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HomeMy WebLinkAboutMiscellaneous - 87 FOXWOOD DRIVE 4/30/2018Date ..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..........v.. ZZ-4�7— 49— . ..................................................................... has permission to perform ...... ./.......v . ........................................ wiring in the building of .............................. ....................................... at ....... ?.7 .......... ........... -1, North Andover Mass. c. No. ............ ....... ............. Li ���1?3- w . . . ......... . Check # PLE�CTRICAL INSP��f -t� 9074 �orrsnronwaaUh o` li%9aC/tuda�! 1Jsparintsr� o�„tira �awicae BOARD OF FIRE PREVENTION REGULATIONS For Office Use Only Permitt Number: (Rev. q® 7z/ um Occupancy & Fee APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK (ALL WORK TO BE PERFORMED Wmi THE MASSACHUSETTS ELECTRICAL CODE 527 CMR 12;00) PLEASE PRINT IN INK OR TYPE ALL INFORMATION Dater City or Town of: ,Alfa, ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to erform the electrical work described below. Location: (Street & Number) D / �(%� Owner or Tenant: j .P ) e asa 1 Owner's Address: _S .�y►q,Q Is this permit in conjunction with a/I Building Permit? Yes o No IL/ (Check Appropriate Box) Purpose of Building: g (-e t, Utility Authorization #: Existing Service: Amps / Volts Overhead ❑ Underground. ❑ # of Meters New Service: Amps / Volts Overhead ❑ Underground.❑ # of Meters: Number of Feeders and Ampacity: Location and Nature of Proposed Electrical Work: ll`e p (JI, No, of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Transformers Total KVA No. Of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures . Swimming Pool: Above ground o In Ground o # of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners Fire Alarms # of Zones # of Detection & Initiating Devices # of Sounding Devices: # of Self Contained Detection/Sounding Devices Local ❑ Municipal Connection o Other o No. of Switches No. of Gas Burners No. of Ranges No. of Air Conditioners TOTAL TONS: No. of Waste Disposals Heat Pump Totals: Number: TONS: KW: Security Systems: No, of Devices or Equivalent No. of Dishwashers Space /Area Heating: KW Data Wiring, No. of Devices or Equivalent: No. of Dryers ... Heating Appliances KW Telecommunications Wiring: No of Devices or Equivalent: No. of Water Heaters KW No. of Signs: # of Ballasts: OTHER; # of Hydro Massage Tubs No. of Motors Total HP INSURANCE COVERAGE: Unless waived by the owner, no pe for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equi lent. The undersigned certifies that such coverage is in force, and has a hibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER C3Please specify: /AJ� ! cam" Estimated Value of Electrical (When required by municipal policy) Work to Start: 10 /U /01 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I artify, er the pains and penal !es of perjury, that the Information on this application is true and complete. Firm Name: (% 1 LIC. #141� Licensee: Signature: LIC. #. / py/licabl/ e, epter,�e a tin the numberGllne) / ,�j� Address:�� ll i uA o t � /y' /J, /l % l� 1 *31 QIIC 7GI }! AI4 T..I it 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 o OR Agent ❑ Signature of Owner/Agent: Telephone # rPERMIT FEE: S —� Id Date. � /-� / A - - TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... has permission to perform ...�. ..... �J ..................... plumbing in the buildings of ... ........................ at. . 7 . rA �.Llt- ................. North Andover, Mass. Fee. Lic. No.. . ........ .*.-.