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Miscellaneous - 705 BRADFORD STREET 4/30/2018 (3)
Ilk „�jp fa hitPs 11� tr>oreduW canlxjrec«ds1z1032 P.. t if n + -MeftCd Pan* *21082 v .. x wryy Town of North Andover, MA I • iQ --. *Electrical Permit -IN Conjunction with a Building Permit (Commercial or Residential) TIMELINE submission received Aug 10, 2016 ac 12:51 pm ® Electrical Review In Progress s�, Permit Fee vP Mme sc 0 (�j Permit Issuance D__,n,Pnt Your request is in progress We'll let you know of any updates via email. Feel free to check the status at any time by coming back to this page. � CI C Great%rldRd 0 - Attachments -OT93JHI001 F_Wed_Aug_10_2016_16:51:.PDF - - - - - Upbad-tl nuc.s: t�, 201 F, byio<Ya;rnro 1251 P 8)10)201616 LiLi Wednesday, Aug 10, 2016 12:51 PM Joe Joe Vaccaro 705 BRADFORD STREET, NORTH ANDOVER, MA oa,n-r MELTON JR RIX E Attachments -OT93JHI001 F_Wed_Aug_10_2016_16:51:.PDF - - - - - Upbad-tl nuc.s: t�, 201 F, byio<Ya;rnro 1251 P 8)10)201616 LiLi Wednesday, Aug 10, 2016 12:51 PM N, l.ommonwea& o f Maddackmelld Official Use Only c7 n lug 2eparlmenl of gire Serviced Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. l/07] 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: _ q j q / 1 6 City or Town of: Al- r c�y 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) '�p�" -t3rbAgr ck Owner or Tenant Owner's Address Telephone No. Q%q' G%7— 65-71 Is this permit in conjunction with a building permit? Yes Er No ❑ (Check Appropriate Box) Purpose of Building '661" 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: �1 3 J T VV) -e \ S 1')- ,� � 1 rnnmletlan afthe follosvihQ table n:av be waived by thelnspectorof {mires. No. of Recessed Luminaires No. of Cell.-Susp. addle Fans P (Paddle) r o oto Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool rnd. Above n-rnd.Ei cy g ng No. Baatt o ter Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o ete and Initiatin Devices evvices No. of Ranges No. of Air Cond. Tons tal No. of Alerting Devices No. of Waste Disposers P eat ump •_•_um•,. er Totals: ons _ o. oSelf-contained- Detection/Alertine Devices No. of Dishwashers S ace/Area Heating KW P g Local ❑ municipal'❑ Other Cyosnnection No. of Dryers Heating Appliances KW Security of Devices or Equivalent No. of Water KW Heaters o. o o. o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP a No of Device or Equivalent OTHER: Estimated Value of lectrical Work: Attach additionalrletnir yaesiren, or as regtaren oy me ntspecror of Wires.31r 000 (When required by municipal policy.) Work to Start: Z3 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 cove ge 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 and penalties of per jury, that the information on this application is trite and complete. FIRM NAME: K fqS4 &Jee4r%ee. l I h C. LIC. NO.: 16%(b4 is Licensee: l; rbr- L ere Z$e Signature LIC. NO.: (If applicable, enter "exempt" ht the license iunmber /hie Bus. Tel. No.:7-1.22x=(0� Address: I Wof 1*- iNV t ,tuA Voy, . Alt. Tel. No.: 'Per M.G.L. c. 147, s. 57-61, security work requires Departmt 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 PERMIT FEE: $ Signature Telephone No. MMWYYM �R0� CERTIFICATE OF LIABILITY INSURANCE DAA 11MMS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT FEDERATED MUTUAL INSURANCE COMPANY PHONE0 FAA% e HOME OFFICE: P.O. BOX 328 D OWATONNA. MN 55060 ADDRIESS: CLIENTCONTACTCENTERIaIFEDIN3OOM INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 207-673.6 INSURER B: NORTHEAST ELECTRICAL INC ENSURER C. 1 NORTH AVE INSURER a. BURLINGTON, MA 01803 INSURER E: INSURER FS CAvaRArlt:S CFRTIML`ATE NUMRFR* 0 REVISION NUMBER: 0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM& TYPE OFINSURANCE UBR WVDOENERALLIASILITY POLICY NUMBER EPF E%P LIMITS rA X COMMERC►lLLOENERALLIABILITY CLAIMS -MADE FR OCCUR FN N 8884084 12/31/2015 12/31/2016 EACH OCCURRENCE $IAOOAK D 0 RENTED =100,00( MED EXP (My one pawn) O(CLUDEC PERSONAL B ADV INJURY =1,000,00( OINERALA00REOATE ;2,000,00( PRODUCTS = COMPIOP AGO 112,000,00C OEWLA.00REOATE LIMIT APPLIES PER: X POLICY MIPIOT LOC A AUTOMOBILE LIABILITY ALL O AUTOSUUO JMAU(UTOWNED HIR80AUTOS HO*OWNEDTY AUTOS N N 0684085 12/31/201$ 12/31/2016 PIKED ED BINDLE UMIT S11000A« BODILYINJURY (Perperson) BODILY INJURY (Per accidenq 0 AMAOE A X UMBRELLA LIAR EXCESS UAS NX OCCUR cwMs•MADE N N 9884087 12/31/2015 12/31/2016 EACH OCCURRENCE $2,000,0« _ AOOREOATE E2,000,00C DEO I IRETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIH)E OFFICERIMEMBER EXCLUDED? (Mandatory In NH) Itnes, describe unde DESr CAPTION OF OPERATIONS below NIA N 8884086 12/31/2015 12%31/2018 X TORYWCSUOMMMIITT ITS ERS E L EACH ACCIDENTCUTIVE sf,000, OOC LL DISEASE • EA EMPLOYEE $11000100C 91 OtSEASE •POLICY OMIT $1,000,000 DESCRIPTION Or OPERATIONS I LOCATIONS I VEHICLES Wbdi ACORD 101. Additional Remarks Sdmdule, H mon space Is ngolred) THIS COPY IS NOT TO BE REPRODUCED FOR ISSUANCE OF CERTIFICATES. - i T', J bow Anda ACORD 26 (2010105) 00 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORI THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED It ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 0 1968-2010 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD ii t4' The Counuot►lyentlll of Massachusetts Depmllneni of Inditshlat Aceldents Office ofIllyestigntlons IF I Congress Street, Suite 100 Boston, MA 02114-2017 mmp nulss govIdIn Workers' Conitpensation Insurance Affidavit: Builders/Conti•actors/Electrictnns/Pitimbers llcavt Iv o • patio le se Print Le bl Name (Business/Organizatlon/lndividual): Northeast Solar Services Inc Address: l North Ave Suite A Ci /State/Zi :Burlington / MA / 01803 prone #:781.270 - 6555 Are you an emptoycil Check the appropriate box: Type of project (required): 1. ❑✓ 1 am a employer with 12 4. 