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Miscellaneous - 9 GARDEN STREET 4/30/2018 (2)
O O O 9D O O O O 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance -with the provisions of M.G.L. c. 143, § 3L, the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. Permits shall -be limited as to the time of ongoing construction activity, and may be_deemed.bythe ,Inspector_of-Wires abandoned_and_invalid_ifhe—.. _ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or•the installing entity stated on the permit application. ' The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending through August 15, 2012. yule 8 — Permit/Date Closed: Note: Reapply for new permit 01� OPermit Extension Act —Permit/Date Closed: Date... .. ........ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ......... ........ 'L -z..:........ i.has permission to perform ....... !4 7 ... .1'� . ... ....... An��S .... ...' wiring in the building of ......................0 ............................... at .............q.. .....57.................... . North Andover, Mass. Fee.3:�� Lic. No.. ...... ......... CAL INSPECTOR Check # 7136 L. '(f - 2� Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only I/ +l Permit No. ,3/,�, Occupancy and Fee Checked [Rev. 9/051 (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: % S — D '7 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his oyr her intention to perform the electrical work described below. Location (Street & Nu Owner or Tenant i Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Existing Service 2d Amps l / Z70Volts New Service Amps / Volts Number of Feeders and Ampacity and Nature of Proposed Electrical Work: Utility Authorization No. Overhead ® Undgrd ❑ Overhead ❑ Undgrd ❑ No. of Meters I No. of Meters t /Completion of the following table may be waived by the Inspector of Wires. No. of Recessed LuminairesNo. 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. o. o]Emergency Lignting Battea Units No. of Receptacle Outlets 12 No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. o Detection and InitiatingDevices No. of Ranges No. of Air Cond. Total Tons No. Alerting Devices g o. o No. of Waste Disposers ea P umber Tons KW o. of Self -Contained Totals: 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 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: 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: INSURANCEF<1 BOND ❑ OTHER ❑ (Specify:) I certify, under the ams and altie of perjury, hat th information on this application is true and complete. FIRM NAME? t LIC. NO.: 152,S: 2%7 Licensee: Signature LIC. NO.: (If applicab e, enter "exe pt" n e license n er e.) Bus. Tel. No.: D — Address: j6 0 Alt. Tel. No.. O *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 Signature Telephone No. PERMIT FEE: $ __ J?� 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance•withthe provisions of M.G.L. c.143, § 3L, the f permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. Permits shall-be limited as to the time of.ongoing construction activity, and may be.deemed-by the Jnspector-of Wires abandoned_and.invalid-if-he—.. _ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of r the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this puipose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was t "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending through August 15, 2012. �ule 8—Permit/Date Closed: �' *** Note: R ply for new permAll" Permit Extension Act —Permit/Date Closed:-- Date....... � ..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... ./ .... T`1G�........-. A. ............... ,has permission to perform ........E ......................................... wiring in the building of ...........�....................................... $at ........., .........5 ....... ...... . , North Andover, Mass. Fee ,5 —. Lic. No..{ .�!/ ELECTRICAL INSPEC & Check # 8 910 t l_ "A Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No, y� Occupancy and Fee Checked tev.1/07] (leavehlanlrl APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C (MEC), 527 CMR 12.00 (PLEASE PRINTININK OR TYPE ALL INFORIMATION) Date: City or Town of. NORTH ANDOVER " �� ' To the Inspector of Wi es: By this application the undersigne gives notice of hi or her inten 'o to perform the electrical work described below. Location (Street & her) Owner or Tenant n & l 1.... Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes Purpose of Building © NO ❑ (Check Appropriate Box) 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: of Recessed Luminaires 5 No. of Luminaire Outlets No. of Luminaires No. of Receptacle Outlets No. of Switches `n A c:om letion of the ollowin table ENo.of CeiL.-Susp. (Paddle) Fans No. Tra Hot Tubs Gen Swimming Pool Above El In- o. LyrndL na Bari No. of Oil Burners FIR No. of Gas Burners o• No. of Ranges No. of Air Cond. TOta1 Tons No. of Waste Disposers eat Pump Number Totals: Tons I No. of Dishwashers Space/Area Heating KW No. of Dryers ---- Heating Appliances No. of Water No. of KW Heaters KW No. of Signs Ballasts . No. Hydromassage Bathtubs INo. of Motors Total HP OTHER: be waived by the Inspector of Wires. KVA KVA ALARMS ;No. of Zones of Alerting Devices ❑Inumcipat Cnnnerf m. ❑ Other No. of Devices or Data Wiring: No. of Devices or No. of Devices or 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: a Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAG : Unless waived by the owner, no permit for the performance of electrical work mayissue 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 6 BOND ❑ OTHER ❑ (Specify:) I certify, under thpvains and penalties of p fury, that the information on this application is true and complete. FIRMNAME• c` LIC. NO.: f q Licensee: Signature (If applicable enter ' empt " in th icense numbe li LIC. NO.: ��' Address: Bus. Tel No.: p' L-2& -•/ 53 r Alt. Tel. No.:V r, 0_7 *Per M.G.L c. 147, s. 57- 1, security work requires Department of ublic 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 Signature Telephone No. PERMIT FEE. $ ; •a� The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 ;Mashing ton Street Boston, MA 02111 c Workers' Comwww-nnus.gov/dia . pensation Insurance Affidavit: Builders/Contractors/Electricians/Piambers P—Plicant Informntinn Name(BusinessiolgwirahonAndividual): Ad&ess: City/State/Zip: ae S l-2 % /`)i:{4 C, Phone # I�ifi i L� bt1 Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. Q Demolition 9. 0 Building addition 10.0 Electrical repairs or additions 11.0 Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other omeowners who submit this affidavit indicating they are doing all work end then hire outside contractors must submit new affidavit indicating such 3Cotrtractors that check this box musrattached an additional sheet showing. the name of the sub -contractors and their workers' comp. pot; J, icLmTWtian. 