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HomeMy WebLinkAboutMiscellaneous - 90 LANCASTER ROAD 4/30/2018R TOWN O,W RTH ANDOVER PERMIT FOR PLUMBING This certifies that ............................. has permission to perform .................................... M", plumbing in the buildings of ........ ;-- ................ at . >....... North Andover, Mass. ...... Fee ... Lic. N,.,�t. 54.�P,3 67� PLU 'BIN INSPECTOR Check # . '/0 d /!� !�PIN,)- INSPECTOR 7201 10 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS p�, Date Building Location /C/ .44 "VC;4;6�' Owners NameTjFO/,!S Permit # %,cr Amount /. '5 New 0 Renovation [a Replacement FIXTURES Plans Submitted Yes 1:1 No (Print or type) Check one: Certificate Installing Company Name DAVID 1 -he -H Corp. Address /l 697710AIW.064 4QI✓I'a Partner. DAA c-vT NL,4 o / ? 2.4v Business Telephone 9 7 8— 6 ff 2.— !0 3 7.7 � Firm/Co. Name of Licensed Plumber: 0AV I 0 LIQ e—H Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy El Other type of indemnity 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 ignaMre Owner E Agent r 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 anIl p orm Permit der Peit Issued for this application will be in compliance with all pertinent provisions of the Mas chu 3t e P mbi ode and Chapter 142 of the General Laws. V By:o t ens um er Type ofPlu g License TitleaY993 APR City/Town License Number Master Journeyman APPROVED (OFFICE USE ONLY COMMONWEALTH {?F 'MASSACHUSE-17S IN PLUMBERS AND GASFITTER;; LICENSED AS A JOURNEYMAN PLUMBER DAVID A LACl/ = L1 COTTONWOOD DRIVE DRACUT MA 01826-167 24993 05/01/08 262261 t Location No. Date Nom,. TOWN OF NORTH ANDOVER F 9 s i J Certificate of Occupancy $ Building/Frame /Frame Permit Fee $ a+c"usa 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # % 18894 _- �Building Inspe�toi 09 M X z O O Z M 90 O Mn r v M r r Z G) TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT 5VA RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: x x DATE ISSUED: SIGNATURE: - Buil n ssioner/I r of Buildings Date SECTION 1- SITgANFORMATION 1.1 Property Address: nn 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: Zoning Distrid Proposed Use 1.4 Property Dimensions: Loot Area Fronts ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReWred Provided EMred Provided 1.7 water Supply M.G.1—C.40. 34) Public Private ❑ 1.3. Flood Zone Information: Zone Outside Flood Zone 1.8 Sewerage Disposal System: Municipal 5( On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No 2.1 Owner of Record ,� 2:0. Name (Print) G -E cJ GAS _ 7 i1/ C.4 7- 4!& 10 Address for Service : G 77 n -ice 71 - 'Signature Telephone 2.2 Owner of Record: -.-9 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 Signature Telephone 09 M X z O O Z M 90 O Mn r v M r r Z G) 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 all applicable) New Construction ❑ Existing Building Repair(s) ❑ Alterations(s) - ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be� Com feted b ernut a licant��� OFFICIAIUS T......x, .r _ q {}NI �x r .. _- 1. Building (a) Building Permit Fee Multi lier 2 Electrical r C5 Q (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) 4 Mechanical HVAC Q 5 Fire Protection 6 Total 1+2+3+4+5 Check Number i SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize. / to act on My behalf, in all ers relative to work authorized by this building permit application. Si e of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, �� L / A 44 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 PrP -C _ �/ /kcy Z 4r 4� Siwner/A ent Date NIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 ND3RU SPAN DUvIENSIONS OF SILLS DINIENSIONS OF POSTS DIIVIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIlVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE f T146 O z Cd x O a "b o •i v z C7 a °co o DD o v c a 0 w Q R0 q a w Z W OD o •Vid G a o G w rQ cn °° cn F- c o CD c ;.= c C O ` C H O ::gC O. V V '•C.0 C. R O m C ;= O O 4D CD o v .. S a N O m .a. C r=•+ O O s cm _c N CD O O N N C" m C C � � m _ ' N O N m E� CD O acs N m � .0 :CD � �Z `o c a aCD `�� m o = m «�• r N m s W C N+L••-ca MD CL=t *co cc *E 3 "r d LU o o c c V� C. O O � Z eCOCe a 0 �=j- E d N t N O i df 0 75 CD C: 01 c 00 0 cm c N CD O Z 0 0 zip C/) F O �zO a:j v Cn �D C/) 0 w U C/) a T O O 4.4 co G L 0 V Z co C. O y D � O tm CO) O CA CD O M� M— W W CD 0 CD c C2 030 cc O a p- t a CA Q c O L)CL C2 'fl CO2.• CD C Z � V COC CL O C cc CIO _.p Gerald A. Brown Inspector of Buildings Please print TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 HOMEOWNER LICENSE EXEMPTION DATE: �� Telephone (978) 688-9545 Fax (978)688-9542 JOB LOCATION: .:V7 Number Street Address Map/Lot 9�_ 6�1-�1� 37 HOMEOWNER Z�/ -/_/4,,g? �S %IS-��7�3a77 Name Home Phone Work Phone PRESENT MAILING ADDRESS`s=_-j_,w Z== City Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other Applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. 1__� HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Forth Homeowners Exemption -- - -- ------ IF tv 71 r 3997 V Date-09---s—Z..? ,...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........� N.�...�. �/s/z..c .......,r���.,/%. f..� . r.. s ..................... has permission to perform ..........,!`jr {' �a..r���..................................... wiring in the building of ......'%�G!�.h' �!` .`t ........................ .... ........................ at .......�1...rf<a..i'Q7''. ........ , North Andover, ass. ..... YZ Fee . ..... Lic. No. A/... ......... .......JJJJ.///..... .. r ...... ELECTRICAL SPECTOR C Check # S Z �� `�� saw �"i�� L �'.' a� ,o Official Use Onl �f THE COMMONWEALTH OF MASSACHUSETTS Permit No. / r Department of Public Safety BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy & Fee Checked APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 y (Please Print in ink or type all information) Date To the Inspector of WirreS: Town of North Andover The undersigned applies for a permit to perform the electrical workedescribed-below., ., Location (Street & Number�y¢ Owner or Tenant Owner's Address f� t Is this permit in conjunction with a building permit Yes • No • (Check Appropriate Box) Purpose of Building t��f .�_ _j! Tnyl.Z _ --Utility Authorization No.. Existing Service__ ��� Amps cs� Voits Overhead • Undgmd New Service Amps Voits Overhead • Undgrnd No. of Meters No. of Meters Number of Feeders and Ampacity ip Location and Nature of Proposed Electrical Workr/-� ��D �� � ""rte ""T- zy-11 l, %S //V 2�",6w r ER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE = BOND = OTHER = (Please Specify) _ (Expiration Date) Estimated Value of Electrical Work$_ Z�f_g © _ Work to Start_ Inspection Date Resquested _Rough__ _Final Signed under the Penalties of perjury: ,' /' / FIRM NAME 0!