Loading...
HomeMy WebLinkAboutMiscellaneous - 804 FOREST STREET 4/30/2018 (2)N° 1581 Date 2,1. 5..... t NORTI� , i� 3�:•_'``°- "°o� TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ................................. has permission to perform-... ................................................... wiring in the building of ..' .,. ��� ..: - ��� - �-�.O_ ................................................................... 4y at.........................................:c! .......................... , North Andover, Mass. Fe ............... Lic. No� ............. J .. .......... --P .... ELECTRICAL INSPECTOR 04/05/44 14:00 35.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer ly The Commonwealth of Massachusetts Office Use Department of Public Safety permit 70. BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 3/90 Occupancy b Fee (.Tecked�— (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 I;r'FORM TION) Date 31r-/% City or Town of inn �u v er To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street b Number) ( .9 Owner or Tenant Lre y, k-- Cal , h o / c. /I.?- / PC -Y11 Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No � (Check Appropriate Box) Purpose of Building , /n Utility Authorization N0. Existing Service Amps / Volts Overhead ❑ Und d ❑ y gr No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ 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 ❑ In- grnd, grad. ❑ Generators . KVA No. of Receptacle Outlets No. of Switch Outlets No. of Oil Burners No. of Gas Burners No. of Emergency Lighting Battery Units FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Ranges No. of Air Cond. Total tons No. of Disposals No. of Heat Total Total Pum s Tons KW No. of Dishwashers t No. of Dryers No. of Water Heaters KW Space/Area Heating KW Heating Devices KW No, of No. of Signs Ballasts No. of Self Contained Detection/Sounding Devices Local Municipal 11 ❑ 0ther Connection Low Voltage 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 ❑ NO ❑ I have submitted valid proof of same to this office. YES ❑ NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ® BOND ❑ OTHER ❑ (Please Specify) Estimated Value of Electrical Work $ f � D l� Expiration Date Work to Start Inspection,Date Required: Rough Final Signed under the penalties of perjury: FIRM NAME AMERICAN Licensee11T(`AART1 T SAIM JL� S' _ - " 0 IC. N0. —_19190 Q Ixignature LIC. NO. Address 7 CENTRAL STREET9 ARLINGTON MA 02476 Bus. Tel. No. 781-641—inn OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial 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 $ 3S Signature of Owner 0 r Agent Locationgi�j� No. "� U `-a Date TOWN OF NORTH ANDOVE!h p Certificate of Occupancy $ Building/Frame Permit Fee $ an Folundation ermi# Fee $ AC us " `��e m Pie $ 2 Sewer Connection Fee $ Water Connection Fee TOTAL a':' A U550 /$ ZS w uilding Inspector Div. Public Works PERMIT -NO APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. v PAGE 1 MAP d40. LOT NO. I 2 RECORD OF OWNERSHIP :DATE BOOK :PAGE ZONE SUB DIV. LOT NO. i PURPOSE OF BUILDING �1`A ./D `t/I C ,1/ywl AP"L LOCATION n D /i �JnT� OWNER'S NAME: V O .S /y NO. OF STORIES OWNER'S ADDRESS 1J�7 BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME oog&049/ 4 �-�IG�Li - ©I v �/ 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 IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE 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 INSPECTOR L DATE FILED 6/ SIGNATURE OF OWNER OR AUTHORIZED AGENT i FEE i`1 snow PERMIT GRANTED )%oz zt— 19 le 0.0as-3-1 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST 3 qCZ EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. LAM 4 APPROVED BY BUILDING INSPECTOR OWNER TELJ �op —.2& CONTR. TEL. N 79 [ V"If CONTR. LIC. q 0 CLIACZ H.I.C. It BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS.OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA - APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. _ CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH 3 1 2 13 PINE CONCRETE CONCRETE BL'K. BRICK OR STONE HARDW D PIERS PLASTER _ ORY WALL UNFIN. 