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Miscellaneous - 75 LOST POND LANE 4/30/2018 (2)
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O � sM CD coA NO Nip bN .0•0-0prt?Q �JE CT a >rt 05• ro cr 3 CD CL O p IDA— � S ^� P- Un O P Cx lA ., 1• n m O L C CDo 1-,$ -v 3 0 '-' O N CD co CD 0 co o -., All wood constructed walls and 0 J I'•' lD -P y d ceiling to have 5/8" type 'X' fire installed 7 p S S< r :� u CD O p C 0 W np �•0� . co 0 i3 CD O co , c+s o°Dv , . ^ a ,+ 6• °. �, !9n .+ Co C M:. p. b Q a y 0 !v 0 0 v� n CD ,a0 `� N3 m N ►� < Nm �I �'CCDD5' 3 0Cl, •_ M^ u� I Wy O CD01 : C1 CD d `L ILA I " Ca3 0 O� Cr n CD 0 W (7) t0 CIL (D CD S Z5, CL Co 9 00 CD t0 �+ Q CCx " CV .Or ,tea ca 0 co !D 3 _ ;� a3 00 Nd CD W CD O W u� O CCD SCD CD p ,Oy CD �! :3.A ON co p S p co pO a Crco lD CCD CCDD fn W N d i u 18'0" 1 1 i ------------------------------------ - - - - - - - - - - 1 1 i v v v v v v I S R C:> II 4 4 CD 1 -P o x ' I 4 ' a 4" Concrete Slab Slope 1/8' per foot 1 I ' 212" lu 0 I I C9 _ 0 I Ip 32 60 60 i 6$011' I I G F 4 � I I 1 I 1 1 s I I L I I I I cr J ��I x GARAGE FINISH All wood constructed walls and ' ceiling to have 5/8" type 'X' fire installed CD I �- rated Wallboard [ 3401 .9 .2 ]CDI o CL CL 20 minute fire door (min.) ' 4"(mn) Step down into Garage o ' ------------------------------ - - - - -- - - - - ----------- ►� 1 t 1 ----------------------------------------------------------- 41 1'0" Dia. Concrete Pier (4 req'd) - Bottom 4'0" Below grade o — - — - — -- 11'0" 1 6'911 I 695" 24'6" j. 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II- Q Q W O NI E 0>% Qcno o° � N N N N N N N N N N CO co co n O\ wcotocoOLd XXXX N 0LL- N N N N N N N mQ O C)oo�rooocooooAD o opODcotooCI—D NuXXv (xx x x x x x E+M N c,4Q ONN N N NN o!n N N N N N N N N N N CO co co n O\ wcotocoOLd XXXX N 0LL- N N N N N N N mQ O C)oo�rooocooooAD o opODcotooCI—D NuXXv (xx x x x x x E+M N c,4Q ONN N N NN o!n N N� X r CDD N O ® m 0 Os O � a 2 x 10 Ridge Board r A f N X O t0 �D Q7 O d s n 3 o � � y O � ' X O N C 0 � c b v �� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING �•1 IPrint or Type) NORTH ANDOVER, . Mass. [)ate///,2- BJ Locationuildin6 6D Permit 2407 Owner's n Name F-/, n Loc- New Renovation ❑ Replacement ❑ FIxTURE6 ........ Plans Submitted: Yes ❑ No. ❑ Installing Company Name ✓6t //CsS� / C� �' Address / 97 Ma Business Telephone f6 Name of Ucensed Plumber Check one: ❑ Corp. ❑ Partnership rm/Co. INSURANCE COVERAGE: Check one I have a current liability Insurance policy or Its substantial equtvalen L Yes ❑-- No ❑ If you have checked ygj, please Indicate the type coverage by checking the appropriate box. A liability insurance policy [y' Other type of indemnity ❑ Bond ❑ Certificate 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 signattxe on this permit application waives this requirement. Check one: SIgn❑ slate of Owner or Owner's AGent Owner ❑ Agent I hereby certify that alt of the details and Information I have arbmttted for entmed1 In applleatton are true and accurate to the best of my knowied a and that all plumbing work and Installations performed under the pemnl! I for this application will be in compflancs with aA p pertinent provisions of a Massachusetts State Plumbing Code and Chapter 142 olAwAamad laws. This Chynown N""OED (OFFICE USE ONLY) ILman./L s. N. License Number 9jcd-.,2— Type of Plumbing Ucense: Master Journeyman 0 zW < N » i 3:0 • j M E. s M h U i» 1~t < M r` _ a _ ks i • }' » O= i et 0 L 30 J O s H S » O 1 e) O O A < 0 sus—aaatT. SAS[M[NT IST