14m an employer that i5.pzoviirw9 workers' co►npensadon insurance or a to eet: Below information. A f � nP y is the policy mid job site . Insurance Company Name: Policy # or Self -ins. Lie. #: Expiration Date: Job Site Address: City/State/Gip: Attach a copy of the workers' comtpensation 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 certify under the ormation paints and penalties of perjury that the in f provided 110,vtded above is true and correct Mme. Phone #: A [I. icial use only. Do not write in this area, to be completed by city or town offciaL y or Town: Permit/License # Issuing Authority (circle one): Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector ther Contact Person: Phone #: Are you an employer? Check -the appropriate box: [.� [° am a employer with 4, ❑ I am a general contractor and I employees (full and/or part-time).* 2. ❑ I am.a:sole proprietor or have Dred the sub -contractors listed partner- on the attached sheet t ship and have no employees These sub -contractors have working for me .in any capacity. Mo workers' comp. insurance workers' comp. insurance. 5. ❑ We are a corporation and its required.) 3. ❑ 1 am a homeowner doing officers have exercised their all work right of exemption per MGL myself [No•worken, comp, Z. 152, § 1(4), and we have no insurance required.] t .employees. [No workers' comP• Insumnee required_] d -1 H `MY applicant that checks borC iF l must also till out the section below showing their workers' compensation Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. Q Demolition 9. 0 Building addition 10.0 Electrical repairs or additions 11.0 Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other omeowners who submit this affidavit indicating they are doing all work end then hire outside contractors must submit new affidavit indicating such 3Cotrtractors that check this box musrattached an additional sheet showing. the name of the sub -contractors and their workers' comp. pot; J, icLmTWtian. 14m an employer that i5.pzoviirw9 workers' co►npensadon insurance or a to eet: Below information. A f � nP y is the policy mid job site . Insurance Company Name: Policy # or Self -ins. Lie. #: Expiration Date: Job Site Address: City/State/Gip: Attach a copy of the workers' comtpensation 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 certify under the ormation paints and penalties of perjury that the in f provided 110,vtded above is true and correct Mme. Phone #: A [I. icial use only. Do not write in this area, to be completed by city or town offciaL y or Town: Permit/License # Issuing Authority (circle one): Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector ther Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the'foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or bmstee of an individual, partnership, association or other legal entity, employing employees. 'However the owner.of a dwelling house having not more than three apaa-tments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence.of compliance with the insurance 'coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither t}re commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation• affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), addresses) acrd phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also 'be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not'the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the nurnber. listed below. Self-insured companies should enter their self insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which wiil be used as a reference number. In addition, an applicant r that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating -current policy information (.if necessary) and under "lob Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for firtum permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license: or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit The Office of Investigations would Ifice to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-9.77-MASSAFE Fax # 617-727-7749 Revised 5-26-05 www.mass.gov/dia Juba Electric 589 Chickering Rd. North Andover, MA 01845 Nov. 24, 2006 Brian Cockell 9 Garden St. No. Andover, MA 01845 Dear Mr. Steve Juba, Subsequent to our conversation back in September or October this is a written letter to verify our mutual agreement of contract cancellation and any further commitment or contractual obligation by either party, Juba Electric and Brian Cockell. The conversation was initiated by Brian expressing desire to terminate the existing contract. As was discussed at that time Juba Electric was to review all accounts and get back to Brian within a reasonable time period if there were any obligations due to Juba Electric. The only request by Brian was that of receiving the bathroom fan interior fan parts, since they were not at the 9 Garden St. domicile. As of this date, no parts have been received. Fan: NuTone, model: 668RP, VH668RP. The fan is part is the assembly. The lamp socket, lamp holder and lamp cover are not present. Since no disagreements and no payables have been submitted at this time, both parties are now free of all obligations. Sincerely, Brian Cockell 9 Garden Street CC: A copy of this letter may be made available to the Building Department of the Town of North Andover should they desire it to clear any open building permits or restrictions. j JIM l,t iMVIllty 17r UJ[1 yr AL3 .....,.. w ..., j{ DEPARIIIWOFPUBf1CSOM Permit No. BOARDOFFMPi�EVENHONRBGUiATi0N5527C14R&W Occupancy & Fees Checked —` A.PPUC,A77ONFOR PE &ff TO PEMFORMELE=C, U WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PL9ASE PRINT IN INK OR TYPE ALL MORMATION) Dates '� Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street 8c Number) /M� C,�T— Owner or Tenant Owner's Address Is this permit in conjunction with a building pe t: Ye4M No (Check Appropriate Box) Purpose of Building. Utility Authorization No. Existing Service Amps �� olts Overhead Underground No. of Meters New Service Amps...�.V olts Overhead Underground Q 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 Trwfomrers Told KVA No. of Lighting Fixtures Swimndng Pool' Above Below Oenentm KVA ground ground No. of Receptacle Outlets ! No. of Oil Burner No. of Emergency Lighting Battery Units No. of Switch No. of (Ias Boman FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tone No. of Detection and No. of Disposal No. of Heat Total Total Pu . Tons KW Initiating Devices No. of Sounding Devices No. of Dishwasher Space Area Heating KW No. of Self Contained Detection/Sounding Devices LocalMunicipal _ Other No. of Dryer Heating Devices KW a Connectiogs No. of Water Heaters KW No. of No. of Sign Bailasis No. Hydro Massage Tubs No. of Motors Total HP 9 �; j b IhareshN0vaWpmdcf 0 teOffiM YM ® rl� a+ind�gifie box INANE BWO�m rj anm (PlntseS�ec y) liapectiniDaleltmxsW �vb� n1 c iVon� VU I n �•�— v t� ,' 'SINS<JRAI�WAIVEIt;Iam IhettheLiot�edll�mttiat tbetmy9gr>a�ernifisj�appicatirnwai�ea9isrequeret ease check one) Owner [:3 Agent Q ,eAT, v) YES 0 NO 94 /A -S E*wdVali dEhcnicalwc& $ Ficial U=wNa J3 dl�{d AI<TUNa sub�r>aalegiivala�tasiagtitedbyMasiacht>sts�Gt�alLawa Telephone No. ...PMWr FEE S l Town of North Andover Building Department Mr. Peter Murphy Electrical Inspector 1600 Osgood Street, North Andover, MA 01845 August 10, 2006 Dear Mr. Peter Murphy, This letter is to inform you of our desires to proceed with final electrical finish work from Bailey Electric Inc. rather than continuing with Juba Electric. We at first hired Juba Electric to do our renovation electrical work but found we could not get enough of his time consistently. When we switched to Bailey Electric they were able to schedule the work and arrive on the day they said, and be done that day. If there are no objections from your department, we would like to continue to use Bailey to complete the electrical finish work and any other electrical work as our remodeling comes closer to completion. Thanking you for your patience in this matter. Sincerely, Brian Cockell 9 Garden Street North Andover, MA 01845 6GUl Date.......