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Miscellaneous - 790 TURNPIKE STREET 4/30/2018 (6)
Vii------ .._\ Office Use Onty T uflf 9h5&[Lhuj:;zit5 Permit No. (/ Occu anc Fee Checked Gi Ee;P1Z'tII =T1 of ifull tc fC>Cj P :1 ,! 3(gp (leave blank) BOARD OF FIRE PREVENTICN REGULATIONS 527 CAR 12.00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts 'Electrical Cade, -527 CMR 12:00 (PLEASE PRINT IN INK OR. TYPE ALL INFORMATION) Date / %� t wires: Mj or Town of NORTH A * DIZE To the Inspp ectt or of The udersigned applies for a permit to perform ttte electrical work described below. Location (Street 3 Number) T (J -t. \ ```Q e Qwr,er or Tenant Qwner's Address. Yes No (Check Approoriata Sex) Is this permit in conjunction with a building p ermit: Flrocse of 9uilding f> ��� C S Utility Authorization. No. G Amos _J Vc"s Overi-2=d Unegrhd � No. of meters Y'�ting afvlCJ!1�a Volts Overhead `— Uncgrnc I No. of ,Meters c o Amos: — ' Ne -,v .,eriic.. _J Numcer of Feeders anc Amcacity v o F v t Ilk. cacicn anc Nature o. �r ccese'd _ ectric�i Tocat Z' No. . ^' _`.ys - I .No. ct :ranstormers - KVA No. of '_ig.^•t:ng Outlets I At7ave.-- 'n- — No. of LightingFlxtures i Swimming pool grna. — gr a• t Generators KVA Na. of Emergency Lighting , No. of Cil Furriers i Sar ery Units No. of Switcn Outlets jNo. pr `,-las burners Total No. at Ranges I. Nc. cf Air Ccr.c. tens NO. a -Jlscosals !-!eateat Tocai Tocat No.pr H:ons KV -1 i SaaceiArea Heauna (bV No. or Cisnwasners - No. at Criers Heat:nc ✓ev:ces KOV No. cr No. a a , ^r •_v�,or uoarors KYJ Sic, -.s Ballass Na. Hvcro Massage Tuds No. of Marors: ota::HP OTHE Ei( IZ S E ( \ot r =ARE ALARMS No. of ZOMes I No. of Cecection and - Initiating Oevlces No. of Sounding Cevices NO. ::On Contained Oetac::dniSaunaing Devices Mumcioat --Other i Lccat Cannec::on Law Voltage Winng INSURANCE CGVERAGE. pursuant :a the reeutremencs ct massacnusacs generat ! aws = _ 1 1 have a current Ltaotttty Insurance Palicy enc!uCrng Czm=:eceC Coeraacns _ ave ge or a YES. c. ecasleecuicacencne ES at cavera ge Cy Nave suamiaea valid proof of same t0 the Office. . _3 cnecxtng the acorpdnace pox. INSURANCE — SONO = OTHER ::(P!ease, Scecity) (Exatranon Oate) sumatea Value of E!ec:y, a6 ncal Work S 6® F Rau n riot werx :e Start lnscec::on Ca:e Aacues:zc: g• Signea under the-Pertaltles at perjury: UC. NO. FIRM :NANIE adore LIC. NO. ____---- Licensee �� 'toy— VlA PY�CDt��� SSri (• h5 1 A Bus, Tal. No.- -3 1hr-Uh Kc� �� ���5��v� alt. vet. Na. A O C r e s s -------v -e- OWNER'S INSURANCE .vAtvER: I am aware triad trio t:censea aces not nave (no :nsuranca coverage or Its supscanclat eaurvalen� e^ autrea oy Massachusetts General Laws• aria that my signature on :n:s zermtt application waives :Ns reautrernent. ownneer�.% g tP!ease checx one) _ / V v 7alecncne No. 13 C' FE= S iSigcature of Owner cr Agentt Date .... .. TOWN OF NORTH ANDOVER PERMIT FOR WIRING o T- CPW This certifies that ..... ....... � ct—..: e.:^ .. ..`2 . ........................ ,. has permission to perform v....... wiring in the building of .... de ct/ d # g .................:.:....................................... . � 7.:.. /� ti .......... , North Andover, Mass. Fee../7,l �........ Lic.No. :-.�*rL ............................................................... ELECTRICAL INSPECTOR C. WHITE:. Applicant CANARY: Building Dept. PINK: Treasurer uhE Cf==UM of _49MBar4mitts lepr=zw of Vuhilc BOARD OF FIRE PREVEMON REGULATIONS :u7 C.JR 12:00 Office use Only AW Permit No. Occupancy & Fee Checked 3fg0 leave blank) ^� j' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in acw'-rdance with the Massacnusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date QI}� or Town of NORTH ANnOVER To the Inspector of wires: The udersigned applies for a permit to perform tree eiec-.nc3t work described below. G Lccation (Street & Number) 0 I (1 sr 5IiC Imo Cwner or Tenant Cwner's Address Is :rtes permit in ccnjunc:ion with a building permit: Yes No _ (Check Apercpnate Bcx) Parccse cf Buiidinc _1� �1c �� U� Utility Autncrization No. E .istinCJ. Service Amps f VCits Cverre-c _ Unccrnc r Ne,.-., Service Ames ecus Cver-a_d - Unc:rrc Numcer of =eecers arc Amcac::y L==aden anc Nature ci =rc=CseC -Iec:.:=S:.:crx No. of Meters No. of Meters No. at - ansformers °tat No. _. _igrang Cut:ets No. _. -_. --=s cvei — :n• — No. at L:gnnng = Swimming xtures g ' _ct — -•-c. — I Generators KVA No. at Emergency Lignting No. v ?ecectace Cutlets No. a. Cit Burners Banery Units i No. of Switcri Cutlets _ No. . Zas=_.n_._ I -iP. ALARMS No. of Lanes a No. at Ranges 7z -a: I No. at Cetecaon arc :,No. A,r Z ars intuating Cavices No. of :isoosats No"t ?•;-os ',ns % No. at oisnwasners SCacerArea -eannc C•% No. at Driers Heacrc Cewces C:J No. at Scuncing Cevtces No. at Self Cantainea Oe:ec::antSounctng Oevices — Muntcicat j `aa't _ Cannec::on _C:nar No. at No. a I Law Voltage No. of Water Heaters Cil S;Cns _•..•_:s Wirmc No. -�vcro Massace '%_s No. at :!eters - CT..En. INSUFANCS CCvE-AGE. Pursuant :o the recutrernents ar ' :assac-usa-5 canerat Laws I nave a current Liactiity Inst.'tanae Pouc/ inc:uc:ng C:.t-c:eteC Coe a-, cns Caverage or its sucs:anttal ecuivatent. YES = NO = t nave sucnurteo vatic or --cit at same to the Ctfice. YES = NO = t you nave cnecxec YES. ;tease inatcate the type at coverage cy cnecxing :Me accracnate oox. INSURANC-Q = BOND = OTIHSP = (P'easa Scec!+f S (Exciration Oatef s::rnatea Value of Etecstaat Worx 5 i= nal 'Ncrx to star, tnscec=an Casa=ac::eS-ZeC: Rcugn S;gnea uncer :ne Penat•• e of ryury. :RM NAME � e� / co UC. NO. 30516 8� censee S:g-a:urs NO. ACCre33 CWNEA•S INSURANCE WAIVER:,I am aware mat L•ce^see Ices _ct wave -me insurance coverage or its suostantial eeurvafent as re- auirea oy Massaenusetts Genera► laws. ana Mat MY s:%nan. a an ;-.:s :er...tt aooncanon waives this reauirement. Owner Agent tP'ease cnecx ones Vf. �a 'ejecncre No. PERMIT FES S iSignattue at Cwner ar agem Date....`. �%. T, TO 2857 0, TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........ \ja.. 5'. ... C. k�. 6!.% Z.T ......... has permission to perform ....... I ........... E'A ... �,q. .................... wiring in the building of ........ M.P.. ......................... at ..... 7.20 .. ...... ...................... .North Andover, Mass. Fee...77..�—.O... Lic. No .............. ............................................................... ELECTRICAL INSPECTOR C— k-,-� — (U/% 12:50 75.