3 BASEMENT AREA FULL 1/1 1/1 % FIN. B'M'T' AREA FIN. ATTIC AREA _ N_O B M'T FIRE PLACES _ _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 _ _ DROP SIDING WOOD SHINGLES CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING HARDVJ'0 COMMON ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR_j_ CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR I� POOR _ ADEQUATE NONE 10 PLUMBING 5 ROOF GABLE HIP BATH (3 FIX.) GAMBREL MANSARD 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 s TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMF_& 3 COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMSGOAS B'M'T 2nd _ I.* 13rd ELECTRIC NO HEATING WILLIAM J. SCOTT Director To*n of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 146 Main Street North Andover, Massachusetts 01845 In accordance with the provisions of MGL c40, S 54, a condition of Building Permit Number 4g�� is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S 1.50A. The debris will be disposed of ia: (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition perm; i from the: Town cif North Andover must be obtained for this project through the Office of the Building Inspector. 32 ' •� OL d BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 689-9535 A r-1 N P � �o olid C x x o � C h O C C3 V �d,'O CLC C la R O C CL O C O CD CD Ea : 4- co Ots z m o n N EE O C O U � W CD QQ' u h a C � C :O w a� O N 'c° O � OS CL O m u C7 .b x a, y O O '- O H m cc o Z o. c a � tA C CD W f.. n W o co O �...yt •vl C ++ W F- ui z W .q Q Q � E e•,ttr N � ►"V /'--� �o C c� o � C h O C C3 V �d,'O CLC C la R O C CL O O CD CD Ea : 4- co Ots z m o n N EE O C O o :w CD 'cm y R C � C :O � cc 0O3 O N O � OS CL O m O CMOa y O O '- O H m cc o Z OC �' C n � tA C CD W f.. n W o co O �...yt •vl C ++ W F- n � C LU cm LO n m� O - cc s ` H .= .2a Cu— 0O3 yJ O m rr, m oc 113, W cc o U Of OC C N O O 2 aO ..l a Date/AI-1�715� Z TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that !��� .' . ��'.:' . '....�..................... . has permission to perform ...�........................ . plumbing in the buildings of l'� /-"./ ..................... at. ..... .!..' ..... `.............. . North Andover, Mass. Fee. Lic. No... � ). .2. .1 ......... ...... ......... PLUMBING INSPECTOR Check # 5419 I 1 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) Mass. Date Permit # =?�Building Location O Cd r� Owner's Name rf X n - �® r,,Q4 Type of Occupancy Residential New [J Renovation [-1 Replacement Plans Submitted: Yes ❑ No ❑ [AA FIXTURES Installing Company Name Ile ritage Htg. &Plg. Co. Inc. Address 35-Pleas.ant-19--treet Stoneham, Ma 02130 Business Telephone__-__ 731 �_3$= _776__ Name of Licensed Plumber Gordon Switzer Check one IX Corporation L7 Partnership F1 Firm/Co. Certificate 714 INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes N No [ - If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy IN Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing v+ork and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts Stale Plumbing Code and Chap r 142 of the General Laws. By_ Agn ire of L.fcerisod mor Title Type of Liconse: Master tX Journeyman ❑ City/Town 8322 APPROVE) (OFFICE t1SE OtJLY) License Nurnber_______._____�_____ z U) U� n N rn zrA O X f- -. til O W b O~ w a N N! 1 n z cn a cc ¢ T. ¢ of z — O u Z z — 1) ut t) �J OJ O _ N W CC N 00 of X ¢ W f U W In X a a N O d cc 4 S a (t1 rd 2 z W O 7 a W j N c[ :1G ti IJ V1 fY J Z -- O W O ON � �- $4 7 Z O O _ W O HO J m d J f O f- N U. X 7 '.] M d � O L_ N 14 N U VJ SUB—BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5THFLoon 6TH FLOOR 7TH FLOOR ' aTH FLOOFI Installing Company Name Ile ritage Htg. &Plg. Co. Inc. Address 35-Pleas.ant-19--treet Stoneham, Ma 02130 Business Telephone__-__ 731 �_3$= _776__ Name of Licensed Plumber Gordon Switzer Check one IX Corporation L7 Partnership F1 Firm/Co. Certificate 714 INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes N No [ - If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy IN Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing v+ork and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts Stale Plumbing Code and Chap r 142 of the General Laws. By_ Agn ire of L.fcerisod mor Title Type of Liconse: Master tX Journeyman ❑ City/Town 8322 APPROVE) (OFFICE t1SE OtJLY) License Nurnber_______._____�_____ V) z O U W M N z_ N N w ¢ C7 O a w W U. 2 U z m n J