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HomeMy WebLinkAboutMiscellaneous - 9 PETERSON ROAD 4/30/2018North Andover Board of Assessors Public Access , f MO DTM swcKusE� Click Seal To Retum Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial Page 1 of 1 roperty Record Card Location: 9 PETERSON ROAD Owner Name: ATRE, ANAND ATRE, VIDULA Owner Address: 9 PETERSON ROAD City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 5 - 5 Land Area: 0.12 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 2004 sgft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 348,700 348,700 Building Value: 200,900 200,900 Land Value: 147,800 147,800 Market Land Value: 147,800 Chapter Land Value: http://csc-ma.us/PROPAPP/display.do?linkId=1888952&town=NandoverPubAcc 5/17/2012 f l �I 'Ni - N 0 N ILLL f' Q 0 w z O U) Ix LU F- W a T CO 72 W U af R0 80 LU � J CL Q Ii d @ O �o �o IxF- 0 J 00 U O J m O Lii N 7-5C o'o 00 o {o ocicq N N N"N d n h O" O m U .fY U � ca ai N J m p cm ai ro tr a v 0CFU V' U U)mca0n cnia)cjo N (I).1i a c f2 w. 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N L LL .. @ S',U U) ILL 0 � N O CU�{� (6 =' � D 0, O m I m o0 L. Y ca o� ami =3 m X Y ca "I -X w j,= m F-COLL2w[DYW mm,Q �z I J 0 V' N C7'Q > tU U. C9 T Z i 0 F- o CLF0 is aU F- oX�Ii�LL ? =LL �Y0 aM U 0 r a) LT ca d Date .1-G& i ...... . HORTM ,a1tiOL ?Oy\,--...ao ,OWN -OF NORTH ANDOVER o �! PERMIT FOR GAS INSTALLATION o Sy• �SSACMUSEt This certifies that .c'3�' P14. t ............................ . has permission for gas installation .. Lt..(-/ .................... in the buildings of .... f 'k. 1. t.t4 C. � ..................... at ...`'� .. �T. {t.. £ , ............... . North Andover, Mass. Fee..'./f . ' . Lic. No...0. 0.4 . ......� . � l .. . GA INSPECTOR Check # 5 3 L 2 :.t ■o® ®®®® now NUNN easiness Tele phone -:2&1 _ —c— Name of LkensW Plumbs of.Gas FAtter. INSURAIVCE:CpyEpA r ;. 1 have a t ' Pa4'" s �tewhh NYYes meets. the-requiremerAs- ,G;;142atzhecksd a e4 ge by c -the APPwPdata IA IiablitY. lnstuaAoe: - - Bond 0 L�i�- NSURANCE-WAMM:,1 am -aware #a.:the ncensee-not=h:mYsigma e.�. p � oecoverage requiredby,'PP�t on wares� requirement Check one: ns rs Agit , . Ownerp Agert 'baeby a � hof the (fda�s IM .1.ham shitted fpr enter in abo en wnrlrand kUtdationap u� the ana true and aoauate.to.On bed.of my- Prowstons of the useds � Gas. Cods aid f>�ttut nsuw for this app *U be in 142 of the Geee of mnoafwe rviftr ail Tle of Ucense_ Title MAnbw City/Town Master Lim" Num Hyman s- a C. _ J a. < s . c 44 1A4 :� S ri �. p ad S * it ' IV ,♦. ,C ; - A. W r= 46 M. ■o® ®®®® now NUNN easiness Tele phone -:2&1 _ —c— Name of LkensW Plumbs of.Gas FAtter. INSURAIVCE:CpyEpA r ;. 1 have a t ' Pa4'" s �tewhh NYYes meets. the-requiremerAs- ,G;;142atzhecksd a e4 ge by c -the APPwPdata IA IiablitY. lnstuaAoe: - - Bond 0 L�i�- NSURANCE-WAMM:,1 am -aware #a.:the ncensee-not=h:mYsigma e.�. p � oecoverage requiredby,'PP�t on wares� requirement Check one: ns rs Agit , . Ownerp Agert 'baeby a � hof the (fda�s IM .1.ham shitted fpr enter in abo en wnrlrand kUtdationap u� the ana true and aoauate.to.On bed.of my- Prowstons of the useds � Gas. Cods aid f>�ttut nsuw for this app *U be in 142 of the Geee of mnoafwe rviftr ail Tle of Ucense_ Title MAnbw City/Town Master Lim" Num Hyman _ • - S - .. _ IL CY % iir f - `- -61 Id Y Z Date./U/ TOWN OF NORTH ANDOVER 3: �, � .., •a OCL ° p PERMIT FOR PLUMBING 41 ss^CHUS w This certifies that ' c ............................ has permission to perform ........................... plumbing in the buildings of ... P.A u at ... ./'"' . ! <. r. s- ..................., North,,Andover, Mass. Fee ���.� ... Lic. No.. .. .....�-- ......... . PLUMBING INS ACTOR Check # 37 �` ��' rt lJ UACNUSETTS UNIFORM APPLICATION FOR P cPrirrt or T ERMIT TO DO PLUMBING Mass- D d� BLrtkwv Lo=tion n owners Nan*w 42s % %Z Type of Ocy l� thea► Q Renvvation Q peDtacernem Puns Subrnitte& Yes. Q mo G FIXTURES F'l 11 lill I im ,2 .. .W 17 qo MiStMAUMZOVERAM I have a aarer►t M O �c�► or Yes )'[ its too statural equi�►atern whic►f meets the tf you have cher edrequkwnd MGL Ch 142 . P mate the type coyer by checking the A riabgTty polictr safe bOm cures type Of indemnity p BardOW"G 'S TRANCE WAnn t: I.am await; #M the 1f2 of the Mass General my the Laws, andthat- coirerage required - azion wanes this Ire d oa,r„es or pis A9MCheck one: Owr w t reertid►r than an o� trie Agent - 0 tue hest c# . deta�s acid ;kx, t tone Dt arw ttrat aq p1,Rr,Du,g rrorik m" for °'d iDOYe:a°°tca are tnie a� accu=ft t�. iwvri clinch ' thepetrnF[icedhoreft,I I Scame -was . �� �u� code and in of lite cer�erai t� - Type of LI � A "Wriber�, p - Z A 2 _ i -► p, o � o` o f � ,p, am•, �`fi �,. a a �a.� wA�. _ o a a' w j o C a a ._.. '.. .7{—/.. .�-- .ter _ _y � `1:.y/�: �... -k'�- � _ ♦ _ � .. � 1 Location No. Z3 Date TOWN OF NORTH ANDOVER pl Certificate of Occupancy $ 968 Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL k'�- 2 E Z� 10/24/95 12:01 :.. 8942 1,000.00 /�0p^e?:;p v 7, t Y ';, - ., v";�".`,.r fir'"z„ _ �� Y' �F ..r. �. Asn 't4 � .1 �'� i lam, .....+�'.+:`lr �i . J .. ti � �. i R) T t Y ';, - ., Location 9 :?_EfER-�nH No.Date NOR*M TOWN OF NORTH ANDOVER C? •... • _ ' • O� l'"T ..,,,ter Certificate of Occupancy $ • : Building/Frame Permit Fee $ 4"0&t� Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $'— rt 2 rz.:' Building Inspector 10/24/95 12:02 150.00 PAID } r` 9277 Div. Public Works Location_ No. 5 Z3 Date TOWN OF NORTH ANDOVER o+ OV • o p Certificate of Occupancy $ # Building/Frame Permit Fee $ ;�b''•°''��' 4cFoundation Permit Fee SsMuse Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL 6D $ el n s— Building Inspector i1//09//95l 114:22 836.00 PAID v = 9278 Div. Public Works PER11IT NO.44. �. . r APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP KVO. ZONA LOT NO. I SUB DIV: LOT NO. --I 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE . — Y'— 1 L0-GTION ��}�n e O PURPOSE OF BUILDING OWNER'S NAME1 _ NO. OF STORIES SIZE J OWKER'S ADDRESS 0 BASEMENT -OR SLAB ARCHITECT'S NAME A I IVS SIZE OF FLOOR TIMBERS 1ST2ND )v 3RD BUILDER'S NAME I , p5 SPAN DISTANCE TO NEAREST BUILDING 1/1 DIMENSI NS OF SILLS jkL DISTANCE FROM STREET "1 ,rte POSTS 6 l - _ DISTANCE FROM LOT LINES -{)SIDES 51 REAR 145 GIRDERS55(j AREA OF LOT +4 IS BUILDING NEW\�o fC O� V �J FRONTAGE -T►+l' HEIGHT OF FOUNDATION � THICKNESS SIZE OF FOOTING IS BUILDING ADDITION' MATER:AL OF CHIM EY IS BUILDING ALTERATION IVv IS BUILDING ON (OL!OR FIL D LAND ' WILL BUILDING CONFORM TO REQUIREMENTS OF CODE `, Y IS BUILDING CONNECTED TO TOWN WATER I , BOARD OF APPEALS ACTION. IF ANY„,V A r /A IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS INE Ve,S INSTRUCTIONS SEE BOTH SIDES PERMIT FOR FOUNDATION ONLY ® PAGE 1 FILL OUT SECTIONS 1 3 REGULATED BY PAR.