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File y n APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in ac rrdanr„ with n e Massacnusetts E.ec . icai Cade. 527 CMR 2:00 (PLEASE PRINT IN INK OR TYPE Al! iNFCR.1ATICN) Date (y)Q or Town of NORTH AMrOV=R To the In pec:or of Wires: The udersigned acpties for a permit :o per.'crn trre eiec=c-at wcrx descriLed below. L ccancn (Street 3 Number)- Cwr,er cr 7enar.: Cvv ,er's ACcress ADD / V1, Ire Is t:as permit in caniurc:ion with a cuilcirg =er^It: Yes v No _ kZieck Ac.^.rconate SCxj 01 ITPautntuuuT uL" �"ut �c to �tzftiit �-^� HOARD OF r(RE PRc1E4711CN RE•'sUUMCNS :r? CJS 12:110 ISO (leave blank) P..:r^cse -_4 615ftt"i.0 Utility Aumcrizatian No. c..istirg �drric3 Amcs ` ilei, Cverneac _ Unc_ na _ No. of Meters _ Nea,v Service Amcs icl:s Cvern ea_ _ unccrnc No. of Meters Numcer zr =,aecers arc Arncac:ty ar: �4a::.re .czcsec =:eC:.._.=.. No. _. _ _ ..ng __.:els :• -c. _=s No. _. 'ans:err..ers <':A No. a Ger.era:Crs KVA No. ct emergency L.gnnng No. _. ___c:ac:e Cut:ets Cf `IC. _. Cit p...rer5 =a-ery -,nits No. z. _wrtcn C:..:ets No. :. .3s =_. ._-- I F: A L.iRM$ No. 7__nes -atec-xn arc ,�off No. _. ranges No. _. ,:r = . _. _rs int :latingCav:cas Nc. _T _isccsa:sNa•= '93:_5 te d: zns K1.111 I No. c.:curcing Cev:css - ` Na Zr Sett C.JntalneC No. :r Cisnwasners Scacee.area-__..r- f:r 1 i I-etec::cnrScunc:ng cav:ces No. cT :vers �eaan, Cev:ces C:r I Murnccal :nor __C3: _ CCnneC:an ^C Nc. Cr :rater ?-ieacers K:r S:cns _-..- :s No. =vcro %lassace acs Nc.1.!=s -. -= � MAY 1996 IvSLRANC= "':E=ACsc. ?.rsuant :a :ne recc:re^ens =. ::assa:n_sa-s ;ererac Laws I nave a c_rrent L:acaity Insurance Prue; inc.zc:rg — C`-:: ;. etee Cceraccns ,average Cr its sues:arinal ecntva:ent. YES = NO nave sucm:t:ee vane c._ot of same :o ane Cf`ca. YES = %C = you nave cnecxec YES :cease :ne:cate ane type of :overage :v =necx,ng :rte ac cnate --ax. INS::RAvCc 1Z = CT�'.EA = titti'ease S=ec`!) / BOO• � (Exc:raacn Case: =s::Tacec value at _:ecr-:cal 'N rx S ,� '.Vcr.r .o ::�. 1G Ins=i�cn : a:a =re_es:ec: =CtiSn +nor S:gr+ee _neer :no Penalces at-erjury: _ PLt NAME //Li/ L�/� iiii /i//G� UC. tea. 3o2y68r _censee S:yna._r± _ �Y� .Ga �/ C�1rGoZvi1` '_:C. Nc.0 Bus. :at. No. Aecress Alt. '701.ei. No. y C+vNEa'S INSURANCc'NAiVE.R: t ares aware oat -e _-eenseo o" _ct wave :no :nsuranco coverage or its sucstanaat eeumalene as re. euiree oy Mas3a=iusen3 General Laws. ana Mat .-y s:%:•aue =n c=s =er-:t acc��c3t:an wanes :nes reeu,rement. taw r Agent tP'ease cnocx anal (19 1 g r /v -44eC-ore No. PERMIT r.c s ignatwe at Cwner =rtssnt iy_ _ c C+ Y-41 �\.. r� 2�2 Date.:: t, .; a HORTN,. .r� TOWN OF NORTH ANDOVER p PERMIT FOR INSTALLATION g « r - f f S. C Lis w This certifies that ...[ :'�.fP , t/�l:l:fi`t. a v qi has permission for ,g"installation in the buildings_ of ...fit P 1�.P � . _ t . r1 Pu% .......... at 7�d M w 4 °...?� . , North Andover, mass.. Fe. Lic. No.. Y? 6F .. ... _qAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File r , K : Office Use Onty t V T uPermit No. BepartmriTt crf '5Uhlk _sfetq Occupant-/ & Fee Checked r� J1 80ARD OF FIRE PREVENTION REGULATIONS 527 C'dR 12:00 1190 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 - (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 9 /10)96 (X)� or Town of NORTH ANDOVER To the Inspector of wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) i�I O 'T'v �/w�1��e S C�� su CZE #107 Owner or Tenantere?�\rte a� CTCC� Owner's Address �a SZCar-� MIN. It Is this per -tit in conjunction With a building permit: Yes � No l_ (Check Appropriate Box) Purocsa of Suildina Utility Authorization No Existing Service _�Igej _ Amps _J Vcits Overriead Unegrrtd New Service Amos _J Volts Overhead Uncg, No. of Nieters No. of Meters Numcer of Feeders anc Amcacity Lccaticn and Nature of Prcoosed Electrical Ncrky E ' )0--? 6 v� �.t``\ S Tota+ No. of n Outlets i No. of -ubs IVc. of ranstarmers - ��,A _.g.n. g in - tato. of Lighting Fixtures i Swimming Poo gr a e= arc. _ l Generators KVA C I No. at Emergency Lighting No. .f Recectade Cutlets No. of Cil Eurers i 3arery Units No. of Switch Outlets C , No. or Gas=urr,ers ` FIRE ALARMS No. of Zones Total I No. at _election and No. of Ranges No. of Air Cor.c. tans initiating Cav+ces No. of Oisoosals Hear Total No.-_rPucas ;ons Tota+ KW No. of Sounaing Devices i No. of Self Contained No. of Cishwasners - I SeaceiArea Heating KW Oetect:onlSounaing oev+ces No. or Dryers Heapng Oev:ces KVv — Municipal ^Other -coal I Cannecaon — No. of No. at iLow voltage No. of 'Nater Heaters KVJ N i Signs 3a+lasts Nir:nc No 'Hyaro Massage Tubs i No of Motors - Tota+ HP OTHE?.. INSURANCE CCVEP..AGE: Pursuant :o the reeu,rements at aassac-usars general ! aws - I have a current Liae+iity Insurance Policy incluctng Caroc:etee Oeerancns Coverage or :ts suastandal ecuivatent. YE3 = - NO 1 have suamittea valid pract of same to the Office. YES _ NO - It ycu nave checxea YES. please incicate she type of coverage Cy chec,ang the aoproariate pox. INSURANCE . -- 3CNO -- OTHER ::tP!ease Scec:!y) (Exp+rauen Oace) Esttmatea Value of E!ec:ncal work 5 '?, C>6 Werx :o Start tnspec:ton Oate nacues:ec: Raugn Signea unser :he Penalties of perjury: Final UC. NO. - L :censee _ S g^at re rte• . r� L1C/.�N�O(f. - f Bus. •—at. No.. ACCress V ��lYl[a� -�{ n;.• +' Alt. mel. No. OWNEFI'S INSURANCE WAIVER: I am aware that the L:censee aces not nave the insurance coverage or its suastantnal eaurvalent as es te- au,rea nv Massachusetts General Laws. ana that my signature on :,^;s cerm+t aepuc3hon waives this reowrement. Own � Ag en cnecx one) L, :e+ecnone No. HERMIT FEE 5 i (Signature at Cwner cr',gentl <�=�- a P 1 I -- IvAl2 467 _ As Date ....... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... ...... has permission to perform ..... k-".0 ...... .................. wiring in the building of ...................................... at .....7 G%.0.....A.1 ......... ............ . North Andover, Mass. 1;41-7� ....o.....d ... Lic. Nolf�:7�1*-j . ............................................................... ELECTRICAL INSPECTOR C 4 WHITE: Applicant CANARY -.-Building Dept. PINK: Treasurer No X581 Date.....Z/./..:..U.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that ..................................✓.......!..I............................................. has permission to perform .... . .... ...... wiringin the building of ................................................................. 7J r— f ' at ....... ............I Gi f� fl i%* .......... :':�......... ..... , North Andover, Ma� ^' Fee.