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HomeMy WebLinkAboutMiscellaneous - 95 COLGATE DRIVE 4/30/20181 v Location No. 150 Date �,-.6;? , i 140"T"'��y 0"T" TOWN OF NORTH ANDOVER Oft...° ,�0 Certificate of Occupancy $ yes'^•° Eta' Building/Frame Permit Fee $ /�� v s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # /nrG F 7 ' '� 6 7 1, % Building Insp or 60 M Z O TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: So DATE ISSUED: SIGNATURE: Allu,601t,"e— Building Commissioner/Ifor of Buildings Date SECTION 1- SITE INFORMATION 7 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 3Z g InformLOse' 1.4 Property Dime ]cions: 2�G�5 �- Di ct Lot Areas Fronta e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R rid Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSE IP/AUTHORIZED AGENT of Record r1er — IC// -� JAV N Print) �f Addressfor Service �j gnature 2: 2.er of Record: J am tint Address for Service: I n r 611,Tele hone SIECTION 3 4CONSTRUCTION SERVICES 3.1 'censed Constru 'on Supervisor: Not Applicable ❑ tcensed Construction Supervisor: Ay License Number A ress / Expiration Date / n re Telephone 3.2 Reg' ed Homg Improveme t n for Not Applicable ❑ 7 5 Company Name 'i Registration Number Address 0,raDa Signature Telephone 60 M 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 all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) _ ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: I SF,CTION 6 - F.STIMATF,D CONSTRUCTION COSTS I Item Estimated Cost (Dollar) to be Completed b permit applicant OFFICIAL USE ONLY 1. Building (a) Building Permit Fee Multiplier 2 Electrical v (b) Estimated Total Cost of Construction / Q / g/ 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical (HVAC) 5 Fire Protection 6 Total (1+,2k3+4+5) Check Number SECTION a O NER THOR OK BE COMPLETED WHEN OWNERS GE T O O CTO IE FOR BUILDING PERMIT I,A as Owner/Authorized Agent of subject property Hereb auth ' e to act on My behalf in 11 ni0grs r t v to�rojk authol-ize jby this building permit application, C t t Date AGENT DF CLARATION I, as Owner/Authorized Agent of subject e property flerebv declare that the statements and information on the foregoing app cation are true and accurate, to the best of my knowledge r and belief Print Name 0 Date NO. OF STORIES 4 SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 ST 2 ND 3 RD SPAN DIMENSIONS OF SILLS DIMI-;NSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOIJNDATION THICKNESS SIZE OF FOOTING X MA'T'ERIAL OF CHHVINEY IS BUILDING ON SOLID OR FILLED LAND IS 13UILDING CONNECTED TO NATURAL GAS LINE f NO RTH � A ss�cwsc CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number Z-0 Date THIS CERTIFIES THAT THE BUILDING LOCATED THE BUILDING LOCATED ON q� C0 I g d *' MAY BE OCCUPIED AS "% Aw rh , oZ 88-777 S/ti,y /e /'3 Y" / At d(P�,S 1 IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TOa e- T a ►"'C,9 GU v /q a �e S r 6e -,- Building Inspector BUILDING FILE . ^L C/) m C M C/) 0 m _ CO) 10 0 z CD O CLd CL i+ O o p C CL c� CD O a.po co CD _ CO) .p CD O O CA C7� O C CO) CD O �F CD CD y. CD CO) 0 CD C CD C EMSy 0 0 O 2 Q N FL, MC . Egg o m � CZ N CL m Z =-o VNO o, X F NCL o T ? m d -'d O y O S O O N p -I P4 O O = m -1 a > > N 0 0 to -^ O nm o 'o v C =N r� a �� so o CO IA � � �H m � � o m Za �I n °, CD y 3 1hh ►teV`f !^ ON ZN N .� /V c J d O. � d � r � < <O �J ••m N �. ? C � y OD S,C2 n 0 '•� z CD o /^ 0 z 'oma• m Ohm: M3 o c: �E m� 0'! CA CD: - C/) C/) 07 8 p w G w r O. IN N � ,E V Q 0 1 0 IN, H 0 9 0 c FORM -U - LOT, RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT LOCATION: Assessor's Map Number (L SUBDIVISION STREET LLS OUT THIS SECTION*********************** L PHONE% PARCEL -/-,Y_ LOT (S) ST. NUMBER ************************************OFFICIAL USE ONLY*********************************** LRr PMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMI STRATOR DATE APPROVED DATE REJECTED COMMENTS No wAalS Ly/in jQO 0.nOrev d qn AA,'+,'O,) +10 dwAl+A, 0A S/O,-k TOWN PLANNER COMM FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMME DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTO Revised 9\97 jm TE ■ Go L6 ,& -T-5 STRUCTURE LOCATION PLAN CLIENT: THIS CER17FICATION IS MADE AND LIMITED TO THE ABOVE CLIENT. LOCATION: df 6 C.0LAA-rF,: 9r'POET' SCALE: "o N -p' DATE: COUNTY LAND SURVEYS, INC. Pmfm UuI Lard &w% ma •110 w fiO Qbmsta, QUA BIAtl�6p •N7BI S OIIB I CERTTFY THAT THE PRIMARY STRUCTURE SHOWN CONFORMS TO THE HORIZONTAL SETBACK REOUIREMENTS OF THE LOCAL APPLICABLE ZONING 8Y -LAWS IN EFFECT WHEN CONSTRUCTED. (THIS CERTIFICATION DOES NOT CONSIDER ANY OTHER RESTRICTIONS SUCH AS COVENANTS, WETLANDS, EASEMENTS, ORDERS OF CONOITIONS, ETC.) THIS DRAWING SHALL NOT BE USED BY THE CLIENT FOR ANY PURPOSE OTHER THAN THAT OUTLINED ABOVE, EXCEPT WITH THE WRITTEN PERMISSION OF COUNTY LAND SURVEYS INC. COUNTY LAND SURVEYS INC. TAKES NO RESPONSIBILITY FOR THE UNAUTHORIZED USE OF THIS DRAWING OR ANY INFORMATION CONTAINED HEREON. rJitC C' om/xaxu/('acua o.,Gaifa�.