FLOOR IND FLOOR Sl10 FLOOR 4TH FLOOR STH FLOOR STH FLOOR. ITH FLOOR STHFL00RJ — Installing Company Name ✓6t //CsS� / C� �' Address / 97 Ma Business Telephone f6 Name of Ucensed Plumber Check one: ❑ Corp. ❑ Partnership rm/Co. INSURANCE COVERAGE: Check one I have a current liability Insurance policy or Its substantial equtvalen L Yes ❑-- No ❑ If you have checked ygj, please Indicate the type coverage by checking the appropriate box. A liability insurance policy [y' Other type of indemnity ❑ Bond ❑ Certificate 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 signattxe on this permit application waives this requirement. Check one: SIgn❑ slate of Owner or Owner's AGent Owner ❑ Agent I hereby certify that alt of the details and Information I have arbmttted for entmed1 In applleatton are true and accurate to the best of my knowied a and that all plumbing work and Installations performed under the pemnl! I for this application will be in compflancs with aA p pertinent provisions of a Massachusetts State Plumbing Code and Chapter 142 olAwAamad laws. This Chynown N""OED (OFFICE USE ONLY) ILman./L s. N. License Number 9jcd-.,2— Type of Plumbing Ucense: Master Journeyman 0 m m D A w Z N w N C W O O v T N V :* �o z 3 o O O r c 3 z 0o v Z C m m X 3 den V :* �o z 3 o O O r c 3 z 0o v Z C m m 1IrW S -w p Z 0 a� 0 0 z F- LLi 0 w 3 a. 0 7HE00W0NWE4L7H0FR AS&4Qfi1SETls Office Use only DEPARTAMWOFPUBLICSAFMrte[ k-91 r0 Permit No. BOARD OFMEPREVE W0NRWMTIOAiS 527(MR 12.100 Occupancy &.Fees Checked 'r APPUCATIONFOR PERAW TO PERFORMELECIT2ICAL 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) Dat G' 20/ Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 154 Owner or Tenant Owner's Address G�'fl-�no/ Z,,v. e - Is this permit in conjunction with a building permit: Yes t/ No r7 (Check Appropriate Box) Purpose of Building �ihA p� ///?f�fn P,y �Utility Authorization No. Existing Service .0d Amps /�W-) Volts Overhead M Underground ©r No. of Meters I New Service Amps / Volts Overhead ED Underground Q No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA // (Oground ED ground No. of Receptacle Outlets / ` / No. of Oil Burners No. of Emergency Lighting Battery Units %No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pum s Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local a Municipal Connections Other yNo. of Dryers Heating Devices KW _ Na" of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHE • O a -U - S"I-e 0&eC-7Va' w Ir>s<rar=Co=ge. ftT9LHlt1Dthelegt FM13RSOtMa%aft 9ftCiQ1HalLaml IhawaamotLiabt*hstm=PobLyerhdrttgCaT#&t Co crilsskst3ttraleWhdlad YES NO 71 Itmeakmadvalidprodafsam loftOffim YES M NO If}mtmed>I JWYES,pkmemdc*tbetypecfwmaWbyduckirgthe ,Mopt box, 1NKR NCE BOND OTHR (PweSpecdy) EVirgion D Esftn*d ValuecfEkcfiical Wait $ 3060 • `r0 WotktoStatt ._ hspedionD*Regtt *d Rough Final Signedtaxfa�ieP�taltiesofpetjtey. -A� FIRM NAME lioa>,see j je t ` �"' `(�R21 �S BtsimTel.Na M -75V -o735- AdiesS Seer's �� .� C- �,.�s/9f�9 AItTeLNa 2`7q -;?6S -- OWNER'S INSURANCEWAIVER, 1xnm=fttheIJ=w `7q-2!oS=OWNER'SINSURANCEWAIVER;IamawatetlatdteIJ=w treit%=xewa WonlswbsrarWeWnaiatastagtmedbyMasmductlsGalaalLaws mddratmy*,i km,ontbsptat-tiappkabmwanesthis (Please check one) Owner M Agent l Telephone No. PERMIT FEE (� .a cr, m �.