HomeMy WebLinkAboutMiscellaneous - 84 PEMBROOK ROAD 4/30/20188
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TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ............ ....... "— .........................
has permission to perform ......
wiring in the building of ...... 0 ....................................
at ......................... .J.1!C...... . North Andover, Mass.
Fee—.5 ..... Lic. No.'4
2 L2
...............
......... .........
ELECTRICAL INS: ..
" cTolt
Check ae:::5 I
Commonwealth of Massachusetts Official Use Only
Department of Fire Services Permit No.
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] leave blank
APPLICATION FOR PERMIT TO, PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: �J-Vrye- 30 a.pUg—
City or Town of: f) A C)CL)P(Z To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street & Number)
Owner or Tenant C'O k ID
Owner's Address SQ,rn e --
Is this permit in conjunction with a building permit? Yes Q
Purpose of Building (\S } Qi4� 1 (/�
� �
S
Overhead ❑
Overhead ❑
Existing Service Amps
New Service Amps
Number of Feeders and Ampacity
Volts
Volts
Telephone No.
No ❑ (Check Appropriate Box)
Utility Authorization No.
Undgrd ❑ No. of Meters
Undgrd ❑ No. of Meters
Location and Nature of Proposed Electrical Work: � � �V i `acz'lic weLvT
Completion of the followiniz table may be waived by the Inspector of Wires.
No. of Recessed Luminaires g
No. of Ceil: Susp. (Paddle) Fans
No. of Total
Transformers KVA
No. of Luminaire Outlets
No. of Hot Tubs
Generators KVA
No. of Luminaires
AboveIn-
Swimming Pool rnd. ❑ rnd. ❑
o. o Emergency Lighting
Battery Units
No. of Receptacle Outlets l 5
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
Initiating Devices
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/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local ❑ Municipal ❑ Other
Connection
No. of Dryers
Heating Appliances KW
Security Systems:*
No. of Devices or Equivalent
No. of Water KW
Heaters
No. of _ _ No. of
Signs Ballasts
Data Wiring:
No. of Devices or E uivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
Telecommunications Wiring:
No. of Devices or Equivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: /-500 -- (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 1.0, 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 K BOND ❑ OTHER ❑ (Specify:)
I certify, under the afns and penalties of perjury, that the information on this application is true and complete-
FIRM
ompleteFIRM NAME: ` moi' 6Gr' i L` � Jr LIC. NO.:_ ' �
Licensee:� K . Signatur - Of LIC. NO.:, oe-j t7o')q
(If applicable, enter " empt" a license number line.) Bus. Tel. No.: a3 %- i3 %/
Address: t'% �relJ YQ� 9 0 �'G (/ 7'!/s 0y � Alt. Tel. No.: p/
*Security System Contractor License required for this work; if applicable, enter the license number here:
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 a ent.
Owner/Agent PERMIT FEE. $ �
Signature Telephone No.
1
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CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number 509 1/27/06) Date: June 21, 2007
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 84 Pembrook Road
MAYBE OCCUPIED AS Single Family Dwelling IN
ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING
CODE AND SUCH OTHER REGULATIONS AS MAY APPLY.
Certificate Issued to: Andover Construction
51 Thistle Road
North Andover MA 01845
�Z,,,BOa- 6,K,.,
Building Inspector
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APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION
Buildino Permit # 50`1
ADDRESS/LOCATION OF PROPERTY: Ft( p(enq fj
Map 3�- Parcel a9_ Lot Number
SUBDIVISION
DATE REQUESTED FILED/READY FOR INSPECTION
CLOSING DATE ON PROPERTY: &LSI o .7
FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED
ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-
INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE CHARGED IF THE STRUCTURE
DOES NOET AL LICABLE CODES.
SIGNED
ROUTING
CONSER`,/ATION
PLANNING E#
DPW - WATER METER
SEWER/WATER CONNECTION
NOTE
DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO
SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST
DPW 2LA� W"
Signature
File: OC form revised 2006
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Mr. Gerald Brown
Inspector of Buildings
Town of North Andover
Building Department
400 Osgood St.
No. Andover, MA 01845 6/23/06
RE: S ctural Inspection of Installed Engineered Components
80&U4embrock St., No. Andover, MA
Dear Mr. Brown:
Pursuant to Mr. Scott Peter's request I inspected the referenced properties on June 23,
2006, with him.
The purpose of this inspection was to review the installation of the engineered lumber
steel beams and associated hardware in compliance with the approved plans at the
referenced addresses.
In my professional opinion, the engineered structural components of these residences
were installed in compliance with the design and the requirements of the Massachusetts
State Building Code.
If I can be of any further assistance, please call me.