�A. 114.8-S. B -C- - PAGE 2 FILL OUT SECTIONS 1 - 12 __.--- ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDIFEE PAID NGDATE 'ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS V PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED SIGNATURE OWNER OR AUtPtGRIZED AGENT FEE a3 (Q PERMIT FoR FROUBIJILDINIG PERMIT GRANTED () DATE r -FEE PAIDr+_.�----� 19'l DATE: POW OCT 18 1995 tEss FDA entiL - Fraff 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST jAt /yam ER SQ EST. BLDG. COST P. ,FT 1'11 ��_ ] EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY - r �wL�INo R OWNER TEL. # CONTR. TEL. # CONTR. LIC. # OSot�O 9 H.I.C.#^7 �Z18 -d- k BUILDING RECORD n 1 OCCUPANCY. l' 12. SINGLE FAMILoTORIES F MULTI. FAMILY (pT OFFICES, THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM — LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTN1ENtS ` RAGES. ETC. SUPERIMPOSED. THIS REPLACESPLOT PLAN. — _ t CONSTRUCTION - I 2 FOUNDATION _ 8 INTERIOR FINISH CONCRETE_ d . 1 2 {3 CONCRETE BL'K. PINE BRICK OR STONE HARDW'D PIERS PLASTER - _ DRY WALL- UNFIN. - 3 BASEMENT ' .!� I ti 1 * • ^• AREA FULL FIN. B'M'T' AREA FIN. ATTIC AREA _ NO B M'T FIRE PLACES •� _ o HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS ' ' L�) �. •�-b , ifl.�,r I ti �j f +-I� I� - , (��-J' �n j 7( "�---'--� RA '} � • � CLAPBOARDS )CCM k DROP SIDING_ - WOOD SHINGLES ELECTRIQ N - 13t _\ �i •�•3r"d'�` ly B 1 2 �_ 3 _ _ CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING HARDbd'D COMMCN ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME, SWZUON.,MASONRY - "-" -ATTIC STRS. 8 FLOOR BRICK ON FRAME I_ CONC. OR CINDER Elk,' - WIRING STONE ON MASONRY STONE ON FRAME', tN SUPERIOR POOR! ADEQUATE ( NONE - - - .rj ROOF ` GABLE HIPn / GAMBREL MANSARD FLA SHED I 1 10 PLUMBING- - BATH 13 FIX.1 k T )JLET.RM. 12 FIX.) I! WATER CLOSET\_ , / I TILE FLOOR TILE DADO 6 FRAMING 11 WOOD JOIST I PIPE FORE TIMBER BMS. 8 COLS. STEEL BMS. 8 COLS. WOOD RAFTERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd i, / ELECTRIQ N - 13t _\ �i •�•3r"d'�` ly NO`HEAING--) 1 r ( - ( -sj 11 Ww .11193 Hui TIM '' all s S _i _ •" T jug :c d _ CO) O iQ H p, C m y O m 'CO! m n o y.A aN 3 v z CD ? H �CLCD aim.. _ rn C4 cCD D OCA' O =• o CD, �V m a. o o o 'j, O CD c o m ' jv{' O zC A CO) n O H Acm , ?H Z yCD a m o CD c._rei' m O.H. CD CD. CL. y n d 02 m� CO) .= : cmH cm 9 -CL W O Cp iTj o. •c � CCD p .a mcol H j CL CD :n ,� i. m d H — 3 � m CD 0 c CD CDCD CA: CD Qp CO) CD tC CD I c I - m N 3 CA o�€� H a m CD CD d Q m . cD �� rrltaws: o CD a5-5 �f z O f w VJ (n ?] Cn ^7 •, S C- p Z ,� G C cp x to S v N � C o z O f w CCD PI v v O C CD o i - � �y i 0 .. 1 :. ,. i I in r ,vaE��,vvl PEAK 100 YR S70RM-PROP CRUSHED STOr` E�. =Z_00. 9'? EL = 245.2 PROP REM. DRIVE F FILTER BERM !.