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HomeMy WebLinkAboutMiscellaneous - 81 BEVERLY STREET 4/30/2018,a R r sAC CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 533-2011 Date: August 24, 2011 THIS CERTIFIES THAT THE BUILDING LOCATED ON 75 and 81 Beverly Street North Andover MA 01845 MAY BE OCCUPIED AS.2 units of a 4 -family (per ZBA 2010-011)JN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Doug Ahearn JEFFCO, Inc. Location No. s,� 3 .?ami Date %ORT" TOWN OF NORTH ANDOVER �� ..• a 1• D Certificate Occupancy $ ���'p0 of s�cMusE Building/Frame /Frame Permit Fee 9 $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # �� 7 245.1 4� /Building Inspector 4 I co C co co E d a *-o 0 ` v CJ Q 0 4=MV 0 CL ca CA E-4 u No. cm MCD cD E w oNcm co L- CL 0 CD CL:� Z, CID* - "a, CD ct 63) CL ca i 0 0u CJCc —J -0 j CL Cc, W zp to —co CL PQ j w2Uv CQ U) 0, 4 I co C co co E d a *-o 0 ` v CJ Q 0 4=MV 0 CL ca CA JO No. cm 4 I co C co co E d 0 *-o CC, ` v CJ r• 4=MV 0 CL ca CA JO No. cm 4 I 0 co co E 0 *-o Z '00 ca 0 CL ca CA O.S 'E.S MCD cD E w oNcm co L- CL 0 CD CL:� Z, CID* - "a, CD ct CL ca i 4 I 0 E 0 *-o Z 0 ca 0 cm CA O.S cD E w co L- CL 0 CD CD CL ca i 0 cc CJCc —J -0 j CL 0 W zp 0. uwtl-,-,-` CL PQ 4 I -a. Date.... /9.- z.'..l �... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that E�Z........ �'� T lr ................................. .............................. has permission to perform.............. ? ........................................................ wiring in the building of ..� �� © .�?1 �. . Q................................... at ....72. ........ S�— .................... . orth Andover, ass. Fee .... Lic. No. .... y ..................r � ...... r. LEMICAL INSPP,G POR v Check #� 105,10 A I IL N Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. -10-5-1 D Occupancy and Fee Checked :ev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code�E?121 CMR 12.0>0 (PLEASE PRINT IN OR TYPE ALL INFORMATION) Date: City or Town of: NORTH ANDOVER To the nspectof Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 6?V Owner or Tenant V Telephone No. Owner's Address 0 fit9,V— 0 �— Ilaoul!;% Is this permit in conjunction with a building permit? Yes Y No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: (T 1.,4;.,., . rfl o { /1n,.ris,n Mlhln mnv ho wnivoil by the Tn.cnertnr nfWires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators K VA No. of Luminaires Swimming Pool Above ❑ In- ❑ d. rnd. o. o Emergency Lighting Batter Units Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of 7o:.es NO..Detection and No. of Switches No. of Gas Burners Initiatin Devices No. of Ranges No. of Air Cond. Tonal No. of Alerting Devices Heat Pum P Number Tons KW No. of Self -Contained No. of Waste Disposers P Totals: _......................................._.._......._..... Detection/Alertin Devices No. of Dishwashers Space/Area Heating KW Municipal Local [IConnection ❑ Other No. of Dryers rY Heating Appliances KW Security Systems:* No. of Devices or Equivalent No, of Water KW No. of No. of Data Wiring: Heaters signs Ballasts . No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Aaacn aaamonal aerial[ y ueSlreu, ui ua mvur✓cu uy Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such cove ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the a'ns an penalties of rjury, th t th in ormation on this app lication is true and complete. FIRM N a L°% r Eli -5 LIC. NO.: Licensee: �� Signature IC.N0.:2•� (If applicable, enter "exe pt" in thelicen a njituber line.) , / p Bus. Tel. No.: Address: �1/`e 2r 1 �dt r R.�11 Z?�,7/ Alt. Tel. No.: " *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE. $ T..1...,L....... 1x7., / The Commonwealth ofMassachuset l ` T % ! Department of Industrial Accidents Et t; Office of Investigations 600 Washington Street g , Boston, MA 02111 www.)iaassgov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractorsxlectricians/Plumbers Applicant Information Please Print Le�b)y Name (Business/organization/Individual): Address: City/State/Zip: : Phone #: . Are you an employer? Check.the appropriate box: L ❑ I•am'a employer with 4, ❑ 1 am a general contractor and I employees (full and/or part-time).* 2. ❑ I am .a.sole proprietor. or have hired the sub -contractors listed t partner- on the attached sheet ship and. have no employees These sub -contractors have working for me in any capacity, workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required_] 3. ❑ I ani a homeowner doing all work officers have exercised their right of exemption per MGL myself. [No•workers' comp. c. 1.52, § 1(4),'and we have no insurance -required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ]] Demolition 9. ❑ Building addition 10. ❑ -Electrical repairs or additions 11.