-? ......... PLUMBING INSPECTOR Check # A1 ?1 837 I 1 INSURANCE COVERAGE: I have a current liabilitv insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ 0 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Sianature of Owner or Owner's Aaent I hereby certify that all of the details and information I have submitted (or entered) regard' thi pplication are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit i ed f is application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 ral Laws. By Title City/Town APPROVED (OFFICE USE ONE Type of License:El PI r Signat re of Licensed Plumber aster ❑Journeyman License Number: MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING CitylTown:.,L , MA. Date: Permit# a Building Location: S9 �oXi nms D(� V e Owners Name:�Cr Type of Occupancy: Commercial ❑ Educational E[] Industrial ❑ Institutional ❑ Residential New: ❑ Alteration: Mr Renovation: ❑ Replacement: ❑' Plans Submitted: Yes ❑ No FIXTURES INSURANCE COVERAGE: I have a current liabilitv insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ 0 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Sianature of Owner or Owner's Aaent I hereby certify that all of the details and information I have submitted (or entered) regard' thi pplication are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit i ed f is application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 ral Laws. By Title City/Town APPROVED (OFFICE USE ONE Type of License:El PI r Signat re of Licensed Plumber aster ❑Journeyman License Number: FIXTURES Z z rn Y O U IL z P N qZ m= Lu a a. W z W H W Z 0 F co Y U) Q z - a X N W O F" Z W W 0 W Z W N W J z U u_ Q Y=� O 0 9� 2 z Q LL� a Y a 2 W W w O Q m m f9 = Y J J W ca to F O SUB BSMT. BASEMENT 1 FLOOR 2 NuFLOOR 3 FLOOR 4 FLOOR 5 1 HFLOOR 6 FLOOR —T"—FLOOR 8 FLOOR a OnlyCertificate# Installing Company Name: 9�!L"Aation �=orpol Address: ` \ v1-t.r' Sv City/Town: �. State: '��. ` ❑ Partnership Business Tel:01,1; -X - L, (a-- Fax: C(i ' to fit-( ❑Firm/Company Name of Licensed Plumber: d INSURANCE COVERAGE: I have a current liabilitv insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ 0 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Sianature of Owner or Owner's Aaent I hereby certify that all of the details and information I have submitted (or entered) regard' thi pplication are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit i ed f is application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 ral Laws. By Title City/Town APPROVED (OFFICE USE ONE Type of License:El PI r Signat re of Licensed Plumber aster ❑Journeyman License Number: 95bu Date ....... ..... .... ... . ... 0"0"," TOWN OF NORTH ANDOVER (Irso' PERMIT FOR WIRING t. This certifies that ............... 6m ... .... ............................. has permission to perform ....... ............ 5... wiring in- the building of ................ IP/ E..... ...........E'1/..'.................................. ....... .................................... at 1%7 ....... J5�Vwob ............ !� ........................ I North Andover, Mass. — -41 Fee ....3......j.....t......—Lic. No../ " 7 .!Pp.d . .................... 4.4 ...... �.. ELECTRICAL INSPECTOAi Check # a vvnnuvllrr�pliu vI I�IWJJf/irI/MJViiJ ���Q Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (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: City or Town of: NORTH ANDOVER 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 l%�yti Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes 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 n Location and Nature of Proposed Electrical Work: 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. grnd. No—.of mergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I 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 No. of Waste Disposers Heat Pump Totals: Number ...................................................... Tons KW No. of Self-Contained Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW p g Local ❑ Municipal El Other Connection No. of Dryers Heating Appliances KW Systems:* SecuritNo. of Devices or Equivalent No. of Water Heaters KW No. of 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: Attach additional detail if desired, or as required by the Inspector of Wires. 