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HomeMy WebLinkAboutMiscellaneous - 72 MABLIN AVENUE 4/30/2018i Date ....��....�P................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........1..." �i1...................c f.............................................................. has permission to perform A ...... .V61)� �(`A2 winngi''n the building of.. .t. . �'. ?!.......................................................................... at...........C. ................................. , ...... / ................................... . North Andover, Mass. �� Lic. No. —Ti ... Fee-,..:..,.... ......... ELECTRICAL INSPECTOR Check r1 284'? -I j �� 1--P ,?-a1k vy\. 1 t'Z I 1 `� � A �onunsrvicaea.CEh. of Y11! ae3ach•use Official U1�se(C�h�l� Permit No. y � �inpn.rfxi;,un1, o¢ ire �eruices Occupaz;cy and Fee C't.ecked � ' SCARD OF FIRE PREVENTION RFGU_/-,TIONS pzev.,toil (►C vc-L!.«<< j /-',PP L KC., A;TILt� F7- R P LRI'4ti,1 y 7. P ERFORAIE ELECTFUGA artOR Ali wort: to be pet t imce in accordance \vith the \Mass:;citusegs Elecn-m I Code (MLC1. 52'' CA9R 12.00 �"� �PL,E S.L I'r17%�t7'IA'.1/1K C:1 :1 FPE,�L?_. IAtt t R,d/;4TICly; Date; 11/4115 l Citi, of Town of: North Andover To the inspector ` - -By this 0 __ intct�tion is perform the elect icai v, of k described below. L,oc2tiout (Stree(- & Number) 72 Mablin Avenue North Andover, Teteptlone No. 978-208-1473 Owner or Tenant Brian Birchall 0),mwr's Address 72 Mablin Avenue North Andover Is this -permit ixi conjunction with a building permits Yes No ❑ (Check Appropriate PON) Purpose of Build ng residential Utility Authorization No. Existing Service 200 Amps 120 /240 Volts Overhead ❑ Undgrd ❑ Na. of Meters 1 New Service Amps 1 Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Arnpacity Location and Nature of -Proposed Electrical Work' install 24 solar panels on roof C.mmnletion of the following table may be waived by the Inspector of Wires. Attach aQairrunat druu y —, ", -- ....1.. -- — - -- ---c---._ -.1 Estimated Value of Electrical. Work: $23.250 (Vi,'hen required by municipal policy.) Woric to start: TB D Inspection 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 cov age is bi force, and has exhibited proof of same to the penilit issuing office. CHECK. ONE: INSURANCE M BOND ❑ OTHER ❑ (Specify:) I certify, under t)te aims and penalt" ews of perjury, that the information are this application is true and complete. C X FORM NAME: KJ E leC F -Y- C, LIC. NO.: AgLI23 signature LIC. NO.: �(0 Licensee:-rarIK A. KSihL9 gn (�-1'applicable, enter "exempt" in the license rru abet• line.) Bus. Tel. NO Address: R o -e (u 50111 N@IU t el olyd �f Alt. Tel. No.: b8-400- 8 Per M.G.L. c. 147 s. �7-61 security urork requires Department of Public Safety "S' License: Lie. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does rot have the liabitity insurance coverage normatly 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. -- o. o Total No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans Transformers ICVA No. of Luminaire Outlets No. of Hot Tubs Generators ICDA No. of Luminaires A r-ru� e ° d Swimming Pool ❑ . ncy ug ng Batt Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones N`o.-5TDctecflon an No. of Switches No. of Gas Burners Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of AlertingDevices No. of Waste Disposers Heat amp Totals; um "er Tons No. 6f Self -Co utaiue DetectionlAleDevices No. of Dishwashers Space/Area heating KW municipal I oAA ❑ Connection ❑Other HeatittQ A Esances KVEr pp ecui~ttl' !TT_ No. Devices or Equivalent No. of Dryers a of o. o atero. of No. 11 Data Wiring: , Heaters Si9w Ballasts No. of Devices or Equivalent i3P T ecommunications Wiringg: No. Hydromassage Bathtubs No. of Motors Total No. of Devices or E uivalent OTHER: install 24 solar panels on roof Attach aQairrunat druu y —, ", -- ....1.. -- — - -- ---c---._ -.1 Estimated Value of Electrical. Work: $23.250 (Vi,'hen required by municipal policy.) Woric to start: TB D Inspection 