[] Plumbing repairs or additions 12.[] Roof repairs 13.❑.Other t - - -- . ­tr t muse aiso nu out the section below showing their workers' compensation poiicy infomtation. Homeowners who submit this affidavit Indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box mustattocbed an additional A. -or showing the Warne of the sub -contractors and their Workers' comp• pcii^/ infa gnat on. I am an eeRloyer that & prgV1dMg:worherr' cOrApensadon insurance fop MY. employees: Below is the policy and job site information. ' Insurance Company Name: Policy # or Self -ins. Lie. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'.*compensation policy declaratiou page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL e. 152 can lead to the imposition of criminal penalties of a - fine up to.$1,500.00 and/or one-year imprisonment; as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby certify under the pains and penalties of perjury that lite information pravided above is true and correct Sienature: Date: Phone #: F fftciat use only. Do not write Lin tkis area, to he cannp'gted by cky or town official City or Town: Permit/License # Issuing Authority (circle one): L Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone #: Location No. — Date NaRT� TOWN OF NORTH ANDOVER F s 9 i y s �o Certificate of Occupancy $ , ► <K�t�s4 j cMus `� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ^� Check # ! � `5� 2 4 U J 4 14Building Inspector Permit NO: Date Issued- TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received ANT: Applicant must complete all items on this (3eve Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes 100 year-old structure yes TYPE OF IMPROVEMENT ❑ New Building tkAddition ❑ Alteration ❑ Repair, replacement 0 Demolition 4 OWNER: N PROPOSED USE Residential ❑ One family ❑ Two or more family No. of units: ❑ Assessory Bldg 0 Other Non- Residential ❑ Industrial ❑ Commercial ❑ Others: �I� � _��rluuuplaina• (upw=etianci5� � � tf®��V� DESCRIPTION OF WORK TO BE PERFORMED: Please Type or Print Clearly) CONTRACTOR Name: Phone: Address: %? iv\AA/ly cx*A A/4 Supervisor's Construction License: ?I Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. N FEE SCHEDULE: BULDING PERMIT.• $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ �� FEE: Check No.: f (o Receipt No.: a 7� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOS Public Sewer Tanning/Massage/Body ElSwimming Pools El Well ❑ Tobacco Sales Food Pacl g/S# ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed COMMENTS L HEALTH COMMENTS DATE REJECTED S DATE APPROVED Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dempster on site yes . no Located at 124 Main Street Fire Department signature/date COMMENTS CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 533-2011 Date: August 24, 2011 THIS CERTIFIES THAT THE BUILDING LOCATED ON 75 and 81 Beverly Street North Andover, MA 01845 MAY BE OCCUPIED AS 2 units of a 4 -family (per ZBA 2010-011) IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: ee: 200.00 F -eipt: Doug Ahearn JEFFCO, Inc. - /t,,/t ; 4, Building Inspector 6 z • E if N t ca p 0 N C w A m Of C _ m O cm C �C N CD O Z cm C/) E"4 p u C/) Q u C/) d I u O O v .7 2 O co 0 E c L 0 CD � v Z O y 0 C C C H Q 'ca E m m ow CL F— 3� 0 0 _R O d �Q C4caC C CA)COD z J .� C CD CL �..± CO) � C � C C. E Q to U) It W W U) x v ° A C V ° oo O ` �r 0. w C x •dam z w • ; a C o c.° a cin CG w° a°' U � w o'd rs: i7. W o w " /) cm w" o c w�' w cA o cn v .i cn E if N t ca p 0 N C w A m Of C _ m O cm C �C N CD O Z cm C/) E"4 p u C/) Q u C/) d I u O O v .7 2 O co 0 E c L 0 CD � v Z O y 0 C C C H Q 'ca E m m ow CL F— 3� 0 0 _R O d �Q C4caC C CA)COD z J .� C CD CL �..± CO) � C � C C. E Q to U) It W W U) C V O ` C H O C c O C1 V •dam • ; a C Z O OCD CD N 5EQ 03 03 CF D o c N C Om 00 Q • ca cc mm o � �' N r 3 c c � m� ' c •r _ m .0 y Cc CO)41 m a 0 C 07 r.L� 4D N m ; _ O C O Q y,n N � N It Z 0. CDCD N O C 1-- O Q.4 - CM W C O O=. 'p D .y r _ ♦+ •N LU C3 'O cm - C.3O V o32 COD n 'coo "F. a 'a _ cm Mo 4- CL E if N t ca p 0 N C w A m Of C _ m O cm C �C N CD O Z cm C/) E"4 p u C/) Q u C/) d I u O O v .7 2 O co 0 E c L 0 CD � v Z O y 0 C C C H Q 'ca E m m ow CL F— 3� 0 0 _R O d �Q C4caC C CA)COD z J .� C CD CL �..± CO) � C � C C. E Q to U) It W W U) Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No, MGL Chapter 166 Section 21A—F and G min.$10041000 fine Doc:.Building Permit Revised 2011 June/mi Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted"with the building application Doc: Doc.Building Permit Revised 2008mi