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 coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND [:1- OTHER ❑ (Specify:) I certify, under the pains and p nalties ofperjury, that the information on this applicatio is true and complete. FIRM NAME: LIC. NO.: Licensee: ticvt Signatu re LIC. NO.: tOOIR 7 (If applicable, nter "e pt" in the license umb r line.) Bus. Tel. No. Address:/`� S sltJl�kct al �Z/ Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Departm 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) ❑ ower ❑ owner's Owner/Agent Signature Telephone No. PERMIT FEE. $ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organization/Individual): Address: 1CGrJa� City/State/Zip:__ /fib(( Z ( V z-- C Phone #: o20 Are you an employer? Check the appropriate box: L ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. 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. [No workers' comp. insurance 5. ❑ required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] workers' comp. insurance. We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no 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 11.0 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. f 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 information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lie. #: Job Site Expiration Date: 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 do hereby certi er the painj.,,and pffgXes ofperjury that the information provided aboy is true and correct 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 i No. / Date A '-v NORTH TOWN OF NORTH ANDOVER O:1.{O a ; a Certificate of Occupancy $ s,a4us Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 4 3 , . Building Inspl r TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ��,5� ,q�`� BUILDING PERMIT NUMBER: DATE ISSUED: �� O SIGNATURE. Building Commissioner/12EMtor of Buildings Date • • t P"=�O SECTION 1- SITE INFORMATION 1.1 Property.Address: 1.2 Assessors Map and Parcel Number: "0 - , Map Number . Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required -+ Provided R red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of R rd t.l Name (Print) Address for Service : Signature Telephone 2.2 Owner of Record: 2•itame Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name / ! Registration Numbe Addres �/ b(�' gy V Expiration Date Signature Telephone r SECTION 4 - WORKERS COMPENSATION (NLG.L C 152 § 25c(6) 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 .......0 No ....... ❑ SECTION 5 Description of Proposed Work(check all applicable) New Construction ❑ Existing Building ❑ Repair(s) Alterations(s) ❑Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work- � a '0 r for) 61 5�t? ;' r- J"�' r C-" /-/ �;'�o CJ'V SECTION 6 - E9TIMATED CONSTRU TTON COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL VSE ONLY 1. Building (a) Building Permit Fee Multi tier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) �S 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 t Q. Check Number SECTION 7a OWNER AU' ORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR C N TOR APPLIE G PERMIT I> as Owner/Authorized Agent of subject property Hereby autho / e to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION i> 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 Name Signature of Owner/Agent Date 9 m M) .1J m 0 m y d C � PCIO CM) �■ 'O O CD n Z y CL �• ? O CZ So � O � CD o v d� O P.D. CD CD O CD W w a. C• CD y CL v y �• O CO CD CO) O 'o Z O O O Cli CD O CD U2 0 0 z o, O O m O G um O to c .Ort O CA O C N N m c?