1] 1 am a general contractor and 1 6 ❑ New construction employees (Mll and/or part-time).* 2. ❑ i ant a sole proprietor or partner- have hired the sub -contractors listed on the attached shoot. 7. ❑ Remodeling ship and have no employees These sub -contractors have employees and have workers' 8. Demolition working for me In any capacity. comp. insurance i 9. Building addition [No workers' comp. insurance required.] 5. ❑ We are a corporation and its l0.[! Electrical repairs or additions 3. Q I am a homeowner doing all work officers have exercised their 11.[] Plumbing repairs or additions myself. [No workers' comp. insurance required.) t right of exemption per MOL c.152, 61(4), and we have no 12.❑ Roof repairs ,Solar PV 13.0 Othe employees. [No workers coma. Insurance required.] 'Any applicant thal checks boxes I toast atso fill oat tlxi section below showingtheis workers compeaselion policy tnroramtton. t Homconners wbo submit 1116 affidavit Indicating they are doing all %%vrk and then hire oulsideconlroclors must submit a now sf idavit Indicating such. 10ontractor3that check this box must attached an addiilonal sheet showing the name orcin sub.coniractors end atato Whether or not Ihose entitles have employees. Ifilio sub -contractors have employees, they must provide their workers' comp. policy number. I nor all ell pioyer III aI is proplrDng workers' conipensallou lnsrrrnnee jar OW eslproyees. Beloty is 11ie p0Uey and job site hi/brnrailon. insurance Company Name: Federated Mutual Insurance Company Policy # or Self -ins. Lic. 8;9884088 Expiration Date:' 12/31/2016 — Job Site Address: 105L F�ta.��at-d S,,-. AI o(�n d10 City/3tatolZip: AA la�$y� Attach a copy of fhe workers' conlpeusatlon policy declaration page (showing the policy number and expiralton date). Failure to secure coverage as required tinder Section 25A of MOL o.152 can lead to the imposition of criminal penalties of a tine tip to $1,500.00 and/or one-year imprisomnent, 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. Bo advised that a copy of this statement may be forwarded to tine Office of Investigations of the DIA for insurance coverage verification. I rto hereby certify noder the po ris andpenalties of perjery that the it orntadon provided above is trite and correct. it e • 781.270.4888 OfJlclnf use oily. Do not write hi this area, fo be 001409190Y cl(p or lova oj]icint City or Town: PerinIt/Lleense N Issuing Authority (elrele 0110: L Board of Health 2. Building Departmeni 3. Cilyfrolvn Cleric 4. Electrical inspector S. 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TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .. /A/ I `....f .&.). />6 �< ......... . has permission for gas installation .......... . in the buildings of ...l .. r:'.�........................... at .7 .A .... .%.' �� � ! `. `.............. . North Andover, Mass. Fee.).?_-... Lic. No../,.-.'. j .... ............ ....... GAS INSPECTOR t Check # J/ 3 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFrMNG (Print orType) AO. A-1 d d P� MA Date—�2o �� —Receipt# Pemtit# In Building Location Ownees Name 4411, %Mw Map: Lot: Zone: Type of Ocr,.rparicy .5%45/e-� 1�1� New Renovation ❑ Replacement ❑ i Plans Submitted: Yes ❑ No ❑ Installing Company Name EASTERN PROPANE & OIL, INC. Address 131 WATER ST DAA -VERS M—A 01923 Estimate Valueof Work: Checkone: Certificate /"* Corporation ❑ Partnership Business Telephone 800-322-6628>% ❑ Firm/Co. Nameof Licensed Plumber orGas Fitter /�;r'04 Uj INSURANCE COVERAGE: 1 have a current li insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy L7 Other type of indemnity ❑ Bond ❑ 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. Checkone: Owner C3 Agent(? Signature of Owner or Owners 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 thatall plumbing work and installations performed underthe permitissued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By Type of License: ����'1�fir�✓� Plumber Signature of Licensed Plumber or Gas Fitter Title Gasfitter Master City /Town gJaumeyman APPROVED (OFFICE USE ONLY) License Number A Revised 05717/00 i �i■�■oma■■m■■u■ mom EMMMMMMMMMEV- NNN Installing Company Name EASTERN PROPANE & OIL, INC. Address 131 WATER ST DAA -VERS M—A 01923 Estimate Valueof Work: Checkone: Certificate /"* Corporation ❑ Partnership Business Telephone 800-322-6628>% ❑ Firm/Co. Nameof Licensed Plumber orGas Fitter /�;r'04 Uj INSURANCE COVERAGE: 1 have a current li insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy L7 Other type of indemnity ❑ Bond ❑ 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. Checkone: Owner C3 Agent(? Signature of Owner or Owners 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 thatall plumbing work and installations performed underthe permitissued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By Type of License: ����'1�fir�✓� Plumber Signature of Licensed Plumber or Gas Fitter Title Gasfitter Master City /Town gJaumeyman APPROVED (OFFICE USE ONLY) License Number A Revised 05717/00 Q D N U) z m -4 n m N T m in Town of North Andover f NORTN q Buil4ing Department 27 Charles Street o North Andover, Massachusetts 01845 * ,� (978) 688-9545 Fax (978) 688-9542 T O'9.. [OLwKM'YKw r, � ��SSACHUS�t�y APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS LOT NUMBER SUBDIVISION DATE REQUEST FILED In 1 DATE READY FOR INSPECTION I FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED I � ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE 1► I cue_ OFFICIAL—USE ONLY 46 ROUTING ! // DATE tot] D.P.W. — WATER METER I D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIG THE PECTION RE UEST DATE. a SI ATURE / P--PAUTHORIZATION 3660, Date .2.7:1.174.04.