/Y /v F- A, LIC. NO. Bus. Tel No. _ Address ' Alt Tel. No. _ OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this per application waives this requirement. Owner Agent (Please Check one) '1 T37-0-7-7 % �vU Telephone No._ PERMIT FEE $ � (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above' • In No. of Lighting Fixtures Swimming Pool qmd gmd Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners Battery Units No. of Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No. of Di osal No. Pumps Tons KW No. of Sounding Devices _ No./ of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices • Municipal • Other No. of Dryers Heatina Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Si ns Bailases Wiring No. Hydro Massage Tuds No. of Motors Total HP ER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE = BOND = OTHER = (Please Specify) _ (Expiration Date) Estimated Value of Electrical Work$_ Z�f_g © _ Work to Start_ Inspection Date Resquested _Rough__ _Final Signed under the Penalties of perjury: ,' /' / FIRM NAME 0!/Y /v F- A, LIC. NO. Bus. Tel No. _ Address ' Alt Tel. No. _ OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this per application waives this requirement. Owner Agent (Please Check one) '1 T37-0-7-7 % �vU Telephone No._ PERMIT FEE $ � (Signature of Owner or Agent) j Location 901 No. AJ, Date TOWN OF NORTH ANDOVER Certificate of Occupancy $r -OS- -,e.f Building/Frame Permit Fee $ 2 03 Q p Foundation Permit Fee $ a Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ 1 '� a AL $ 1>. , C Ci 6069 Building Inspector Div. Public Works ,Location�� No. J Date TOWN OF NORTH ANDOVER p Certificate of Occupancy $ Q * Building/Frame Permit Fee $ 4W e�h Foundation Permit Fee $ ,/� 01 O 0 s�cNus •Other"Permit Fee Sewer Connec#ion=,Fee-h Water Connection Fee�''Co s TOTI4 '. $ 1140,00 7y � ' • J „/ ��� �� 1993 Building Inspector �— i �= 6031 Div. Public Works Location No. V Date f ' o, NoRT:TOWN OF NORTH ANDOVER Certificate of Occupancy $ VP Building/Frameq?er`rra^it Fee $ cNuSEt Foundation Permit -Fb4- AO $ Other *it Fee 5G0 Sewer C%6cti6n Fee 06 f gQ Water Connectj#n Fed $ lel TOTAL .r` �� $ fit, t1 • o o F Building Inspector f�q� C'..% Div. Public Works APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. /� " _? iQ`� t PAGE 1 MAP 4d0.�0 _ LOT NO. 2 RECORD OF OWNERSHIP jDATE BOOK PAGE '. ZdNE I SUB DIV. LOT NO.� s�l LOCATIO PURPOSE OF BUILDING OWNER'S NAME r NO. OF STORIES A SIZ OWNER'S ADDRESS vv i BASEMENT BASEMENT OR SLAB T—�� ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST y Y/D 2ND �}�a 3 rfa Q BUILDER'S NAME Aglmvp-m— SPAN 1�/ DISTANCE TO NEAREST BUILDING �� DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS � DISTANCE FROM LOT LINES - SIDES �v REAR v GIRDERSD AREA OF LOT y FRONTAGE 7 HEIGHT OF FOUNDATION �,iJ,00ff THICKNESS /, IS BUILDING NEW ��p� SIZE OF FOOTING x IS BUILDING BUILDING ADDITIONS MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILL�LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE „wy� IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY-�f IS BUILDING