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HomeMy WebLinkAboutMiscellaneous - 77 ELMCREST ROAD 4/30/2018N O O Q oO A O O O O O N2 t_ 1 3 Date ... ....... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... ............................................... has permission to perform, -,4-1 wiring in the building of .... ........................... ........ ...... at ... ........ ............. Noi J dover, Mass. Fee..................... Lic. No.. . ................... ... ....................... _ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer NPARTMFNTOFPUBLICSAFEIY . Permit No. &12/--� BOARDOFMEPREVEN170NRF gJL4TIOAS527CMR1zo � IVA Occupancy &Fees CheckedPPLICATTONFOR PEMW TO PERFORM ELECTRICAL 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 2/30/o/ 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) Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes [7.] No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service „ 1 Amps JJ/ a l cNolts Overhead Underground r—J No. of Meters New Service Amps�Volts Overhead Underground EM No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work tot T7 777;G 4�'aYtt rJJM 71/;�7 No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground No. of Receptacle Outlets So. 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 Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipala Oth.;r" No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER. L 6, /'wm 6 J 1-4 h l v4ro o -1. h st=xeCammga Pt �antbtheragtmar ofiM dttsel�GarailLaws Iha%eaa=tLiabkyhm==Pbb ynimkgCmvi& Comageorits >tia e* ivalmt YES NO Iharest>txr 9bdvAidpa1bfsartebthe0(tioe YES U NO r ffjcuhawdta WYES plemea dc*thetypecfm wWbydakittgthe bcx INKRANCE [D BOND 0MiER J3tm*dvalue iral Wak $ WakoSttt InspecdicnD*Retpftd Rough Final Sigred undar�ie P ofpeijrsy. FIRMNAME LiMWNa S 6611 2 j� a r � .�,r LioaiseNo _ BusimTel.Na AILTeLNa OWNFR'SR4Rff ANCEWANFR;IammmthattheLimwdoes_ nutbm eir»a=waaW Qs teWwalettasiecttrWbyMamch Ca>ealLam ar3d1ratrr y*nr s ,mftp=nitappficMmVAai�sthism4ai nett. (Please check one) Owner Agent �d Telephone No. PERMIT FEE LC±5_ Date ... .... .. ....... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........ .......................................... has permission to perform .......... .... /-t- , .. .�C/. ..... . V, A .. // � M.. 0*/�! ...................... fid wiring in the building of .......... ....... ................................................ at ...... 77 .. ........ I ..... ... � c) R� ........ f . ...... ................. North ARd6v . ass. Fee... 3 ....... . . ........... .......... Lic. No i� -iill; .0 ELECTRICAL INSPECTOR Check,, 5294 86/10/7804- 15:25 '-91786821546 i I commw"m of Mass Dep m"o"t of Fire S4 SOAO.Orfft VR'VENTION APPUCAtION: --FOR PERMIT AU -v * tD.bc lxdO=W:i (PLUM PRDffWNK ORTMEAU'LWOM" Northidovar BY this okcadoa&imidicidwOOmn0ficeafhb.or this t'AUt. - V/ offidd um only- ea -oo mpanandfteChwked, 11/991 (Leave ML* PERFORMELECTRICAL WORK Date: 06/09104 To * Imptew _q f Wires., 6—Aantopc&rm*oefeMcd-.Vio*&=Udtcl0w. - 34cam Ebma Road Tjjq&mNo.-,979495-;t-504.. Owner'l Addren X'E�bmvgRmd Psrpoee FaidingSerytee- -Aimp.. ffiAmp Vdb -Aim"achy 1011ft Audarladom NIL Overbmd -UmdgrdEl. me, of 31 . ocro Om*ud[] U94ord.E1 :N'&of.m*tcm. tod to -ov*. 