�PsZ3 .70 P/ r i 516 Al Lp TF=248.0 iz'4S p�F 6 6 _ �I `` TF-2� sroeY ti T F = 490 h5 24 6 x 5 FG 14 3ti �» �h 2 TF=253 sZ o�2��r _A ATF=252.0 t3�r--� q5 x49 \ � - 13 -- tv'i29 '�—,vo ✓O � ; O�— � O� MAS 243/ fc/Zn D a 2� A J• �. f 63r - w { w _ _ 2 tri '� +� %� + 5 \\ 21 T F=2520 2O T F=2520 244x5 3 y� o FG 2�'I 244 x5 FG 26 / 16 0 Lo � 4 g n j x Lo 23 2ho° `'�'N x ` �� -} -,. a �: 4 � i H� Fa1u1 U - LOT REIXASH FORK 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***************** APPLIMIT: l k1 a� /�2Le (f-. Core., Phone LOCATION: Asses s or' s Man Number Subdivision /r l -Q dc�wav� Sheet RECO ffNA O ZS T i AGENTS: Con=_er: at -on ad="n istratcr Cc,:� en Town 'Planner Parcel Lots) St. Nutter Use Only***********x*****xxx***x Date Approved 71 Dare Rejected Date Approved Dace Re;ec=a^ Comr„en s .;Date Approved , FCO.:: : nspec mc.. - e? l th ,V. Date Re; ec ze d L- Date "Approvedb Date Re, ec:=_ Pu: C Ncrta - seT:,er,'water conned -ons i - dr_ve:aa'_ Permit Received by Building Inspector Date OCT 19 1995 /. _, I Lm 70. ,,3 % P117- � W F•vo r.V, � M N O /2.7' i 1� jn QE 7 SOS/ I �S //,-, CO)' GEA7/Fy. TO TyE J /TGE /,1/SU•PO.� qt/O %b .Tf/E AW -V-r /,S LOCATED 0,V T//E GOT .f-1-fAVOVA4' AiVO Tf/AT/T 046LI , COA/Faelw A'/T/1 TA/E Toa.v: pfr vo, a voarLQ ZON/NG--edi/4A7A:7A-,S' ,05-44 OIA19 J -7X4 rJ- 'ZOAf STPEGrTS � LDT UHES. "' 1 f!/A^liYCA CECT/FY Tif�.47'. T.y/.S OA►'ELL/iV6 %S iVOT 6O4474W IAA T.yE FEOE.PAG F,CAOO HgZ.4.�0 A pE,4, �Sya1yN O/V FEM�i' COMMt/N/Ty P.I�ICL '� O.v QED 6�z�%3 4914/ -Fn j /=L or RG 4AI //V / O.P.9irit/ FO.P _ /`�iLGS/.OGr �Eacr� �'O.eP /�lE.P,P//fl.9Gf' �-,vG•WEE.P/�l/6 SE.P�/CES A.VOD/�E.� /1�.4S.S:4C,f/l/SE7T.S O/E/O .�' y","�'' -.F.:�-• rl w. .�.. - �'[E` l�; .. .. . 'y.. L ' 'F:F .: .°!`� - H.�.. �J � "r 'r!.. �._ _ - a'..F ^���.- _R {t..'. �:.',t . r i ,A F 1 . j I i r� II I W ` i .. ..vim , _ �' . ��� � i A`. ,. }�• _ i s J J �N C � CA 10 O CD ci oO -o CL r �. d �• y n� �CD a) CD CD Q. a 03 CD co O CD C OCD H Q O CO) O CG O CD CO2 O 1 co z O CD a O C 2{ � CD G �e N 4 - lid m r, "A M �al, -. RIO Q y = d O O N O m CO) m n H C n c=, g. O O d y n � n 40 N G y ? m m 2 O m y m O Z<.cw, O N CD, � O m a � n .► •- CD CD O co O m CL CD N d y C= m c a dm C �Q CD N H CD O m ))) cm C'! .rt C9 O O Er O n o m.�m n y r rn Q �: ;� C. cs co v �. S,: N Q � ,� n tw 9 �J rA W v z N W 0 c tz FF C �H N 4 - 9 �J rA W v z N W 0 c m IlerI THIS CERTIFIES THAT THE BUILDING LOCATED ON MAY BE OCCUPIED AS IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STA BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO ADDRESS � :., : i p' � ter, •. -5 .. 7 x n .1 a +R..jl 2 .�n �^ 'p'°' 7e p; t n J' l1 i . jC I .i " y �"'i' � ��p. � Y. � •�� a.y+��t �. .� � i � "�,ft ��'t .. l�' .. ..-.�SY'.�+Y, �'z. �q!r _ f�lri �''4g�„i titK. ,.:�. t r (,,, ��° ,`�''�: a ta�s. e.,'s...fd t• t3! w�.. �� � . .� �.4 ti� r Ottice Use Onty u�P LIIIII11tQIt1UPfI Df ;u,Pf#s Permit No " y, 1�L�IF[iMILItt ofuhlit Otxupancy &Fee Checked - % ► BOARD OF FIRE PREVENTION REGULATIONS 521 CMR 12:00 3/90 Peeve blank) APPLICATION .FOR PERMIT TO _ PERFORM ELEOTRICA,L WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date IT A f "-` 4tiXr or, Town-oNORTH ANDOVER To the Inspector.of Wires: . The udersigned applies for a permit to perform /tlhe electrical work described below. Location (Street & NumbeO T !