29 fully,
Donald A. George, PE
CC: Scott Peters
Permit Address Square Footage Amount Pd
Two family project stopped 263 A&B 90 Pembrook Rd $ 5,580.00
New Project 492 90 Pembrook Rd 3000 $ (3,750.00)
$ 1,830.00
/Z
Gerald Brown, Inspector of Buildings
Date..................................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ...ll
....... ...... .........................................
has permission to perform
wiring in the building of ..............
.::.:.......:....:.............� ...................
at .... . ......... . North Andover, Mass.
Fee.'�O �. .......... Lic. No..
.'i�R-ICAL iN*............
SP Z77Sys i
Check. #
67-1.3
Commonwealth of Massachusetts
Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
Permit No. 113
Occupancy and Fee Checked
[Rev. 9 051 (cave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
\I1 .\ork to he pertarmed in accordance \\ith the \I;IssachuSCUS faech•ical Code i\IEC?, i?" (AIR 12.60
I PLE: ISE PRI.NTILVINK OR TYPE; ILL LVI )RH I Tlo,v1 Date: c5 0j
Cih, or Town of: IV, 6miz e v f/z TO lhC 1171NIV OP 11j
13y this ,Ipplil'ation the undersigned gives notice of Itis or her intention to perform the electrical \IIork descrihed below.
Location (Street & dumber) Fz{ �-�Af
(honer or Tenant 6nJ.%
Owner's Address
Telephone No.
Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box)
Purpose of Building 4z, W,0rr 1"4 11111 Utility Authorization No.
Existing Service :\nips / 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: eveg/ _
10
C 'unipleliml IV "flu .'ijIlnu i)w h,hly ))),IL l;v 1, x,111, ,l by lla 1-irrn-, ?„r / It',
No. of Recessed Luminaires
No. of Cei1.-Susp. (Paddle) Fans
No. of Tutal
Transformers KVA
No. of Luminaire Outlets
No. of Hot Tubs
Generators KVA
No. of Lnminaires
Swimming Pool •%boveIn-
El• 11
No.
o. o Emergency rg tug
<Jrud. rod.
Itits
Na. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS 1-4 o. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
i Initiating Devices
No. of Ranges
No. of Air Cond. Total ;No. of Alerting Devices
Tons g
,No. of Waste Disposers
Heat Pump
Number
Tons
KW I No. of Self -Contained
foitals:
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
`vlunici al
Local ❑ P ❑ Other
Connection
No. of Dryers
Heating Appliances KW
Security S stems:*
No. of Devices or Equivalent
No. of WaterKN
No. of No. of
Data Wiring:i
Heaters —
Sns Ballasts
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of :Motors Total HP
I clecommunications Wiring:
No. uI Devices or E uiNalent
(OTHER: �vr� 4
IRm-it, ,l.hu,u:u; Jr7rlu,J lr'l;I,d, •Xaa Il h.b J,r il, l,ctl,,r: f!,.
f .,.timatvd Value of Electrical Work: F7( t k hen required by municipal policy.)
\Lurk to 5tart: 6 —/U— O h Inspections to be requested in accordance with EIEC Rule 10. and upon comPlctiort.
INSLRANCE COVERAGE: 1- nless waived by the owner. no permit for the performance of electrical work (nay i'u
se LII( 7
the• licensee prcvideS hroafOf IiabiIitN insurrttuc inc 11Idina "'.umPlctcJ operation" Covera"e or its .r.rb (antial quiv,llent. I h
nder ,i:.nc l ccrrltrct that , uch co\ rwe I:. In lurcc, and h,Is c: hihitvd prof t„t:;arne to the permit rs>uin otficc.
III:C K0\I- fail t�.\\lis�J t1Fll R ❑ Itipeclly.i
9✓ .','1'!I�t�. /fA//'
fit SIL'/ /!( �(7i/d.S /7
d.11(�t” 7,.fPIN Ij 1Prf_j', ''I[ / .t/1 t� ltA�/)/"11H}1711!/
,ia .•11 LS r%,%/)//(.'!d/!//tl 'J ;1'AJt' ;1;'!f C'U .'-//)-Vis.'/C. I
tR;til �
Licensee:/��
i3us. T1. No.
Address:�/ Ol �n r/ kit. TO.
`Security Sv,tcm Contractor I_Jccnr;c required tier this wc,rk; if applicable., enter the license number here: ---- -
1AVNFR'S INSURANCE 14AIVER: I ;rm aimtrc that the L.i:cn ec cln 171:1 170v1 the li..tbility insuruuc :•.:•:1`t`c n.:rm;Illy _..
required by law. 13y my r.i_natuc bcluvv, I hcr�by Waive this, requircnnnt. 1 ;rm the (ehcck rnc) ❑ .sooner ❑ u\\'nea':, .rte= :Izt.
Owner/Agent
f�
A
Date... :..1y:.. V6.......
