HomeMy WebLinkAboutMiscellaneous - 814 Waverly Roadr-
14
Date .... ... .-.......
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ....... .::.. .......--
......................................................
has permission to perform.. -' - -.. ......................
t _
wiring in the building of ............ .............
at ... I.Al..... . .............................. . North Andover, Mass.
Fee
..................... Lic. No. �T.1alAlo _ ✓ ' u�:...............
.....................................
ELECTRicALI pECTORc
�1 v
Check # y-1,1 /
7357
Commonwealth of Massachusetts
Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code M C), 527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:
City or Town of: NORTH ANDOVER To the Inspector of Wires:
By this application the undersigned gives notice of his or he - in(t�e tion t for the electrical work described below.
Location (Street & Number)
Official Use Only.
Permit No.
Occupancy and Fee Checked
[Rev. 1/07] (leave blank)
Owner or Tenant
Owner's Address
Telephone No.
Is this permit in conj ct'on with a bucil)ding permit? Yes ❑ No 'W (Check Appropriate Box)
Purpose of Building X��� \ � �� Utility Authorization No.�4 g./P//
Existing Service Amps / Volts Overhead ❑ Undgrd ❑
New Service
C-1
Amps �\, / ��-lVolts
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
Overhead`Q Undgrd ❑
J&� W"�W V -N -A �
No. of Meters
No. of Meters
Completion of the following table may be waived by the Inspector of Wires.
No. of Recessed Luminaires
No. of Ceil.-Susp. (Paddle) Fans
No. of Total
Transformers KVA
No. of Luminaire Outlets
No. of Hot Tubs
Generators KVA
No. of Luminaires
Swimming Pool Above ❑ In- ❑
rnd. rnd.
o. o Emergency Lighting
Batter Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
InitiatingDevices
No. of Ranges
No. of Air Cond. Total
Tons
No. of Alerting Devices
g
No. of Waste Disposers
Heat Pump
Totals:
Number
Tons
KW
No. of Self -Contained
Detection/AlertingDevices
No. of Dishwashers
Space/Area Heating KW
Local ❑ Municipal El Other
Connection
No. of Dryers
Heating Appliances KW
Security Systems:*
No. of Devices or Equivalent
No. of Water KW
Heaters
No. o No. of
Signs Ballasts
Data Wiring:
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
Telecommunications Wiring:
No. of Devices or Equivalent
OTHER:
r Attach additional detail if desired, or as required by the Inspector of Wires.
' Estimated Valu of Electrical Work: J (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 coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE EL BOND ❑ OTHER ❑ (Specify:) j�j(�,6,
I certify, under to pains and pet t alties o perjury, that the information on this application is true and complet .
FIRM NAME: �� �� C1�C �C\k LIC. NO.: 'N��
Licensee�NW, - LN (� 1 M +(� Signature LIC. NO.:
(Ifapplica meter ' kxempt " ' th license number line.),, Bus. Tel. No.: \—) q
Address: N J �`�C� Alt. Tel. No.
*Per M.G.L c. 147, s. 57-61, security work requires Departm nt 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: $
Signature Telephone No.
C&Xd 5 3 - � 7 PM
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
M "M - www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): C
Addr
City/State/Zi �I
j� hone
Are you an employer? Check the appropriate box:
1. ❑ I am a employer with 4. ❑ 1 am a general contractor and I
employees (full and/or part-time).* have hired the sub -contractors
21C, I am a sole proprietor or partner- listed 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 am a homeowner doing all work
myself. [No workers' comp.
insurance required.] t
officers have exercised their
right of exemption per MGL
c. 152, § 1(4), and we have no
employees. [No workers'
comp. insurance required.]
Q�
Type of project (required):
6. ❑ New construction
7. ❑ Remodeling
8. ❑ Demolition
9. ❑ Building addition
109 Electrical repairs or additions
1 I.❑ Plumbing repairs or additions
12.❑ Roof repairs
13.❑ Other
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
t 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 must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy infonnation.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information. �1
Insurance Company Name
Policy # or Self -ins. Lic. #:yy��� Expiration Date:
Job Site Address: \City/State/Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 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 may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I d �y�ertify unddr.��nd penalties of perjury that the information provided a¢ove is true and correct.