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 cov age is bi force, and has exhibited proof of same to the penilit issuing office. CHECK. ONE: INSURANCE M BOND ❑ OTHER ❑ (Specify:) I certify, under t)te aims and penalt" ews of perjury, that the information are this application is true and complete. C X FORM NAME: KJ E leC F -Y- C, LIC. NO.: AgLI23 signature LIC. NO.: �(0 Licensee:-rarIK A. KSihL9 gn (�-1'applicable, enter "exempt" in the license rru abet• line.) Bus. Tel. NO Address: R o -e (u 50111 N@IU t el olyd �f Alt. Tel. No.: b8-400- 8 Per M.G.L. c. 147 s. �7-61 security urork requires Department of Public Safety "S' License: Lie. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does rot have the liabitity insurance coverage normatly 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. m 772e Commonwralth of Mfissacllusetts Department oflnduaiiai 1jCcidents office of Investigations 600 1d'ashin on Sfa•egi 3os�o�tt } 0211-2 f�4 x��rr� }Hass c�v1dia i � �r�s; t 2nce AM&Nit, Buildea J an t'actOrs /Eit�cllt�iei ;si`tl�ti i��bt `Tame .j OF Milo-SAK.'l WeEi Ljc, IS- �E3dtaE�S�. we yd { t' 'Incr.-. i 4. �N Z° '° Z uj ti z El E° z x > P - = r - � r u^�90 o °u'9 6o�0 �_z .o no°- A agora - °1h - , ° p C ¢, co m z na > zzi F Paz 00 aFN - o c oc �3_ ° V r° s C z a � wN m �0< m x D Z 2 r m m m (n m 2 Z G)mm -n 2 0 m D e� a no m b 14 Z Z O , G 4 {f? (n m %! 'epi �, ,,��"� rdr Jr1'•:.y. . p 00 1_ Gp os G'' � A info n AIM - - - n mK�s N rnyYc m � x•-nT m I I I I i © — P P - _ 2A ` -- � v z2 n T v� D'1 m G R.T Hsi n O ) O NG' _ Army. ~ v u Mo pym'y -�£ till zOn C '• mC � A �� T.ao ��'c o ��P Lynn P�K y- o v � v n RM o < n v 3 Un c>x Gz mnx 111 _ m A m: 71 {=�J 3 F � ; ° m w czi -fit � I ~ O z m C 4p nm 'x o ?r m L S G� - ➢trli C 3 C r^ m � m X O a 0 o rn G v C o v o 01 Till�c Z oC IL--11 ILI I j Nti AO ADD N N AADD AAA Du mZaA .-4M4o w0� PI O P 101 2mpD :i n-IZ '�+25N9Zv Sn:_ O > jmm 4 mm4455 D2r m O D3� S �inS a v� c o�z5 g'> n "zzs ma°cfcf a� "o -a yyi imp"p c�m➢- vmmr5 I m> _S a <-i0 _D v Oi�� OOnD O jD pZ�AN Dtpii ➢D NIDD t� S m'zo > A s N^ m o ;:m ao nc N�6"o °�Ng-zi>� omo N o oeno� D DA �z aav AC '�>va m�CNz 'v n0 o� mAT y A D NDN YO N Zm OD m20m.-A O =Z n0 im S H �OP m X00 A� •.NS T -- Ca0 NO O Np1 NCiysyn, ymm ' "a Dy< m wlD Dp T�. >1;D o; A N �I� �C Ip.pl, 0y0 ZSN 222D 2 _ a n nm� m not N� -zi o z v � UN S C A YA m DSK yy m Ory K A O aim O R ~aP 04 y 02 y� ~ N O j Ci 2 N Y O Z A a N :..: "gN nn-'�.S�N�$=cm V: 6 vt o K m D� O N Cor >2 4F n�2 y��a n0lmI-- _ NG g o o p DN rz g�mz� m _ y>OF S m z o? Y I c 1 � onm °iyz 1 x�m oA M. 30 n� yA� III < c z III rh o ;I a I rm sob �ne�oo it y> yz I�.I z I I NNO I I I s 4i I DQR A ' I A f�`,DzQ jD I I �i:J =DNoo z jj _ it nz \a f I i ; I 'I j til p 1001 r 00 � III I I I I 3 mS I xy m _ I I I I � = I I - - '--- --..-.._-- -----------. - I �__________________________________._--_________JTIFTI 0 7 _ HOW gm m O a D W � n a Optimize Engineering Co., LLC P.O. Box 264•Farmville•VA 23901 Ph: 434.574.6138.E -mail: grichardpe@aol.com OW Rjasu,aw"-5 Richard B. Gordon, P.E. President August 3, 2015 North Andover Building Department North Andover, MA Re: Solar Panels Roof Structural Framing Support To Whom It May Concern: G, .4I :hereby certify that I am a Licensed Professional Engineer in the State of Massachusetts. Please note the IrH. ,,;,, ;,,: ;,following conclusions: regarding framing structure, roof loading, and proposed site location of installation: r, 1 �r.Existing roof framing: Conventional framing is 2x6 at 16" o.c. with 17-11" span (horizontal rafter f_ ftV0t , r c4:r E .= -.-..-,projection). This existing structure Is definitely capable to support all of the loads that are indicated below for,thls photovoltaic project after sister rafters with a 2x8 using (2)10d nails V o.c. Use of (2) f- slr<,lc:Guard Dog"a FMGD002.screws is approved, or equal shear strength of approx.120 Ib, V o.c. at areas r� carr e, r,cz � raf rra rr��, =r r cyswhere;little.space:is;available only with remainder of member secured with (2)10d nails V o.c. If do knee Hval( �vDr ; r1Eel, sr l,otsister;;thenrinstall?a 2x4:@6"o.c. knee wall over an interior bearing wall to limit span of rafters between supports to 9'-611. 