•• *Ow �� Z o 0 h �� °+ i. —1 iU ze v Q a. o O c E D a = 3 5 - m Z �` 3 o O CD m CD co 3 = -0 n CD c Z C � O CD CD : 7 �. S� m m v = C, EA 69 69 69 fA CCD Z a v CD O � 7D TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: a-17-0 06 c SIGNATURE: - Buildin Commissioner/`IzI26tor of Buildings Date i SECTION 1- SITE INFORMATION 1 1.1 Property Address: ( / 1.2 Assessors Map and Parcel Number: Map Number Parcel Number Name (Print) Address for Service : 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft A Front Yard Side Yard Rear Yard Regaired Provide RCAWred Provided Required Provided 3.1 Licensed Construction Supervisor: 1 -4'- 0 4 5 ai, Not Applicable ❑ 1.7 Water Supply M.G.L.C.40. 54) Public ❑ Private ❑ 1.5. Flood Zane Information: Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record Name (Print) Address for Service : Signalpre Telephone 1 2.2 Owner of Record: A Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: 1 -4'- 0 4 5 ai, Not Applicable ❑ -3 9 Licensed Construction Supervisor: 0 License Number Address J'z Date Signlature ephone Expiration 3.2 Registered Home' Impr.I\/v�e�me., o5ntrra�c(9Ql^/)y'— 'J Not Applicable ❑ Company Name + ` Registration Number Address C _ Expiration gate Signature Telephone SECTION 4 - WORKERS COMPENSATION (M G.L. C 152 § 25c(6) . Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes ........❑ No ....... 0 SECTION 5 Description of Proposed Work check au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify I SECTION 6 - F.STYMATRII CONSTRYWTION COSTS I Item Estimated Cost (Dollar) to be� �0+ CAJL�TjSE O it Completed b permit applicant k •,, • 1. Building (a) Building Permit Fee _ Multiplier 2 Electrical (b) Estimated Total Cost of Construction f �� 3 Plumbing Building Permit fee (8) X (b) r 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 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/AUTHORIZED AGENT DECLARATION y I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print N` Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 3 SPAN DIMENSIONS OF SILLS t DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE /w&k FORM - U - LOT RELEASE FORM 0--- r7 - a j INSTRUCTIONS: This form is used to verify that allnecessary approval / permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT!"/lam �c�tr` �'=�t—Y� PHONE II ASSESSORS MAP NUMBER LOT NUMBER SUBDIVISION _ LOT NUMBER �LVGJ V ZAJ STREETSTREETNUMBER... .............:...... .. ... . OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS DATE APPROVED CONSERVATION ADMINISTRATOR DATE REJECTED COMIVIENI'S DATE APPROVED TOWN PLANNER DATE REJECTED CONRVMNTTS DATE APPROVED FOOD INSPETOR - TH DATE REJECTED eL DATE APPROVED Z S SP TOR - HEALTH DATE REJECTED COMMENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE To: 'Clark Remodeling' CSiD: 2 216101 12:16 PM P 212 Ac®RD CERTIFICATE OF LIABILITY INSURANCkzARic-ID zM 2 DATE(MMfDOJYY) 02/01/01 PROOUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION NSR`POLICY LTR ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Thomas Gregory Associates Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 605 Broadway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Saugus MA 01906-3200 Phone: 181-233-0600 Fax:781-233-0900 INSURERS AFFORDING COVERAGE INSURED INS IRER A. Zurich -American Insurance INS-r2EF' E _ --- EACH OCCIFRFNCF IRED,41•AA(E:Ar,y Dri@fira) MED EXF (An ons T=rson; INS-RER C Clark Remodeling 99 Cliff Ave. Winthrop MA 02152 X Per PLO,ect Agg. --- INSJREF'E. COVERAGES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR`POLICY LTR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE (MMIDDfYY) POLICY EXPIRATI01�— DATE (MM/DD/YY) I LIMITS A GENERAL LIABILITY X� cornvEeaA.LGeaERAL LIABILITY CL-,1JS MADE OCCUR SCP36496652 1 06/05/00 06/05/01 EACH