�/ ........................... ° ` `° • "� TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .................................................................. has permission to perform -�— ........................................................................... wiring in the building of ............................................. at ................................... �f ............ ...... , North Andover, Mass. ,. Fee :��...� ..... Lie. No. ............. ^.... ............................. ELEcrRicALMpEcwk �~ ),Check # 1/ �') l/ I'. ". y170:3,3r Permit No. 60'ai 0copucy R Fea Checked APPUCA71ONFOR PERMITTO PERFORM ELECTRICAL, WORK All. WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSrS ELECTRICAL CODE, 527 CMB 12:00 (PLEASE PRINT IN INK OR TYPE ALL INMRIKATION) I. Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. I A .A Location (Street d Owner or Tenant Owner's Address Is this permit in conjunction with a building permit Yes© No [3 (Check Appropride Boa) Purpose of Building P11 yid e - Existing service 7 o u Amps 1 0 / Z olts New Service Amps. oils Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Elk Utility Authorization No. �! Underground No. of Meters y Undergmund No. of Metes No. of Li&M Oudsu Na of Ha Tubs No. at Tasm"riin TOW No. of LiabW* Rita a Swhnmina Pod Above Below Gamma KVA KVA No. of Receptsctu Oudw Na ofOn Bums No. of Eme Vnmy Ualydna Battery Udti No.of Switeh Oudnb No. of On Bomms FIRS ALARMS No. of Zonis No. of Ramses No, of Ak Cond. Told Tool No. of Dewcdon aW �I No. of Dispads Na of Hest ToW Told Pons Ton Kw ►ddb D•vion No. of Soundirts Dedons •�� No. of Dishwuhew Space Ata Hestina Kql No. of self CwWned DelectiNo. Lo01�0°'�"a Dsvlca Mo OtherNo. of Dryers HeeDrAm KW bner Coactio of Wam Hasten Kw No. of No. of S11108 Bsihnis No. Hydro Mussae Tubs No. of Moors Told HP 1� MIN 011110 itaesanaeGAWF PUauMMAI rRilonedidMaaad»adrGam.11 7hmeat=9Lmb*baa=eicftm ldrBarlsafaerilida�ivsi�t YIN NO o Ihrnesdsrirtedveldpoddsenebfle� YM ti ifyouttatededoedYBS�pkaidtz�llet�Pedaote�t�' iNSURANt� � BM [3 0!h1E+R �lraseSpeoily) /Ei�ioionl� WolklDs R �(` —G it�e- EAMWValredEkc oiWakS tionl7� � l � Pti FIRMNA14E `i�� //J.�� �� L Pl C [.i mNa 0 Busr=T0LNa OWDWSII+TSIJRANCEWAIVFRIanawaedrttlheLicaire — At1RNa c -lJ o c� ���oeaot�eapar�sube�ddt�ivakrit$,er�;adbyMearadieeeGetailLaws arddntnpsig�aeondipearitappfc��lite4it�t a(Please check one) Owner a Agent � Telephone No,31snum or Owner or Rpm pgtlar FEE s 5921 14 Date... N 0 - TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ................. 4 ........... ....................... has permission to perform ........ 1—/.. ... 9 tJ E lift? I ��. . ................... ........ ............................ 46kx, or-Ar--el— wiring in the building of ....... .................................................................. -At .................. ........... Northtknd Mass. .......... 7 Fee../j,5.7 NO..:�� ..... .2'kj i [ ELECTRICAL Check # 11W L UIMV1UIV rvrftun Ur L3 .-•••.. . DEPARIM V1'OFPUBW94MY Permit No. BOARDOFFW MXVffM0NREaLW0NS5V aV 12 - Occupancy & Fees Checked A.PPUCATTONFOR PERMITTO PERFORMELE CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL - 'E, 527 CMR 12:00 --�� (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date ZU// Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number)LA�-�ZA'7 Owner or Tenant Owner's Address S\6 Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building �(,�l•C /410P�mjli,t Utility Authorization No. Existing Service Amps�Volts Overhead Underground No. of Meters New Service Amps _/Volts Overhead Underground 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 FixturesSwimming Pool' Above 1:1and Below Generators gyp ,115 and El No. of Receptacle Outlets j / No. of Oil Burners No. of Finergency Lighting Battery Units No. of Switch t3tiM No. of Gas Burners FIRE ALARMS ° t No. of Zones �� a No. of Ranges No. of Air Cond. Tota Tons No. of Detection and r No. of Disposals No. of Heat Total Total Pumps . Tons KW Initiating Devices No. of Sounding Devices No. of Dishwasher �� Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryer Heating Devices KW Connecdogs No. of Water HeatersKW No. of No. of Sions Balasis No. Hydro Massage Tubs No. of Motor Tota HP — /J(J �;J b A I � nvcy,• I1taeaanentLiah�yinuataeFb6cYttidr>gCar�ei - aritssub�art IhmeahAWdwWpoafaf tot 2OffKZ M S dtedQgthe box' u ilVSURANCE BOND rl o owe-** WodclostaR lilac ` DaleFtq Sg{redurrd3 Plvraldesofpajiry. _ �'/e nc C RRMNAME ? Lica=t_ �/ r/ IU4 Z.l :7 YES © NO Estar*dVakredE1w cdWak$ FkW /�?Q� LioaneNo, / J� ��c 1.3 Liaat9eNo f B Td Na s79- - ,F3 ��3i_, Ju�� 4l A Alt TdNo. ardd atrnyi oa mcnftpmritappirationwanesdi m4irmut - - ---- - ,Please check one) Owner Agent a Telephone No. PERMIT FEE S signature w w Date. ....... s of TOWN OF NORTH ANDOVER F � D • PERMIT FOR GAS INSTALLATION SACHUS This certifies that.. :'? c, .'!P� P *�-� . !�....... . has permission for gas installation_ � .............. �� in the buildings f .... !......................... q at .. / �,� .�.�.��- ...-1�... .... , North Andover, Mass. Fee:.J. '� .. Lic. No.............;c.......... . S / GA ECTOR Check # 1,3 5637 As MASSACHUSEM (Type or print) NORTH ANDOVER, MASSA TON FOR PERMIT TO DO GAS FIT MNG Date Building Locations —oKj %> Owner's Name New ❑ Renovation Replacement ❑ Permit # Amount $ Plans Submitted ❑ Name of Licensed Plumber or Gas Fitter We: Certific to Inst g Company orp. ❑ Partner. ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No[] If you have checked yes, lease ' dicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑. Owner's Insurance Waiver: 1 �amaware 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: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ i I hereby certify that all of the details and information I have submitted (or entered) in a" application are true and accurate to the best of my knowledge and that all plumbing work and install ons performed compliance with all pertinent provisions oft e lYiasssus � a e as Code {APPROVED (OFFICE USE ONLY) Signature of ❑ Plumber ❑ Gas Fitter FT Master Journeyman for this application will be in I ed Plumber Or Gas Fitter AJC/� Icense Numt5er to y U1-4 w 0 o H 0 o w a z O ] o z z w C O F+ w w Ch U z O H z �"0 z �" P4 z z WW� a z a O o° o° w x O w O A 10 .a 1 U 1 w D A a H O SUB-BASEM ENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR STH. FLOOR Name of Licensed Plumber or Gas Fitter We: Certific to Inst g Company orp. ❑ Partner. ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No[] If you have checked yes, lease ' dicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑. Owner's Insurance Waiver: 1 �amaware 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: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ i I hereby certify that all of the details and information I have submitted (or entered) in a" application are true and accurate to the best of my knowledge and that all plumbing work and install ons performed compliance with all pertinent provisions oft e lYiasssus � a e as Code {APPROVED (OFFICE USE ONLY) Signature of ❑ Plumber ❑ Gas Fitter FT Master Journeyman for this application will be in I ed Plumber Or Gas Fitter AJC/� Icense Numt5er Date jf ........ . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SS'4 USf This certifies that ... -- t'!l'�'`�-/J!i!'�� i ' .! .... . � y has permission to ,P/ + plumbing in the buildings of ��-�:j. %�� ..................... . at .. �/...:'"� .............. North Andover, Mass. A. Fee �C ..... Lic. No.. ¢./ �.G? .. ,/ B.INSPECTOR Check # PLUM �3l',�l " 6340 (Type or print) NORTH ANDOVER, Building Location New CHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBIN 7 Owners NamejG Type of OccupancZ A Replacement FIXTURES Date Permit # Amount Plans Submitted Yes 0 No ❑ hec one: ertificate JZLCorp. 13 Partner. 13 Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indi ate th ype of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity13 Bond Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner 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 work and installations performed under rmit ed for this application will be in compliance with all pertinent provisions of the M sac ate Plumbing�Cjd/� �r 142 of_1he General Laws. Y Type of Plumbing License Title City/Town License NumSer Master ED Journeymanlo APPROVED (OFFICE USE ONLY Location a IN CA rd No. Date MORTh TOWN OF NORTH ANDOVER Of •••D ,1h•C 9 Certificate of Occupancy $ s�„' E Building/Frame Permit Fee $ AC Mus Foundation Permit Fee $ Other Permit Fee $ TOTAL $� ' Check # ” L 17451 -- Building Inspector 1.1 Property Address: L &AR3>EQ s I J L V I f V V I J U I l: L r C J I V U 1.2 Assessors Map and Parcel Map Number Number: Parcel Number AN V>O Je M A f3R�s� TARSA CocK tri. L - 1.3 Zoning Information: Zoning Dis;ic—t Proposed Use Address for Service: 1.4 Property Dimensions: Lot Area (sf) Frontage ft 1.6 BUILDING SETBACKS ft Telephone Front Yard Side Yard Rear Yard Rapired Provide R 'red Provided ReqWred Provided Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 1.7 Water Supply M.G.L.C.40. 54) Public 0 Private 0 Zone 1.5. blood Zone Information: Outside blood Zone ❑ 1.8 Municipal Sewerage Disposal System: 0 On Site Disposal System 0 aEC HUN 2- PROPERTY OWN ERSHIP/AUTHORMED AGENT I J L V I f V V I J U I l: L r C J I V U 2.1 Owner of Record f3R�s� TARSA CocK tri. L - Name (Print) Address for Service: Srgnatur Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ NA 6 L - J o 1i N L.G 0 "Ary Licensed Construction Supervisor: C 5 o� a 8 l c� -P 0 6(-)x 13-0) . Arm , License Number Address / IU ( —1 I (.9v — y 1 �p Expi tin Date Si a re Telephone 3.2 Registered Home Improvement Contractor Not Applicable 0 / 'C1 A e L ^^�� 13 753 p` Company Name 3a �o BOX 13;). �.N1�Qy��2 Registration Number !' /// � � / 7 - OO Address ! / r to ExpirationDate Sin Telephone SECTION 4 - WORKERS COMPENSATION (M G.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 ...... R 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: FRAMCY App16ZLO FRA04 f\Gt-J ROOF '-J&J 5 rgWOVO ,6 S 10 1 AJ j N 5121 l I A)d k) LVL ' S Ar 11 Tt+).2ry orld LW WM 1Q MOM ,e C_ K 02 fV �! 3���t Cwtagiec� SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OMCIAL USE ONLY 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) ' ! / i� 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Z 0 U 2 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT f 1, ! G ^1 G3 C 1' e ` ' as OVimer/Authorized Agent of subject property Hereby authorize J o k & j I,,,1g' t MA AJ to act on My be i all m4tters relati work th ' ed by this building permit application. w Signature of 24 Date SECTION 7`b OWNER/AUTHORIZED AGENT DECLARATION I, J 0b A N Ll—WM A AJ as Oum/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 J O RAj L- LTI' 4A&) Print N e I' a �f-- Si ature of Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS Isr2 ND3RD 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 iI _.-� ✓fie �a��+mzoozu�P.alf�r. o� /f�truaeluvel�s I = Board of Building Regulations and Standards BIOME IMPROVEMENT CONTRACTOR �.�' .. Registration: 137552 Expiration: 11/26/2004 Type: Private Corporation WORTH ANDOVER BUILDING CORP_ OHN LEEMAN s 5 PINE RIDGE RD. t.. e.NDO%JET . A,A 0 e 847 A. gze �Onyrno�u�- 0`��1�aaa¢c%ive2: BOARD OF BUILDING REGULATIONS;. License: CONSTRUCTION SUPERVISOR Number. CS 082816 B'rrtitdate: 06/1611958 Expires: 06/16/2006 Tr. nb: 82816 Restricted: 00 JOHN R LEEMAN JR r 45 PINE RIDGE RDS+ NORTH ANDOVER, MA 01845 Administrator •r 11,�: ' - ■ No. 919 P.2 fmwnpmim — r — - - - - - - IRtODUCER Smnel bs Agcy I= TM CERTWIC&w JS DSAS r� DWOBM=cW YAND CONFERSWO RICA'S UPON nM CHIMM A HOLDER. TM TB D(WNOTe ORALMIMCOVERAGRBYMM POLICIES BELOW. COWANEES AFFOItMG COMAGE 15 Central Street Andover, MA 01810 OWANY A AJ -M. Mutual Ins wmm Co North Andover Builders Corp P O Box 132 North Andover, MA 01845 COVE�AGE.S TM n TO CEVY��BPO�OPn�rx�uS1'EBSIDA+YSAVE �iLSStiBDTO x�II�3[J�1�tAMBO Aec�BPR 1ffiPO�ZCY]PMDD IND=&MNarWnWTAWWGAIRYXBQUMMWTM C& CM=UWOPAVYCMMLA TORMMIDOCUMENTW1TBtRB6' =WWMMffi4 MAY ffi V SUID OR MAY PERDIN, THE DEMAWMAUVRM BY ffi POUFS DESMUBEDHEREIN Z SiMn G 70 ALLTBE TONS. EKCI=OINS AND CONDrt7= CE SI1L'HPGU=- LII m nowzq MAYHAvEBEEN RWUCED RYPAID CLAW - CD L TYF&O�II p�AIClIAA VOLUNISWRonn PM= I]ffiTS MUMALLTAMM AGGR6GASS s PRODtXTS4aVJPJOPAM S COMMMRCM4GWdMALLLAULTff F2MSOWL&ADV. DOURY S BACROCCUFAINM s OVIM*S uA►iAGS0WOM&O S hDrOMMUSsrAMM sR s AUTD vmv S Eao GWNADAVI03 AlJlOS RMYWMAUMS PROPOMDAbFAW i OARAMMMUff Ltimv r EMSOCCUMENCEi GATS s F 4HAt1 n►iBRBJd FORK! w�rawYn�►z'x,�Q.� X Svc A ffiMPLOYERS' LMXR TY TOPROPMEra ► OFA ARES 70204ASD32003 101L212003 10%22/2004 El. r.4cR 4cmgw s M - s 500 000 _ s i00 000 CEF=CAU HOWER _. _ C.ANCZ<4L.ATIOI+i SHOULD ANY OF THE ABM DE POU CO JM CANCELT,8DEH8M Tffi m►'P1it 7W DM TRMUM . I= ISSUING CO%u"Y WML MOPAVO& TO MAIL 10 DAYS TAUT P.MNOT= TO TIM CHMS.&MHOLD&RSAMM TO MM Iii. Wr PAUMM TO MAIL SUCH NOTICE? SHALL WOM NO aWGATMM OR LlallIM OF ANY XM UPON Th'R oma.... Town of North Andover Office of the Zoning Board of Appeals Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 D. Robert Nicetta Building Commissioner Dear: M r , + &61 crl�iJ Telephone (978) 688-9541 Fax (978) 688-9542 Date: is -!7- 01 As you know, the Zoning Board of Appeals granted your a plication }dor a Variance �( P and/or Special Permit or Finding for premises located at: (rQ Vd e v► si-✓e Your 20 -day appeal period will have passed on the following date: `Can . 7 . SOD 1. Once the appeal period has passed, please pick up your Town Clerk -certified copy of the Zoning Board of Appeals decision, and your ZBA Board -signed Mylar (if a Mylar was required) from the Town Clerk's office located at 120 Main Street, North Andover, MA 01845 (978-688-9501) 2. Please make a paper copy of the ZBA Board -signed Mylar. 