2. Roof Loading ,;iso .,i: T,urE�,: ;:ri-r • :.,r: • 4.33 psf dead load (modules plus all mounting hardware) rnts.r�ct =�cw s y; .0 • 33 psf snow live load (55 psf ground snow live load reference) il`yl 4.5 psf dead load roof materials Ph wino Uplift live icac of !;Exposure Category B,115 mph wind uplift live load of 19.6 psf (wind resistance) acocle f,e Di isr�a« ,sir+ I)A3. 7AAddress.ofearonosed installation:<Residenceof-B-rian Birchall. 72-Mablin-Avenue: North Andover. Massachusetts ,,„r!This4nstaIIafon design -will be in general conformance to the manufacturer's specifications, and is in t compliance witivall,applicable-laws, codes, and ordinances, and specifically, International Residential Code/ IRC,2009,.2011:NEC, and 2012 ICC Energy Code. The spacing and fastening of the Unirac mounting sra att�ctu we r&i, uet.vbracketsiis,to-have_a maximum of 64” o.c. span along the rail between mounting brackets and secured using 4 s)Oits, acs c,rr• . 511671 x (V/2" Jength'corrosive resistant steel lag bolts. In order to evenly distribute the load across the roof 4�r b .+r„ oN pec 'Jaftem, there -shall.bea minimum of 2 mounting brackets per rafter & min. 2" penetration of lag bolt per 31 wit ,,bracket,:whIch is adequate to resist all 115 mph wind live loads including wind shear. The mounting �{ t bef.vt:vn rr. ,, , uvkrbrackets:shall alternate between adjacent rafters between rail rows for better distribution of roof load. L thin o') cit rir:, -Penetration of=anchors:for modules mounted within 18" of ridge and edges of roof is to be a minimum of 3". �r 11 ri __ ,,, Vie1Ralls;may:be attached•to either of two mounting holes in the L -feet. Mounting In the lower hole for a low In =,r anv� fs( tr. ,;,, ;,.profile; Snore -aesthetically pleasing installation or mount in the upper hole for a higher profile to maximize s,;n,, trio y:(_,, ;,,airflow -under the:;modules to cool them more. Slide the 34 -inch mounting bolts into the footing bolt slots. ss,F. i;,:e; ;,;,.The rails will be attached to the footings with the flange nuts. Very truly yours, Optimize Engineering Co., LLC Richard B. G~, P.E. Massachusetts P.E. Li se No. 49993 tzrl of MECHANICAL ENGINEERING �o�ssgs CIVIL ENGINEERING ELECTRICAL ENGINEERINGRICiigRDs ' O GoHDoN MECHANICAL NO. 49993 K�'D wa Optimize Engineering Co., LLC P.O. Box 264•Farmville*VA 23901 Ph: 434.574.6138•E -mail: grichardpe@aol.com Richard B. Gordon, P.E. President September 22, 2015 N. Andover Building Department N. Andover, MA To Whom It May Concern: Re: Solar Panels Roof Structural Framing Support I hereby certify that I am a Licensed Professional Engineer in the State of Massachusetts. Please note the following conclusions regarding framing structure, roof loading, and proposed site location of installation: 1. Existing roof framing: Conventional framing is true 2x6 at 16" o.c. with 9'-4" span (horizontal rafter projection). This existing structure is definitely capable to support all of the loads that are indicated below for this photovoltaic project. 2. Roof Loading • 4.33 psf dead load (modules plus all mounting hardware) • 30 psf snow live load (50 psf ground snow live load reference) • 4.5 psf dead load roof materials • Exposure Category B, 115 mph wind uplift live load of 19.6 psf (wind resistance) 3. Address of proposed installation: Residence of Brian Birchall. 