`........!... �... Lic. No. ..2 -{..... .. /ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer D006 -ear 4;D-&- S44 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Official Use Only ^` Permit No.�rV Occupancy & Fee Checked APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed 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. Date 9/1242nnn To the Inspector of Wires: Location (Street & Number 790 Turnpike street suite 203 Owner or Tenant Response Networks Managed. by Grubb & Ellis Owner's Address Boston Ma. is this permit in conjunction with a building permit Yes a No ❑ (Check Appropriate Box) Purpose of Building Office Suites Utility Authorization No. Existing Service 2 D Amps Voits New Service Amps Voits Overhead ❑ Undgrnd ❑ No. of Meters 1 Overhead ❑ Undgmd ❑ No. of Meters Number of Feeders and Ampacity Location'and Nature of Proposed Electrical Work Office Fit -up OTHER: Exits and EM lighting ('�) Anwar wi 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$ 49nn _ no Work to Start Inspection Date Resquested Roug LIC. NO. LIC. N0.30' 7110 f �7 Bus. Tel No. Address /�,iX/1'/� S%D�y` �i �Q ��'/7T� W,4— Alt Tel. No. OWNERS INSURANCE WAIVER: I am aware that the Licens s does not have the insurance coverage or its 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. PERMIT FEE $ _ (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above ❑ In ❑ No. of Lighting Fixtures 33 Swimming Pool grnd ❑ grnd ❑ Generators KVA No. of Receptacles Outlets 18 No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets 6 No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No. of Di osal 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 OTHER: Exits and EM lighting ('�) Anwar wi 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$ 49nn _ no Work to Start Inspection Date Resquested Roug LIC. NO. LIC. N0.30' 7110 f �7 Bus. Tel No. Address /�,iX/1'/� S%D�y` �i �Q ��'/7T� W,4— Alt Tel. No. OWNERS INSURANCE WAIVER: I am aware that the Licens s does not have the insurance coverage or its 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. PERMIT FEE $ _ (Signature of Owner or Agent) N° 2185 Date"./ �l7 ........................ TOWN OF NORTH ANDOVER °L p PERMIT FOR WIRING l This certifies that . ........ .. has permission to perforrri�:-- ...... ...... ��.::: ..;k' . ........ wiring in thebuilding of_........ - . _......�.jJ<. . .............. r.... at .,., .. l..a.... ? ... .. , North Andover, Mass. Fee? ............... Lic. No y'f s `�.' ,-(;s< ................. �, ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 1 Of (90111111 all :IP:ti$li IIf tt.9rjtttljusi;ttjj Deprrttinent of Public Safety BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:0') APPLICATION FOR PERMIT TO PERFORM. All work to be performer) in accordance .vith the Massachusetts F.lectrit.il 0 - dr, (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) City or Town of /-f A' I"' O C/e of _— . The undersigned applies for a permit to perform the. electrical /work descrriibe/d� below. Location (Street & Nnmher)- Owner or Tenant Owner's Address Is this permit in conjunction with a buil permit: Yes ❑ No Purpose of Building -_ D lc -2. Utility Existing Service _ Amps _ /_— Volts New Service _Amps /.. Volts Offire.Usc 0 1 Permit No. Occupancy & Fee Checke() 3/90 (leave blank) ELECTRICAL WO K- ;2' CMR 12:00 Date - To To the Inspector of Wires: (Check Appropriate Box) \uthorization No. _ Overhead ❑ Undgrd ❑ l )VencVrd ❑ Undgrd ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work — ate-- l ,�OOK. /2/LdNJ No. of Meters No. of Meters No. of Lighting Outlets No. of Hot Tubs TOTAL No. of Transformers KVA No. of Lighting Fixtures A oveIn- jj � SwimmingPool rnd. 1:1rnd. LJ Generators KVA NoYof Receptacle Outlets No. of Oil Burners No, of Emergency LightingBattery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones >l Tota No. of Ranges No. of Air Conditioners Tons No. of Detection and Initiating Devices Heat Tota Tota No. of Disposals No. of Pum s Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices Municipal local ❑ ❑ No. of Dryers Heatin Devices KW Connection Other No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: svr� Fn o n►% • Y1oo�.. C3 c•Q -- .1'--tzi�fyr61. INSURACE OVFRA(.,E: Pursuant. Nto the requirements of Massachusttes General Laws I have a current Liahility Insurance Policy including Completed Operations Coverage or its substantial oflnivalent. YES 0 NO 0 ! have st!! milted valid proof of same.to this office. YES ❑ NO 0 If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE K. BOND ❑ OTHER❑ (Please Specify) dA -1 Estimated Value of Flrcirical Wor $ r Work to Start L ..Xob • Inspection Date Requested: Rough Signed under the penal ies of r' pv,,7j A..'c�g11P.i lc fY ) r/ FIRM NAME is k.;, �t ('nntrnctor �F- ( (Expiration Date) Final _ 2Y Licensee - - - 23 glair. St Signature , Address AtWnson, N.H. 03611 ---- '�-�Q�-� Bus. LIC. NO.>K LIC. NO., Tel. No. _.......... Alt. Tel. No. .OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the insurance coverage or its 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._ _.—..- .. PERMIT FEE $�S • �_ (Signature of Owner or Agent) Location �� U r� J2I� No. Date �QRTti TONIN OF NORTH ANDOVER O'i..w ;• 1ti0 # Certificate of Occupancy $` -1 C14UsE<� Building/Frame Permit Fee $ r Foundation Permit Fee $ Other Permit Fee $ TOTAL $a 3' Check # :4 r /� 1 IUB �i 1 6 7 / Building Inspector TOWN OF NORTH ANDOVER WELDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING for Official Use OnI BUILDING PERNIIT NUMBER: Q Com- DATE ISSUED: �y ` ` � ,� �j Buildin& Commissioner or of Buildings Date f -!A 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 790 Turnpike sheet suite #203 98 50 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area (sf) Yroritagie (ft) 1.6 BUILDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 1.7 Water Supply M.G.L.C.40. M) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 private 0 Zone Outside Flood Zone 0 Municipal On Site Disposal System 0 *41makom N AM 2.1 Owner of Record WHBB R.E. Name (Print) Address for Service: Signature Telephone 2.2 Authorized Agent Grubb & Ellis Boston,Ma. Name Print Address for Service: Signature Telephone 617 772 7200 9" '0111L 3.1 Licensed Construction Supervisor Not Applicable 0 Dwight Brown 058659 AddressLicense 38-Balcom Rd. Pelham, N.H. 03076 Number 3/31/2002 Licensedon Supervisor: 77' Expiration Date Signature Telephone �ph 3.2 Registered Home Improvement Contractor Not Applicable, 0 Dwight Brown 110 . 