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING - _.1(2_,,_ /,,' 4 4 ........................................... This certifies that . rz� ..... ................ ..... v ... has permission to perform wiring in the building of ..... ........ 44 ........................... at .... ........ 6 rl�-�n i�� .............. -North Andover, Mass. ... . . Lic. No .............. ................... _e ..... . ... ........... ELECTRICAL INSPECTOR Check # / -"=-2 9 T1HC0MM0AWE4LTH0FA"S" DM34.1Z�OFPMLICS9FE!'P - . BOARDOF)WPREVEWO1t/REGuL4no SS27amiz. D Office Use only —' Permit No. Occupancy & Fees Checked — o� CATIONFOR PERmmTO PER;FnmAELrr-mYf AY WORK ALL WORK TO BE PERFORMED IN ACCORDANCE wrrH THE MASSACHusm ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat T Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street 1 Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: YesMJ No (Check Appropriate Box) Purpose of Building ASE (- 5 ; � J Zy Utility Authorization No. Existing Service Amps/ Volts Overhead L.J Underground New Service Amps / Volts Overhead = Underground Number of Feeders and Ampacity No. of Meters No. ofMeters Location and Nature of Proposed Electrical Work l 4 No. of Lighting Outlets No. of Hot Tubs No. ofTrandbnnets Total No. of Li do Fixtures �' g Swimming Pool Above Below KVA .. . ground MI K VA No. of Receptacle Outlets Na of Oil Bunters " Na of Emergency Lighting BatteryUnits No. of Switch Outlets No. of Gas Bttmers No. of Ranges No. of Air Coad. Total tas FIRE ALARMS No. orzooes No. of Disposals Na of HemPURIM Total 1a Na otlhtectiooand ..... .� Tabs KW btitiating Devices Jo. of Dishwashers Space Ate& Heating KW Na ofSooding Devices Na of S&Cottt fined lo. of Dryers Heati Devices KW DeteetiadSoardidg:Devices Local Municipal Connections E3. Other •� lo. of Wetter Heaters KW No. of No. of ra MQMMW-ND Asst>atitbthes tags c'�ataaii��s . eatatttatLiabthyL�stratmA�tyit�t�tg Co►or�st>l>�at�aietri►ci� y eatlminedw5dpioofdsaneb4teOlf� YI~5 ND IfjwhatedtodaisdYE^�pltaseitid�leiheec�fonB� �afebrDc . `- C_ f fIioalSselVa Signawle Ui�dati Btts�sTdNn AItTeLNa � � �� d 7 7 ER'SMJRANCEWAIVER, Ianawatethatthelx=edneshdteirmratoeao►+aagea s>) atr�erpava>eltas tmy ecatthispe�rrtteppficEdmvm-�$xstecg �t by t Card Laws .e check one) Owner � Agent (� t•'-1 Telephone No. p �� „_PERMIT FEE $ ��(� Location No. 3a3 Date TOWN OF NORTH ANDOVER 0010-, 0 y " Certificate of Occupancy $ sACMUS t� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL Check # � 9 G 15�-65 /M /y Building Inspector 10 3, 3 T'`"sArr'd 0-0 V o ©S- d 5� v.A•D F�j IZD is ~ Oe�P?'. -' ?'�� TTF.! ANDCV ERZ L +� . /s tacs4rWP o v rNE Lor q,S _f-JVM-.✓ A.VO .44r/r.04WS IGLt/iG1�i!/ wrry Ar., &S!Azewzwd-m-dmZ.4re ws ,e+rM.eMW .rErA4c rs Aza n srr s ! or tive's Ir 1 A,407 e..r CE.tr/WY r.V.Ir rA'/,s GOGI rEO /W rA'E ^EACs rG /r O OO / 440ACO 44mlew. Sy""" O/V <<.M.f Cp,a I,yv,ViTy �o4 < 00 z5oeq P> moc ®Joj .vor /ror eovvoty- soavo.�.rr .Ir/O•V r.I .{/ f.�? .: _ .tTi,�/G .�BL�f�OS. PL or do,�Z Aoov /A/ .pe.4/I✓A/ f' le Wiu.LkM BAcpwfT �4oHE5 JAO. i4, Ave-- elA944r E.vd•••vL�E•twfs .sE.er�cEs 64 /4,W .j7'.AfET ,4,voorE,t ,y.+s,�,c,�.vse-rrs oi8io N2 Date......./11c"A N- 3531 ................ °'<�`°„•'"o TOWN OF NORTH ANDOVER .r 0 - PERMIT FOR WIRING This certifies that ........ v! 1........ /....../S .:..,.p .................... has permission to perform ............r ��'!.f/......>% `�:.`.!.•••.................. wiring in the building of .. �I /�� Y�`� ............. ... .................. ... . �vS...... 1 �{c�fi%i r.... .�orth Andover, N16s. -76r / �,�Fee 1.��s (�Lic. No...! ; .::......../...... :............. �ELECTRICALINSPECTOR Check # 1 % WHITE: Applicant CANARY: Building Dept. PINK: Treasurer vmciaii uuse unit' Permit No. 31 />��i '��t:'/Gf'��i1¢.L� /sem �� y%G�'c,5'.S'1¢(%!r•vG.S'�i�%�%� Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be Wormed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number 7 Owner or Tenant � All I 7'% ( ) �- viG J _ P Owner's Address 1 D V l D:?� /✓f /, fL JL Date To the Inspector of Wires: Is this permit it conjunction with a building permit Yes /lq— No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization Existing Service Amps Vats Overhead ❑ Undgmd ❑ No. of Meters New Service % J Amps !4®1 a Voits Overhead fes' Undgmd ❑ No. of Meters %Number of Feeders and Ampacity, Location and Nature of Proposed Electrical Work :I— [VL! INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO = 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 of Electrical Work$ Work to Start Inspection Date Resquested Rough Final Signed under the Penalties of perjury: FIRM NAME `/�M✓LI i r/i� �T % �L� G %'�iC LIC. NO. /J /I Bus. Tel No. Address IAI n I t Q -TZ L/J J)�til/✓ Alt Tel. No. OWNER'S INSUkKNCE WAIVER: 1 am aware that the Licenses does not have the insurance coverage or ftfi substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMITTEE $ v , (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above ❑ In ❑ No. of Lighting Fixtures Swimming Pool grnd ❑ gmd ❑ Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners Battery Units No. of Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. of Ran es No of Air Cond Tons Initiating Devices Heat Total Total No. of Di sal No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices ❑ Municipal ❑ Other No. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Bailases Wiring No., Hydro Massage Tuds No. of Motors Total HP INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO = 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 of Electrical Work$ Work to Start Inspection Date Resquested Rough Final Signed under the Penalties of perjury: FIRM NAME `/�M✓LI i r/i� �T % �L� G %'�iC LIC. NO. /J /I Bus. Tel No. Address IAI n I t Q -TZ L/J J)�til/✓ Alt Tel. No. OWNER'S INSUkKNCE WAIVER: 1 am aware that the Licenses does not have the insurance coverage or ftfi substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMITTEE $ v , (Signature of Owner or Agent) 0 Date. .......... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that . ��J�!'.!!".'.. (..!............ has permission to perform .....}� .......................... plumbing in the buildings of .... %. °.�� ,.! 7 ............... . at .. �< ?...l.� ! �./ ^c r� �� ............. North Andover, Mass. Fee. Lic. No.. . ........ PLUMBING INSPECTOR Check # > > 7 5117 A i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS r Date Building Location �aS Owners Name 6cAT%-C' Permit # Amount Sr�O Type of Occupancy New a Renovation Replacement ri Plans S FIXTURES Yes,r,-J' No 13 (Print or type) Check one: Certificate Installing Company Name e, orp.4 q66 Address `ry1 o Partner. �— Business Telephone CL? y _� Firm/Co. Name of.Licensed Plumber: Insurance Coverage: Indicate the typeof insurance coverage by checking the appropriate box: ITLiability insurance policy Other type of indemnity ❑ Bond Insurance Waiver. I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance ignature Owner M Agent 1-1 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 Massachuse Statbin ode and Chapter 142 of the General Laws. By: Signal nse um er Type of Plumbing License Title City/Town i ense um Master 11, Joumeyman F] APPROVED (OFFICE USE ONLY 0 Date ........ TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that... ..!:'. .... ...�..... .� .. ......... . has permission for gas installation ..../�.:.�.. J ....... ....... . in the buildings of ....... 1?.F:.....'-'......................... at .............. .�.. .` .... , North Andover, Mass. Fee.... ..... Lic. No..1........ 1. .........L................. .GAS INSPECTOR Check # 3 �' MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations Owner's Name New [ Renovation ❑ Replacement ❑ Date t — k 1 -0 -2 - Permit dZ Permit # Amount $ 7 c�7v Csryrr Plans Submitted ❑ Name of Licensed Plumber or Gas Fitter ` / Un A lee- 1. —11, Qggk one: Certificate Ins fling Company Yporp. U ❑ Partner. ❑ Finn/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No ❑ If you have checked yes, please indigate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 13Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 ofthe Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent 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 Massachusetts State Gas Code aid CIjeter 1,4*2%f the General Laws. OVER (OFFICE USE ONLY) S'gnature of] lumber ❑ Gas Fitter Master ❑ Journeyman sed Plumber Or Gas Fitter jW Wr Licerlse Numer • Name of Licensed Plumber or Gas Fitter ` / Un A lee- 1. —11, Qggk one: Certificate Ins fling Company Yporp. U ❑ Partner. ❑ Finn/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No ❑ If you have checked yes, please indigate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 13Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 ofthe Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent 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 Massachusetts State Gas Code aid CIjeter 1,4*2%f the General Laws. OVER (OFFICE USE ONLY) S'gnature of] lumber ❑ Gas Fitter Master ❑ Journeyman sed Plumber Or Gas Fitter jW Wr Licerlse Numer 13661 6.1 -51 Date ............. . TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... .......... �., . ............................................ has permission to perform ................................................... wiring in the building of ...... A. ...... ................. -<-7 ... ............ North Ando ,�ise at 44 �nj . .., r .... . .... sytr ,.5. .......... ..... Lic. No. " .i..Ie.'Feea..