� // i:-nean.i n ° Owner or Tenant %����s��' '✓�y�'�%% Owner's Address Is this permit in conjunction with a building permit: Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. _093Y� Existing Service Amps _/ Volts Overhead r❑—I Undgrnd ❑ N of Meters New Service ° Amps ��1�d Volts Overhead LJ Undgrnd No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work &e(A OTHER: INSURANCE COVERAGE Pursuant to the requirements of Massachusetts general Laws 1 have a current Liability Insurance Policy including Comole Operations Coverage or its substantial equivale ittnt. YES I have submitted valid of of same to the Office. YES _ If you have checked YES. please indicate the type of coverage by ep checking the appr, nate box. INSURANCE •POND OTHER = (Please Specify) (Expiration Date) EstimatedValue of Elect ical Work $ Work to Start I Signed underth Pen (ties of'perjun FIRM NAME _ ^� .LicenseeAA I Jr Insoection Date Requested: Rough CAP Final UC. NO. J IT 17� �jus. lei. No. Address , ���SOJ 402071A Alt. Tel. No. OWNER'S 'INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re quired by: Massachusetts. General Laws. and that my signature on this permit application waives this requirement. Owner Agent (Please check one). - /1 Telephone No. PERMIT FEE S (J (Signature of Owner or Agent) X-6565 Total No. of Lighting Outlets I T No. of Hot Tubs No. of Transformers KVA No. of Lighting Fixtures Swimming Pool Above I rnd. g g ElI Generators KVA No. of Emergency Lighting No. of Receotacfe Outlets I No. of Oil Burners I Battery Units No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Total Ranges No. of Air Cond. No. of Ran g I tons Initiating Devices No. of Sounding Devices No. of Self Contained No. of Disoosals Heat Total Total No.of Pumos Tons KW No. of Dishwashers I Soace/Area Heating KW Detection/Sounding Devices Municioal E^ Local I I Connection L Other No. of Dryers + Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: INSURANCE COVERAGE Pursuant to the requirements of Massachusetts general Laws 1 have a current Liability Insurance Policy including Comole Operations Coverage or its substantial equivale ittnt. YES I have submitted valid of of same to the Office. YES _ If you have checked YES. please indicate the type of coverage by ep checking the appr, nate box. INSURANCE •POND OTHER = (Please Specify) (Expiration Date) EstimatedValue of Elect ical Work $ Work to Start I Signed underth Pen (ties of'perjun FIRM NAME _ ^� .LicenseeAA I Jr Insoection Date Requested: Rough CAP Final UC. NO. J IT 17� �jus. lei. No. Address , ���SOJ 402071A Alt. Tel. No. OWNER'S 'INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re quired by: Massachusetts. General Laws. and that my signature on this permit application waives this requirement. Owner Agent (Please check one). - /1 Telephone No. PERMIT FEE S (J (Signature of Owner or Agent) X-6565 ,�"'� �� ,� _I - i_. u � dr . .alp - �� � .. 'q� ^� _. f ,' .. I � � _ � . � ,., ;6 - ^'�- ` i I � � �. f .. t• �.' � .. .T... _ � -- - Y 4 �_ .._. w i Q� i T4,j Date.........d -k 1,- 2711 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....... .......... F. / * , C *-*........................ **"*****'*** **** .... * has permission to perform ........./4......... . ...... wiring in the building of .............././<. de -s -v ...... at....................... ,North Andover, Mass. Fee.. A.(.L.A). Lic. No...