155 Company Name. Registration Number 38 Balcom Rd-. Pelham N.H. 03076 10/9/2000 Address Expiration Date t �elephone�� Signatu603 �635 8�651 "a M X 0 S., 0 M X Z 0 Z M 90 0 -n ic vC M: Z G) 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 Yea ....... 11 No ....... ❑ 5.1 Registered Architect: Partridge Tackett Architects Name: Address Signature Broad street Boston, Ma. 02110 Telephone 617 338 8507 i)wi oht Rrnwn rj r PPl ham rnnq f-rnnEinn I Not Applicable ❑ Company Name: Responsible in Charge of Construction Area of Responsibility Registration Number Expiration Date Name: Address: Signature Total Not applicable ❑ Registration Number Expiration Date Name: Address Signature Telephone Area of Responsibility Registration Number Expiration Date Name Address Signature Telephone Area of Responsibility Registration Number Expiration Date Name Address SignatureTelephone i)wi oht Rrnwn rj r PPl ham rnnq f-rnnEinn I Not Applicable ❑ Company Name: Responsible in Charge of Construction New Construction ❑ Existing Building X11 Repair(s) Ek Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: -Renovate existing office suite A-2 A-5 ❑ A-3 ❑ ❑ Independent Structural Engineering Structural Peer Review geqwred Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property Hereby authorize to act on My behalf, in all matters relative two work authorized by this building permit application Signature of Owner Date USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A4 ❑ A-2 A-5 ❑ A-3 ❑ ❑ lA IB ❑ ❑ B Business 0 2A 2B 2C 0 0 0 C Educational ❑ F Factory ❑ F-1 ❑ F-2 0 H High Hazard 0 3A 3B 0 0 IInstitutional ti 0 I-1 ❑ I-2 0 1-3 0 M Mercantile 4 0 R residential 0 R-1 ❑ R-2 ❑ R-3 0 5A 5B 0 0 S Storage ❑ S-1 ❑ S-2 ❑ U Utility ❑ Specify: M Mixed Use 0 Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND OR CHANGE IN USE Existing Use Group: Existing Hazard Index 780 CMR 34: Proposed Use Group: Proposed Hazard Index 780 CMR 34: Independent Structural Engineering Structural Peer Review geqwred Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property Hereby authorize to act on My behalf, in all matters relative two work authorized by this building permit application Signature of Owner Date trop (�� ki.. .kX�V)�.a�j�s` d"a�afLA' � f$ffi1JW%aR�dv.d�"ek3�i.i�E4•�' _ =�8, I, ,as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury Print Name Signature of Owner/Agent Date Estimated Cost (Dollars) to be Item Completed by permit applicant 1. Building 30, 925.00 (a) Building Permit Fee Multiplier 2 Electrical 5200.00 (b) Estimated Total Cost of Construction from (6) 3 Plumbing Building Permit fee (a) X (b) 4 Mechanical (HVAC) 3425.00 5 Fire Protection 3450.00 3 3 6 Total (1+2+3+4+5) 42,000.00 Check Number '"r)SA i 3 Gt�S.V 3 Iy f '!._:Y: •Es; ls..,f jiit �'. dS y) 5... *� tik f . •: 4 ttb��``3 _`.`T '... �`Tn 'SL'� £i l ifi t..a+5 ✓1... 1.4,,. J - fi,A,. 7�Z�... 2� ,aE�:h:l v t"NA�StX��; -'�'� ..Y��iL ✓rr:'3� �Zi,�, F��'v �� � �3 'J�' ) t � 4 + h+' iT *i.�'f �F3T` 'r ,l Z•y' -F. # k f�`113y 7y`x t.Mi , +'v>.,v-w ,/:"?.. 7vv, }. a'1s�nv�x �„Y,,. 7.n .e S., 4n#k.:""r.« 1'•$ .. t. Y n. ., ani, N •:...'� , e. i'.4.. NO. OF STORIES SIZE 3 BASEMENT OR SLAB slab SIZE OF FLOOR TINIBERS 1ST 2ND 3RD SPAN DEMENSIONS OF SILLS DEMENSIONS 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 � . lam=a - .`a.IY u Vyl\U 11\V\..11V1\ A1'1'111C1 V 11 PROJECT NAME: Response Networks, Tenant Fit -out LOCATION: 790 Turnpike Avenue, 2nd Floor North Andover, Massachusetts SCOPE OF PROJECT: In accordance with Section 116.0 of the Massachusetts State Building Code, I, Martin J. Tackett Massachusetts Registration No: 10284, being a Registered Architect in the Commonwealth of Massachusetts, hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning the Architectural aspects of the above referenced Project. To the best of my knowledge such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, applicable standards of practice, and applicable laws for the proposed project. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 116.2.2 of the Massachusetts State Building Code. 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction contract documents as submitted for the building permit and approval for the conformance to the design concept; 2. Review and approval of the quality control procedures for all code -required controlled materials; 3. Special architectural or engineering professional inspection or critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in appendix B. Pursuant to Section 116.4 1 shall submit periodically, progress reports together with pertinent comments to the Building Commissioner. Upon completion of the work, I shall submit a final report as to the satisfactory completion and readiness of the project for occupancy. Notary: Massachusetts 15Ye2istration Number: Yartrid ackett Campbell Architects road Street Boston, MA 02110 (617) 338-8507 (617) 338-8521 facsimile Then personally appeared the above-named on (date) and made oath that the above statement is true. BeR My ', RA L, 1_ REN' C`''. Ngiary?ubliC C4 _,. Phiildel _ q&' Phiia Cly + &.R r isskWi Exp rea'March 31, 2003 (signed) (date) Board of Building egulations One Ashburton Place Rm 1301 Boston, Ma -,02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE,:x .M' .`�. Birthdate: 03/31/1955 Number: CS 058659 Expires: 03/31/20027:7- :. _: " =' Restricted To: 00 r , DWIGHT A BROWN 38 BALCOM RD _ ._.: . ,._.... PELHAM, NH 03076 te,. Tr. no: 20357 Keep top for receipt and change of address notification. BOARD OF'BU DI G REGULATIONS w H I 'License CONSTRUCTION SUPERVISOR .y Number•._CS 058659 Birthdate 03/31%1.955 Expires 03/31/2002 Tr. no: 20357 Restricted T�: DWIGHT A BROWN''' 38 BALCOM RD PELHAM, NH 03076!,. Administrator HOME IMPROVEMENT CONTRACTOR. _ ROistraii'on 110155 Type INDI,VIDUA'C Ezp>.ration 1.0104100 DWIGHTA BROWN' 'DW:I.GHT..A. BROWN, ALCOM.RD . ADMINISTRATOR rUnHM`NH03076 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass., 02919 Workers' Compensation Insurance Affidavit Please Print Name: Dwight Brown d.b.a. Pelham Construction Location: 790 Turnpike Street North Andover suite &203 City Phone 603 635 8651 F7am a homeowner performing all work myself. xal 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. Company 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. 