OCCIFRFNCF IRED,41•AA(E:Ar,y Dri@fira) MED EXF (An ons T=rson; $ 1000000 $ 3000000 $ 10000 X Per PLO,ect Agg. --- PERSON-L&ADV'INJURY $1000000_ GENERA - ACGR=CATE $ 2000000 PP.ODU779-CJMP/CF'A9G $2000000 — ! GEN'-.AG:SRcCATE LIMITAPPLIES P=R'. R F;FCjO- LOC � 7 POLICY �I—] AUTOMOBILE LIABILITY ANY ALTO COM51NIED SINGLE LIMIT (Ea ar.Cid=rit) $ L_ At - OWNED AU -OS BODILY IN..UPI' m SCHEDJL .AUTOS fP=r parson` ' -y .A�-!TOS NON.0 VNED ALTOS BODILY INLJRY I $ --- PP.OPERTY DAV"AGE (Para::cid?ni) I — -- GARAGE LIABILITY AUTO CNLY - =A Ar.;!DE\T Ea ACC i OTHER TH-N AUTO CNLY $ ANY ALTO r-- -- m 1 EXCESS LIABILITY EACH CCCLRRFNCE $-- EOCCUR � CL AIVS MADE - DEDUCTIBLE j I AGGRE3A.TE -----' $ ---__ u- — -- $ j COMPENSATION AND EMPLOYERS' 1 EMPLOYERS' LIABILITY V✓..: ..TA U 10TH- l"OP.1' L!MI"r` ER E L E4; ACCID _PR $ E.L. DISE4SE-EAEMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1$ � OTHER — 1 DESCRIPTION OF OPERATIONS,LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT'SPECIAL PROVISIONS Evidence of Coverage. CERTIFICATE HOLDER N ADDITIONAL INSURED; INSURER LETTER: CANCELLATION TOWNAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAI'_ 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Town o£ North Andover 27 Charles Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR North Andover MA REPRESENTATIVES, ACORD 25-S (7(97) �/(,��.,_ �\ DACORD CORPORATION 1988 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston; Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Name: M, City i YET1�.iZ�.(O f � (st - C7) I, S Z Phone 6 ( ?7 9 �/, Q 7_-�- � �- am a homeowner peYforming all work myself. ` I am a sole proprietor and have no one working in any capacity I am an employer providing. workers' compensation for my employees working on this job. Companv name: Address City Phone #: Insurance Co. Policy # Company name: Address City: Phone #: Insurance Co. _ _ _ _ _ Policy # 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 of ($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. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct Signature Date Print name Phone # Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone #.• ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION e - ��tC TJOiJt73L49Z1LEC7.Lf/t 0����JA%C�IIOP,l�C i BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Numbers CS 063945 --" i Birthdate:', 12/19/1964 ° Expires: 92/19/2002 Tr. no: 5109 Aestricted To: 00 MICHAEL N CLARKE 99 CLIFF AVEe WINTHROP, MA 02152 Administrator ✓h6 iJa»tfJtp9(6dCYi�A[ gffll,�wF�ts \\\= r HONE IMPROVEMENT CONTRACTOR Re4istratian. 12008 _ - ExPzraton= 1011512001 Type: OBA -CLARKE MODELING CO �,tHAEL CLRRKE t ADMINISTRATOR 99 CLIFF AVE VINTHROP HA 02152 Feb -07-01 07:42A Pinzer- David inzer David Pinzer 75 Lost Pond Lane North Andover, MA 01845 home 978-685-3062 mobile 978-502-3741 9FAX 810816-4289 dave@pinzer.com FaX (810) 816-4289 P-01 To: Michael McGuire From: Dave Pinzer Fax: 978-688-9542 Pages: 3 Phone: 978.688-9545 Matte: 02/07/01 Re: Project to finish basement - CC: Mr. McGuire, Thanks for your time yesterday and for returning my call. If there's anything you can do to expedite our permit for this job, we would very much appreciate it. Ne attached the plans for the first and second floors of the house. You have the basement plans with our design for the work to be done. As you can see, what we're doing is putting in a few closets for storage, building a wall to section off the mechanical systems. and finishing off the existing walls. I'm sure you have the