�c m ..N C Cr N CL m m ... a �. O dCA of � N m a?n B O O ^' -I O m O _ m y OCa C09 O O N• C2. : =r Ca Com? O O H O m CL CD d CO) O �; Cr C d ; G W d �1 OO C : CD N H CD 'C O A cc CA V Co ,.. =: CD; .� m a� N 0 Wim: d 0) a, nom: 1 � O � . CO) Cl) m T m CO) Cn O r� Cn Ri z�°] CJ ,u - n \ / 0 u rn Cn Cn a ro O 7d 'T1 w 'JU Cn q V X17 O �T1 G 117 r rt CO Cn b C<,) � 71 a a0 O Cn G� Ir 0 0 z o, O O m O G um O to c .Ort O CA O C N N m c?�c m ..N C Cr N CL m m ... a �. O dCA of � N m a?n B O O ^' -I O m O _ m y OCa C09 O O N• C2. : =r Ca Com? O O H O m CL CD d CO) O �; Cr C d ; G W d �1 OO C : CD N H CD 'C O A cc CA V Co ,.. =: CD; .� m a� N 0 Wim: d 0) a, nom: 1 � O � . CO) Cl) m T m CO) Cn O CC/ Ri z�°] 17 w ,u - z '17 w Cn PJ A w a ro O 7d 'T1 w 'JU O X17 n �T1 G 117 r rt O Cn b C<,) � 71 a a0 O 0 iJ I ommi 0 O C 1110 l-AW1I1llU1IlNCdll11 UI /v/doodwluJCIIJ Department of Industrial Accidents ` Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Ci '72��(/ /Phone am a omen er performing all work myself m a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employ es working on this job. (''mmnanv name' Company name: Address City Phone#: 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 andlor 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. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. Y do herby certify under the pains and penalties Signature Print the information provided above is bue and correct Official use only do not write in this area to be completed by city or town official' ❑Check d immediate response is required ' Building Dept Contact FORM WORKMAN'S COMPENSATION Date C] Building Dept C] Licensing Board p Selectman's Office Health Department 0 Other HOME IMPROVEMENT CONTRACTOR Registration 111113 tt Type - DBA Expiration 08/25/g8 2. J.A.S. REMODELING CONTR JOSEPH A. SHAW G�oT 6�lASHINGTON WAY ADMINISTRATOR ,' NGSTON.NH 03898' v Af Town of North Andover ti Nark . 0 1tut0 167 'YO Building Department o 2 27 Charles Street North Andover, Massachusetts 01845 978 688-9545 Fax 978 688-9542 .r RAreo rP�tLy DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and.a condition of Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will %be disposed of in /at: Facility location Sig e of Applicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. • . � � ,: car^. MASSACHUSETTS UNIFORM APPLICATION -FOR.PER MITTO.pO°PLUM6LN-G (Type or Print) Date: ,:..;,.� NORTH ANDOVER ,Mass. . a Building Location 00.Y Permit 3y Owners tv� New 12' Renovation Replacement [� FIXTURE i I i i I I i I I i I I Name Plan A:. •:fit : (Print or Type) Check one: Certificate Installing Company Name 6�ma-y'dy Rud •l"wo, (� Corp. Address T V Partner. "'Firm/Co. Business Tele hone Name of Licensed Plumber: PA �Ilt 0V $. . Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond Insurance Waiver: !, the undersigned, have been made aware .that the licensee of 1 -- this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner Agenf\• I hereby certify that all of the details and information 1 have submitted (or en(cmd) in ahavc application ate true and s We to Ute be of Illy '• . knowledge and that all plumbing work and installations licrfotntcd under Permit i t%ucd for (his application will be in eomptianee with all palinept pro. ;d wisions of the Massachusetts State Plumbing Code and Chaplet 142 of lite Ccnual Laws. '-W By Title. City/Town: APPROVED TOFFICE USE ONLY) nature of L censed Plumt�e�c Type of Plumbing License License Number Q Master ,Journeyman z • Z trt -- N ttl OJ O Z 1. > us W N x rn a ac _ z o z 0 cc a� CC O W W • rq !- V y�j of X< z_ d z X W ac O n 7. W Q N (t a a W' x O a D x a Q a z J .. t4 y W S~ �'• O G • S. J Cl a t1C a t- J a X W .Q • Q X� 1- O N y Z N f. Y Z O p of z Y W F' IG O X 0 W Z d H> oa -1 j a cc � a .a 3 O< 'a: t - Y J m G O J 3::Z f- N U. O n o a m Q SUB—eslwT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR f 6TH FLOOR i 7THFLOOR < STH FLOOR A:. •:fit : (Print or Type) Check one: Certificate Installing Company Name 6�ma-y'dy Rud •l"wo, (� Corp. Address T V Partner. "'Firm/Co. Business Tele hone Name of Licensed Plumber: PA �Ilt 0V $. . Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond Insurance Waiver: !, the undersigned, have been made aware .that the licensee of 1 -- this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner Agenf\• I hereby certify that all of the details and information 1 have submitted (or en(cmd) in ahavc application ate true and s We to Ute be of Illy '• . knowledge and that all plumbing work and installations licrfotntcd under Permit i t%ucd for (his application will be in eomptianee with all palinept pro. ;d wisions of the Massachusetts State Plumbing Code and Chaplet 142 of lite Ccnual Laws. '-W By Title. City/Town: APPROVED TOFFICE USE ONLY) nature of L censed Plumt�e�c Type of Plumbing License License Number Q Master ,Journeyman Date. -/My; `# 3472 / TOWN OF NORTH ANDOVER ...... o p PERMIT FOR PLUMBING g SSACMUS� v} This certifies that .y.y!/:P-.N -'-. G !R ... /P,./ -� ........ has permission to perform ..lr A/C 0...w C. .............. plumbing in the buildings of j>pL v.i I .................... V3 at. .... North Andover, Mass. Fee. Lic. No.. /.'VA . ... ......... PLUMBING INS CTOR g WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Office . The Commonwealth of Massachusetts Uy �_�Use Only � b . t. Permit No. Department of Public Safety / .e ed an_ =� BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy & Fee Check 3f90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Ao wont to tw Wortnea in accordance min Me Mausct+u"= F"et"al Code. 527 CMR 12--oo (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date ki _ _-4-2 11 - .,,/a,.�i _ To the Inspector of Wires: City or Town of f of ► 'f The undersigned applies for a permit to the electrical work described below. )-++,_ i " N-4 r Location (Street & Number) w Owner or Tenant t.v dd off Owner's Address is this permit in conjunction with a building permit yes ❑ no (Ch -;k Appropriate Box) Purpose of Building �/ C llr:L�/f 6t d Utility Authorization No. Volts Cverhead ClUndgrd ❑ No. of Meters Existing Service _�mps._J New Service Amps �(u Vcits Overhead ❑ Undgrd kms' No. of Meters i Number of Feeders and Ampacity Location and Nature of Proposed Electrical War ' TOTAL I Cutlets I Na of Hat Tubs 1 No. of Transformers KVA No. c. lighting..utlets Abcve {- -I in r-- No. of Uahtinq Fixtures 15wimmina Pool erne. crud L Generators KVA No. of Emergencl Lignting No. of Receptacle Outlets INo. of Cil Burners Battery Units No. of Switch Cutlets I No. of Gas Burners FIRE ALARMS No. of Zones TOTAL No. of Detection and No. of Ranges No. of Air Conditioners TONS Initiating Devices HEAT TOTAL TOTAL No: of Sounding Devices No. of Disoosals No. at Pumos TCNS KW No. of Self Contained Detection/Sounding Devices No. of Dishwashers Soace/Area Heating KW Municipal Heating Devices KW Local ❑ Connection []Other No. of Dryers Low Voltage No. at No. of Wiring No of Water Heaters KW ISicns Ballasts No. of Hvdro Massage Tubs INo. of Motors Tctal HP I OTHER: INSURANCE COVERAGE: Pursuant to the requirements et Massachusetts General Laws I have a current Liability Insurance Polio y ding Comoleted Operations Coverage or its substantial equivalent. YE NO ❑ I haave submitted valid proof of same tat otfce. YES NO CI It you have checked S, please indicate the type of coverage by checking he acpropriate box. INSURANC 8ON0 ❑ OTHER ❑ (P!ease Specify) (Expiration Date) Estimated Value of Electricat Work S Work to Stag Inspection Date Requested: Rough . Final Signed, under the penaltiessat perjury: LIC. NO /,--- FIRM NAME-4,6f-&'12�Li�!���/ //11 ��NO------ Licensee NO._ Licensee CiNo �.