�_ ... x�� ELECTRICALNSPECrOR Check I — T1IEC0MM0NWF-4LTH0FMA,MCHIWM DFPARTMFM'OFPMMCS-i E - . BOARDOFFIREPRE IEWONA%VL4HOAN527(MIZW Office use owy IPem�it No. ccupancy & Fees Checked AA AALICATTONFOR -r F-mYJ 1 TO rr" URIVI.EL, UMCAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wim, The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) Owner or Tenant %',�} /ice Owner's Address Is this permit in conjunction with a building permit: Purpose of Building -Aj•oor� Existing Service Amps Volts New Service Amps ..L.Volts Number offeeders and Ampacity Location and Nature of Proposed Electrical Work i No. of Lighting Outlets No. of Lighting Fixtures No. of Receptacle Outlet A No. ofSwitch Outlets No. of Ranges No. of Disposals Vo. of Dishwashers lo. of Drye s lo. of Water Heaters o. Hydro Massage Tabs 'HRR• /� �/% Yes =No Q (Check Appropriate Box) No. of Hot Tubs Svrimming Pool No. of Oil Bument No. of Gas Burners No. of Air Cond. No. of Heat Space Area Heating Heating.Devices No. of Signs No of Motors Utility Authorization No. Overhead L, j Underground E No. ofMeters --- Overhead 0 Underground No, of Meters G Below Generators K.VA ground KVA Na Of Emergency Lighting Battery Units To FIRE ALARMS No. ofZonEs Ton oral Trial Na ofDetection and obs Kw hitiatingDevices KW Na ofSwndieg.Devices No. ofSaircoetnioed DatectiariSoandntg.'Devices KW Lomat Municipal 001;r E No of connections MMCoMW- Ats�nntb9teragtritorla�s�Cterlaaila►ks . eaanartIiabTtyltzsrartaeptilicyirtdtrdrlg Cov�slbAartialetri►eiatt Y NO e%hn1iitedM0tGdp1oofo1samelD t O&t YES NO ffjwlta►edtedoadY6�ptease' mriabbcm A2AlJCE BUND Q►� t :bSart bn==LWNaPzW HMO- INANEI u A 49174-r- w/dlo-2 9 �.�% Q' Lite wNa �Ys Ke 170 J -e V� Si/ i1 J vv--- ,,x'1 .�` /�Z�GG/ I�oa>seisb _2 a C/ .7 17 �/l � f� %ir=TelNa 97�'i-lo 354.e-2-- � t1 %(�1 —� �� AltTdNtz T�','SPNEURANCEWAIVER;lamas;meti vdrLicrnserinevnot}l dritmmr=aNPep-its �H,,»,Watas trnysaerntlas�by�CslaalLaws p�� thisle�r,�,c � LG wY1PnC�-P� . ee check one) Owner Agent Telephone No. PERMIT FEE G"' Date. . `.! .. �... . ............ . r. " - � °� TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ................ has permission for gas installation in the buildings of...I...................................... . at ........ . . . . .. . . . . . . . . . '. . . . . . . . . . . . . , North Andover, Mass. - Fee .......... Lic. No...!:...:. GAS INSPECTOR Check # 5 C , 3; MASSACHUSETTS UNIFORM APPUCATON FOR PERNUr TO DO GAS FITTING (Type or print) Date. L NORTH ANDOVER, MASSACHUSETTS ` Building Locations Permit # d -0' 1 Amount $ Owner's Name ,A�-r_ New EIK Renovation Replacement 1:1 Plans Submitted Check one: Certificatetalling Company [][-Corp. Partner. 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 13 No 13 If you have checked }_es, please mdic e the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity E] Bond 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 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 Massachusetts State Ga�,+dejapd Chir 142 of the General Laws. (APPROVED (OFFICE USE ONLY) nature of Licensed Plumber Or G tter III Plumber / I()P ) 0 G s Fitter cense um er NIaster MJourneyman x w U z H a z Z o Z w � w z H z w w a w U a z> -1!4H z a o w w o° o° O w O A C7 a U a 9 A a F O SUB -BA SEM ENT B A S E M ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6 T H. F L O O R 7TH. FLOOR 8-T H. F L O O R Check one: Certificatetalling Company [][-Corp. Partner. 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 13 No 13 If you have checked }_es, please mdic e the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity E] Bond 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 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 Massachusetts State Ga�,+dejapd Chir 142 of the General Laws. (APPROVED (OFFICE USE ONLY) nature of Licensed Plumber Or G tter III Plumber / I()P ) 0 G s Fitter cense um er NIaster MJourneyman Location `1d5�A�I�� S No. `3C;�.3 C Date T-°�� Oa. TOWN OF NORTH ANDOVER Certificate of Occupancy $ • s, a s�CMus Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ a S TOTAL $ 1-2S Check # 1541,7 Building Inspector . -J Town of North Andover Office of the Building Department Community Development and Services Division William J. Scott, Division Director 27 Charles Street D. Robert Nicetta North Andover, Massachusetts 01845 Building Commissioner CHIMNEY APPLICATION AND PERMIT DATE LOCATION �� d / 10 n �t OWNER'S NAME BUILDER'S NAME ti MieS MASON'S NAME MASON'S ADDRESS MASON'S TELEPHONE MATERIAL OF CHIMNEY INTERIOR CHIMNEY EXTERIOR CHIMNEY NUMBER AND SIZE OF FLUES THICKNESS OF HEARTH Telephone (978) 688-9545 Fax (978) 688-9542 PERMIT # <3CD3 (�- Will chimney or fireplace conform to requirements of the code and have rules and regulations been received: DATE SIGNATURE OF MASON CONTR. LIC. # EST. CONSTRUCTION COST/CONTRACT PRICE PERMIT GRANTED_��o� QoZ FEE: ' ROBERT NICETTA, BUILDING INSPECTORT'�j�/� INSPECTED REMARKS SOLID BRICK REQUIRED THIS PERMIT MUST BE DISPLAYED ON THE PREMISES BOARD OF APPEALS 688-95=11 BUILDING 688-9545 CONSERVATION 68 8-95 30 HEALTH 688-9540 PLANNING 688-9535 -7 i3ra d +-o r,6 "-WOOD STOVE INSTALLAHON CHECKLIST F'=".FIST IIU: Permit A building permit is required for the installation of any ;olid fuel burning appliance. The building permit and installation inspection are limited to the stove installation and not to the stove construction. t Stove A. New ,� Used S. Type/radiant Circulating C. Manufacturer �& r'fi'I, s +o N e Lab. No. Name/Mcdel No. r"' 0 d e X 9 a Collar size Dime nsionsiHeight 96 11 Length Lis ., Width e rr +o toyraA,% enCtosed'', Chimney A. New Existing S. Size (flue area) C. Other appliances attached to flue (Number and flue size) _,iloy te, 0. Prefab (Manufacturer—name and type) E. Masonry/tined f=lue liner type 6 manutacturu) Unlined F. Height (refer to diagrams) cap t i-111VIN= T HEIGrIT Hearth (non-co&Vtible) A. Materials ii I e B. Sub -floor construction U 6.,r\ E C. Minimum dimensions (refer to diagram) Pir Clearances and Wall Protection (see stcve inEtallat:cn c!e=_rances chart) A. Type of wall protection provided ► i I 'P- Or G4- 6wC, B. Clearances (refer to diagrams) R e--rr She d' e -C I ced FIREPLACE "°bORr•lER HEARTH WALUCENTER. ayIODEL 9Q INSTAt-u{ ""'" Height of irisaation infill 41' concre block mortar m front sh( 1 1/21, _ oven ti] 1„ lean anent 4" cont H tar-�k '-6 LP ;al 3shing er ]ointS BVI concrete b Odr, a011w' , a � 4- 1 ORDERING PARTS MENTIONED ON THIS PAGE CONTACT EARTHSTONE 800-840-4915 OR YOUR )L.IER. �r,(,10DELS 60 & 90 & 110 USE 6 INCH INSIDE DIAMETER GREASE DUCT/BUILDING HEATING APPLIANCE CHIMNEY CHIMNEY ROUND TOP (P -CT) CHIMNEYS FOR RESIDENTIAL -TYPE LOW -HEAT APPLIANCES SHOULD EXTEND AT LEAST 3 -FT STORM COLLAR (SC -C1 ABOVE THE HIGHEST POINT WHERE THEY PASS THROUGH THE ROOF OF A BUILDING AND AT LEAST 2 FT. HIGHER THAN ANY PORTION OF A �FLASHING BUILDING WITHIN 10 FT. OF THE CHIMNEY. ► �--- ROOF BRACE KIT (RBK) IF REQUIRED EXISTING ROOF IF A CEILING OR WALL DOES NOT HAVE A FIRE RESISTANCE RATING AND IS PENETRATED BY A MODEL PS GREASE DUCT INSTALLED AT THE CORRECT MINIMUM CLEARANCE FOR UNENCLOSED DUCT, THEN AN ENCLOSURE MAY NOT BE REQUIRED AROUND THE DUCT SHAFT. REFER TO LOCAL JURISDICTION AUTHORITIES. EXISTING CEILI 3" MIN CLEARANCE TO COMBUSTIBLES REQUIRED FOR SELKIRK METALBESTOS MODEL IPS Cl 15" FIGURE 18 80" SELKIRK METALBESTOS IPS Cl UL LISTED GREASE DUCTIBUILDING HEATING APPLIANCE CHIMNEY 3" MIN. CLEARANCE TEMP. GAUGE FLUE TO PRIMARY HOOD VIA ADAPTER SLEEVE FOR SELKIRK MODEL IPS -C1 (SUPPLIED) THIS DIAGRAM GENERALLY DEPICTS THE INSTALLATION REQUIRED TO MAINTAIN THE U.L. LISTING OF THE OVEN FOR THIS TYPE OF VENTING APPLICATION. FOR SPECIFIC INSTALLATION REQUIREMENTS REFER TO SELKIRK METALBESTOS MODEL IPS GREASE DUCT INSTALLATION 8. MODEL PS AND IPS GREASE DUCT COMPLIES WITH NFPA, SBCCI, ICBO AND BOCA WHEN PROPERLY INSTALLED PER ITS INSTALLATION INSTRUCTIONS. CONTACT LOCAL AUTHORITY HAVING JURISDICTION REGARDING FIRE RATED DUCT SHAFT. NOTE: OTHER U.L. LISTED SYSTEMS MAY BE SUBSTITUTED FOR THE METALBESTOS SYSTEM DEPICTED IN THIS DIAGRAM. -TO MAINTAIN THE U.L. LISTING OF THE OVEN THE SYSTEM MUST BE A U.L. LISTED GREASE DUCT WHICH IS ALSO A U.L. LISTED BUILDING HEATING APPLIANCE CHIMNEY INSTALLED IN ACCORDANCE WITH THE MANUFACTURER'S GREASE DUCT INSTALLATION INSTRUCTIONS. v`';'j?DA1Vc>Iw;.° I NCE TNS; '_v COMA,... Date.. t/: 3 . ` .'.- TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .. !-?� .':.... _%.... ! .:.... . has permission to perform .....A y. ` ". plumbing in the buildings of ....'�- ................ at ...�?.c".). .P)A/-a c� !CC <<............ .North Andover, Mass. r , Fee ? .' ... Lic. No... ! ....... I .............. PLUMBING INSPECTOR Check # C C 5192 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location � s 13r1kJ S Owners Name of New 01-� Renovation M Replacement FIXTURES / I -.- Date Q U 316 L Permit # Z— Amount 3 L r, Z Plans Submitted Yes ❑ No E] (Print or type) ,�I �,,n, Check one: Certificate Installing Company Name 1l�1, j� AC, ©, Corp. f 5.d 6 Address%®� �� 7� / Partner. LFi �` ! 1 ❑ Busyness Te ep oFirm/Co.Firm/Co.Name of Licensed Plumber: 97 F-3 3 � Z-1 -?/ (/ 3 Insurance Coverage: Indicate' -the pe of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance ygnature Owner 11 Agent 11 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 Massachusetts e Plu N g Code and Chapter 142 of the General Laws. BY rgna urero rcense r Type of Plumbic License Title i� City/TownrL cerise 1Pum er Master y Journeyman ❑ APPROVED (OFFICE USE ONLY u w 11 CERTIFICATE OF USE & OCCUPANCY Building Permit Number 3C>'?3 Date 66 -1l —Gc�, THIS CERTIFIES THAT THE BUILDING LOCATED ON r70\5- BP8J 6R0J 1 MAY BE OCCUPIED AS 31/V Je- Fla'"I A M e- IN ACCORDANCE WITH THE PROVISIONS OF THE MASS 11 SETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. �o0'N► s r 3 8 k t+tS a t 1 v !v -. Z CERTIFICATE ISSUED TO e X Ae /4 /) Building Inspector A..' YAL \� L PC �: mm L .r C'1''� c v 1 `0 �Ea cl) � \: L v � � Z o m U cm 2d me E O1 CA m 3 r rm co O cc r4: U til: av g m a �• H m � VJ c1 W Q� ♦: a,CL O • m O lam. ev S Z o O : .: •coo c C2,a m ` e cp •o = m CA N ~ �O+ m a y0„ m L y C O L m •... LU OZ ate+ H .ca d� <D Z oc �E vs o C-3 co CL m Z R cm'� O F. 0D O CD O O D I ca O H .E CD s �r C O Q Q _Q CL CO2 O O v o. CO) C O LDO C Q CO2 W O v d CO2 C CD of C O .0 0 � O O mm 3� co 0 Q Q 0. = Q:4 � C O O O CO Z CD O. y C 0 U) 0 w w Irw U) 04 -S CD `''ON �� oj u u T O v �� SIN) w O Q L b xG c a w u 2 c v G O 1i� v z up. cn w° U w w cn cn �: mm L .r C'1''� c v 1 `0 �Ea cl) � \: L v � � Z o m U cm 2d me E O1 CA m 3 r rm co O cc r4: U til: av g m a �• H m � VJ c1 W Q� ♦: a,CL O • m O lam. ev S Z o O : .: •coo c C2,a m ` e cp •o = m CA N ~ �O+ m a y0„ m L y C O L m •... LU OZ ate+ H .ca d� <D Z oc �E vs o C-3 co CL m Z R cm'� O F. 0D O CD O O D I ca O H .E CD s �r C O Q Q _Q CL CO2 O O v o. CO) C O LDO C Q CO2 W O v d CO2 C CD of C O .0 0 � O O mm 3� co 0 Q Q 0. = Q:4 � C O O O CO Z CD O. y C 0 U) 0 w w Irw U) -S CD �: mm L .r C'1''� c v 1 `0 �Ea cl) � \: L v � � Z o m U cm 2d me E O1 CA m 3 r rm co O cc r4: U til: av g m a �• H m � VJ c1 W Q� ♦: a,CL O • m O lam. ev S Z o O : .: •coo c C2,a m ` e cp •o = m CA N ~ �O+ m a y0„ m L y C O L m •... LU OZ ate+ H .ca d� <D Z oc �E vs o C-3 co CL m Z R cm'� O F. 0D O CD O O D I ca O H .E CD s �r C O Q Q _Q CL CO2 O O v o. CO) C O LDO C Q CO2 W O v d CO2 C CD of C O .0 0 � O O mm 3� co 0 Q Q 0. = Q:4 � C O O O CO Z CD O. y C 0 U) 0 w w Irw U) Location���`'� No. a Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ ;s Eta' Building/Frame Permit Fee $ s�cMus Foundation Permit Fee $ —� Other Permit Fee $ TOTAL $ S Check # 3 7p) o 15 2 9 / Building Inspector 1.1 Pr city Address: 1.2 Assessors Map and Parcel C6 a Map Number Number: a '13 Parcel Number 1.3 Zoning Information: 71 51n Zoning District Proposed Use 1.4 Property Dimensions: L4(,78'( Lot Area(sf) SOb-� Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R 'red Provided Required Provided 30 a Lf y&0+ a as + 1.7 water S M.G.L.C.40. 