1 do herby certify undell5e pains and pen -&es Qerjury that the information provided above is hue and correct C 9/12/2000 Print name Dwight Brown Phone # 603 6-�5 8651 Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check d immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone #: ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all -necessary 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 Pelham Construction PHONE 603 635 8651 ASSESSORS MAP NUMBER 098 LOT NUMBER 0050 SUBDIVISION Office Fit—up LOT NUMBER STREET 790 Turnpike street suite #203 STREET NUMBER OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS Igoe venom me noon no none owns Mono ME a am man was Oman a am M-Mummom a news am man now MwnMMMMw DATE APPROVED CONSERVATION ADNflNISTRATOR DATE REJECTED CONM4EN'M DATE APPROVED TOWN PLANNER DATE .REJECTED CONIIVIENTS DATE APPROVED FOOD INSPECTOR - HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR - HEALTH DATE REJECTED CONMIENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS AY 3/CJ DATE APPROVED DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR TIATF h 0� �ph w o w° cn o or. w° w°' U w 0 o a w°' w a UW a�' c9i w a o n°' ii H w a w Ao z U)U) v Q �M :moo Q I �: :oma • CS •a'C ' Y C=C C R O MO C / 0 Lym C : m o C42 C oma :oma �• y rr C �. E yE E o m CC C y y . 0 3 t CZ- c : 0_m o a r'�•� y O O OC is E m _ 0: y O cc m � s C cm C ycaQ 32 CA V .mo= •o *a v H 0 O CLcm C Q a �: y O C •O = m O.~ O CD N f'^ CIO r O = r.+ m w W F- .y Ctt„ C Z CLD) .y CD C3 CD C_ H a m� O.S _ 0 MIN � N.O CD 43 �w W G h h E i a. O i O O V _O H O CO2 O V c _cc CL. h 3 f' O A 9 O C' CL cm< }+ cc O O Zs CLCO2 c 0 w cr uiLUa uiW U) N2 1'926 Date..l...�1 TOWN OF NORTH ANDOVER PERMIT FOR WIRING p �SgACMUgE` .N. Q r This certifies that k"�' r� ` cG has permission to perform .... ...... (' = c S C K IA wiring in the building of .... . `4......................=........ ... ................... �?r ST d th Andover Mass! yat....7 ...... �.....t?. t..... Su<Fe A� $Fee7Sr... Lic.No�°........ .. ....••:•"••••'/ ELECTRICAL INSPECTOR /— L OOV WHITE: Applicant CANARY: Building Dept. PINK: Treasurer J LU � ✓ Office Use Only E 9# of 19ag aar4pefts Permit No. Elepartmeitt of Vuhur tafetg Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 1 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:p*11�-f (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date T& or Town of NORTH ANDOVER To the Inspector ofIr The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) MIl 'Ititrn Owner or Tenant Grubb & Ellis Owner's Address Boston Is this permit in conjunction with a building permit: Purpose of Building Office suites Existing Service 200 Amps _� Volts New Service Amps _ I Volts Number of Feeders and Ampacity Yes ❑ No ❑ (C Utility Authorization No Overhead ❑ Undgrnd ❑ Overhead ❑ Undgrnd ❑ No. of Meters Location and Nature of Proposed Electrical Work Suite 306 Office Renovat-eon No. of Meters No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ I Generators KVA No. of Emergency Lighting No. of Receptacle Outlets 20 No, of Oil Burners ' Battery Units No. of Switch Qufle4s 4 No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and i Total No. of, Ranges No. of Air Cond. tons Initiating Devices No. of Sounding Devices No. of Self Contained No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices LocalMunicipal ❑ Other ❑ Connection i No. of Dryers Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES _ NO _ 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 appropriate box. INSURANCE BOND ` OTHER (Please Specify) (Expiration Date) Estimated Value of Electrical Work S Work to Start Inspection Date Requested: Rough Signed under the Penalties of perjury: FIRM NAME Peter Vaillancourt Licensee Peter Vaillaricourt Signature Final LIC. NO. LIC. NO. Bus. Tel. No. 81 64..8 3865. Address 27 Kensington Rd. Arlington, Ma. 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. Owner Agent (Please check one) JQJ�./ Telephone No. 781 6483865PERMIT FEE S (Signature of Owner or Agent) x•6565 .1 . Date .... 71 .......... 1 768 NORTI 0 TOWN OF NORTH ANDOVER 0 ,6. PERMIT FOR WIRING C04 This certifies that ...... Pt.�nL ...... vc ..... ................... has permission to perform ... () ... E-JE.KS ...... ............................. ng in the building of 7. RM .. t.kl (::n:. ....................................... . 7R.at .. )........k. .M/,n..../. ............. North AndoveMass.,- h Fe'.. I-- Lic. No.. ..... .. .... W. ................ 75" ;�, LECTRICAL ASPEMR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 45 MAP ______ ,� FORWARD RCEI. — 111� ,.,._. Ottice Use only A►/ ll ll 1f �5zl Permit No. / r '91partm Tt of ViLh IL—F-afe-q OcaipanCJ & Fe9 Checked atso (leave blank) BOARD OF FIRE PREVEN ION REGULATIONS .27 C'dR tZ:aa APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the MassaCht.lSetts Electrical Cade, 527 CMR 12:40 13/99 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date ector off Wires: QM or Tawn of No TH � NrnQ FU To the Inspector Tne udersigned applies for a permit to perform the electrical work described below. Location (Street & Nurnber) 790 Turnpike str Grubb & Ellis Owner or Tenant Boston Ma. Owner's Address _ Is :his permit. in Conjunction with a building permit: Yes —X No (Check Appropriate Sex) Purccse of Suildina office suites Utility Authorization No. Existing Vcits Overhead '_ Unagrnd Na. of Meters Sarvice inn Amps _l _ Volts Overhead Uncyrne I_ No. of Meters New Sar�ice Amos _I Numcar of Feeders aria Amcacity aticn ane Nature at Prccesed=iectr:cal "1crx off !Itlo. of ;ig.^ang Cutiets i No. . . 7,os I ACover— 1n- — No. Of Lighting xtures 29 swimming ?oa grna. No. of Receccacie Cudecs Na. of Switc t Outlets 3 No. of Ranges Nta_mf Oisaasals Na. of Cisnwasners - it No. of Driers No. of water Heaters i No. ct Cil =urners No. or Gas =urners Torai Nc., c'. air _-r,c. tens t ezc Tocol Totai No.cf ?nncs :ons {W i I SaaceiArea r!eatir.a �'✓ Heaung Cev:ces row KVI iNo. Cr No. of Sicns - Sadasts I, No. of motors I Totai �4P 9 exits wit Tocai I .NC. of Transtarmers KVA Generators KVA No. at Emergency Ughttng 3artery Units FSE ALARMS Na. of.Zanes I: Nd. of Oecectian and. ininaung Oavices _ Na. ct Souncing Cevices, - I No. of Selt Contained 0etectean1Saunaing Oeviees Munic:oat - Other Lccai _ Cannel^on _ i Low voltage Wring I INSURANCE CCVEPAGE: Pursuant :o tne.reeulremenis at massacnusar-s general Laws - . _ = 1. I have a current Liaoiiity Insurance.Potic/ inctucmg Ccr.._:eee OoeraIt youvnave c ecxea YES. pleasle inaecui icaenthe tyoeof coverage Cy nave suominea vatic ;.root of same to the Office. YES — NO cnecx,ng one aoprooriate cox. cec:. aon Oace) INSURANCE = 3CN0 = OTHER - t �Pease S`Y) (Exaira Estimacea value at Eiectncal 'Work s 5,000 Rau � Fnai werx :a Start Inscection.Oate Aacuestec: g• Signea .Incer tne-Penalties at perjury:VO UC. . =iPM NAME �✓ LIC. NO. �-- I i �<� ,vca� signaccre .