�-� - Signature Sus. tel. No. Address Alt. Tei. No. aired by OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage ar its substantial equivalentscheck as reg Massachusetts General Laws, and that my signature on finis apptication waives this ;;;7n, Owner Agent (Please check one)` Taieoncne No• PERMIT Fc: S_�'1 M so r L,,,- � . « f ...-y� - _T .�.�.r-.ti; fir- +..vF3'�-�-.-...a r '...--+t • -�. ,..� i . i 2906 Date ........ 41W.- TOWN ,..TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .....G.a `V Q t°.. f /��.. c f � • .. I/ (J' ................................................................................ has permission to perform ....... `Q' :..2..... f ..J.l.�`J� c.` ............. wiring in the building of Z� .......!.. �.. J ....................... ...P..... .....%....... at ..... /,.X)l...7........�`q �.wuod .. v �............. . North Andover, Mass. Fee.aA.: d v...... Lic. No. f..� ,............................................................. fELECTRICAL INSPECTOR WHITE: Applicant CANARY Building Dept. PINK: Treasurer GOLD: File Location ? r—o iC CVMQ4 No. Z- �� C--- Date Z� TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ ,ether Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL c< ?11/94s� 42/09/% 12:48 9548 wilding Inspector 25.40 PAID Div. Public Works Locati Q he No. i Z Date sJ�CHUSE� i TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ 1 / 14;12 1,M-00 PAID 9281 (V") Building Inspector Div. Public Works Location No. ZS Date i F � � A;= 9280 Lot `P a TOWN OF NORTH ANDOVER Certificate of Occupancy $ 6--D '.;- Building/Frame Permit Fee $ Foundation Permit Fee $ t (DQ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ 5� Building Inspector Div. Public Works .. .. � „ , _moi t .. 'a �.. rq-.✓�-`.. ./ _ _ �..._//'"`7^,_: Location 8,%'t"Dryc��1 T (0 No. Z Date -16 FY Water Connection Fee $ 4,n77, 5d TOTAL $ 67 J P Inspe tor` 8963 Div. RUEWC70rks AORTN TOWN OF NORTH ANDOVER 3?o'tf� !• '��c �; .. Certificate of Occupancy $ +# BuildinglFrame Permit Fee $ Ac Foundation Permit Fee $ a Other Permit Fee $ Sewer Connection Fee $ FY Water Connection Fee $ 4,n77, 5d TOTAL $ 67 J P Inspe tor` 8963 Div. RUEWC70rks PER111T NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 N4AP K40. LOT NO. I 2 RECORD OF OWNERSHIP (DATE BOOK 'PAGE ZONE SUB DIV. LOT NO. 7� P 1 I LOCATION 2 PURPOSE OF BUILDING OWNER'S NAME OL `f1 NER'S ADDRESS /� ARCHITECT'S NAME 6 , 4e af NO. OF STORIES SIZE 'Vil e tt W �� 2. 44 BASEMENT OR SLAB �aS-r°� � vT SIZE OF FLOOR TIMBERS IST 2 z) 2ND � �// D 3RD 4.[ A Bla1LDER'S NAME V � a- _1 a / / ,r C� Q�/1 SPAN DISTANCE TO NEAREST BUILDING e\ [/ DIMENSIONS OF SILLS �x DISTANCE FROM STREET T�1� "' POSTS DISTANCE FROM LOT LINES - SIDES REAR v GIRDERS �/ 2 AREA OF LOT �i ^ / _ /JAI/ C �.�+FRONTAGE / HEIGHT OF FOUNDATION II THICKNESS / }I V IS BUILDING NEW j SIZE OF FOOTING X IS BUILDING ADDITION �() D MATERIAL OF CHIMNEY s, IS BUILDING ALTERATION A' IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE s 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 Ys INSTRUCTIONS PERMIT FOR FOUNDATION ONLY SEE BOTH SIDES REGULATED BY PARA. 114.8-S. B.C. PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 DATE CFEE PAID -ICo -_ ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING -b ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED SIGNATURE OF OWNER F -E E 1.4 PERMIT GRANTED to ,9 DATE: L d FEE 3 PROPERTY INFORMATION LAND COST 75-7 ey�� EST. BLDG. COST���71 �,c��� v���je EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. �J 4 APPROVED BY OWNER TEL. # CONTR. TEL. # �! 112 CONTR. LIC. # H.I.C. # st' 63 c,Z80 ?