CONNECTED TO TOWN SEWER T IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES • U 0 InPAGE 1 FILL OUT SECTIONS 1 - 3 a�YW r�Ff3�`�n D D PAGE 2 FILL OUT SECTIONS 1 - 12 m --s- � /�jr!w pow ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR gig FEE 1,I), () D ��d • C), OWNER TEL. #-� ,1'(7 PERMIT GRANTED 19 CONTR. TEL, # CONTR. LIC. # 3 PROPER INFORMATION LAND COST EST. BLDG. COST `:?C2 i O O G C✓J� ` EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN c. BUILDING INSPECTOR 1 OCCUPANCY SINGLE FAMILY *- STORIES MULTI. FAMILY STUCCO ON MASONRY OFFICES - - APARTMENTS _ _ STUCCO ON FRAME CONSTRUCTION 2 FOUNDATION BRICK ON MASONVY- BRICK ON FRAME 8 . INTERIOR FINISH CONCRETE WIRING d 1 2 13 CONCRETE BL K. GABLE 1. PIE 11 BATH 13 FIX -1 BRICK OR STONE HARDW D PIERS _ PLASTEREll DRY WALL ✓="' _ 3 BASEMENT UNFIN. AREA FULL FIN. BM'TAREA _ 1/1 1/2 1/1 FIN. ATTIC AREA NO B M T FIRE PLACES _ HEAD ROOM r. MODERN KITCHEN 4 WALLS 9 FL_O_OJRSCLAPB O �J 3 DARDSIG DROP CONCRETE I WOOD SHINGLES �I EARTH I� ASPHALT SIDING HARD%,✓'D VERT. SIDING ASPH. TILE ~ STUCCO ON MASONRY _ _ STUCCO ON FRAME BRICK ON MASONVY- BRICK ON FRAME ATTIC STRS. & FLOOR _ CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I� POOR ADEQUATE NONE 10 PLUMBING 5 ROOF GABLE 1. I HIP 11 BATH 13 FIX -1 SLATE NO PLUMBING TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DAD 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCETIMBER BMS. 6 COLS. I STEAM D HOT AIR FURN. 1 BUILDING RECORD' 12 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH' PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. h*ngeN +'+a�tmardrae c+ F ; F 5 A .iit s t; R f f �r t 7 NO. OF ROOMS ' GAS OIL i B'M'T 2nd _ ELECTRIC 1st 1-T,-dj NO HEATING G' f FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction i have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: L7 l, U J J, 10 c Hp Phone - LOCATION: Assessor's Map Number Parcel Subdivision Lots) 2W 8D Street ,On, , �� St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: "y Date Approved Conservation vation Administrator Date Rejected Comments IR "-00- 1 - - -4, - - ly Town Planner __Omk Comments Food Inspector -Health Septic Inspector -Health Comments Public Works - sewer/water co - driveway permit Fire Departments EG _71 ►- 1P_:,4by by +i ilding Inspector l Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected ns /w� Date F CERTIFIED F'OUNDA TION PLAIV LOCATED IN L�azzN SCALE: /".r 4-0' DATE: Scott L. Gi/es R. L. S. 50 Deer Meadow Road North Andover, Mass. 466,'7'1 Q S. F' k O Zo' 5 24' gnu ST HSE 4 2 16 44= 41 h0 Ir2„3q -- _ LS ti L'I 15 !� lw I Ta EulEl,DING DEPARTME[�!� I CERT/FY THAT OFFSETS SHOWN ARE FOR THE USE . THE OFFSETS OF THE BUIL DING INSPECTOR ONLY SHOWN COMPL Y AND SUCH USE /S FOR THE WITH THE ZONING DETERM/NATION OF ZONING SY LAWS OF CONFORM/T Y OR NON- CONFORMITY " WHEN CONSTRUCTED. tW2 n T11 0 5 A Z z yH w C rbO Z v, G S O EL 'D Ti G C O O a- OTJO d T CO) 'C7 n O CD Z CO) CD O 'O z CL r n 2 O CL CO) Ilk) aC d >, c v CD CL o CD 0 CCD O CCD m z ER ID m CCD Q y, y D o M z 0 Cfl COD z F CO) C3 O m CD C7 + CD r� CD T O z D c CD r 0 14 r c �� o 2 • N O Q N a C3m .F m y CL o m CMM" `cma`o' , N =r H ._.►� .d•�m N T =rr m CA o � •o " CI) ff CD m S Amo- - n, o ZS:cw O N mC1 :Q O n N O :� �� :• c,.... CD CD CCD m N C � m 3 : Ad �� N O• mto co) CA CD C. .