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
_ � r
�_ -.-
This certifies that .�.........�.t'.".4:�::-;��::-.......................................................
his permission to perforrn� .......t..
wiring in the building of......,f..................1........................................................
'-•—�'.......... ,North Andover, Mass. -
Fee,.' .?�Z.......... Lic. No.��.` ! '..... 1-- ,v.
ELECTRICAL INSPECT�(SR
Check # 1/5490?
Y
3
F Official Use Only
Permit No_
elfJaowgw.7w ogss>4ed6sr`'7 7s
a04uW-le 4 p-*;-- 5410 Occupancy & Fee Checked" _ "
BOARD OF EIRE PREVENTION REGULATIONS 527 CMR 12.00
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All wok to be performed in accordance with the Massachusetts Electrical Cade 527 CMR 12:00
(Please Print in ink or type all information) Date G ' /3 � O
To the Inspector of wires:
Town of North Andover
The undersigned applies for a permit to perform the electrical described below.
Location (Street 7NumberJAA-e
Owner or Tenant l
/
Owners Address
is this permit in conjunction vwith a
Purpose of
Yes
E>ksfing Service A►np, Voi s
New Service 1�-�� A Vohs
■
on
(Check Appropriate Baa,}
ilfilitY Aute fQo.
2.9
Number of Feeders and Ampacity QST ^
Loc a ion and Nature of Proposed Elect Work
Undgrd ❑ No. of Meters
U (K No. of Meters
S-URANCE COVERAGE Pursuant to t
I have a current Liability Insurance Policy
Matt valid proof of same to the
E = BOND = OTHER =
Estimated Value of EI Work%
Wo* to Start
Signed under the Penalties of perjury:
FNW NAME
qui en6ts of Massachusetts General Laws
paled Operations Coverage or its substantial equivalent F.S NO =
= No = if you have checked YES please indicate the by checking the appropriate box
Specify? (Expiration Date)
tnspeetion Date Res/ue
qst/edj Rough L'J'� (��
l� D` Final
-
6( W Y'0 IA .CA- G{ f+L0-H C//Com- 1 ._— n LIC. No. C --
LIG. NO:
�
/ Bus. Tel No. %O 6 E- � " 6 R
Addis /(�- �� Z r l'� 0--p S �� An Tel. No.
nralent as required by Massachusetts
OWNER'S INSURANCE WAIVE :tam aware that the Licenses Iles net have the insurance coverage or its substantia) egii
Gertml Laws. And that my signature on this pen -nit application waives this requirement. Owner Agent (Please Check one) r .�
Telephone No. PERMfTfEE
(Signature of Owner or Agent)
Total
No. of Hot fuse
No. of Transformers KVA
No. of Lighting Outlets
Above ❑ In ❑
No. of L6hting Fixtures
Swimming Pool
gmd ❑ gid ❑
Genowalors . KVA
No- of 6rmergency 9
No. of OR Somers
UBattery nits
No. of 04te Outlets
No.
No of Gas Burners
of Zone
No_ ofS titch OuU�s
Total
a
No. f E)el>�On and
No. of
No ol Air Cond
Toms
t Dev ms
No. of Ranges
Heat Tont:.
No_
Pum ns To
KIN
No. of SourMnmg DeAces
No,
Not.of`Self Contained
Aevmaes
Ram Head KW
No- of Dishwashers
p Municipal D Other
Loral
Heating Devices KW
No of DryerS
No Of
NO. Of
Low Voltage
No, of Water Heaters KIM
S
Batases
Wring
w, "-im mna -nafse Tuds
NO. Of Motors
Total HP'
S-URANCE COVERAGE Pursuant to t
I have a current Liability Insurance Policy
Matt valid proof of same to the
E = BOND = OTHER =
Estimated Value of EI Work%
Wo* to Start
Signed under the Penalties of perjury:
FNW NAME
qui en6ts of Massachusetts General Laws
paled Operations Coverage or its substantial equivalent F.S NO =
= No = if you have checked YES please indicate the by checking the appropriate box
Specify? (Expiration Date)
tnspeetion Date Res/ue
qst/edj Rough L'J'� (��
l� D` Final
-
6( W Y'0 IA .CA- G{ f+L0-H C//Com- 1 ._— n LIC. No. C --
LIG. NO:
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/ Bus. Tel No. %O 6 E- � " 6 R
Addis /(�- �� Z r l'� 0--p S �� An Tel. No.
nralent as required by Massachusetts
OWNER'S INSURANCE WAIVE :tam aware that the Licenses Iles net have the insurance coverage or its substantia) egii
Gertml Laws. And that my signature on this pen -nit application waives this requirement. Owner Agent (Please Check one) r .�
Telephone No. PERMfTfEE
(Signature of Owner or Agent)
J, / 41 � -7 AI�7
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