16 arcs. oa me twin Ne. of SwedN& of. Cnl4;0*0*Baur TTIIXEomy us "U27 My-IMU P.S= Tr ermcra KVA No: Of uglaks OU#tb. N416,0(lm Taw GatorsK-VA NtL:of Upft Above N&.d-Rmqcpotad&c 16 ME ALUM,� Na of Zam U No:vf(;=Bunmm D 6 aed ML f elewcm of " - I - - - I No - . of Ak. Coat. TOW Rkel. NO. o(Aleft"ey . .. N4h'aCW=teDlqmom To lKW E_ _,T-= Tft Of 1ltebry e> Sp&WAma.B*Xft JKW LoadCi ©Otln LReadog-Appimmm jKW rata. No. if 11% or Mi. -At IATSDItANCE Hoonme pr CHEc2L ONE. -I EadmaWd.-VAUC wofttostwt 0 I coo, Yndar t FSRM NAML-.- Lueopm-VIRM zooz Of Moson - - -Totd 18P RAGE: Ualm mmvedby ft owm, no pan* for.tbe pc&rmmm of damW v*wk mw zone unlm* roof of li*ft 101mrano .including "conocwd opwtdiolf cmmp or its smbft", apdvalcat . ut Sikh wvefw LAIOX Bom--[:] mimR000pwyll_ (When requiredbymunicipdpolicY.) wofpe Wom rjw . q be �ecp�od is a000tdance.ai�-MEC Rale l0, and TTpoa ooh. W o"d, ",dw Wormadan on. dds rqvpfiadmistmeando' ='-d:EISCtm Co NA IMAM pieo*ft sip" . an IAC.�12 - A R, X1 MA 0184-5 KCN WAM:9 -I m'swom dint. &C Lkmw does nor hove bwwLsmm HaA0QNV RMON dO NMOL 9956 999 8L6 YVJ 9V 6T 6002 90/01 Location ll E`met` eS� )Pu No. " / Date NORTH TOWN OF NORTH ANDOVER Certificate Occupancy $ + of r,0 Building/Frame Permit Fee $CHUS Foundation Permit Fee $ Other Permit Fee $ TOTAL _ $ �73 Check # 47" 9 1Y)hj r L, Building Inspector Location No. ' /� Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ �' r Foundation Permit Fee Other Permit Fee $ TOTAL $ r Check # �a 14789 (&--- Building Inspector 1.1 Property Address: �t 1.2 Assessors Map and Parcel Number: 77 �l lM c R -e � � ND � � � Map Number Parcel Number 12 �► v� �- 1.3 Zoning Information: e� knX 1.4 Property Dimensions: ��f Rio 1p5it�® Zoning District Proposeld Use Lar Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R red Provided u /IS� 1 0 1.7 Water Supply M.G LC.40. 54) 1.5. Flood Zone biformation: zone. Outside Flood Zone 1.8 Municipal Sewerage Disposal System: On Sita Disposal System ❑ Public if Private ❑ SECTION 2 - PROPERTY OWNERSEEMAUTHORIZED AGENT 2.1 Owner of Record cru - 41 �'2- �� �jcrn r��e��- �� �— Ale = ✓1� me rint) ) Address for Service: Signature Ly Telephone 2.2 Owner of Record: A -Ad AAM R . ame Print Address for Service: Signature V Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable Licensed Construction Supervisor: License Number Address t Expiration Date Signature ^ Telephone 3.2 Registered Home Improvement Contractor Not Applicable Company Name Registration Number Address Expiration Date Signature Telephone i Sj G• 9 0 C 2 rT 0 SECTION 4 - WORKERS COMPENSATION (1mLG.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit wall result in the denial of the issuance of the building rmit. ` 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 Brief Description of Proposed Work: q AY1 A d r (34wre-fil- P\fP*I'P-. Re A K 9,e t ele- r --k, e �s I SECTION 6 - ESTIMATED CONSTRUCTTON CnCTC I Item Estimated Cost (Dollar) to be :" a ;" a Completed by permit applicant 11 O 100 O (a) Building Permit Fee 1. Buildingj' 1 Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing > Building Permit fee (a) x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 1940 