� o 0 O C4, � � o D N C2 .� 0 C • d r CL -0 • :� Cl) � c o� o = . � co O CD 0 w yH w C rbO w G S O EL G G r• 7d b o O a- OTJO y 0 9 O C CD 0 y 0 9 O C CD To , n!o A,,n± A -J o o JEP- a J i t,o ►w J j a cin. irl+tJ nla� S��u�=��f�/ �yo-►o� �+-�' i,.rt=��r.��_�/ v V2015,3 v CERTIFICATE OF USE &OCCUPANCY Town of North Andover Building Permit Number 125 (1993) Date AUGUST 300 1993 THIS CERTIFIES THAT THE BUILDING LOCATED ON 90 LANCASTER ROAD (lot #30) MAY BE OCCUPIED AS SINGLE FAMILY DWELLING W/21,2 CAR GARAG4N ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO A. J. Maillet 3 Westcott Rd. ADDRESS Andover, MA �dsAGNUS� Building Inspector v, C � O � O — O CA Cl) 'C O CD n Z CO) CSD O 'G CL r MM = = y nCc -0 70 O O CD CCD O CL O cr CD coo O CD m G' CIO 10 CD O 7 y� CD y 0 O CCD O C CD C C 9=. p _ • +� O coo O cr y .i 7 C m - CMO C y 1 m m C2 yma� c Z � ?� ti m c =r a. 5 m COD m m IN, O -a o imp m a 3' c co -00 C2 t�• c = _A o ZS:CO23 o �+' � � CIII : c� m oa CD CA V ►-+ O m r0 G '"� o c �m l l = wm VJ �. o y =W �-r C am ECL (n o c _ 1 a Nibco C CID) y m. o �SL0 zCD C2, o CD : c 0 _ CD V1 � W O � p ?: = CD Fl tz CL. in GoO �4 c o CDe _ o ° Mo m w °X cam, Y ?� cn �Q vGv Cii a- r � �-?r, ;v -n �F- oda = X a (Dn cn Irl - a. � t7C t7 O M �~r-z'6- 'tiht z " . O PQ U1, y 0 0 c A Date .....2.; ?. V ........ TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING US This certifies that ........ ..... .......................... ........ .. ... ........ 6.!. has permission to perform ...... .................................... wiring in the building, of ......... ........................................... at ... ......... .............. . North Andover, Mass. Fee ............. Lic. No. A-.----- ............... EtECTRICAL eS.;P�ECrOR Check # 5406 7BECOMMONW ALTHOFM4S,SACHUSE77S Office Use only DFPA1UAIDVl0FPfMCSAF= Permit No. BOARDOFFMPREVEMONREGVLAHONS527CMR12iX1 Occupancy & Fees Checked a APPLICAHONFOR PERMIT:TO PERFORMELE=CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION)," Datee l2oi 16 ;-700 V 1Z Town of North Andover To the Inspector of Wires: The undersigned applies for permit to perform the electnc-,'kl work described below. g PP P P Location (Street & Number) 57,0 /—,.I -,,y %. OwnerorTenant 0/ �, --*14/!4! Owner's Address 5.4-J" ge Is this permit in conjunction with a building permit: Yes a No © (Check Appropriate Box) Purpose of Building ��� �,y 7�,q Utility Authorization No. Existing Service Amps122 231p Volts Overhead a 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 Fixtures Swimming Pool Above Below Generators KVA round emund No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units ,No. of Switch Outlets k 0 No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges© No. of Air Cond. Total Tons No. of Detection and _ No. of Disppsals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained DetectiordSounding Devices Local Municipal Other No. of Dryers�q (0 Heating Devices KW Connections a No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER- limaarneCavec� F'l><sralttvtheregmarla�Isafll�adlt�ftst.;ataalLaws a bIhareaamaltLiaWhmaarneFbhymditCm#e CownWoritssub9ataleguivalaa it YES NO ffineat niledvaidptodofsarrebtheOffm YES(a ffywhaedrdodYES,plea9egdc*theNxcfo by dn-kirwdr box M NSLIRANCE BOND M OIHM r7 WaktoSw kq)edimI a*RaWesbd Stgnedurdcr Ftrtal of paw RRMNAME EVimfimDaie Fstirrl&dvakrofl7ecWcal Wodc $ LicffwNa Licame Signanne L;oerrem Btsin=Tel.Na Alt Tel Na OWNER'SP4SURANCEWAIVER;IamawarethattheLxemdoesnothaletheirmtratceoDvetWaZakft ialegrivaiertasmgmtdtryMassadttsetlsCordLaws andthatmyWaMecnthispeoritapplicationwavesthism martat (Pleas heck one) Owner Agent a Telephone No. �3a 7 PERMIT FEE $ tgna ure of Owner or Agent Date ........ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... U-/. 1... A .............................. has permission to perform ......... rf..f ............ wiring in the building of .................................. . ............................................. .............Nle"dovq vassat ........... ...... Fee, —JO .. Lic. No/7//- .. ................. . . . ................... . .i E ECT c F � AL INSPECTOR Check # 4432 THECOWOA WEALTHOFA14&"OWJSEM DEPARMENT OFPUBLICS4FETY BOARD OFFLREPREYEVHONREGUL 47TOAiSS27CMR 1100 Office Use only Permit No. Occupancy & Fees Checked u LICATIONFOR P��►MIT TO PERFORM II,£CI'RICAL Wn% ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 �© O (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date �z3Ir c3 Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street J Owner or Tenant Owner's Address To the Inspector of Wires: Is this permit in conjunction with a building permit: Yes o No ® (Check Appropriate Box) Purpose of Building �-� Ey ��,¢ L Utility Authorization No. Existing Service Amps/ Volts Overhead [:3 Underground New Service Amps / Volts Overhead r-1 Underground Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Meters No. of Meters No. of Lighting Outlets No. of Hot Tubs _ No. of Transformers _ _ Total rte, yy IT.—.?Lighting Fixtures Swimming Pool Above Below KVA El Generators �_. KVA . uround ground No. ofReceptacle Outlets No. of Oil Burners �__� No. of Emergency Li tin Battery Units No. of Switch Outlets No. of Gas Burners ` —r FIRE ALARMS No. of Zones No. of Ranges , No. of Air Cond. Total �— Tons No. of Detection and No. of Disposals No. of Heat Total Total P s KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW �-�- --- -- No. of Self Contained . . . Detection/Sounding Devices LocalMunicipal Other No. of Dryers Heating Devices �_ KW Connections a No. of Water Heaters KW No. of No: of Si �— Bailasis r No. Hydro Massage Tubs No. of Motors Total HP OTHER: It�su-anoeCaa�ge Rtrsttaitothetequrterrta�iset�Ga�aalLaws Iha%eaommLial*hnrarmpbicyirrh>&gCar4i* , CoAWcritssdiaiecpm-diart YES EJ NO Ihawstbnkedvaliddpafofsmmlot4eOltio:: YES M. NO If}wha%ectlac WYFS,pimeat&WthetMx,,foo,byctal&gtbe INKMANCE BOND O-ffM (PI�seSpecify) WcdcbSwt hq)mti tDa1eRewe*d OWNER'S II,SURANCE WAIVER; ut aadtvtmysignLtmcn spwntapplcMmwai%mftts34mmlem (Please x) Owner r7V Agent FxprA D* lid Vahtecr Med rW. Wc&$ _ AkTe1N,9✓-----, m*red bylvlassad;lsws C=aral Laws Telephone No. PERMIT FEE r CD Name The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Name: Location: city Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 1 am an employer providing workers' compensation for my employees working on this job. Companv name: Address i City Phone #- -insurance Co. Policy_* Company name: Address City: Phone#• -T Faiture