septic plans on file, but if it helps, these are Septic specs I have: • The design flaw was based on 4 bedrooms x 165 gallons per bedroom per day = 660 gallons per day. • The septic tank required was determined to be 660 G.P.D. x 200% = 1320 G.P.D. • The septic tank installed is 1500 gallons. Thank you again. I'll call you this morning to make sure that you've received this and to check if there's anything else you require. V Feb -07-01 O9:59A Pinzer David Pinzer 75 Lost Pond Lane North Andover, MA 01845 home 978.885-3062 mobile 978-502.3741 eFAX 810-818-4289 dave@pinzer.com FaX (810) 816-4289 P-01 To: Michael McGuire From: Dave Pinzer Fax: 978-688-9542 Pages: 2 Phoas: 978-688-9545 ftte: 02/07/01 Re: Basement Plans CC: Mr. McGuire. Thanks for pushing this through. Michael Clarice, our contractor, will be by tomorrow morning for the permit. I've attached the plans for the basement work. =I s Feb -07-01 10:00A Pinzer (810) 816-4289 P.02 1� l� —j- U) m m C/) Cl) m .. .. a: 1= O O to CD CA .O co 0 CO) d cm O CA 10 C) C c CA d n CD 0 co CD y CD CO) 0 O �• N O Q H EL m C/2 CD o Cl) O H O d C-) r11 Z ?-c N '4 Er m aid y O ...4 O m y p O =' m O: G ; m y^� 0 to CA c m C ?y� .� r m S 4p.� C/)c C? � //^� � m m N 0 CD n°_ H �• o C3 a d cn a r ` N r^ m 1 1 m CD o C0� , z SCD cnz y C* s . �m (/� p m ,� cn 4 co C', O =fiCD W �o w M ""X � � P M "� r ni ti n T T w �.� d n ) f) M� O it 4 O N6 0 c KAREN H.P. NELSON Dim for BUILDING CONSERVATION HEALTH PLANNING DATE 0 �• • - Town Of NORTH ANDOVER •� �; WMION OF PLANNING & COIBiUNI = DEVELOPMENT LOCATION OWNER' S NAME r BUILDER'S NAME CHIMNEY APPLICATION AND PERMIT MASON'S NAME ✓-114 - MASON'S ADDRESS_ M.nSONS TELEPHONE_ MATERIAL OF CHIMNEY // la, v- 0- �, 120 Main Street. 01W- (508) 682-6483 PERMIT # INTERIOR CHIMNEY l/ Q-. EXTERIOR CHIMNEY •,i�. NU, BER AND SIZE OF FLUrc X %� THTC CIESS OF HEARTH oC� Will cn4--e.r or f _ca to requirements of the code ana have rules es and re, --u- 1 at:c:.s oeen received: T^ DAL 0, 5 .. T CONTR. LIC. SIGi+r,T TRr OF MASON L... _ CTION PRICE EST. CONSTRU PERiIT_T GRAPiTED ROBERT NICETTA, B `Z7-D;_:G -..=OR INSPECTED REMARKS FE.. �... �^ mTTC REQUIRED THIS PERMIT MIUST BE DISPLAYED ON THE PRE.•IISES u it 0 rte-. N C�7 �`+�• u�ro O cpC CD 0 C ' ,.. 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O W y 0 0 c :r 014t &mmor> wvdt4 of Masac4tweffs Ilepart nettt of Public Omfetg BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Only Permit No. ! 3 '✓ Occupancy & Fee Checked / 3/90 (leave blank) Ward Area APPLICATION FOR PERMIT TO • PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12!000 (PLEASE PRINT IN INK OR TYPE �� BALL INFORMATION) Date �& - City or Town of • % la ('Nbwew To the Inspector of Wires: The undersigned applies for a permit to pe & N b 7S CU Location (Street um er) Owner or Tenant Owner's Address thea electrical work described below. ' �fi Gee f C, -Iva V P: Is this permit in conjunction with a building permit: Purpose of Building Existing Service _ New Service Amps _J Volts Amps _J Volts Number of Feeders and Ampacity Yes ❑ No ❑ (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgmd ❑ Overhead ❑ Undgmd ❑ No. of Meters No, of Meters Location and Nature of Proposed Electrical Work Installation of alarm system No. of Lighting Outlets No: of Hot Tubs, No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- gmd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Dpilection and Initiating Devices No. of Sounding Devices No. of Self Contained No. of Ranges No. of Air Cond. Total tons