3. Please bring the Town Clerk -certified copy of the decision & the signed Mylar to the North Essex Registry of Deeds, 381 Common Street, Lawrence, MA 01840 (978-683-2745), as the decision and Mylar must be filed at the Registry of Deeds as soon as possible. 4. Once this is completed, please bring: A. copy of the certified decision, B. a paper copy made from the ZBA Board -signed Mylar, & C. the Registry of Deeds receipt to the Building Department, which is located at 27 Charles Street, North Andover, MA 01845. Failure to file the decision and Mylar with the Registry of TN va x:11 ie�„14 m .�n2wr innbilitV to exercise your variance and/or special permit and .L, s `v'r.� urt — 1 v - 1 your inability to obtain a building permit with the Building Department. "Furthermore, if the rights authorized by the variance are not exercised within one (1) year of the date of the grant, they shall lapse, and may be re-established only after notice, and a new hearing. Furthermore, if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two (2) year period from the date on which the Special Permit was granted unless substantial use or construction has commenced, they shall lapse and may be re-established only after notice and a new hearing.” If you have any questions, please feel free to call (978-688-9541) or fax (978-688- 9542), Monday through Thursday, 9:00 AM to 2:00 PM. Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535 Town of North Andover NORTF/ 0:4tOR #t Office of the Zoning Board of Appeals - - Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 Ss�cHU D. Robert Nicetta Building Commissioner Any appeal shall be filed Notice of Decision within (20) days after the Year 2003 date of filing of this notice in the office of the Town Clerk. Property at: 9 Garden Street NAME: Brian S. &Tarja K. Cockell ADDRESS: 9 Garden Street North Andover, MA 01845 Telephone (978) 688-9541 Fax (978) 688-9542 HEARING DATE: December 9, 2003 PETITION: 2003-041 TYPING DATE: 12/11/03 The North Andover Board of Appeals held a public hearing at its regular meeting on Tuesday, December 9, 2003 at 7:30 PM upon the application of Brian S. &Tarja IC Cockell, 9 Garden Street North Andover, MA requesting a Variance from Section 7, Paragraph 7.3 and Table 2 in order to construct a proposed deck; and a Special Permit from Section 9, Paragraph 9.2 of the Zoning Bylaw to extend apre floorttnng, noily room conforming structure on a non -conforming lot in order to build a proposed deck, gr oundand a 2"d floor bedroom. The said premise affected is property with frontage on the North side of Garden Street within the R-4 zoning district. Published in the Eagle Tribune on November 3 & 10, 2003. Only the legal notice was heard at the November 18, 2003 meeting. The following members were present: John M. Pallone, Ellen P. McIntyre, Joseph D. LaGrasse, Joe E. Smith, and Richard J. Byers. William J. Sullivan chaired but did not vote. Upon a motion by Joseph D. LaGrasse and 2"d by Joe E. Smith, the Board voted to GRANT a Variance from Section 7, Paragraph 7.3 and Table 2 for relief of 21' from the lfraop��aze� for Brian S. &Tarja ar , and 15' from the rear setback per Plan of Land location 9 Garden Street, North Andover, Cockell by Frank S. Giles II, P.L.S. 449793, Date: August 12, 2003. Revisions: September 10845; and 6, 2003,Proposecolt L. Giles Frank S. Giles Surveying, 50 Deermeadow Road, North Andover, Changes to Existing House preliminary master plan, Tarja & Brian Cockell, 9 Garden St., North Andover MA, Job no. 566 bate 6-24-03, 10-16-03 Harmon J. Kiley, Jr., Registered Architect #3864, Hermit Woods Design, 800 Main Street, Lynnfield, MA 01940. Upon a motion by Ellen P. McIntyre and 2 Byers, the Board voted to GRANT a Special "d by Richard J. Permit from Section 9, Paragraph 9.2 in order to construct a deck, ground floor family room, and 2nd floor bedroom on a pre-existing, non -conforming dwelling on a non -conforming lot per Plan of Land location 9 Garden Street, North Andover, Ma prepared for Brian S. & Tarja K. Cockell by Frank S. Giles 11, P.L.S. #49793, Date: August 12, 2003 Revisions: September 26, 2003, Scott L. Giles Frank S. Giles Surveying, 50 Deermeadow Road, North Andover, MA 10845; and Proposed Changes to Existing House preliminary master plan, Tarja & Brian Cockell, 9 Garden St., North Andover MA, Job no. 566 Date 6-24-03, 10-16-03 Harmon J. Kiley, Jr., Registered Architect 93864, Hermit Woods Design, 800 Main Street, Lynnfield, MA 01940 on the following condition: 1. The proposed addition will be no greater than 30' in height. Voting in favor: John M. l atione, Ellen P. McIntyre, Joseph D. LaGrasse, Joe E. Smith, and Richard J. Byers. Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535 • Town of North Andover Office of the Zoning Board of Appeals Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 D. Robert Nicetta Building Commissioner Telephone (978) 688-9541 Fax (978) 688-9542 The Board finds that the applicant has satisfied the provisions of Section 10, paragraph 10.4 of the. Zoning Bylaw by reducing the non -conformity of the ect lthe neigng hborhood or derogate from the intethe removal of the rear bulkhead nt and the granting of this Variance will not adversely affect m e the Zoning Bylaw purpose of the Zoning Bylaw, and satisfied the provisions of Section 9, Paragraphg that such change, extension, or alteration shall not be substantiallymore detrimental Uhar. t11c existing structure to the neighborhood. Furthermore, if the rights authorized by the Variance are not exercised within one (1) year of the date of the grant, it shall lapse, and may be re-established only after notice, and a new hearing. Furthermore, if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two (2) year period from the date on which � e Specbe rel estabal lished onlyit was after notice, unless substantial and a new hse or earing construction has commenced, it shall lapse y Town of North Andover Board of Appeals, R A': Cc1, rl • William J. Solivan,Chairman Decision 2003-041 ` M42P8&35. J - Page 2 of 2 1 1 Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535 � Essex North County Registry ^ eeds 381 CommonStreet� -- Lawrence- , 'assachusetts 01840 01/01/04 COCKERLL KB # 11 Rec: Type PL 50.81") uV[' 1067 ' �. P. 2O.00 # 12 Rec. R*= D. Type—~^ 5. C5 50OO DOC. 1O68 ^ L P. 21OO K. D. 5.00 Total # 13 ��k _,--~ 15 0.015 /MHNK YOU/ Thomas j, Burke O, CA v u. a vi � U A '� o ,1 w x w , lj G U X a A w w" a � W W aG � w" a O DO o u: Cd u. W W A W o z cn G 0 cn 0 w a -kM M� w Ico Ccm C C Q ■� yO O 'g m m co O O a F, +�+ = 3� O O � i O CDa a- �a ca C cc c Z CD Q CL LD CO) � C C R _y 0 0 N UA U) lz W LLI 19 �1 O O c Oi l v fq: O h %;, C 3 Q 1 � c • CML. O .� c C `• O m O C C2 !_ Ma60M O o A4� 1Hmm Wis. c os cCA X c Q d = C •O = y�0... O COL.