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HomeMy WebLinkAboutMiscellaneous - 98 GREENE STREET 4/30/2018X Date.. TOWN OF NORTH ANDOVER PERMIT FOR WIRING .1 This certifies that ...... A. ..........Iq ...... has permission to perfbrm-'!:� .......................................... wiring in the buildingof ... ............................................................ at..... ..............% .......­* '*'-.-...............�........ . North Ando v.e.r., Mas. Fee..K.W...... Lic. No� ./...Z�I—G?—'............./;ELECTRICAL INSPECTOR Check # row THE COAMOATHEALMOFAASSAMUSEITS Office Use only DEPARTAlE7�70FPUB1ICWLI'Y / Permit No. � BOARDOFFIREPREVA NAWONREGUL4HONS527CMRl2.� u 7 �/ Permit Occupancy & Fees Checked ` APPLICATIONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSST�ELECTRICAL CODE, 527 CMR 12:00 n� (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date---. :�I:�/eagor Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work!describe below. Location (Street & Number) G ` S. 77 Owner or Tenant .1� /' Z/ 44 Owner's Address �q,4 r Is this permit in conjunction with a building permit: Yes F-1 No ® (Check Appropriate Box) Purpose of Building gee - &/tPir Utility Authorization No. Existing Service e= Amps,Volts Overhead © Underground r-1 No. of Meters ` New Service Amps Volts Overhead Underground r --J No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets v No. of Lighting Fixtures FIRE ALARMS No. of Receptacle Outlets h� v� No. of Switch Outlets No. of Ranges No. of Disposals Total o. of Dishwashers No. of Detection and 114). of Dryers Pumps No. of Water Heaters KW No. Hydro Massage Tubs OTHER- No. of Hot Tubs Swimming Pool Above Below tNo. oI lranstormers Generators No. of Oil Burners I No. of Emergency Lighting Battery Units No. of Gas Burners 'Total KVA KVA No. of Air Cond. Total FIRE ALARMS No. of Zones , Tons No. of Heat Total Total No. of Detection and Pumps Tons KW Initiating Devices Space Area Heating KW Nq, of Sounding Devices No' of8elf Contained Detection/Sounding Devices Heating Devices KW Local Municipal Other Connections No. of No. of Signs Bailasis No. of Motors Total HP hiunanoeCoVetage. Pt tothewWmTnitsofM;as�Ge)eralLaws [have aamentLabilityltmuarxocPohcyinchwingComplete Omalioris Coverage oritssubWjilialequiv�t YES M NO tn [haw gl&dValidproofofsametotheOffice. YES � YyouhaVucrd<edYES, pleaseindicalethetypeofco by lreclartr7, thebox NSURkNCEE BOND r7 MIER (Please Specify) Will Dale W d ill C d EstimatedVahleof $ VoiktoStart 011 G'r • kqectionDaeReWested Rough >ignedunder Pnaltiesofperjurf.. MMNAME Final IicenseNo. �/22 LicenseNO �y / BusbessTel No. Ali �r irhPce � � �f/C /�/g lrt �i 1f�P�/ � j G/"3 Ah Tel No. )VvNXS INSURANCE WAIVER, I am aware that the Luse does not have their i%r&D-,coverage oriis substantial equivalent as regtmed by Massachusegs General Laws A thatmy signahue on this peumt application waives this regttnement ?lease check one) Owner ® Agent 0 �� Telephone No. PERMIT FEE $ lgnature 7T Mwner or Agent The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston; Mass. 02111 Workers' Compensation insurance Afildavit Name Please Print Name: Location: City Phone # F7I am a homeowner performing all work myself. 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. Policv # Company name: Address City: Phone #: Insurance Co. Policv # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of.a fine up to $1,500.00 and/or one years' imprisonment -as well_as_civil,penaltiesin-the form of-a..STOP WORK.ORDFR..and..a.fine.of_(.$1.00..00.)_asday against me. understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name P:hone.# Official use only do not write in this area to be completed by city or town official' / City or Town Permit/Licensing Building Dept ❑Check if immediate response is required Q Licensing Board ❑ Selectman's Office Contact person: Phone #.- Health Department Other k S/ NORTI, Of ".0 ' •.�ti0 O p «� �,SSACMUS� Date.../. .......... — ('3 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..................................................f�......................................... has permission to perform ......... ^ :........... ............. wiring in the building of ....�................. : -''. p . ........................... Q at ................ ......:........