to secure coverage as required. under Section 25A or MGL 152 can lead to the brosition of criniital up penalties d.atrne to $1,50C and/or one years' imprisonments welLas_civil.Renaltiesjnlheim -d-aBJ3 P l+YDW-ORDER„and alkw-�&Asimm)$xlay-againstml- understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification n ! do hereby certify under the pains and penalties of perjury that the information provided abovee is true and correct. Signature Elate Print name Pbone#. Official use only do not write in this area to be completed by city or town driicia City or Town P . �Clieck if immediate response is iu:giu�ir+ed " [] BuildingDept Licensing Board p SelectrnAn's Office Contact person: Phone # Health Department I] Other 6047 6S - Date.... ......................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............ ...... .............. % has permission to perform jk. ....................... wiring in the building of .................................. ........................... at ................ ...... :eO.. ,North Andover, Mass. Lic. No. T Fee ..:�q ................ ......... Azz .. AR, ...... .... ..... iiE ELECTRICAL INSPECTOR Check # J D�M1irIl1�V1'OFP[18[�SAF'BJY Perndt No. ` Oecapumy R Fen ChKJwd umm—m— APPUCA77ONFOR PERAR710 PERFORM FT C1 ICAL,,W TORK ALL WORK TO BE PERFORMED IN ACCORDANCE WLTH THIS MASSACHUSSTS MSCMICAL cODB, 527 cMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INMRMATION) / Date o� . Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) z0 Owner or Tenant Owner's Address Is this permit in conjunction with s building permit: Yea C3 No IM Purpose of Building ,���] "=A" 7J L To the Inspector of Wires: (Check Appropriate Box) Utility Authorization No. Existing Service Amp I Volts Overhead Pq Underground No. of Metas New Service Amps..1 Volts Overhead Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 13.e�iL-- ,iii` 7— Na of Usisim Oorkb RM No. ofHot Tobe - NO. d7iwbmmn TOW KVA No. d Uabdog Fistma Swimming Fool- Above amw 11 Below Osonatsn KVA No. of Receptacle Outlets /6 CJ No. d Olt Boman No. of Em pacy Uandns Bwwy Units Na of Swleda Ontlma No. of Ou Bmnme FIRE ALARMS No. of Zoom No. of Ronan No. of Mr Coad. TOW TM Na of Detecdw ead a�5o. of DbpoesY No. of Haat TOW Told pump Ton KW IddatbW Dnkn No. of Soondhq Dellen No. of Diahwuban Space Ana HeWna KW No. of Self Canubw O No. of Dryan HeWna DrAm KwIM Comacdom No. of Weser Hcdme KW No. of No. of Sias BWJdA e NO. Hydro Mauve Tabs Na d Moan ToW HP hauanaeC WW& Asti11111DIva}aenm dUndizaamudlallt IhmactoOlirht'thP '-,yirtdrBCpiia; rbA*d1"WgiAW IhnsftritdvdpoddzbNe�n 7rIlouheddmdygy,M UCLYZS %v— e°`�� pka ad�tYR���by NMRANCE aum a 130idmDow dVsdEkWWWcdr S W01kbS41t Razad Rotel Arid S5ledurds PliWbdpetjiry. ' FRtMNAIM LmnNm [�t�e Si�iarae [�amrelvo Ad JM IN r I1L�No. OVV1�R'SIIV3IAtAi�WANi iaae+iahttbeti�ee�ggs�lheireisnecuia Orida�drlegiva�tar=9ndbyMwdsroaa=dLm ardtfatrr�sgtl�ontlilsperr� Vullil ==firers a (Pmhkawcv� beck one) Again in Telephone No. -PER r FEE i 101 alb XMdW0FpEWX3LW r tenni! Na 6 09 --�, Occups'y 3 Fen Cteuked ---� APPLICATIONFOR PATO PERFORM FT CTRICAL WORK ALL wORK?0 ee l�F7lPottMlD INACCORDAhICC8 al[rit TFtB MASSACNUSSTS BL6CMXAL CODB, 527 Chau 12:00 (PLEASE PRWf 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 wort