�u6ctid �! BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 007864 f = Birthdate: 04/18/1954 Expires: 04/18/2004 Tr. no: 65 Restricted: 00 GERARD E WELCH PO BOX 248, N ANDOVER, MA 01845 Administrator (`7 am a homeowner performing all work myself. r Q! am a.sole proprietor and have no one working in any capacity am an employer providing r.igy Warne- � for my employees working on this job. situ:. Phone #- rarwra Eo secure caverage as tegtsn t under Secffon 26A or 11ilCE. 1,52 carrfi d b iffi * Y O d Criminal ancVOr one Years' j►r P&A)nment aswen as c1W penaftles in VW joEm of a ioP41Kit3it ! ar►d afire of (ft aaflne upFto $1. understand copy this t may be forwarded to they O Office, of I�� Ofthe ©►A for emwage � �� � i I do herb certify nd t P NWth&kAwmatroopAwkbdabomvisbweaodccffea Signattlr Date - Phone #� ficial use only do not write in this area to be completed by city or town Oiiic e p.Check ifimmediate response RrC1Building Dog - 0 o t ' ' ' Budding Dept p LiM ming Board )ntact person. 0 S--1L9ct ?' en's �ce Phone # Q Health Department Cather IRRVAR's COMPS SArtcN North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: (Locatio -9f Facility) Signature of Permit Applicant Yate NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector m m m m cn Cn 0 W y C � CO) C 10 0 CD 0 Z y CD O d � C9• d =• CO) >Cc o C-) c v CD CD o CL C� �C CD CCD O CCD C O ra CD Q O CO) O ' CO CD C C =r-, O d 2 O 97, =$4c0• H y O am n m n H C! d 0 m Z �� N O� .d.► O H T Er m =rd O y m O m y p O m m n m O_ O`a ~c sL ii .0 C y' C.) Er5' �' `•' O H O m : CL��•, C� CD CD 0 m H V C O. CD: to :� z� tad A� 7d Cn!2, ro a s ►Zi CO) rI m 10 „' f O CO) OD (0 CA m CDs F-1 ' y o CD O o z .now OP c�� .t. 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J�- ` a I- 1 U O LU LL � Q X N x N lu lL �N !F- N X N -C ISI <` . J�- ` a I- 1 Date.... koRTh 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING S" CHUS This certifies that .... ....... /q.j..y . ........................ has permission to perform ...... /-. ..... ... ............................ wiring in the building Qf wle.lc .. ...................................................... Andover, Mass.................. at ....... ):'-5 ...... C ...... ............... Fee ... . ........ Lic. N&I ............. �ECTRICAL INSPECTOR Check # Offic'al LJse Only Permit 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 (Please Print in ink or type all information) Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number 17f- © L G ffTe- Owner or Tenant 6 F Q fZ b Owner's Date �— 5 — O Z To the Inspector ofWires: is this permit in conjunction with a building permit Yes 20' No ❑ (Check Appropriate Box) Purpose of Building C/ A16, L £ X 411 -5e b W f-LrL l At6 - Utility Authorization No. Existing ServiceZ�d Amps 2 Voits Overhead ®� Undgmd ❑ No. of Meters New Service :Z00 Ampsh;'O2 O voits Overhead Undgmd ❑ No. of Meters / .r Number of Feeders and Ampacity `Location and Nature of Proposed Electrical — C Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above ❑ In ❑ No. of Lighting Fixtures Swimming Pool gmd ❑ 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 sal No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained J No. of Dishwashers Space/Area Healing KW Detection/Sounding Devices ❑ Municipal ❑ Other hb. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Bailases Wiring No.. Hydro Massage Tuds _ No. of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws T I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = valid proof of same to the Office YES = NO = K you havqochecked YES please indicate the type of coverage by checking the appropriate box INSURA = BOND = OTHER = ,(Please Specify) 4 -Z(2A� (Expiration Date) Estimated Value of Electrical Works / Work to Start Inspection Date Resquested Rough Final Signed under the Penalties f FIRM NAME ` LIC. NO. Lkensee J 11 Signature LIC. NO. 4 'L - hs. Tel Alt Tel. 7/ OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not haveahe insurance coverage or $s substantiial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) ,�O(/ �/(//► Telephone No. PERMITTEE $ (Signature of Owner or Agent) VjORTN 4, 0 SA bdus Date.. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ...... .................... I ............... has permission to perform .......... plumbing in the buildings of..... ..... ............ at .. rte. ....... North Andover, Mass. 4�1 Fee..:.'..... Lic. No . ...... . /....... -LUMBJNG,WTOR Check # ?z N& # 31Ga� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location 1 Owners Name of Date 0 v(-5 C�� c ra Permit # Amount fie,, New ml Renovation 1:1 Replacement 1:1 Plans Submitted Yes 0 No ❑ FIXTURES (Print or type) p Check one: Certificate Installing Company Name RF�OR-`4���O�e 11��% ❑ Corp. Address ea T-'�o k � Partner. Tsk"JV"-yy 'M cw2n Business ephone �,� —(� Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type insurance coverage by checking the appropriate box: Liability insurance policy 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 Signature IOwner 11 Agent 11 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 u tts State Plumbv ide and Chapter 142 of the General Laws. BY i o icense um er Type of Plumbing License Title `a0-2 a— City/Town License Numner MasterJourneyman ID (OFFICE USE ONLY