72 Mablin Avenue, North Andover, MA This installation design will be in general conformance to the manufacturer's specifications, and is in compliance with all applicable laws, codes, and ordinances, and specifically, International Residential Code/ IRC 2009, 2011 NEC, and 2012 ICC Energy Code. The spacing and fastening of the Unirac mounting brackets is to have a maximum of 64" o.c. span along the rail between mounting brackets and secured using 5/16" x 3 %" length corrosive resistant steel lag bolts. In order to evenly distribute the load across the roof rafters, there shall be a minimum of 2 mounting brackets per rafter & min. 2" penetration of lag bolt per bracket, which is adequate to resist all 115 mph wind live loads including wind shear. The mounting brackets shall alternate between adjacent rafters between rail rows for better distribution of roof load. Penetration of anchors for modules mounted within 18" of ridge and edges of roof is to be a minimum of 3". Rails may be attached to either of two mounting holes in the L -feet. Mounting in the lower hole for a low profile, more aesthetically pleasing installation or mount in the upper hole for a higher profile to maximize airflow under the modules to cool them more. Slide.the 3B -inch mounting bolts into the footing bolt slots. The rails wiil be attached to the footings with the flange nuts. Very truly. yoisrs, Optimize Engineering Co., LLC OF MA&VQc I c Richard B. G , .E. s RICHARD B. Massachusetts P.E. Lice se No. 49993 o CORDON h4ECHANICAL � MECHANICAL, CIVIL, ELECTRICAL ENGINEERING U NU. 49993 GIsTE� FrG51ONA&�- c r� :D LO N � O c0 J r2 O N Date............ TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ........ ..................... has permission to perform--'-. ....................... plumbing in the buildings of .. ............................... at .... X.F. ...... I North Andover, Mass. Fde3,R,.b.3.�. Lic. No.�Jc'�_/ ......... ............ PLUMBS G' PECTOR Checkff C903 6549 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS 2 S 6 y� l Date 7/2,S-/JS— Building � Building Location 7a I-" � A S t- Al A Of Owners Name -R I A N rB) Re 4 A L L Permit # Amount r Type of Occupancy ? CS , New5M. Renovation ® Replacement Plans Submitted Yes11 1:1 No FIXTURES (Print or type) , Check one: Certificate Installing Company Name 41 k'/ 4 �< Corp. rlPartner. 11 Firm/Co. Name of Licensed Plumber: �Gii�fC Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 1 Other type of indemnity a 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 Signature Owner 11 Agent 0 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 Massactts S ming ode�aC of the General Laws. D (OFFICE USE ONLY Type of Plumbing License License e Master ❑ Journeyman MASSACHUSEM UNIFORM APPUCATON FOR PERNffr TO DO GAS FTITING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date % ^ -,s^ 0S- Building Locations 7 A MA BIJA/ AVE �/d' A-A)1`D ayUe Permit # Amount $ -99 l AN T l I CN ALL. Owner's Name New 10 Renovation ® Replacement El Plans Submitted 0 SUB-BASEM ENT B A S E M ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR STH. FLOOR 6TH. FLOOR 7TH. FLOOR w 0 o z c' z o H w Z z v, C o c z x o• o o Che one: Certificate Installing Company LCorp. Date.. .�........`�........ . - � Partner. ElFirm/Co. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION �}� This certifies that ..`:�`�.........../;. ,",,,,,,,,,,,,, has permission for gas installation: in the buildings of ... 0,� ... ... t..�...................... . Zeck one: :s No )ox. Bond 1 c)verage required by Chapter 142 of the ement. at ../ ..�?z:?.......... , North Andover, Mass. —1 Agent V � )ove application are true and accurate to the Fe6�_....r.. Lic. No;;7... _ :. � m, ........ rnvt Issued for this application will be in GAS INSP1V�TAA er 2�fe General Laws. Check # CP6Z3 t/ 515 Or Gas Fitter 10 f tm er Master APPROVED (OFFICE USE ONLY) ® Journeyman Official Use Only THE COMMONWEALTH OF MASSACHUSETTS Pemrt No. Department of Public Safety BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occu &Fee Checked 4/0 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL RK All work to be performed in accordance with the Massachusetts Electrical Code 27 C 12: rb-5 (Please Print in ink or type all information) Date � To't or of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number q'�- A q b 11 n V Q✓ Owner or Tenant SIN 9&( Owner's Address J iv,-� Is this permit in conjunction with a building permit es No • (Check Appropriate Box) Purpose of Building +v1 V Utility Authorization No. Existing Service Amps Voits Overhead Undgrnd No. of Meters New Service Amps Volts Overhead Undgrnd No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work NO. of Lignting outlets No. of Hot fuse No. of Transformers KVA Above • In No: of Lighting Fixtures Swimming Pool gmd and Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners Battery Units .