described below. Location (Strut R Number) Ownef or Tenant Owner's Address Is this permit in conjunction with a builft perp& YeaE3No El Purpose of Building ,�,f�sJ rc7 „,=A J L Existing Service Ampa�/ Volt Overhead New Service Amp... IVoks Overhead (Check Appropriate Boit) Utility Authorization No. Underground No. of Meters UD& ound No. of Meters Number of RWea and Ampacity Location and Nature of Proposed Electrical Work No d I oft ovda Na of He IVA Na o(Trannhow ra Told Na d Uandty le<taa � Swltmdna Root Above votow tWotr fleo�elon KVA KVA Na at Receptacle Oaded /6 CJ Na d OIt BwoNs Na of Ernog y t jOWna Bir Units No. of switch Oubm Na dGee Bowen PIRG At.AUW Na o(zones Na of Range Na of Air Coad. Tad ?awe Na of DetjW" cad Na. d Dbpoeeh Na d Heat Tod Told Tome KW dye Deviate Na d Dlehwuhm Spew Arne HaftHw Kw Na of Sam Devian Na of Sdf Congaed �. O il Na d Dryer Hesting Dem KW-Lmdbm&dp No. d Water Neaten Kw No. d Na d Connections Siam Bdede Na Hydro MwW Tobe Na d .Mobs Tod Ht t I IN ins�taeCbieiig� Pioautbbe�dlblr■daart(lssljsr. Cm NO � � � NO Ilaft0dv0praafaf a 10900ft YM TywhaiediededYB4�pleaeidtsbfntyped 20-RANM Sao OTm � �le■eS�edyj WCAIDSWt i,recionl>*Regsged F�tr*+dValiedPhliOigtait s Stied Poir�c(p" liar $ Li =?b Bu*=TdNn OWbWSABURAP�WAIVl tIemaamelltfeLae:ac �'h1Na �lleiavaioec°t°orkta�ilaq�irrd�tmbYhieradiu�tGl�ImiLstia adQatrrWsiBlrrtreonfiptsmi tiiregrieasBt (P one) Amt Telephoaa No. ��-�� 7-,3,3)L 1111= 91 Uw rgBg s PR-12-r C E* v.. DEBU71WHNT0F,PtUX&4FjffT Po Wt Na Ooo"=" S: I%U t'.Ibetoed MFIUCARON FOR PE1z1 ff M MWOM FT CMCU WORK Au woRK To BE PFBPORM0 IN MXORDA= MtM TFC MASSACHUSars M.ECMEAL coos, 327 CMR 12:00 (PLEASE PRIIVT IN INK OR TYPE ALL MRMATION) DtuO ��� p f ---ct2,5- Town of North Andover To the Inspector of Wires: The undersiped applies for a permit to perform the electrical work described below. Location (Street d Owner of Tenant Owner's Address is this permit in conjunction with a building perdu Yes (J No Vj (Check Appropriate Hos) Purpose of Building ,-nf/ T/�f L Utility Authorization No. Existing Service Amp... /Volt Overhead Un11 �r td a No. of Metas New Amp.. /Vohs Overhead Underground No. of Metas Number of Feeder and Ampscity utcation and Nestor: of Proposed Electrical Wort 7— Na d U Oetled Na Of Hat Tabs Na d7tmdonnen Tod Na ofUO&S RIUM Swb= do Pad Above �� aeoWal� KVA KVA Na of Receptacle ON" 6 Na d on Bmawa Na of U� Bawry thdin - Na of swltck oodw Na dam Heroes PIRG ALARMS Na of Zama Ha of amps No, of Air Cad. Tad Tan Na of Detsedoa aid - . of Dopa* Na d Fiero Tod Tod Tom DevineNIL Of Sawift �� Na of Dlabwahae Span Ana Heeds{ KWhNiNkig Na of SSB ow Davlom Coommwddorn OrFrer� Na at Dryer Homing DrAm KW No. of Wow Neese KW Na d Na of shm BdW* Na Hydro Mamp Tube Na d Mose Tod FQ <{ 11RI rne0OYr P Atalartbbere4iOr�dlVlm�dasrClaassiL� ]tuneaasmtl�6i�isua�A,ig�irjdri� oria>ixriri Ihma�rn�dvMpax arweit e03Ot Y$9 �►a: Yl� NO r)'°uhsueded�d7�PlasidNlefFetypedao�eogby MfaNt3 sem 13 am 0 �le•eSpeoi� > i *ODed WC&IDSW j DaRa RouIb FslimrledValredPlttivlWbt s SVrwd Ptr-dpejugr Rd FOiMNAME LinnNts Imre �� I�rb Btzr�t 7KNn aftWSIG ANCEWAM t:IaflssiwefFniFeLnmM �. A!'I�M ardtMtrr� raeonfipeszt dirsgdr®t �' zsassIoeaole oribs�rYa4 tISXq* dbyM=dnwGnsWLl w (P beck one) Apot Telephone No. 91f1-f5�31-�3aa7FEE z 2