a O O O r F- 0 z Z A O W z z a j q ¢ m J O LL m LL O m z W LL O a O ►- z C, 4 O U W m, W a a p Q Z J aI I Location e 0 q v No. 6 Q3 Date -fib- OZ TOWN OF NORTH ANDOVER a # • • i .. o # Certificate of Occupancy $ t �'��°''•°''< Ss�cNust r Building/Frame /Frame Permit Fee 9 $ Foundation Permit Fee $ e Other Permit Fee / $ as TOTAL $ Check # r 5 5 Building Inspector V6 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING >Se#1<o�ar< telebi y BUILDING PERMIT NUMBER: G� DATE ISSUED: a SIGNATURE: A110 r Building Commissioner/1t r of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel 10 — S—D Map Number Number: C),co VT Parcel Number 2.2 Owner of Record: �C:,(V1%-92 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 Not Applicable ❑ Front Yard Side Yard 3.2 Registered Home Improvement Contractor Rear Yard Required Provide Required Provided Required Provided Address Expiration Date Signature Telephone 1.7 Water Supply M.G.L.C.40. 54) Public ❑ Private 0 1.5. Flood Zone Information: Zone Outside Flood Zone ❑ 1.8 Municipal Sewerage Disposal System: ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSEMAUTHORIZED AGENT 2.1 Owner of Record Name (Print) Address for Service Signature Telephone 2.2 Owner of Record: �C:,(V1%-92 Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: 'D Address u 9C A4-)0 - 4 1 Signature Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone v rn SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6) 71 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 ....... ❑ SECTION 5 Description of Proposed Work checkall a licable New Construction ❑ 1 Existing Building ❑ 1 Repair(s) ❑ 1 Alterations(s) ❑ 1 Addition ❑ Accessory Bldg. ❑ I Demolition 1'-' ( Other ❑ Specify Brief Description of Proposed Work: I SECTION 6 - RCTTMATF.n rnNCTV_FTrTTnN rrAVrc Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building(a) i Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 PlumbingBuilding Permit fee (e) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5) J Check Number .sa. �,iavi. in Vrrllr,lw tiv LL1V1l1GH 11V1� 1V DE l.VlrlrLh IEV Wn-En OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT . //) /% ,/7 n Hereby authorize_ My behalf, in all matters r as Owner/Authorized Agent of subject property work authorized by this building permit application. to act on Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, r:1 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 e Si attire of Own r/A ent 6 _10: a V_ at + C� } Date ti NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1ST2 ND3 SPAN DIMENSIONS OF SILLS 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 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Print Name: Location: City Phone am a homeowner performing all work myself. 01 am a sole proprietor and have no on6 working in any capacity EY, am an employer providing workers' compensation for my employees working on this job. • • - - •,�: ai, CQmRM name: Address city., Phone #� Failure to secure coverage as required under Section 26A or WL 152 cM 1ead to the WV0S ion derWkWpenagift.of a fine u to 1, and/or one years' imprisonment as wen as civ penalties in the form d a STOP WORK O ft and a fine d 3100 P � � � understand that a copy of this statement may be forwarded to the OMM of Investigations d the DIA for coverage verdiccaatio�n. ainst me. 1 I do herby certify under the pairs and penakies of perjury that the k*rmatior► 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 ofneiar ©check Yimmediate response is r&A&w Building Dept Contact person: Phone !?M WORKP ARTS COi pENSRTIOR E) Building Dept ' p Licensing Board D Selectman's ice" Q Health Department Q Other O z tI� A O 0 H w z z '•m C O C o w z O N x o a 0 �C3� � c x O w z z Q E¢ o v \ w E L '0 cn a G �(..' w ono w r.w U Q w as pa ono w w W A U ci � iw d Sao n; CO C w w w M c W z �'' v� . L 0 s O '•m C O C O N 0 �C3� � c CD E¢ o m�:L Q�..o. N C . C mCL:R N � � Oco 3Q _?:0.3 N m 32O • �� t zip CA .` N O O N m *p C- V S.: 73 cm m m ; L . r.0 cr- C y ¢ C 6 CL =0 L c m � O:�yz m O C O ca CL cm c f- 3 N x m a- � : o •O. N m ~ CD COD y0. W Oc L +r •N O C � dL W Z CJ CD 0 FE h a 0 - ca _ .0 cam O a� 0 E �17. 1— .0 Q I Q L d O O. c"cC Scc.Q c O m Z ts CDCLCOD c _0 U) VJ W W W LLJ VJ