` tenses ��' 27 Kensington RD Arlington, Ma Sas. Tel. Na. R-32465— Alt. ,et. Na. ACCress OwNEP'S iNSUPANC= `NAIVE?: I am aware that tr.e C:csnsee ooesmat nave tri@ insurance coverage or its suoscanaat eauwale � as au-rea ov �tassaenusects General Laws. ane :nae my signature on 'nes cermrt aeoueaursrt waives :his reaurement. Cw^ t,�� ` IP!ease cnecx one) PEPMIT FEE 5 iSigr.ature of Cwner v Agenn /�04cpo 1U1'',,Dll L - Location No. �C/ Date NORTH TOWN OF NORTH/ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ sncMusE Foundation Permit Fee $ Other Permit Fee b1sN $ g �' Sewer Connection Fee $ Water Connection Fee $ TOTAL $ 144 AL AL Building Inspector 3 " L08410/99 14:48 84.00 PAID Div. 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LAr j `1 YV h �7 A,)tF--D S I G N S a 493 Main Street May 14, 1999 Michael McGuire Town of North Andover 27 Charles Street North Andover, MA 01845 (978) 688-9545 From: Andrew Clark Expose' Signs & Graphics 0 493 Main Street Northborough, MA 01532 (508) 460-1187 Northborough, MA 01532 O Tel: (508) 460-1187 RE: Sign permit for 790-820 Turnpike Street This letter accompanies the application for a permit to replace a sign that was destroyed in a car accident. Not only was the sign broken, but the island where the sign was located was also destroyed beyond repair. The sign we are requesting is smaller than the previous sign, meets code for height and size and will be placed in a smaller island that what used to exists. The island will be located 10' from the edge of the road. Please call me at your earliest convenience. If you have any questions, or require any additional information, please don't hesitate to give me a call. Thank you for your assistance in this matter. Sincerely, 0 Andrew M. Clark Expose' Signs (508) 460-1187 Fax: (508) 460-1188 ��nr.�'�!t'hitt• -_ ■ - - -•'z�•-- �. �.. -- -- r�r,...: , . �.:..:: .,t. ,� v -: ;�:•�ti 1 ,,� � �$ p .�li''1 - ,�. moi,. � Y( ,,. ✓ �e '� 5v i -F= � `f.(�� �\.i� �r �. � �- . �, °y� � .. �` T�4� �� �� i� � t� � .. •, `'k� �. i l E 'i �c t� �_ � s'f �"'C.�.y. a i �`.�-. . j, �:7.''^ ',. .. i j.:. YY ... ' i5�:� � . �':.� ��`�'' . °� ;r;,. ,hS . Y � r�r,...: , . �.:..:: .,t. ,� v �s � �, � �s��-� �� ✓ �e '� �\.i� �r �. � �- . A4 \\ � .. � .. ` t � .1 '\ .q:.' '%�q, ti �� .. i j.:. YY r�r,...: , . �.:..:: .,t. ,� v S I G - N - S 0 493 Main Street Northborough, MAO 1532 0 Tel: (508) 460-1187 Fax: (508) 460-1188 Mkcw4j O lc(ullf ic. 11-� to A C4 ko f4 AN4 i 0 -qzo II c i�Po �e-a ;s 'V� e0J� (ed IOCJ,�),j A -t o/D (9 4 Tc j� P(/. a7+ w i ff �2 �(� Cex your «-4� iSdZc t c e s i -I c eae� In r, ! 7 _ -g JUN 2 2 a ( . FN C : 23E INV -- 235 47 N'V - 34 52 - 'k ` A lif J ea"V� oaceu Jul -28-99 01:58P P_01 OERNiOR NIASONRY a LANDSCAPE CONSTRUCTION ` 12 WALNUT HILL PARK WOBURN, MA 01801 WOBURN: (781)933-4137 STONEHAM: (781)438-4137 o NUMBER OF PAGES INCLUDING THIS PAGE: 3 MESSAGE: Jul -28-99 01:58P A P.02 r'1 U 'LA 9 P G JU �G a � tU r � y Location / ! / urs 4 r No. Date r �p� NORTH TOWN OF NORTH ANDOVER ���%,�sc :•,tiOL der p Certificate of Occupancy $ .es Building/Frame Permit Fee $ Foundation Permit Fee $ i S CMUSE cn v a 3423 Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL$ , P I 4 r, Building Inspector Div. Public Works PERMT NO. APPLICATION FOR PERMIT TO BUILD — NORTH AY16OVER, MASS. PAGE l MAP 4-40. 09B—LOT NO. 0090.. R 2 RECOOF OWNERSHIP DATE BOOK 1PAGE I ZONE SUB DIV. LOTT N NO. I LOCATION 790 Turnpike street #306 PURFb:n F BUILDING Office Suites OWNER'S NAME WHBB R.E. For Grubb & Fllis OWNER'S ADDRESS Boston Ma. ARCHITECT'S NAME Partridge Tackett Architects NO. STORIES 3 SIZE B EMENT OR SLAB slab - SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME Pelham Construction SPAN DISTANCE TO NEAREST BUILDING ` •- DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES - SIDES REAR GIRDERS , AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS 15 BUILDING NEW SIZE OF FOOTING X - IS BUILDING ADDITION MATERIAL OF CHIMNEY . IS BUILDING ALTERATION Renovate existing office IS BUILDING ON SOLID OR FILLED LAND - WILL BUILDING CONFORM TO REQUIREMENTS OF CODE yes IS BUILDING CONNECTED TO TOWN WATER yes BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER yes IS BUILDING CONNECTED TO NATURAL GAS LINE no INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDINGINSP CTOR DATE FILED 10/7/99 FEE f' PERMIT GRANTED ® �O 19 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST 19,000-.00 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY ✓ BUILDING INSPECTOR f OWNERTEL # 617 772 7200 CONTR. TEL. # 603 635 8651 CONTR. LIC. # 058659 H.I.C. # 110155 Comments j Public Works - sewer/water connections driveway per/mi/t/ Fire. Department ��� Lf'/`,K�l Received by Building Inspector Date FORM U VERSIFICATION FORM INSTRUCTIONS: This form is used to verify 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 local or state law, regulations or requirements. ****************Applicant fills out this section**,*************** APPLICANT: Grubb # Ellis Phone 617 772 7200 LOCATION: Assessor's Map Number 098 Parcel 0.050 Subdivision 'Lot(s) Street 790 Turnpike street St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector -Health Date Rejected Date Approved Septic Inspector -Health Date Rejected Comments j Public Works - sewer/water connections driveway per/mi/t/ Fire. 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DEPRRTMEN S"FETq. a 7, C0NSTRUC JJN SUPERVISOR LICENSE r 5 Nuohr ""'ti Expit,6s, Birt-fr4ate - CSz._._03/31/2000 0341/19SS Resir�e�`I 00 t 38 �NlID ys mid PELAK Nil 03076 :. L .Y Flim Tr..e Commonwealth of Massachusetts Department orindustrial Accidents Office of Investigations Boston, Mass. 02191 Workers' Compensation Insurance Affidavit Please Print I I am a nomeowner perrorming all work myself. F1711 am a sole proprietor and have no one working in any capacity F7I am an employer providing workers' compensation for my employees working on this job. Company 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 ($100.00) a day against me. I understand that a copy ofth�1atement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify Signatu Print name �$ and penalties /(4./ K that the information provided above is true and correct. It Official use only do not write in this area to be completed'bftity or town official' ❑Check if immediate response is required Building Dept Contact person: Phone #. to U one # ,663 a 3 ?