(A.91U ............................................................. ECTRICALINSPECTOR "A/23/95 14:50 216.N WHITE: Applicant CANARY: Building Dept. Treasurer GOLD: File 3 6�1, 01 O Date ......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... ................... 2 ............... .................................... has p4rmission to perform ......... w rik in the building .............................................................. iri ng of ........ .............. ��- —16 at .... North Andover,, S. . ......... ..... .. �r ...... .. s... Lic. No. ...... ................ ..... . .......... ..... Fee ... .............. ELEcrRICAL INSPE R Check # �� / , / ' 4 Commonwealth of Massachusetts Offiic t Usc only = Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked i / - 11/991 Iearc btanl: APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Allcork to be performed is aeeardaaoe with the Maaachusars Electrical Code: (MEC 527 C 1200 (PLEASE PRINT ININKOR TYP 7I0hq ` Date: City or Town of: 1�' L /� To the Inspe for of t=ires: By this application the undersigned gtv" tike of his or her imenti0 to perform the electrical work described below. Location (Street & Nu bcr) T � Owner or Tenant Telephone No. L__1 -Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No V (Check: Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑� No. of Meters Nen' Service Amps I Volts Overhead ❑ Undgrd ❑ No. of Me= Number of Feeders and Ampacity _ Location and Nature of Proposed EIectrical Wort;: No. of Recessed Fixtures -- -- ..F No. of Cal -Scup. (Paddle) Fans w uVcww• v No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No.. of Libihting Fixtures Swimming Pool Above ❑ in- ❑ I Emil- rnd. o. of mcrgcncy Lighung I Battery Units No. _of Receptacle Outlets No. of Or7 Burners _ FIRE AL4R11S 7Nof Zones ' - No. of Switches . No. of Gas tumors = No. of Detection and Initiatint, Devices No. of Ranges Na of t1ir.Cond. - Total: Tons No. of Alerting Devices b No. of Waste Disposers Heat Pump Totals: umber I Tons I KNV No. of 'cif- ontained Detection/Alerting Devices No. of Dishwashers SpacdArca Hcating ICtiV Local ❑ Municipal C1 Other Connection No. ofDr-ers Hcating Appliances KW Security Systems: No. De ices or Equivalent ofring: No. o He:ttcrs K'1V o. Sins Bof �ilasts Wi , Data No. of Devices or E uivnient I No. Hydromassage Bathtubs No. of lrlotors Total l3P Telecommunications Wiring: No. of Devices or Equivalent Attach additional detail if desired, or as required 4, the Inspector of 167res 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 eahtbited proof of same to the permit issuing office. ---'—CHECK ONE: INSURANCE ❑ BOND. ❑ On- ER . ❑ (SPAY) Estimated Value of Electrical Works $u ) (E on=Date (Whenaired b municipal it mq Y � -policy.) Work to Start . ' Inspections to,be requested in accordance with MEC Rule 10, and upon completion. I certify, wider the pains and penalties of perjury, that tile.urformation on this.application u true and complete " FIRM NAME: ADT Security Services 111 Morse Street, Nor,I"►•o , MA 062 LIC. NO. 1533C Licensee: John S. Bassett Signatu IC. NO.: 1533C (lfapplicable, elver "exempt"hi the license numberUnt) Bus. Tel. No.: 781-')78-1111 Address: AIL Tck. No.: 781-279-17I� 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 C3 owner's aceat. Owner/Agent Signature Telenhone No. PEIWIT FE' E:.S ' 7'