- —IREALARMS No. of Zone o. of Detection and `j 3 9'13 ✓ 1 iihating Devices lo. of Sounding Devices Date 13� ........................... lo./ of Self Contained Lelection/Sounding Devices • Municipal Other HonrM ocal Connection •��"�0 TOWN OF NORTH ANDOVER ow Voltage Marin '. PERMIT FOR WIRING • o; LY+i(iA �'OaJ-Aa� v\ ,SSACMUS� - -J This certifies that ... 51..... =I4 s ?.• ................................................ has permission to perform............................................................ wiring in the building of..................................... ............................................ ......... , North Andover, Mass. Fee.,/0.4 ............. Lic. No�. Nq .... ELECTRICAL INSPECCoi Check # = NO= Nerage by checidng the appropriate box. )ate) Final LIC. No. E -3 ? -B9 -0 LIC. NO. bstantial equivalent as required by Massachusetts it (Please Check one) 61�76D � 4 4 ERMIT FEES Z16' Official UseOnly, ` THE COMMONWEAL 7N OF MASSACHUSETTS Permit No._ 46y� Department of Public Safety BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy &Fee Checked APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the (Please Print in ink or type all information) Massachusetts Electrical Code 527 C R 12.Q0 Date 1 1'> 1 b To the Ins or of tires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number 1 �- A q b 11 A Owner or Tenant 1' 1 Owner's Address J a ry,,� �° Lj Is this permit in conjunction with a building permit es No • (Check Appropriate Box) Purpose of Build' Utility Author¢ation No. Existing Service Amps Voits Overhead • Undgrnd • No. of Meters New Service Amps Voits Overhead Undgrnd No. of Meters Number of Feeders and A npagty Location and Nature of Proposed Electrical Work No. of Liahtino Fixtures _ - -- - Above • In KVA No. of Receptacles Outlets I No. of Emergency Lighting No. of Oil Burners �_.. _..1— No. . No. OTHER: n �cltQ�� LD � T �L )-(.T •� Ckiz-T \ { 1A r0 il✓dt GIS �% -to rrju 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 = M you have checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE = BOND = OTHER (Please specify) Estimated Value of E f I Work$ v d (Expiration Date) Work to Sta U Inspection Date Resquested Rough Final Slgned under the Pe espf ry: FIRJ M NAM atr� (� ` LIC. No. E3 g �$ 9 t? Licensee Pa a � (� S 110-�.� Signature 2Q C / 1 �-f o ! 1, LIC. NO` Address S 4, &o "t. I c� S4, 0,,-i C1C s.� 011,70 Bus. Tel No. ! v i �. '1 ` �b (I Alt Tel. No. _ f'. ►� - �7 1 _ `�' ) n OWNER'S INSURANCE WAVER: I am aware that the Licenses does not have the Insurance coverage or Its substantial equivalent as required by Massachusetts General Laws. And that mysignature on this pemrtt application walves this requirement Owner Agent (Please Check one) �y (Sign of Owner or Agent) Telephone No. 7 ' ` rL7 U ( 6 �_LMIT FEES + Q b FIRE ALARMS No. of Zone TSI J&20CM No. of Detection and No of Air Cond ' To Initiating Devices Heat Total Total No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained Detection/Sounding Devices Space/Area Heating KW HeatingMunicipal Devices KW • • Other Local Connection No. of No. of Law Vottaae OTHER: n �cltQ�� LD � T �L )-(.T •� Ckiz-T \ { 1A r0 il✓dt GIS �% -to rrju 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 = M you have checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE = BOND = OTHER (Please specify) Estimated Value of E f I Work$ v d (Expiration Date) Work to Sta U Inspection Date Resquested Rough Final Slgned under the Pe espf ry: FIRJ M NAM atr� (� ` LIC. No. E3 g �$ 9 t? Licensee Pa a � (� S 110-�.� Signature 2Q C / 1 �-f o ! 1, LIC. NO` Address S 4, &o "t. I c� S4, 0,,-i C1C s.