54) Public EPrivate ❑ 1.5. Flood Zone Information: Zone Outside Flood Zone t� 1.8 Municipal Se—werag/e Disposal System: LtV On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIPJAUTHORIZED AGENT 2.1 Owner of Record _Q ex e, 1177 >ti 90 (3 o.ar 9a b -J o r tk An d 00e r - N me( t)Address for Service SiYn.t&Z Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Ui M ia.A qua.,rreik" c� Licensed Construction Sripervisor: `0 y Q 7-L)'-'nS ip 1 License Number Address 14� Xo %3 a Expiration Date Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone z 93�:i� SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6) I A 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 buildi rmit. affidavit Attached Yes ....... No ....... 0 —Signed SECTION 5 Descriptignof Pro osed Work(check all applicable) New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: II`` S--(NL)c T 10YO d Com, L in o cry C c� '\ Y% Ll )'I A - CA_ 01 Cat- (i a/ -aa. o Un er- SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by rnut a plicant OFFICIAL USE E31TLX x..rr m� �r 1. Building LID, non (a) Building Permit Fee Multiplier Soo t-,7 5o' — O 3� 2 Electrical JKI (b) Estimated Total Cost of Construction 3 Plumbing 1 QO0 Building Permit fee (a) X (b) 4 Mechanical (HVAC) 5 Fire Protection Npr 6 Total 1+2+3+4+5) a 70, on o Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, Ann r as Owner/Authorized Agent of subject property. Hereby authorize M \ am, (2w. r rc.- 'V to act on My 11 isnatters / work authorized by this building permit application. Vi lrrtNt�_ Signa ire 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 s Print Name Signature of Owner gent Date � NO. OF STORIES I SIZE rig VC044ar KSY'QJe BASEMENT OR SLAB c SIZE OF FLOOR TIMBERS 1 s 2 3 SPAN L 9 —a0' DEVIENSIONS OF SMLSH.),-Ja DIA ENSIONS OF POSTS 1r DMIENSIONS OF GIRDERS W j HEIGHT OF FOUNDATION RTHICKNESSU) SIZE OF FOOTING I '-kAy X MATERLAL OF CHIMNEY {+1 CV- IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Ics E Vt 14c> vwq. 9 - FORM U - LOT RELEASE FORI'41 INSTRUCTIONS: This form is used to verity 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. *******,***APPLICANT FILLS OUT THIS SECTION""" ` APPLICANT L. i l l i 0r -n 8Ct r rC LOCATION: Assessors Map Number % oa SUBDIVISION STREET 13 ro- A4Co r S -t-. ************* ** * * * ******OFFICIAL USE RECOMMENDATIONS OF TOWN AGENTS: r / CONSERVATION gMINISTAATOR ��'c-E- �1C-sCcrlS�tic%w i•e.J°eVh V* COMMENTS TOWN PHONE L2 a -Q,3a O PARCEL LOT (S) ST. NUMBER _:7 % DATE APPROVED _J/--2fb1 DATE REJECTED DATE APPROVED DATE REJECTED COMMENTS 7 l.e1w 1 FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PE FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR Revised 9\97 jm p.% DATE MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.0 CITY: Lawrence STATE: Massachusetts HDD: 6235 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 10-25-2001 DATE OF PLANS: 10/20/01 TITLE: The Melton Residence PROJECT INFORMATION: Bradford St COMPANY INFORMATION: William Barrett Homes COMPLIANCE: PASSES Required UA = 647 Your Home = 645 Permit # Checked by/Date Area or Insul Sheath Glazing/Door Perimeter R -Value R -Value U -Value UA CEILINGS 1018 38.0 0.0 31 CEILINGS: Raised Truss 2000 38.0 0.0 51 WALLS: Wood Frame, 16" O.C. 1780 21.0 3.0 92 GLAZING: Windows or Doors 412 0.350 144 DOORS 110 0.350 38 FLOORS: Over Unconditioned Space 2560 25.0 97 BSMT: 8.0' ht/6.0' bg/2.0' insul. 1280 15.0 192 HVAC EFFICIENCY: Furnace, 86.0 AFUE COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4. Builder/Designer -4Z@LADate 1011,96- Qj GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT TOWN OF NORTH ANDOVERBUILDING DEPARTMENT This form shall be used to assist the Building Department in their determination of exemption under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The applicant shall provide all of the necessary information as requested below. P, ex 0'\e I---o1k) 5---. Caul b,3 Permit Applicant Property address Map / Parcel • Applicant's Phone Number 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 Growth Management Bylaw. I also understand providingthis 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 bylaw, provided that no additional residential unit is created. _v�The lot(s) was / were created prior to May 6, 1996 and are exempt from the provisions of 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 are met and or represents dwelling units for senior residents, where occupancy of the units is restricted to senior citizens 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 part of a development project which voluntarily agreed to a minimum 40 %permanent reduction in density (buildable lots) below the density 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 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 bythe 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 and 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 ]at which is ready for a building permit ( 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 submit an approved FORM U with this EXEMPTION. PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A DETERMINATION THAT THIS APPLICATION IS ALLOWED UNDER 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 OR INACCURATE INFORMATION OR THE CHECKING OFF OF A ABOVE EXEMPTION WHICH DOES NOT COMPLY, WHETHER DONE TO MY KNOWLEDGE OR NOT IS GR0,11DQS FOR REFUSAL BY THE BUILDING DEPARTMENT TO ISSUE A BUILDING PERMIT. x APPLrCAWS SIGNATURE DATE THIS FORM TO BE ATTACHED TO THE BUILDING PERMIT APPLICATION The .Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print I Name: Location: city Phone F7 I am a homeowner performing ail work myself. F7I am a sole proprietor and have no one working in any capacity L / �I am an employer providing workers' compensation for my employees working on this job. CCompanv name• G61 nen ux l 1)111n4e yoej e rin ale C.yi 111 ae7l Aarre ff ex Address 1042 Tyin ,oi bCt St" City A,)0 dove Phone a- a 3 a O Insurance Co Mi.r�viat.n� Ga.S✓a��v n6Aadrty Policv# ttJG `7SS'37G 970 �r - Comoanv name: Address City: Phone #: Insurance Co. Policv # 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 civil penalties in the form of a STOP WORK ORDER and a fine cf ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify un jtffi�pa� and penalties of perjury that the information provided above is true and correct. Signature ���%ca Date Print name �.l% (f tara� �J rr�-l-f- _• Phone Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensina ❑ Building Dept ❑Check if immediate response is required ❑ licensing Board ❑ Selectman's Office Contact person: Phone »: ❑ Health Department ❑ Other Town; of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 I DEBRIS DISPOSAL FORM t4aRTH A- 9 7 O�R�T�� rPP,y'(y 9SSACHUS�'� In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in /at: Facility location I Signature of Applicant Dat NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. ✓�iG lUU//6iI[4/[lUC[Ll[J[U` �:llsu[[[;�![,[r!!a BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 052241 Birthdate: 10/10/1952 Expires: 10/10/2001 Tr. no: 7876 Restricted To: 00 WILLIAM K BARRETT. 1049 TURNPIKE ST N ANDOVER, MA 01845 Administrator 1. 2. 3. 4. 5. 6. 7. i REQUIREMENTS FOR BULDING PERMIT SIGNOFFS BY BOARD OF HEALTH To be filled out by the applicant and submitted with the Building Perini application What' is the proposed project? Deck pool addition other Are plans attached? (For additions and new houses on septic systems, complete floor plans of proposed construction and any existing house must be submitted. For pools and decks, a site plan with location of pool or deck is required. Dimensions of deck are needed.) I Is municipal sewer available at this location? If sewer is available and a house already exists, is it tied in to the sewer? i Is the location served by private well? i If this project is an addition and the house is served by a septic' system, has there been a Title 5 inspection done recently on the septic system? If, yes, is the inspection report on file at the BOH? new house Yes No Yes No Yes No Yes No Yes No Yes No J.VVILLIAM HMURCIAK, P.E. DIRECTOR TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 DRIVEWAY PERMIT Telephone (978) 685-0950 Fax (978) 688-9573 F ON v 5 2,4➢l->P—l7 Ste' BUILDER phone OWNER G IZY-i/L,�q s3 %T �o�t — hone X 78 -Gg z - 23 Za THE NORTH ANDOVER SUPERINTENDENT OF OPERATIONS MUST BE NOTIFIED OF THE GRADE AND SETBACK FROM STREET. CALL THE SUPERINTENDENT'S OFFICE BEFORE FINISH GRADING AND SURFACING FOR APPROVAL OF SUCH ENTRY. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. X 17-42 APPLICATION FOR SEWER SERVICE CONNECTION North Andover, Mass. C/C�� /� 49,-- Application ,}gamApplication by the undersigned is hereby made to connect with the town sewer main in-5heet— subject to the rules and regulations of the Division of Public Works. 9 % The premises are known as No. 7 l]-;) ,�/� el-tv'r Street or subdivision lot no. Owner Address Contractor Addres goel -\11 plicant's Signature PERMIT TO CONNECT WITH SEWER _9 f-/1' - The Division of Public Works hereby grants permission to to make a connection with the sewer main at ( -=li subject to the rules and regulations of the Division of Public Works.. Inspected by Date Street Division of Public Works Bv See back for rules and regulations APPLICATION FOR WATER SERVICE CONNECTION �l North Andover, Mass. � tre Application by the undersigned is hereby made to connect with the town water main in et, subject to the rules and regulations of the Division of Public Works. Thepremises are known as No. �� ��� � Street or mon lot no.L A0 14,1 1041 v -m '0 Owner Address Contractor jAddr ssp icant"s Signature PERMIT TO CONNECT WITH WATER MAIN 9 C. // a The Board of Public Works hereby grants permission to to make a connection with the water main at subject to the rules and regulations of the Division of Public Works. Inspected by Date Street �y—�— Board of Public Works By See back for rules and regulations A N _t c C CL N a w N Et- 4° a G o o 0 c6 va NNI 0 � "46 w o m w IUL0 C3 1� W3 � LU w � rD um aj ruLn '?l �M O.L z � .o o c 3 ® o M�. � .3 y � 0 o SO : °- O u b - Ln 4- a, to a) 0a°i u c u- cc Co �`'• ., o urns O �• _ x c v a = O CLC m a c V w p C �s 0 o N C W E a` c o o f W y N N CL m Ln fD .�C O O t O .., C �1 g L z =M 0 F A ci cgi U � z z oz co wo 02U cu w 0 W to ao' ca w x 0 ER W � E� �2 chi co w W z C2 —co ii � w 0:) cin cn .c3 v \ a� : C g eo m C �L O 1r! o a V:+ N EE�� �o o • �: tl r rm ei m c : �//�, a t J' 2 r H L o : L. 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