�I9 ctm at4rA �� 1 OCCUPANCY SINGLE FAMILY SiOk1E5 _ MULTI. FAMILY OFFICES _ ` APARTMENTS CONSTRUCTION 2 FOUNDATION 1�11 8 INTERIOR FINISH CONCRETE d 1 2 0 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. + DRY WALL UNFIN. ' r h YiD V ��•�" �� ���}�"�•>Io 3 BASEMENT AREA FULL FIN. B'M'TAREA _ 14 1/2 FIN. ATTIC AREA NO BMT FIRE PLACES T L HEAD ROOM — MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS DROP SIDING B _ 1 22 J —I— �— 3 _ CONCRETE WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ EARTH HARDVJ'D COMMCN 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 SUPERIOR I�dPOOR _ ADEQUATE NONE 5 ROOF GABLE HIP GAMBREL MANSARD FLAT SHED 10 PLUMBING BATH Q FIX.) 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 WOOD JOIST I 11 HEATING PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 6 COLS. STEAM STEEL BMS. 3 COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING _ RADIANT H'T'G 7 NO. OF ROOMS UNIT HEATERS GAS OIL B'M'T 2nd _ Isi T3rd I ELECTRIC NO HEATING _ e I C C ='a o m 2 O - •Noa N d O < m C/) O mn m Cl) Z NCL m m ?� N m CL C3 o W o CD O O m N '^ m p -0On.� m p o Z� W O N C! CD C N a aco�. Co CL . �► S m o ?� CD m 972 c CL m O d N N G. Q C .W n H r m � Co n.► < N CD W N yCD O CD pr HOD r.: m CD 0 �3. C� � CO) o m rn C •m v-�N -v ? a m. m C70 ZEL � CJS o n � m M. m (n v, toAli n OI^ C O O O m \) N C C/) In O CO) C-) Cl)CD Z CO) CD O 'O C r C7 C. = y a O Co cmcm ov CDCL CD o ~ Cr 1w CD O CD CD ov o0 � C CD CD CZ CO) O O I co CD •� S y v O CD O Z O � O r -r CD O CD C C ='a o m 2 O - •Noa N d O < m C/) O mn m Cl) Z NCL m m ?� N m CL C3 o W o CD O O m N '^ m p -0On.� m p o Z� W O N C! CD C N a aco�. Co CL . �► S m o ?� CD m 972 c CL m O d N N G. Q C .W n H r m � Co n.► < N CD W N yCD O CD pr HOD r.: m CD 0 �3. C� � CO) o m rn C •m v-�N -v ? a m. m C70 ZEL � CJS o n � m M. m (n CR toAli n OI^ /� O .z O O O m \) N C C/) In O na^' ^' f-1. ~ < O R � J r � 3rD � •� z z N z o W CD v v •z a� Cit m C;77 0 c CD ps FORM U - LOT RELEASE 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***************** _3�s X % r Phonei�APPLICANT: dol? LOCATION: Assessor's Map Number Parcel Subdivision �OX��It�D� Lots) (o Street li o d d 1/f- I v 2 St. Number_ ************************Official Use Only************************ RECOMMENDATI PS OF S: qq Date Approved Ad� `S Conservation Administ ator Date Rejected Comments Town Planner Comments Date Approved Date Rejected Date Approved Food Inspector -Health Date Rejected Septic Inspector -Health Comments Y Date Approved Date Rejected Public Works - sewer/water connectionsj�t,J - driveway permit !p- l'6 -%S' IN WM%NIAl 1 kb. L d 7-6`6 22, 9Z6 s, F = e.. SZ63 AC, 1-1 --- ,,,j& 00 ,ti N �o ^ j0, i �0 S //EPEBY �E.criFY r17 ryE rir� /.t/sa.�•r.4.vO TI% Tf/E BAAo/t' Tygr TyeO/rELG/.yp /S LGYATEO 0.1 rye COrOO -TOWWW ANO riWr/r aamf cav a ,;&ew lY/T// ZON/.va zeaoLATzwr ,or&ft0/, JEr,"cfS FEOM STREETS f LDT U•v---x o r FGA7WZC 4CC;-1FY r.Vilr ,?W" OA-e"1N6 /S .VOr 40G4TE0 /,S/ ryE FEOE.lAG .,CARO WZ4G0 SHOIvN Oit/ FEMA' COM,yt/.viTy P-4.�/GL '� zscao98 oa�z PG O T /J /N O.P•9iriV FO.P �OXwOaO /LE/9LYy Cp,eo �EP.P/i1l4Gf' E.1�6.WEE.P/•l/6 SE.Pi�/CES A.t/OOYEA ; �1.4S.S.4C.fil/SETTS O/8/O EC COLLOPY ENGINEERING CONSULTANTS 65 AYER STREET METHUEN, MA 01844 FRANCIS H. COLLOPY REG. PROFESSIONAL ENGINEER Mr. Dick. Tobin Foxwood Realty Corp. 733 Turnpike Street Suite 311 N No. Andover, MA 01845 Dear Mr. Tobin: w�u Residence: (508) 685-7969 Office: CIVIL (508) 685-8069 STRUCTURAL Fax: N DYNAMICS November 28, 1995 I am writing relative to the existing foundation at Lot 6 on Foxwood Road in No. Andover, MA. I inspected the site on November 27 with you for the purpose of providing my opinion on what should be done to repair the 1/2" wide crack in the garage foundation which recently opened near the right front corner of the garage. I have shown the location of the crack on the enclosed engineering sketch of the garage floor area. This crack occurred in an area where the fill on the inside of the garage was approximately the same height of the surrounding ground level. This is an unusual location to get a crack in a foundation wall. You indicated that it