- �OwO L ,N =oc p U= 'E dt .E- 8 cis^ y o0 les Q h a O� O� _ � ��y• C =4-06�mO� 0 w a -kM M� w Ico Ccm C C Q ■� yO O 'g m m co O O a F, +�+ = 3� O O � i O CDa a- �a ca C cc c Z CD Q CL LD CO) � C C R _y 0 0 N UA U) lz W LLI 19 toRT;j r p ry) "11. `""° COP Zoning Bylaw Review Form � Town Of North Andover Building Department 27 Charles St. North Andover, MA. 01845 �� S4Mo IY'`•9 �'SRCHiSS�'Phone 978-688-9545 Fax 978-688-9542 Street: a S Ma /Lot: of g -Applicant: Q LAP r- `r Z)r A Request: Y a y ` 02 S`t Date: a m 3 riease Ve auviseu mat aver review of your Application and Plans that your Application is DENIED for the following Zoning Bylaw reasons: Zoning R-9 Remedy for the above is checked below. Item # Special Permits Planning Board Item # Item Notes Setback Variance Item Notes A Lot Area Common Driveway Special Permit F Frontage Variance for Sinn 1 Lot area Insufficient R-6 Density Special Permit 1 Frontage Insufficient 2 Lot Area Preexisting L- S 2 Frontage Complies e S 3 Lot Area Complies 3 Preexisting frontage 4 Insufficient Information 4 Insufficient Information B use 5 No access over Frontage 1 Allowed G Contiguous Building Area 2 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies 4 Special Permit Required Lle S 3 1 Preexisting CBA e S 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 Left Side Insufficient 3 Preexisting Height e S 4 Right Side Insufficient 4 Insufficient Information 5 Rear Insufficient l Building Coverage 6 Preexisting setback(s) e S 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D Watershed 3 Coverage Preexisting LA f S 1 Not in Watershed e S 4 Insufficient Information 2 3 In Watershed Lot prior to 10/24/94 J 1 Sign Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District IF Parking 1 In District review required 1 More Parking Required 2 Not in district e 5 2 Parking Complies 3 Insufficient Information 3 Insufficient Information 4 Pre-existing Parkin Remedy for the above is checked below. Item # Special Permits Planning Board Item # Variance Site Plan Review Special Permit Setback Variance Access other than Frontage Special Permit Parking Variance. Frontage Exception Lot Special Permit Lot Area Variance Common Driveway Special Permit Height Variance Congregate Housing Special Permit Variance for Sinn Continuing Care Retirement Special Permit Independent Elderly Housing Special Permit Lar a Estate Condo Special Permit Planned Development District Special Permit Planned Residential Special Permit Special Permits Zoning Board Special Permit Non-Conformin Use ZBA Earth Removal Special Permit ZBA Special Permit Use not Listed but Similar Special Permit for Sign R-6 Density Special Permit Special permit for preexisting nonconforming Watershed Special Permit EEI I The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for Any inaccuracies, misleading information, or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department. The attached document titled "Plan Review Narrative" shall be attached hereto and incorporated herein by reference. The building department will retain all plans and. documentation for the above file. You must file a new permit application form and begin the permitting process. G �� Building Department Official Signatut z Application Received Application Denied Plan Review Narrative The following narrative is provided to further explain the reasons for DENIAL for the APPLICATIONTfor the property indicated on the reverse side: Referred To: Fire Conservation zoning Board Planning Department of Public Works Other Historical Commission TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAM RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING .,,g. �' Se3g5fmsr _�:i".;.,.. .n'e';�•^,3i '�'�'; 4'ssei°�. ��{1.i4,i'1'+#'°'" Y :.-�"++@` a'f✓x� -:: - .. BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/Inspector of Buildings Date SECTION 1 -SITE INFORMATION 1.1 Property Address: q � &W 1.2 Assessors Map and Parcel Number: Map Number Parcel Number �'6@� GR'eI y�j fltJ4 ®`�„r 1110le 1.3 Zoning Information: Zoninp, District Proposed Use 1.4 Property Dimensions: 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.GL.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Na (e Q Address for Service 7z 97?- 9;;'.5-33 9,P - Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Si nature Tel hone 00 M X z O SECTION 4 - WORKERS COMPENSATION (M.G.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 .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check aIl applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: &4V Akk-r10A) 0-r- 1.20' o S'70,C y , r-�� FSI y ,� 4Lp 2— &;7 j 44 SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant bme V ' NLX 1. Building �D BSS (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbin Building Permit fee (a) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, osemi✓ CdC4Gf1"Z.L a Owner/ orized Agent of subject property Hereby authorize to act on My behadf,4 all matters rel ive rk authopzed by this building permit application. Aignature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 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 Name Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS IST 2 ND 3 RD 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 Application for home-based business permit - JAN 3 0 200 914 5 Aim Name: Tarja Cockell _ AfC Address: 9 Garden Street 0 1U( CPO North Andover MA, 01845 Business: Herbalife independent distributor (products: skin care, targeted nutrition), direct sales from home or visiting customers. If you need further information, please call (978) 975 3382 January 29, 2001 Tara (ockell J A) Application for home-based business permit Name: Tanja Cockell Address: 9 Garden Street nEJEETEU North Andover MA, 01845 Business: Proprietorship (Tanja Cockell) Designing and producing textiles for interiors (wall hangings, Appliques, woven rugs...) Product selling through Craft Fairs, Art Shows, Galleries and Internet If you need further information, please call (978) 975 3382 January 29, 2001 F6i.' C Tana Cockell Borrower/Client Cockell Address Gard6n Street SMSA 4160 City North Andover County Essex State MA Zip Code 01845 Lender/Client Interate National Mortg. Building Area Summary 1st Floor 1 1 152 SF 2nd Floor 285 SF 3rd Floor SF Basement SF Garage SF Total GLA 1,43 SF SQUARE FOOT CALCULATIONS Level Dimensions Factor TSquare Feet 1 30 X 13 X 1 = 390 . ;...1 31 X 12 X 1 = 372 1 30 X 13 X 1 = 390 2 30 X- 38 X .25 = 285.00 _ GU, <�. t. t ; ��.E� i �' ek /,� �,� f - , (� �vt �H. ori S c. r r Fvuat I�eGF e N ON D v m z cn m m --1 It, Town Of North Andover Building Department 27 CHARLES ST 978-688-9545 Project: Building Permit Application Enlargement of side enclosed entry APPLICANT: Brian & Tarja Cockell �9 Garden St" DATE: September 21, 1999 Title of Plans and Documents: Please be advised that after review of your Building Permit Application and Plans that your Application is DENIED for the following reasons: Zoning Use not allowed in District Not in conformance with Phased Development Violation of Height Limitations Sign exceeds requirements X Violation of Setback Front Side Rear X Insufficient Lot Area Insufficient Parking Violation of Building Coverage Insufficient O en S ace Use requires permits prior to Building Permit Sign requires permits prior to Building Permit X Form U not complete by other departments Not in conformance with Growth BY -Law Other Remedy for the above is checked below. X Dimensional Variance Special Permit for Watershed Review Special Permit for Site Plan Review Special Permit for sign Complete Form U sign -offs Copy of Recorded Variance Information indicating Non -conforming status Copy of Recorded Special Permit Other Other Plan Review The plans and documentation submitted have the following inadequacies: 1. Information Is not provided, 2. Requires additional information, 3. Information reouires more clarification. 