�.. ......,•,, North Andover, Mass. Fee �� �...... ....... Lic. No. f ��.j ��........:... : �.�`:�..................... / ILECTRICAL INSPECTOR Check # P `-,' Official Use Only Permit No. yr'Uc; q9 E C09lMo ALOfOT5 ,4SSACHVSETtS oepartment of ft 6f:c Safety Occupancy & Fee Check BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12: (Please Print In ink or type all information) Data To the lnsP6ct6Y6f Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Owner or Owner's Address •��A ' Is this permit in conjunction with a building permit ` . Yes 0 No .i' (Check Appropriate Box) p� Purpose of Building a /1l�/ _ (/�Ci�di� Utility Authorization No. Z,�G/ Q / Existing Service �yy Amps i D Voits Overhead Undgmd 0 No. of Meters New Service Amps Volts Overhead) Undgmd 0 No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work s Is ;0'- 9. 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 C% NO 0 have submitted valid proof of same to the Office YESAe No o M you have checked YES please indicath the type of coverage by checking the appropriate box INSURANCE X BOND 0 OTHER 0 (Please Specify) (Expiration Date) Estimated Value of Electrical Work$ �v`� Work to Start Inspection Date Resquested / Rough Final Signed under the Pe H ry2 � LIC. NO. NAME I%L�I A''�e /cam) 7r,) J U/O-cjr Bus. Tel No. "l--.27.2 -'OW-1 /D 114 Address / Alt Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance o erage or its substantia equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ 1% ) U (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA 4 Above 0 In 0 No. of Lighting Fixtures Swimming Pool grnd 0 grnd 0 Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners Battery Units .i No. of Switch Outlets No of Gas Bumers 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 Diposal No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. of Distrwashers Area Heating KW Detection(Sounding Devices 0 Municipal 0 Other No. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Bailases Wiri No. Hydro Massa Tuds No. of Motors Total HP 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 C% NO 0 have submitted valid proof of same to the Office YESAe No o M you have checked YES please indicath the type of coverage by checking the appropriate box INSURANCE X BOND 0 OTHER 0 (Please Specify) (Expiration Date) Estimated Value of Electrical Work$ �v`� Work to Start Inspection Date Resquested / Rough Final Signed under the Pe H ry2 � LIC. NO. NAME I%L�I A''�e /cam) 7r,) J U/O-cjr Bus. Tel No. "l--.27.2 -'OW-1 /D 114 Address / Alt Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance o erage or its substantia equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ 1% ) U (Signature of Owner or Agent) Name: Location: Citv Phone # I am a homeowner performing all work myself. 0 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. Com an name: Address City: Phone #: Insurance Co Policy # Compgny name: Address Ci : Phone #: Insurance Co Policv # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of.a fine up to $1,500.0( and/or one years' imprisonment -as -well -as -ch il,penaltiesjnfhefnrmnfa STOP WORK ORDFR.and afine_of.(.$1O.O.DO) aaiayagainst.me. I understand that a copy of this statement may be forwarded to the office at Investigations of the DIA for coverage verification. I 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 PermVl icensi Building Dept ❑Check if immediate response is required E] Licensing Boan F-1 Selectman's Of Contact person: Phone #: ❑ Health Departrr El Other W � U CL W (J, 06. 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Of r Pantie r i PROPOSAL SUBMITTED TO PHONE DATE Payment to be made as follows: dollars (S STREET JOB NAME _ workmanlike manner according to specification submitted, per standard practices. Any altera- CITY, STATE AND IIP CODE JOB LOCATION rAr written orders, and will become an extra charge over and above the estimate. All agreements ARCHITECT DATE OF PLANS withdrawn by us if not accepted within days. JOB PHONE ACCEPTANCE OF PROPOSAL. The above prices, specifications and condi- tions are satisfactory and are hereby accepted. You are authorized to do the work ♦ v nereoy propose to Turn+sn marernaTs ana +aoor necessary Tor Tne compieuon or f - WE PROPOSE hereby to furnish material and labor — complete in