
°
w°
E
a
cn
04
o
U
z
z
Q
]
o
cz
'
w°
'
C2
v
c
x
U
c
w
1:4
W
z
a
'
a�'
_
�
ii
V.
w
U
x
w
w
'�
n0'
v
'
V)
c
w
x
O
U
U)
�
w
z
a
w
A
w
a
w
ad
v
E
m
z
°
cn
ui
0=
5
2
H
C*
W
H
W
u
COD
H
c
O
•N
.®
C.
co
m
z
m c
E
CD
L
N
CD 3
=
N
ra
R
NN
O
Ea
v
L •G
a�
coC
L
N y
C:
c
c
:a
IRCO
> Z
o
CO
C.
C
tom C
•O
t=
N
CL—O
o
m
ca m
to
t
""
._-� •O =
.Q= R
.
•C
Z
N
CCa = v
Ocm
O
-p C
aoy:_
O
L
0
0
O
U
M
U
W
E
CD
L
0
C.3
Z C13
CL
O CO)
co0
C C
COD
co
.LA co MW W
co 0 co
co
CD L
cc O Q
CL CMa
C
CO)
cc
c
.V J 'O
0 �
C Z CD
�..± V2
� C
—
C
0
J
Z
LL
m
P�
W
CL
cc
z z
O w
Q
Q
W W
z
O 0