No. of Disposals No. ot�Heat Total Total Pumps Tons KW No. o! 0tshw2shers Space/Area Heating KW Detection/Sounding Devices Local M Municipal ❑Other Connection No. of Dryers Heating Devices KW No. of No, of L Voltage No. of Water Heaters KW Signs Ballasts Wiring (J 7 - No. Hydro Massage Tubs No. No. of Motors Total HP T7 OTHER: e 5Jkox,(- �S INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General taws I have a current Liability Insurance Policy indud- Ing Completed Operations Coverage or its substantial equivalent. YES ❑ NO. ❑ 1 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 )YX BOND ❑ OTHER ❑ .(Please Specify) Cl/� 3O�(J- (Expiration Date) ! .. _ Estimated Value of lepc-tr• 1 Work $ Work to Start D �_ Inspection Date Requested: Rough Final Signed under the Penalties of Penury: FIRM NAME LIC. NO. 1 2 3 1 0 Licensee Signature AM7- LIC. NO. Bus. Tel. No.617-431-5800 Address 60 William St./Wellesley, MA 02181 ___ Alt. Tel.No.b17-431-5817 OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws. and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE $ 7 (Signature of Owner or Agent) NOMY Inspector fa rough and/or final inspectlim Pamit must be obtained before oommencaw am. and all work in compliance with G.L.C. 141 & all appka- z I z V V 4 O C- o O v G7 M M Z I M r— m C-> C7 a Z C> O -v Office Use Only -73 Of 4t Tnmmnnmealt4 If Massar#BMS Permit No. Ileputment of Pubilc *61V Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 J (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date T& or Town of NORTH ANDOVER To the Ins ector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) ��"'t Owner or Tenant �V� LUL' SNC Owner's Address �/o /yo, 1414-i"'ve2 Is this permit in conjunction with a building permit: Yes 2�No ❑ (Check Appropriate Box) Puroose of Building 5��� L �/9�/G �� �1Utility Authorization No. Existing Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service �00 Amps ��0 / �5/o Volts Overhead ❑ Undgrnd No. of Meters --�— ,tl Number of Feeders and Ampacity V vh Location and Nature of Proposed Electrical Work Hot No. of Transformers Total No. of Lighting Outlets o No. of . ,ot Tubs KVA No. of Lighting Fixtures Swimming Pool gmd.i Above— In - No. grnd. _ grnd. '� Generators KVA No. of Emergency Lighting No. of Receptacle Outlets O I No. of Oil Burners I Battery Units No. of Switch Outlets No. of Gas Burners No. of Ranges / I No. of Air Cond. tons FIRE ALARMS No. of Zones 4 No. of Detection and Initiating Devices No. of Disposals Heat j NO °f Pumos Total Tons Total KW No. of Sounding Devices No. of Self Contained No. of Dishwashers / I Scace/Area Heating KW Detection/Sounding Devices No. of Dryers , Heating Devices KW Municipal Other Local ❑ Connection i No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massacnuserts general Laws I have a current Liability Insurance Policy including Comoiet Aerations Coverage or its substantial equivalent. YES vNo = I 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 appro a box. INSURANCE BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Work S Work to Start Insoectton Date Requested: Rough L LFinal Signed under th Penalties of perjury: F FIRM NAME L LIC. NO. Licensee / Y Signature LIC. NO. `y�33� Bus. Tel. No. - �f"� —//6 Addresso�-� Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. 01r/0�/^Agent (Please check one) C' OF Telephone No. PERMIT FEES O (� (Signature of Owner or Agent) x.5565 g coo " � � � •' « TOw,y ., r O O y m .D Z . � : :� :n J�zO m t -D. N : /�o �1 1 Z y /1/9fi 14:18 35.00 RAID`.