Sig -nature: \\ --%*,t1J `\ Date:
Phone
Official use only. Do not write in this area, to be completed by city or town official
City or Town: Permit/License #
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone #:
Location t,� If i i 1
No. '2q9 r25' -- Date
�aRTM TOWN OF NORTH ANDOVER
t
-79
• ; . Certificate -ofOccupancy $ f
��s^° • E��
cwus Building/Frame Permit Fee $
s�
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #�
Building Inspector
BOLSE, Double 1-3/4" x 9-1/4" VERSA -LAM® 2.0 3100 Sfbor BeamlPorch beam
BC CALC@ 9.2 Design Report - US 2 spans ( No cantilevers 10/12 slope Monday, July 24, 2006 13:01
Build 141
Job Name: Towler
Address: 125 Colonial Ave
City, State, Zip: N. Andover, MA
Customer: Dellagatta Contracting
Code reports: ESR -1040
File Name:
BC CALC Project
Description:
Porch beam
Specifier:
V
Designer:
Kimberly Smith
Company:
Cyr Lumber Co
Misc:
39 Rockingham Rd, Windham, NH
. .r yr 1 .r .b . � . . a. .r .i• . g �tr . . 3 . . +r e
' . i s o � .r :. r, � � v v r., .t...
.r V,t V V . • . s V dr i 2
y v
Load Case
V
Total of Horizontal Design Spans = 16-00-00
Load Summary
l-��
f;;
Gje
Duration
Load Case
Live Dead Snow Wind
Roof Live
Tag Description
Load Type
08-00-00;...,..
AL
08-00-00
End
B0, 1-3/4"
B1, 3-1/2"
1 3 SEASON FLOOR
B2,1-3/4"
LL 1733 lbs
LL 4950 lbs
16-00-00
LL 1733 lbs
DL 1269 lbs
DL 4229 lbs
Unf. Area
DL 1269 lbs
SL 1110 lbs
SL 3700 lbs
25 psf 40 psf
SL 1110 lbs
Total of Horizontal Design Spans = 16-00-00
Load Summary
Value
% Allowable
Duration
Load Case
Live Dead Snow Wind
Roof Live
Tag Description
Load Type
Ref.
Start
End
100% 90% 115% 133%
125% Trib
1 3 SEASON FLOOR
Unf. Area
Left
00-00-00
16-00-00
60 psf 10 psf
08-03-00
2 ROOF & CEILING
Unf. Area
Left
00-00-00
16-00-00
25 psf 40 psf
09-03-00
3 WALL
Unf. Lin.
Left
00-00-00
16-00-00
100 plf
n/a
Controls Summary
Value
% Allowable
Duration
Load Case
Span Location
Pos. Moment
6562 ft -lbs
43.0%
115%
13
1 - Internal
Neg. Moment
-10303 ft -lbs
67.5%
115%
2
2 - Left
End Shear
3024 lbs
42.8%
115%
13
1 - Left
Cont. Shear
5259 lbs
74.3%
115%
2
1 - Right
Total Load Defl.
L/712 (0.135")
33.7%
15
2
Live Load Defl.
L/963 (0.1 ")
37.4%
15
2
Total Neg. Defl.
-0.012"
2.4%
14
2
Max Defl.
0.135"
13.5%
15
2
Span / Depth
10.4
n/a
1
Notes
Design meets Code minimum (L/240) Total load deflection criteria.
Design meets Code minimum (L/360) Live load deflection criteria.
Design meets arbitrary (1") Maximum load deflection criteria.
Minimum bearing length for BO is 1-5/8".
Minimum bearing length for B1 is 4-7/8".
Minimum bearing length for B2 is 1-5/8".
Entered/Displayed Horizontal Span Length(s) = Clear Span + 1/2 min. end bearing +
1/2;intermediate bearing
Connection Diagram
• •
a minimum = 2" c = 5-1/4"
b minimum = 2-1/2"d = 24"
Member has no side loads.
Connectors are: 1/2 in. Staggered Through Bolt
Page 1 of 1
Disclosure
Completeness and accuracy of input must
be verified by anyone who would rely on
output as evidence of suitability for
particular application. Output here based
on building code -accepted design
properties and analysis methods.
Installation of BOISE engineered wood
products must be in accordance with
current Installation Guide and applicable
building codes. To obtain Installation Guide
or ask questions, please call
(800)232-0788 before installation.