4- Information is incorrprt S All of the ahnva # ## Foundation Plan Plumbing Plans Subsurface investigation Certified Plot Plan with proposed structure X 1 Construction Plans 116 Affidavit Mechanical Plans and or details Plans Stamped by proper discipline Electrical Plans and or details Framing Plan Fire Sprinkler and Alarm Plan Roofing Footing Plan Plans to scale I e:+ nim.. Plan Review Narrative The following narrative is provided to further explain the reasons for denial for the building permit for the property indicated on the reverse side: MUR i UAGE IMPECTION PLAN %1 BOSTON SURVEY:, _INC. P.O. Box 220 Charlestown, MA 02129 (617)242-1313 MAIN (617)242-1616 FAX APPLICANT. BRIAN S. COCKELL & TARJA K. COCKELL LOCATION. 9 GARDEN STRET CITY, STATE. NORTH ANDOVER, MA DEED/CERT: 46451/254 PLAN REF: 502/600/ N—N .-O/(S-/30 , _2S"C- isL.>J0(\(C -]>tS'� �° 97-08799 ,6_0 0 C,.Osu secJ16N ��oor PIA— Rwc>' 1-'M""N3 JT 1ft-', �r-e t° yes f"J 5 r cj)p 4 r -e -- c-- .[) 0 /U rOA-al /(I ll"J 6 --,4 ra�� /`rzr -�- Se -1104 0�5_` rind ,2��i.ySG vv ico savr� X' .e m v�- 1994 (c) Boston Survey Software PREPARED: 11-11-1997 Z � PPr 0(/AI `,-/,,"''tel �r 'S e-- /� K - '���FP�rN� �N SCALE. 1 inch = 20 feet Perm%� t� `'k oni CERTIFIED TO: INTERATE NATIONAL MORTGAGE �o _CA � v a y` � _ S,,1ba J�t)SP keitn�S.Vv o�!i Sr d -e poP^C The permanent structures are approximately located on the ground as shown. They either conformed to the setback requirements of the local zoning ordinances in effect at the time of construction, or are exempt from violation en- forcement action under M.G.L. Title V11, Chapter 40 A. Section 7, and that there are no encroachments of major improvements either way across property lines except as shown and noted hereon. YAW, '"q According to Federal Emergency Management Agency O JONy� maps, the major improvements property fall in an . J. area designated as Zone 0 - RUSSELL y ommunity Panel No: a,.S 00559 00036 38 7 Effective Date: g NOTE: Zone C Is areas of minimal- flooding (no shading). This =p g designation is not based on an elevation certificate. NOTE: This is not a boundary or title insurance survey. This plan was pared iR et:EoYdance to procedural and technical standards for Mortgage Loan Inspections as adopted by the Massachusetts Board of Registration of professional engineers and land surveyors, 250 CMR 6.05, and use for any other purpose is prohibited. This plan is not to be used for recording, preparing deed descriptions, or construction. 537 Date. . NORToq TOWN OF NORTH ANDOVER ,s'6 p PERMIT FOR GAS INSTALLATION S. a This certifies that .. ..... .'.�.' ...... ............... has permission for gas installation .. .... ........ ... . in the buildings of at . G?' .. ?� .`''.: .............. , North Andover, Mass. Fee..* .'...:. Lic. No..: %.`?..! ..... . :..... . ........ GAS INSPECTOR d WHITE: Applicant CANARY: Building Dept. PINK: Treasurer -�0 MAP ✓IASSA CATON FOR PERMIT TO DO GAS FITTING Date _! 2 ® 19 9 or print) INVKIH ANDOVER, MASSACHUSETTS Building Locations / [���, c�i Permit # �33 Amount S Owner's Name �N 6exi :k New 12/ Renovation ❑ Replacement ❑ - Plans Submitted ❑ (Print or type) �y Check e: Certificate Installing Company Name `%/t/ P*e 6�L1//�!�/%L'lo /�i�/ylo . �-- orp. /7f-- f�, Ww d.+iir iD Address ❑ Partner. ness Name of Licensed Plumber or Gas Fitter ❑ Firm/Co. INSURANCE COVERAGE Check on I have a current liability Insurance policy or it's substantial equivalent. Yes Nom If you have checked ves, please indicate the type covertge by checking the appropriate box. Liability insurance policy 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. Signature of Owner or Owner's Agent Check one: E]Owner ❑ Agent nereov cerr.uy mai ail ui uJe ueiaus anu inrormauon i nave suomittea for enterea) in aoove appucauon are true anu aucur is w Lim best of my knowledge and that all plumbing work and installations perform e under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas;Ae and Chapter 142 of jbz-�Peneral Laws. By: Title City/Town APPRLf�OVED (OFFICE USE ONLY) dPignature of I lumber . ❑ as Fitter Master ❑ Journeyman sed Plumber Or Gas Fitter �X3 License I umoer MoRT;,j Zoning Bylaw Review -form Town 0 No u<� ; rth Andover Building -Department A99q'.o 1•y �J 27 Charles St. North Andover, MA. 01845 Phone 978-688-95.45 Fax 978-680' 4642 Street: _ Map/Lot: `i a g z. Applicant: 'ZAAQ -T zl_ . Request: T, rn r V .ft►hdt-m't 43.Oil Date: a m 3 0111 11 A... --A N - -- -• »• .`ve%wyv W1 Y"I PAP! uv.n.anu dans tnat your Application is DENIED for the following Zoning Bylaw reasons: Zonina R- y Remedy for the above. is checked below.,.. Item Notes Variance Item Notes A Lot Area Frontage Exception Lot S ecial Permit F Frontage Hei ht Variance 1 Lot area Insufficient Continuing Care Retirement Special Permit 1 Frontage Insufficient S Decial Permit NonConfforminq Use ZBA 2 Lot Area Preexisting `A e .5 _ 2 Frontage Complies Ll e- S 3 Lot Area Complies _ - 3 Preexisting frontage 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage 1 Allowed G Contiguous Building. Area 2 Not Allowed 1 Insufficient Area 3 Use Preexisting - 2 Complies 4 Special Permit Required Lle 5 3 Preexisting CBA Lj >? S 5 1 nsufficienti Information 4 insufficient Information C Setback_ _.. H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient- _ 2 Complies 3 Left Side Insufficient 3 Preexisting Height e S 4 Right Side Insufficient 4 Insufficient Information 5 Rear Insufficient ® > 1`c K_t{r I Building Coverage 6 1 Preexisting setbacks a 'S 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D Watershed 3 Coverage Preexisting s 1 Not in Watershed 4 Insufficient Information 2 In Watershed J Sign 3 Lot prior to 10/24/94 1 Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information -E Historic District - K Parking 1 In District review required - 1 More Parking Required 2 Not in district e_5 2 Parking Complies 3 Insufficient Information - 3 Insufficient Information _ 4 Pre-existing Parkin Remedy for the above. is checked below.,.. Item # Special Permits Plannin Board' Item # Variance Site Plan Review Special Permit — Setback Variance Access other than Frontage Special Pefmit Parkin Variance. Frontage Exception Lot S ecial Permit Lot Area Variance Common DriveMY Special Permit Hei ht Variance Congregate Housing .Special Permit Variance for Sign Continuing Care Retirement Special Permit special Permits Zoning Board Inde endent Elderly Housing Special -Pe rtnit Large Estate Condo Special Permit S Decial Permit NonConfforminq Use ZBA Planned DeveI2 Ment District Special, Permit7 Earth Removal S ecial 'Permit ZBA S ecial Permit Use not Listed but Similar Planned Residential Special Permit S ecial Permit for Silan, R-6 Density Special Permit Special permit for preexisting nonconforming The above review and attached explanation of such is based, ora the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the, above reasons for Any inaccuracies, misleading information, or other subsequent changes to the information submitted by the applicant shall be grounds for thisreviewto be voided at the discretion of the Building Department. The attached document titled -"Plan Review fVarrative" shall be attached hereto and incorporated herein by reference. The building department will retain all,plans and"documentation for the above file. You must file a new permit application form and begin the permitting process. - reas APPLICATION for the property indicated�on the reverse side: ons for DENIAL for the Kererred To: Conservation tonin Board Plannin De artment of Public Other Historical Commission Date ./ 3 Zi.' -N° 4210 �+ ORT:��o TOWN OF NORTH ANDOVER ° PERMIT FOR PLUMBING This certifies that `.!57 ........ .•.•••••.•••.• has permission to perform ... ??� u .%�...................... plumbing in the buildings of .. ... . at ... ... �?�a <<<. ............. h North -Andover, Mass. t Fee. r.).?-: .... Lic. No... PLUMBING INSPECTOR ✓ V WHITE: Applicant CANARY: Building Dept. PINK: Treasurer A :Q MASSACHUSETTS UNIFORM APPLICATIO FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS /��l, Date Building Location % / 1z/J ST Owners Name xee/� �DL�I Permit Amount J^, •- Type of Occupancy 4nS New d Renovation Replacement ❑ Plans Submitted Yes No Ky all' 14 XZI (Print or type) ' Installing Company Name zj��i>71�/N6�,�%�ir/� �� Chwkone: Certificate Q Corp. ri Partner. 13 Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity 11 Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner n Agent E] 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 work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts to Plumbi Chapter 142 of the General Laws. By igna oi Lipenseaum er Type of Plumbing License Title 01IF3 —/ City/Town icense um er Master Joumeyman 1 APPROVED (OFFICE USE ONLY THFCOMMONWEALTHOFMAS94CHUSE.7TS Office Use only DEPAI AIENTOFPUBLICSIMY Permit No. �7 BOARDOFFMPREVEMONRWULWONS527CMR12.M Occupancy &Fees Checked ID APPLICATIONFOR PERMIT TO PERFORMELE=CAL WO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Ala, /Z G-` Town of North Andover To the Inspctor of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street � Owner or Tenant Owner's Address [s this permit in conjunction with a building permit: Yes No (Check Appropriate Box) ?urpose of Building Utility Authorization No�{O 3xisting Service %1. Amps/Z0/2-A1- Volts Overhead Underground of Meters j lew Service Amps/W 77.6C'U Volts Overhead M Underground[Za No. of Meters lumber of Feeders and Ampacity ocation and Nature of Proposed Electrical Work P-ew tjti b1-9-/ZJ of Lighting Outlets No. of Hot Tubs No. of Transformers Total NQ. of Sounding Devices KVA- Qo. of Lighting Fixtures Swimming Pool Above Below Generators KVA Signs round ground Total HP Jo. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units lo. of Switch Outlets No. of Gas Burners fo/. of Ranges No. of Air Cond. Total FIRE ALARMS No. of Zones . Tons o. of Dishwashers .Heaters Massage Tubs No. of Heat Total Pumps Tons Space Area Heating NQ. of Sounding Devices No' bf Self Contained Heating Devices Detection/Sounding Devices KW No. of No. of Signs Bailasis No. of Motors Total HP Total No. of Detection and KW Initiating Devices KW NQ. of Sounding Devices No' bf Self Contained Detection/Sounding Devices KW LocalMunicipal Connections YES E:� NO Other Pblaltiesofpeijtuy._ JD In � cu ked m Q h ''�-'/SURANCE WAIVER; I am aware that theLicenso does nothal TiaAmondhispemritapphcadoilwaivesftmgiiL xnt k orae) Owner ® Agent ignature 01 Uwner or Agen FstQ� ValueofEocttCal Wcdc $ Rough Final �r- LicawNo. , I U 33 — Lic=NO Bt>suxassTel No. 'F 71f 6Y 3 f- 1, Tel No. tegtcoedbyMaxssachus2nCenedLam Telephone No. PERNIIT FEE $ 5�� ,4 yr L- 07-0s_ AVA, -4 , #I Date... ............... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........ 7U6,* 1-6,ee-e7— .......................................... I ................... has permission to perform ..... :�� I/M "7. ..... 4.� wiring in the building of .......... *BR * 114 * * c * at ........... If ......................... Z)IF ......... 5.�� ........ . North Andover, Mass. to, .3 41-- Fee ...!2�! ........... Lic. No . .....T..... ....... . ........... ......... ELECTRICAL INSPECTOR Check it 2-f� 576 I TRE COM OATWE4LTHOFM4SS4CHU,SEi77S Office Use only DEPARTNIENIOFPUBLICWHY Permit No. *% 6 BOAROOFFIREPREVE2VTIONREG' ONS527CM12.M Occupancy & Fees Checked APPUCATTONFOR PERMIT TO Effo"ELE=CAL WO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE ASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 /� (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical *o fk described below. Location (Street 6 Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Purpose of Building Existing Service �z%y Amps Volts New Service Amps/W 12A 'O Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Yes No I I (Check Appropriate Box) rcy� --- Utility Authorization No. Overhead Underground of Meters / Overhead M Underground10 No. of Meters No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA round round No. of Receptacle Outlets No. of Oil Burners No. of Emergency Ligliting Battery Units No. of Switch Outlets No. of Gas Burners No, of Ranges No. of Air Cond. Total FIRE ALARMS No. of Zones Tons No. of Disposals No. of Heat Total Total No. of Detection and Pumps Tons KW Initiating Devices No. of Dishwashers Space Area Heating KW Nq. of Sounding Devices N4' -'Q • of Self Contained . Detection/Sounding Devices No. of Dryers Heating Devices KW Local Municipal Other Connections No. of Water Heaters KW No. of No. of Si s Bailasis No. Hydro Massage Tubs No. of Motors Total HP J THER- . • II : . /' I I I .I i" �• 1 1 .hl _ • I/ :I' /. Y. 1.1:r': • :. •'" • R "f$ `•' IIf:1 .11 /'•11'`:I •I"111•" �� �� Y�1 • I ' .IY/' •/'1. /i YES OD" NO Ester edVA&of) bc"Wotk $ AtoStat kgearonDateRo Rough Final .A4 P�altiesofpetjoty J f/l /6 �_ L(J Licm&�No. ���i33 btokeww Q IV6 11 q\IE2;SINSURANCEWAIVER IamawmethattheLiomgF--doesnothave that my siignattneonthis pemritapplication wives this reqdmm-ot ;ase check one) Owner ® Agent Ignature 5T Owner or 7gent LicffwNo BusbssTelNo. q7I u —` 7" Alt Tel No. eg valentascegtmedbyNLw--achustsGeneralLaws Telephone No. PE1?JMlT FEE $ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston; Mass. 02111 Workers' Compensation insurance Affidavit Name Please Print —� Name: Location: City Phone # I am a homeowner performing all work myself. FT I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: Address City: Phone #: Insurance. Co. Policy # Company name: Address City: Phone #: Insurance Co. Policy # 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 and/or one years' imprisonment -as _well.as-civil,penaltiesin.iheform-fa_STOP WORKARDFR.and_a.fine-of_(.$1AOM.)_aliayagainst.me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. ! do hereby certify under the pains and penalties of perjury that the information 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 official' City or Town Permit/Licensing E] Building Dept ❑Check if immediate response is required E] Licensing Board n Selectman's Office Contact person: Phone #: n Health Department Ei Other