` S I ❑ , Building Dept ❑ Lincensing Board ❑ Selectman's Office ❑ Health Department ❑ Other DEBRIS DISPOSAL FORM _ -In accordance with.the provisions of MGL c 40 S 54, a condition of Building Permit Number Is that the debris resulting form this work shall be disposed of in a property licensed solid waste disposal facility as defined by MGL c 11, S 150A The debris will be disposed of in: Ar dn VIA, Location of Facility Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector r Li CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number__ " 1` Date /d _a V-0 0 0 THIS CERTIFIES THTT THE BUILDING LOCA " / C1i9� r [ K� TED ON tS MAY BE OCCUPIED AS IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. 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E a c A � U O M 00 3� Location / Cho / D r4 -'10 r , ` No. r Date «C 'r3�62 TOWN OF NORTH ANDOVER, Certificate of Occupancy $ Building/Frame Permit Fee $ %J Foundation Permit Fee $ GM Other Permit Fee $ a c Sewer Connection Fee $ =� Water Connection Fee $ o TOTAL Building Inspector Div. Public Works PERatIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. E PAGE 1 MAP K40. 098 LOT NO. 0050 2 RECORD OF OWNERSHIP JDATE BOOK 'PAGE ZONE SUB DIV. LOT NO. -I I LOCATION 790 Turnpike street PURPOSE OF BUILDING office suites OWNER'S NAME Grubb & Ellis NO. OF STORIES 3 SIZE OWNER'S ADDRESS Boston Ma. BASEMENT OR SLAB slab ARCHITECT'S NAME Partridge Tackett Architects SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME Pelham Construction SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS " POSTS + DISTANCE FROM STREET DISTANCE FROM LOT LINES - SIDES REAR " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING x IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION Renovate existing office IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE Yes IS BUILDING CONNECTED TO TOWN WATER yes BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER yes IS BUILDING CONNECTED TO NATURAL GAS LINE no INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING l ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDINGIN8 TOR " DATE FILED 7/13/99 SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE PERMIT GRANTED 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST 30, 000 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY •UILDING INSP[CTOR OWNER TEL. # 617 772 7200 CONTR. TEL. # 603 635 8651 CONTR. LIC.# 058659 H.I.C.# 110155 1 OCCUPANCY SINGLE FAMILYSTORIES MULTI. FAMILY OFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION _ 8 INTERIOR FINISH CONCRETE _ B I p CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ _ DRY WALL UNFIN. 3 BASEMENT AREA FULL I IN. B'M'T' AREA '/. 1/1 1/1 FIN. ATTIC AREA NO B M i FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS 8 t DROP SIDING CONCRETE WOOD SHINGLES EARTH _ _ ASPHALT SIDING HARDW'D _ ASBESTOS SIDING COMMON VERs. SIDING ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME WIRING 5 ROOF A �� 10 PLUMBING GABLE IGAMBREL MANSARD I�I BATH TOILET -1 RM. 12 FIX.1 BUILDING RECORD 12 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. a ROLL ROOFING MODERN FIXTURES TILE FLOOR _ mMer TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE HOT AIR FURN. TIMBER BMS. & COLS. -FORCED STEAM STEEL BMS. 8 COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT .HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd ELECTRIC _ Lt 13rd NO HEATING 6 /PER311T NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 7 <! - MAP 440. 098 LOT NO. 0050 2 RECORD OF OWNERSHIP JDATE BOOK PAGE ZONE SUB DIV. LOT NO. F-1 I LOCATION 790 Turnpike street P PURPOSE OF BUILDING off i C'P OWNER'S NAME Grubb & Ellis NO. OF STORIES 3 SIZE OWNER'S ADDRESS Boston Ma. BASEMENT OR SLAB slab ARCHITECT'S NAME Partridge Tackett Architects SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME Pelham Construction SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS + DISTANCE FROM LOT LINES - SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION Renovate existing office IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE yes IS BUILDING CONNECTED TO TOWN WATER yes BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER yes IS BUILDING CONNECTED TO NATURAL GAS LINE no INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INS TOR 11114, DATE FILED 7/13/99 SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE PERMIT GRANTED 19 3 PROPERTY INFORMATION - LAND COST EST. BLDG. COST 30.000- EST. 0.000,EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY NUILDING INSPKCTOR OWNERTEL.df 617 772 7200 CONTR. TEL # 603 635 8651 CONTR. LIC. # 058659 H.I.C. a 110155 BUILDING RECORD i OCCUPANCY 12 ~ SINGLE FAMILY I SiORIES MULTI. FAMILY OFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION _ 8 INTERIOR FINISH CONCRETE 3 1 2 I3 CONCRETE BL'K. _ PINE BRICK OR STONE HARDW D PIERS PLASTER DRY VJALL _ _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ 44 1/1 % FIN. ATTIC AREA _ N_O 8 M FIRE PLACES HEAD ROOM 4 MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING CONCRETE EARTH HARDW'D COMMON ASPH. TILE B 1 � _ _ STUCCO ON MASONRY STUCCO ON FRAME BRICKY BRICK ON FRAME ATTIC STRS. & FLOOR I_ CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR I_ J POOR ADEQUATE I NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH Q FIX.I _ GAMBRELMANSARD I TOILET RM. 12 FIX.) FLAT SHED_ WATER CLOSET ASPHALT SHINGLES LAVATORY _ _ WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ TILE FLOOR _ TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 6 COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd 10 13rd ELECTRIC NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. i FORM U - VERIFICATION FORM INSTRUCTIONS: This form is used to verify 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 local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: Grubb & Ellis Phone 617 772 7200 LOCATION:. Assessor's Map Number 098 Parcel i Subdivision Lot (s) 0050 Street 790 Turnpike Street suite # 200 St. Number I i Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved ..Conservation Administrator Date Rejected Food Inspector -Health Septic Inspector -Health Comments Public Works - sewer/water connections - driveway�erm' a .Fire.Department Received by Building Inspector Date Approved .Date Rejected Date Approved Date Rejected, Date Approved Date Rejected The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02191 Workers' Compensation Insurance Affidavit Location: Q cQ(/h ��CQ am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity F7I am an employer providing workers' compensation for my employees working on this job. Comoanv name: Address City: Phone #: Insurance Co. Policv # Company name: Address City: Phone #: S. f 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 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 Signature Print name of per/!ry that the information provided above is true and correct. Official use only do not write in this area to be completed'by city or town official' ❑Check if immediate response is required Building Dept Contact person: 4/ /15S hone #-60—=' h �,6 S ❑ Building Dept ❑ Lincensing Board ❑ Selectman's Office ❑ Health Department ❑ Other C/) C C/) 0 m O CA n Z CA CDCL r C O y O O 0 CD a� O Q ` ...T CD CD O CD _ CD 3, CZ C7 y -• o CD CO) O CD Z O O o CD 0 CD 0 •. 