BC CALC@, BC FRAMER@ , AJS-,
ALLJOISTO , BC RIM BOARDTM, BCI@) ,
BOISE GLULAMTM, SIMPLE FRAMING
SYSTEM@) , VERSA -LAM@, VERSA -RIM
PLUS@ , VERSA -RIM@,
VERSA-STRANDTM, VERSA -STUD@ are
trademarks of Boise Wood Products,
L.L.C.
_.v
Location � '
P V
NO. Date
NORT" TOWN OF NORTH ANDOVER
Ot,,,°G
:°amw&'.'%
p
`
Certificate of Occupancy
$
Building/Frame Permit Fee
$
y,SSA�NUS t�
C
E"" ;Foundation Permit Fee
° i
�Permit ees
$�
$`•���
Sower, Connection Fee
$
Wat�rr.,Eonnection Fee
$
-M-r A
J %P J J
,99e Building Inspector
`- 6 V 6 Div. Public Works
PERMIT NO... y
APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
/PAGE j
MAP 4-40.
I LOT NO. Q
,r
2 RECORD OF OWNERSHIP iDATE
BOOK PAG
ZONE
SUB DIV. LOT NO.
—
LOCATION
PURPOS OF BUILDING L�
OWNER'S NAME ,y T ��Q�L J /�'
NO. OF STO 4
OWNER'S ADDRESS/�aJ�,�lC
l
BASEMENT OR SN's
ARCHITECT'S NAME
SIZE OF FLOOR TIMBkPtk IST 2ND 3RD
BUILDER'S NAME �mm�� 1 �dG L !� �.� t?'�p
SPAN
DISTANCE TO NEAREST BUILDING
DIMENSIONS OF SILLS
POSTS
DISTANCE FROM STREET ("'("'�
DISTANCE FROM LOT LINES - SIDES ?OVfI� REAR
J
A. �
GIRDERS
AREA OF LOT FRONTAGE
HEIGHT OF FOUNDATION T KNESS
IS BUILDING NEW
SIZE OF FOOTING X
IS BUILDING ADDITION
MATERIAL OF CHI EY
IS BUILDING ALTERATION
IS BUILDING OA SOLID OR FILLED LAND
WILL IJSb CONFORM TO REQUIREMENTS OF CODE
r
IS BUITf4G CONNECTED TO TOWN WATER
'B{
BOARD OF APPEALS ACTION. IF ANY
IS B ILDING CONNECTED TO TOWN SEWER
pi 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
OR AUTHORIZED AGENT
pX
FEECP',O
PERMIT GRANTED
✓;/� 19
0WNER TEL.
CONTR. TEL. #
CONTR. LIC. #
3 PROPERTY INFORMATION
EAT. G. COST
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
4
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY
STORIES
MULTI. FAMILY
OFFICES
APARTMENTS
CONSTRUCTION
2 FOUNDATION
8 INTERIOR FINISH
CONCRETE
PINE
3
1
2 13
_ _
CONCRETE Ell. K.
BRICK OR STONE
HARDW D
PIERS
PLASTER
DRY WALL
_
_
_
_
_
_
_
UNFIN.
3 BASEMENT
AREA FULL
FIN. B M AREA
_
'/, '/t V.
FIN. ATTIC AREA
_
NO B M'T
FIRE PLACES
_
HEAD ROOM
MODERN KITCHEN
4 WALLS I
9 FLOORS
CLAPBOARDS
B
_
1
2
�_
3
_
_
_
DROP SIDING
CONCRETE
EARTH
HARDW'D
COMMCN
WOOD SHINGLES
ASPHALT SIDING
ASBESTOS SIDING
VERT. SIDING
_
ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY
BRICK ON FRAME
ATTIC STRS. & FLOOR _
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
_
STONE ON FRAME
SUPERIORIPOOR _
ADEQUATE I NONE
5 ROOF
10 PLUMBING
GABLE
HIP
BATH (3 FIX.)
_
GAMBREL
FLAT
MANSARD
SHED
TOILET RM. (2 FIX.)
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. & 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 _
t.e 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.
4
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FORM U - LOT RELEASE FORM
s
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: �0 , t _g�a Z, le Phone G.FJ -c;_ r�
LOCATION: Assessor's Map Number
Subdivision
Street Lt% V 4, 2J,
Parcel
Lot (s) /02 ,4
St. Number_
************************Official Use Only************************
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Comments
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Comments
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Date Rejected
Date Approved
Date Rejected
Date Approved
Date Rejected
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Public Works - sewer/water connections
- driveway permit
Fire Department \�
Received by Building Inspector Date
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