accordance with above specifications, for the sum of: Payment to be made as follows: dollars (S All material is guaranteed to be as specified. All work to be completed in a substantial workmanlike manner according to specification submitted, per standard practices. Any altera- Authorised tion or deviation from above specifications involving extra costs will be executed only upon Signature written orders, and will become an extra charge over and above the estimate. All agreements Note: This proposal may be contingent upon strikes, accidents, or delays beyond our control. Owner to carry fire, tornado withdrawn by us if not accepted within days. and other necessary insurance. All subcontractors are covered by personal liability insurance. ACCEPTANCE OF PROPOSAL. The above prices, specifications and condi- tions are satisfactory and are hereby accepted. You are authorized to do the work as specified: Payment will be made as outline above. Signature Date of Acceptance: Signature OFFICES OF: APPEALS 111.11l.DING CONSEI1VA'1.1UN HEALTH PLANNING Town of NORTH ANDOVER U1VISION OF PLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON, UIRECI.OR 120 Main Street Nc)r(h Andover. Massac'I a sclIS c) I H4 ; { ((il i)GHS-477S In accordance wit 1. gwv—,rOvisiOri-s 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 c 111, S 150A. The debris will be disposed of in: (Location of Facility) ;IOTA': Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. P C') C) z cn m x 0 z T z D v. CO) 10 C 'v o CD a z CO) CD O �• r G O � C = CA MW O 2 v CD CD •� o CL CD CD O CD C CD y CD CD � v H O 'O Z CD Cl) '..� O � • CD O G CD �C O Q • y O Q y So do y .� tq =�m0 m C H C7 CL a T Z --I 0, .=.r Cdr C9 G T_ .► S a ? C. O T CD O CO y p O =rcD > > O CO) O ; 03 O y C9 14 tit �. y - a C o� CD W yCD um . CL CD y m o d� O y CA p, W C W — o ,c y C �C CA Q � 1 CD .0—► H . O CD . co O C, O CD G oZ CD 0 CDCD CD m: m m L y O o ~" co � c1 g b r7 O C w rD :5 fD O a�n x Ci7 t'" y r^1. ='- aGa C' '.y �=' �' O OQ x p�p 11 a 0 C77 �' a O p- O o 0 c Lopation�.f-. No. Date NORTH TOWN OF NORTH ANDOVER % Certificate of Occupancy $ • Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ / TOTAL 10 3 341/13/97 12:07 ,T Building Inspector 25.00 PAID Div. Public Works PER111T NO. i. 0 APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. /PAGE 1 �1AP 4-40. LOT NO. 2 RECORD OF OWNERSHIP ;DATE BOOK ;PAGE ZONE SUBDIV. LOT NO.I LOCATIONTIE PURPOSE OF BUILDING cf OWNER'S NAME NO. OF STORIES SIZE OWNER'S ADDRESS Xn,,rl �l/I/IJL. BASEMENT OR SLAB ARCHITECT'S NAME BUILDER'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS "' POSTS DISTANCE FROM STREET DISTANCE FROM LOT LINES - SIDES REAR " ' GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION 15 BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 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 DATE FILED / / 3 / T� PERMIT GRANTED 19 0�33 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BUILDING INSPECTOR OWNERTEL.# 4 �f CONTR. TEL. # " o` CONTR. LIC. # H.I.C. # 163,31Z BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY ORIES MULTI. FAMILY FICES P APARTMENTS _ CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH 3 1 2 13 PINE HARDW'D PLASTER CONCRETE CONCRETE BL'K. BRICK OR STONE PIERS DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ 1/1 1/2 1/. FIN. ATTIC AREA N_O B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING STUCCO ON MASONRY STUCCO ON FRAME CONCRETE EARTH B 1 2 �_ 3 _ HARDNU D COMMON ASPH. TILE BRICK ON MASONRY ATTIC STRS. & FLOOR BRICK ON FRAME I_ CONC. OR CINDER BLK. WIRING STONE ON MASONRY _ STONE ON FRAME SUPERIORI_I POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE GAMBRELMANSARD I I HIP BATH (3 FIX.) TOILET RM. 12 FIX.) _ FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. d COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL I'M 'T 2nd _ lit 13rd ELECTRIC NO HEATING 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. In V\ h W to o ui z . D p ion O CLC a cc O �o o R a0 Z C. CD Ea C CM E .S LA O C 0 CD OZ Cc cc ca 0 CD c. E 4-4 m •- 1 H m3 CA C/)3m d:cm _;, � vm o0 v sm- p„ Cos Z Mo. W O v� •v U r c N OCO a v/GlmmM j:S o► o = ;ars y O m m a C Z m o O C. w"Z 0 V h OC c ac , W c C•— x •o C42 h m +O+ ~ t cc LL. y '_.. 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