� 011,70 Bus. Tel No. ! v i �. '1 ` �b (I Alt Tel. No. _ f'. ►� - �7 1 _ `�' ) n OWNER'S INSURANCE WAVER: I am aware that the Licenses does not have the Insurance coverage or Its substantial equivalent as required by Massachusetts General Laws. And that mysignature on this pemrtt application walves this requirement Owner Agent (Please Check one) �y (Sign of Owner or Agent) Telephone No. 7 ' ` rL7 U ( 6 �_LMIT FEES + Q b 0wwvR. Regovo © K 0 0 3 r Location - 44 0'.., No. �7-q Date v�1 4j Check # 40 18 3'19 Building InspOor TOWN OF NORTH ANDOVER AL9 # y Certificate Occupancy $ # • , of t<�' s�CHUS Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ 76, TOTAL $ Check # 40 18 3'19 Building InspOor 0 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING a:• BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/12ELWor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 2 V 1.2 Assessors Map and Parcel Number: ©0 7 oe a Map Number Parcel Number 1.3 Zoning Information: Zonin Diatrid Proposed Use 1.4 Property Dimensions: LA Area Fronts 8 1.6 BIJU DING SETBACKS ft Front Yard Side Yard Rear Yard RegWred Provide Regilind Provided ReqWred Provided 1.7 Weer Supply M.GI.C.40. § 34) 1.3. Flood Zone Info®atioa: Public ❑ Zone Outne side Flood Zo❑ 1.: . SabviarW DbpoW System: Municipal )t On Site Disposal System ❑ 1.01 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 1C 'iStfICt: ""e mo /' 2.1 Owner of Record ?�i ca pe-�A&A AV;V "Name (Print) Address for Service �- CVM -X87 -g( q Signature Telephone 2.2 Owner of Record: Name Print Address for Service: SiRnature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable if Company Name Registration Number Address Expiration Data Signature Telephone z O SECTION 4 - WORKERS COMPENSATION (KG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......0 No...... Failure to provide this affidavit will result SECTION 5 Description of Prosed Work check ae ■ ble New Construction ❑ Existing Building ❑ . Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify ` '; \ t ` Brief Description of Proposed Work: - "v N { i� -44.,a t IN\ K sial) f e,p6gc�w A ill To s e role, t;, -v% t;�g A-a£tg ow.8 (avw- Ra�rtti, rePic ,ce. �ktS�ir� bi cker, tie, S . I CR.CTION 6 - ESTiMATim rnNCTiMirTTnN rneTc Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building l poo rco (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) r17.. 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 °�' Check Number JM\ AAA l♦ iw IlVllq 1V DL' l.V1RYLL& ALIP WrMf% . OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT L as Owner/Authorized Agent of 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/AUTHORI7ED AGENT DRrr.ARATTnnr I, �R X4111 �I �C4�/L►-�- ,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 E MAN cite -R ALL Pri ame Si tune of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TlrvMERS 1 2' D 3 KU SPAN DM ENSIONS OF SILLS DINIENSIONS OF POSTS DM ENSIGNS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CH MMY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Ilk r 978-688-9545 978-688-9542 Fax TOWN OF NORTH ANDOVER BUILDING DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER MA 01845 HOMEOWNER LICENSE EXEMPTION ItONT1, O#4�aao y�4 H � 9 • off+ ��� # Please print DATE 5V ill 6 JOB LOCATION —72 AtAVSLI �A Number Street Address Map/Lot HOMEOWNER R i A+A 1 �° � �A�LL, ��9 4?7-66Yq Name Home Phone Work Phone PRESENT MAILING ADDRESS Z M AWL, /aVF N . Xik) ogLa 94 A 01 gys- City/Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section 108.3.5.1.) DEFINITION OF HOMEOWNER: Person(s) who owns a parcel of land on which helshe resides or intends to reside, on which there is or is intended to be, one or two family dwelling, attached or detached structures attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEWOWNER'S SIGNATURE APROVAL OF BUILDING OFFICIAL J 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 at: 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. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 10A. 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