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, , 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 D^E�CI ARATION I, eh 6 45 :J �/� Q VIS ��/ V �— as Owner/AA41i&v: �� of subject property Z" Herebv declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Signlla�tur�e�'/of�! Owner/Agent Date FORM - U -LOT RELEASE FORM K etc ,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. �rrrrrrrrrrrr/rlrerrrrjrrrrrrrrr■rrorrrrrrnrrroorrroosornoorrrorrsrr•rrrrrrrrr■ APPLICANT .I VYI 6 ! y. I L PHONE ASSESSORS MAP NUMBER 0 5;4 LOT NUMBER QQ �3 SUBDIVISION LOT NUMBER -f' ��-7 STREET L t W C K�? T STREET NUMBER < �rrsrssrrssnsorsrrsrrrrrrosnrrnrrssrrrsorsrrsrrrrrrrso■osorrosrarrsrsornnor■ OFFICIAL USE ONLY loanssrrrrrrorrrsorrrronrrrrrs'■rrrrorororrrrrrrsrnsosrrssroorrrrorrr■.rrrrrr■. REC011�Ilbi.ENDATIONS OF TOWN AGENTS IN* ■rr�rrrrrrrr/r'rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr�rrrrrrr• ■'soonn rrrrrr■ DATE APPROVED "V CONSERVATIONADmn S A ®� / DATE REJECTED t COMIt�N TS ` \ TOWN PLANNER COMMENTS FOOD INSPECTOR -'HEALTH SEPTIC INSPECTOR - HEALTH COMMI✓NTS PUBLIC WORKS — SEWER / WATER CONNECTIONS DRIVEWAY PERMIT ME DEPARTMENT COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED RECEIVED BY BUILDING INSPECTOR DATE. F E C E 0 E FAPR 2001 BUILDING DEPT. CER'1TEU IFICT IFN r E K SURVEY INC ♦ HAVERHILL, MA Phone 978-469-1985 ♦ Fax 978-469-7046 OWNER C{JA S 'r4h0V 1)?4p0t r DEED REF. BIZ PG. 740 ADDRESS OF PRINCIPLE BUILDING PLAN REF. 3819 Tl 6ZM6Wr XD • DATE OF INSPECTION AQ,9/L Zo f Zoo/ A), AAWD / r✓Ifl SCALE: 1"= q0' ti DoT 3 /3, Zoo I hereby certify that the Location of the principle structures COl A(A' with the local zoning bylaws in effect when constructed and/ or is exempt from violation enforcemnent action under Mass B.L Title VII, Chap. 40A, Sec. 7. • Subject building is not in a Flood Hazard Area. D Subject building is in a Flood Hazard Area. Flood Hazard determined from the FIRM ma p# I1 W? 4-47036 Dated t pORTF/ Town of North Andover � '° ;"a p L Building Department ; 27 Charles Street t y North Andover, MA. 01845 �; °•;,.° .:{g D. Robert Nicetta Ss^�H„S4 Building Commissioner (978) 688-9545 688-9542 Fax Please print. L� % DATE JOB LOCATION 5-6 Number "HOMEOWNER C.t�2J1°y W II� Name PRESENT MAILING ADDRESS City Town HOMEOWNER LICENSE EXEMPTION ,\-V - Street Address V A- Home Phone F-1N\c&-e12 05-1 Map / lot V91f3 617 1699-'"7y13 Wo Phone ve 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 HOMEWOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures ac- cessory 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 No. Andover Building Department minimum inspection procedures and requirements and that he/she wi comply with said procedures and requirem Tts . � 1 >//w/ HOMEOWNER'S SIGNA APPROVAL OF BUILDING OFFICIAL 9 Town of North Andover Building Department . 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax. (978) 688-9542 DEBRIS DISPOSAL FORM f tAORTH O 0� y y COCINN� K■ 7 Y Q .9StR9r:D 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, sl 56a, The debris will be disposed of in /at: JV �,,��-� , /V � U Y-A-q CA Facility loca i n Signature of Applicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. 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