probably could be attributed to the compaction equipment which was used to compact the soil in the garage in recent days. This provides a very logical explanation since the unbalanced soil pressure is practically negligible. This crack can be properly repaired by an approved applicator of a structural epoxy product known as Sikadur Epoxy Resin. This company, manufactures a number of products for this kind of repair where you want to prevent leakage and to restore the structural integrity of the wall. The product which I believe is best suited for your repair work is "Sikadur 35, Hi -Mod LV". This is a high - modulus, low -viscosity, high strength epoxy grouting, with a sealing & binder adhesive. This material is pressure injected into the cracks in a systematic fashion so as to guarantee a full depth repair. I know of two such companies which specialize in this work, and with this product line, namely: Jager Construction Wayne Fortier P.O. Box 325 Crack -X Amherst, N.H. 03031 So. Natick, MA 1-800-722-0768 1-800-548-3379 1-617-235-2389 Upon inspection of the actual crack to be repaired, the Sikadur contractor may recommend another similar epoxy product. It is my understanding that each of these companies stand by their work with a guarantee. There is a loose section of concrete wall which should be removed and replaced, as indicated on the enclosed engineering sketch sheet, prior to the crack repair. The new section should be connected to the existing wall at the cut line with epoxied dowels. It is my understanding that your intent is to construct your slab as shown on the attached sheet, utilizing a mat of reinforcing rods in the slab, so as to connect your slab to the rebars which are in place and which will project out of the existing wall. This is meant to provide a tension tie across the garage slab, and minimize the effects of any outward pressure. There is very little such pressure in the vicinity of the existing 1/2" wide crack, and after the repair with the proper epoxy product, the wall should be acceptable for use. If you have any questions concerning this matter, please do not hesitate to call this office. Sincerely, COLLOPY ENGINEERING CONSULTANTS Francis H. Collopy, P.E. Structural Engineer Attachment COLLOPY ENGINEERING CONSULTANTS 65 Ayer Street METHUEN, MASSACHUSETTS 01844 (508) 685.8069 POO 0-04-5 JOB fOXX W vo D %L E p L 7 - SHEET SHEET NO. / 6F CALCULATED BY F!� L DATE CHECKED BY DATE ,¢.t.6.419. -_s ..... KAREN H.P. NELSON Dinvor BUILDING CONSERVATION HEALTH PLANNING DATE �.- • NORTH .ANDOVER - PLANNING & C0NmUN= DEVELOPMENT CHIMNEY APPLICATION AND PERMIT LOCATION GUC OWNER'S NA14E BUILDER'S NAME /"ir MASON'S NAME 120 Main Street~ 01845 (508) 682-6483 - ... . PERMIT, Z� MASON'S ADDRESS w` ' S TELEPHONE MATERIAL OF CHI:,11lE': INTERIOR CHIMNEY Or EXTERIOR C i LVEY �iiJ . NU14BER AND SIZE OF FT. - :HIC: LESS OF HEART1,i //a Wi'_'_ cn;-nev or to require eats of the code and have rules apdred •latio::s --e=n received: DATE SIG,+ATURE OF MASON _ CO'3TR. LiC. = 111A- .:Crc^+ = 'COTRC PRI CONSTRUCTION COS. PERI.IIT GRJ�IITED ROBERT NICETTA, Bi:ILDI_:G -i S EC' -OR INSPECTED REMARKS FEE c --� 3viCr REQUIRED THIS PE-R-`4IT :MUST BE DISPLAYED ON THE PRE IISE S CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number_ 525 (193j) Date T_ uNE 99h THIS CERTIFIES THAT THE BUILDING LOCATED ON 87 FOXWOOD DRIVE (Lot #6 MAY BE OCCUPIED AS _ SINGLE FAMILY DWEIIING W/ CAR IN ACCORDANCE GARAGE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TOFoxwood Realty C- 733 Turnpike S ADDRESSNorth An ve i ,'�ACNt15� ui din pector C W Q O c•co) CQ y = -� CD 0 m c7 p c w CD 3 m YI •r`� 0 _ � m O T f� ••itY _3 m d ? m C3 m �O w C4 m CO) 0 a.c 0 �. 'T m •CD -4g m CO) CD co 0 Z C. CC.)CA -Z ETI ?� : kC O —s �,� __— W 0 m ., r T - C. 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