1 „ cn 2 F-� 0 z cn C 0 c?�O Qo c. 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CL tR CD 0 OM 0 � N a) y W'02 y co .2 ea CD MD ui E Z cD 0 cm .0 c ti CL W. 5 O;a -0 0 m CD 0 L- = � M� Cc — > :U V Q 0 0 w W L) E CD O CD 0 m CL CO) O O O CL CO) O cc CID 'a CO) ,;-Nw 014t &MMOnurr# of ffiggar4usetts +Mepartmtrtt of Public _%fttq BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Permit No. Occupancy & Fee Checked 3/90 (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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date �L / -7 - City or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform. the electrjcal work described below. Location (Street & Nurgber) Owner or Tenant Owner's Address ��/y !i WE ��/X /1:01/ DSO& l Is this permit in conjunction with a building permit: Yes ❑ No UQ (Check Appropriate Box) Purpose of Building &_ /ly4aott,� Utility Authorization No. Existing Service Amps _/ Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work LC7 W U0 6L—f fit% 1/12 �5 /k i- -t,2,-j0�, -F�E W42 No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- r— grnd. grnd. Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners I Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of zones No. of Detection and No. of Ranges No. of Air Cond. Total tons Initiating Devices No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices LocalMunicipal ❑ Other ❑ Connection No. of Dryers Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES re -,—&O C 1 have submitted valid proof of same to the Office. YES ZI NO T -41f you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ❑ BOND ❑ OTHER C (Please Specify) (Expiration Date) Estimated Value of Electrical Work $ Work to Start Signed under the Penalties of periur) FIRM NAME L n _ Licensee Address LJC/y e G// i OWNER'S INSURANCE WAIVER: I quired by Massachuse�l (Please check one) of Owner Inspection Date Requested: Rough Final .4—_ 7 i f / LIC. NO. V Signature AIC. NO. Bu . No. Tel. No. the Li ensee does not have the insurance coverage or its substantial equivalent as re - that y nature on this permit application waives this requirement. Owner Agent PERMIT FEE S x•6565 VA 2280 Date TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING SACHUS ell, z Ui .............. e'-1 This certifies that ................... ........... .... ....... has permission to perform 2...d ...... wiring in the building of .................. XL.': ... vJi— .......... CU ....... . North Andover, Mass.' at ....... ....................... Fee. .. . ........ Lic. No.. ......... co...................................................... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File W u41! &MMUMEZILIq of s1i*u5e Bepurtmettt of Public *ufetq ' BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Only Permit No. Occupancy A Fee Checked 90 (leave blank)0 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the. Massachusetts Electrical Code, --527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date or Town of NORTH ANDOVER ' To the IVpector. of. Wires: The udersigned applies for a permit to—perform the electrical work described below. Location (Street & Number) / C/���1 Owner or Tenant /'e/i erZ A/ y Owner's Address 5�911 e Is this permit in conjunction with 4 building permit: Yes i._;� No ❑ (Check Appropriate Box)' ��sy Purpose of Building D T r �C S/��9G 1:2 Utility Authorization No. Existing Service�47_V Amps /02 / ,20 K Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps _J Voits Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets I No. of Hot Tubs ( No. of Transformers TotalNo. No. of Lighting Fixtures / I Swimming Pool Above; Swimming grnd.:_: In - gmd. Generators KVA No. of Receptacle Outlets d I No. of Cil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Self Contained DetectioniSounding Devices Local � Municipal Other Connection r No. of es Ran 9 No. of Air Cond. Totat tons No. of Disposals I No.of Heat Total Total Pumps Tons KW No. of Dishwashers I Space/Area Heating KW No. of Dryers Heating Devices FC1N No. of Water Heaters KW No. of No. of I Sians Ballasts Low Voltage Wiring 'No. Hydro Massage Tubs I No. of Motors Total HP OTHER: !� /? / /� / 7� r jL r U�x�� �X /�/ /.G -.0 �-CT INSURANCE COVERAGE: Pursuant to the requirements of `.Massachusetts general Laws I have a current Liability Insurance Policy including Comoieted Operations Coverage or its substantial equivalent. YES ---"No = 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 aper" per priate box. INSURANCE BOND = OTHER Z (Please Specify) (Expiration Date) Estimated Value of Electrical Work S oy Work to Start Inspection Date Requested: Roush CFinal Signed under the Penaities of_�erju�ry,.c: FIRM NAME T / L�/� ��</ C U%Z LIC. NO. Licensee S/i�1 Y Signature � `""� UC. NO. 42/165 /- �S /' /r Bus. Tel. No. 7s<S SYyd �t a�L Address V ` �A< ris — 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 ants permit application waives this requirement. Owner Agent (Please check one) ' (Signature of Owner or Agent) Teieonone No. PERMIT FEE S x-6565 T 2276 0 S. 5 Date....-"'.............. TOWN OF NORTH ANDOVER PERMIT FOR WIRING 4 a3 This certifies that ....... .. ................ . .. ...... a . ....................................... has permission to perform ................. wiring in the building ofl—AeLl ...... .... ..... !�j.z)nz ........................... at.................. r.... .............. North Andover, Mass. Fee ..... .......... Lic. No. WHITE: Applicant CANARY: Building Dept. ................................................... ELECTRICAL INSPECTOR PINK: Treasurer GOLD: File NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 Fax: 978-688-9542 DATE: l � 1, 27 CHARLES STREET ADDRESS ZONING DISTRICT: —,7 - TYPE OF BUSINESS: BUILDING LAYOUT PROVIDED: YES �T AVAILABLE PARKING SPACES:' ZONING BY LAW USAGE: YE NO �' BUILDING INSPECTOR SIGNATURE