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Home My WebLink AboutMiscellaneous - 991 JOHNSON STREET 4/30/2018t- Location U kv S u-,0 a No. Date /4>-c-)(,9 ' , 4 NORTH TOWN OF NORTH ANDOVER OL Certificate of Occupancy $ Building/Frame Permit Fee $ �cHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 30 + Check # 7 i i 684 i Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: C-� qg C SIGNATURE: r AV# Building Commissioner/I for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: L, --,,N i 3oUN10r4 S 911-) 1.2 Assessors Map and Parcel Number: Map Number Parcel Number `� 1.3 Zoning Information: Zoning 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 Reglured Provided 1.7 Water Supply M.G.L.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 Historic District: Yes NO 2.1 Owner of Record / Ufa kN b FMA TTEO 1�3 Name (Print) G ` Address for Service : ` Signatu Telephone 2.2 Owner of Record: Nfime Print Address for Service: Si ature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable Ix License Number Expiration Date 3.2 Registered Home Improvement Contractor t Not Applicable ❑ Corilpany Name Registration Number Address Expiration Date Signature Telephone 60 M z O 1157% rn SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 2506) 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. Si ned affidavit Attached Yes ....... 11 No ....... ❑ SECTION 5 Description of Proposed Work check au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: A kx 10 �Avx lAb 1,141 3ncx )4" SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant 5 (}Fk'ICIAI�USEOIYL _ , r 1. Building )) { o (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) 3d 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 7 I, I / 5011 sv N tMATyI.D as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in allafters relative to work authorized by this building permit application. GI o�3 Signature oAV4ner 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/A ient Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIIVIBERS 1 RT 2 ND 3 RD SPAN DIMENSIONS OF SILLS DRvIENSIONS OF POSTS DEVIENSIONS 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 Tel: 978-688=9545 Town of North Andover Building Department 27 Charles Street North Andover MA 01845 HOMEOWNER LICENSE EXEMPTION f NORTFr � st:r w Ta � Z OR4TE0 f M 9SSRGHUSr`s Please print. DATE JOB LOCATION ON l J T Number Street Address Section "HOMEOWNER W w-"11] )T �g�- v�)� Number G Home Phone Work PRESENT MAILING ADDRESS 1� I �S►1►p�_j) . f�,N t) W t2 hq A v i�yS City Town State Zip Cf The current exemption for "homeowners" was extended to include owner -occupied dwellings of six 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 109.1.1) DEFINITION OF HOMEWOWNER: 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 to six family dwelling, attached or detached structures ac- cessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance 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 No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATUR APPROVAL OF BUILDING OFFI Note: Three family dwelling 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0 Construction Control. • 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 FILLS OUT THIS SECTION*******'t*************** APPLICANT_®�S,J�( p ; T LOCATION: Assessor's Map Number 1 n SUBDIVISION STREET.c- PHONE �i� ,(_ PARCEL 0-11 C LOT (S) ST. NUMBER �l ****************************OFFICIAL USE QNLY******************** RECO)p4ENDATIONS OF TOWN AGENTS: ATION DATE APPROVED DATE REJECTED i, TOWN PLANNER COMMENTS FOOD INSPECTOR -HEALTH c<w L SEPTIC INSPECTOR -HEALTH COMMENTS J�,e 4 �4i, DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED 0 DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT 0+ RECEIVED BY BUILDING INSPECTOR DATE_ Revised 9197 jm C/) M M Cf) 5 C2 y CD d 'v O �" � Z CO) a0 '0. r c =c CZa. CO) nto -0 O � O v CD cr d CD .-t CD O CD IMI W . C CD y CD =C y � I CO CD a- ce O 10 Z CD O CD O CCD E C C?=o _ d �• H O CT 0 So O S CD .0 CO) = :*CD n m C7 m F =M m ZCL y ? m ��m tm CD -4 O m N p _ �_ O IE g m• m > > CD -00 �. CD ..« � O y C* zicC.)A • - -I.., C CD: yCL: Q o CD _? : :S m O m y� �� CL m CC,o O Cf1 y 0. 0): CS HC O .W - � d N q%lmr 91 C : �Cp S -� i 10 : ` co ? o N *tea a a O �'a► 3 m •� �ocj : � cm: 5 0 t W O : �2 4 � -CD c _CD i CD i jr- CD 1 nn 0 �o o ;mb::� � co '1 C r Cn d rt cn o b7 tz '37 7d rl w�! n ?7 ',O rcp to tz m n O 0 r Cl O x rD O o t� 70;1^ r11r Ma 3 , , ref 5 Q��52 y• r u ' ('azctl ' 2 `Iro2�� W060 i � _ _ '�-0,00 MORTGAGE INSPECTION PLAN TO THE (_ASSUranra Mprtnae Corj�_of America LOCATED IN AND ITS TITLE INSURERS. I CERTIFY THATN O R T H A N D O V E R I HAVE EXAMINED THE PREMISES AND THE BUILDINGS SHOWN DO ( ) CONFMI�TOO THEhZ014HO LAWS AND AMENDMENTS, I.0.(FRONT, SIDE, R REAR YARD SETBACK ONLY) MASSACHUSETTS ENFORCEMENT ACTION UNDER MASS G.L TION TITLEENI, CHAPTER 40 SECTIOO7,CONSTRUCTED. OR ARE ,UNLESS OTHPT FROM ERWISE NOTED. I FURTHER CERTIFY THAT THIS PROPERTY IS p p t LOCATED IN TILE ESTABLISHED FLOOD HAZARD AREA. COMMUNITY PANEL NO.: 250098 0010 B DATE: 6/15/83 EXAMINATION OF THE RECORDS IS MADE ONLY SUBSEQUENT TO THE RECORDED DATE OF THE LATEST DEED AND DOES NOT INCLUDE VERIFYING TILE ACCURACY OF THE DEED DESC RIP71ON PREVIOUS TO ITS DATE OF RECORD. THIS COMPANY IS NOT RESPONSIBLE FOR ANY INDENTURES MADE SUBSEQUENT TO THE RECORDED DATE OF THE LATEST DEED OF RECORD. WHENEVER BUILDINGS ARE SHOWN LESS THAN ONE FOOT FROM DIE PROPERTY UNE IT IS ADVISED THAT A MORE PRECISE SURVEY BE MADE TO VERIFY TIIESE MEASUREMENTS. THIt-UERTIFICATION IS BASED ON THE LOCATION OF SURVEY MARKS, AND DOES NOT REPRESENT A PROPERTY SURVEY. VEMFICATION OF SURVEY M EJlS TS, AS SHOWN, MAY BE ACCOMPLISHED ONLY BY AN ACCURAIIy INSTRUMENT �a�f}Ci "F 'bw,4f1 THIS CERTIFICATION TO BE USED FOR MORTAE,� URPOSES Rl OFFSETS AS SHOWN ARE .4 ; �'' B�,. 1 � USED FOR THE ESTABLISHMENT OF E. T .p9'� 1 -' JAMES W. BOUGIOUKAS R.L.S. #9529 DEED BOOK 2193 PAGE __ 219 CERT. N0. PLAN BK. PAGE - PLAN 1 9959 DATED September 22_; 1994 SCALE 1'- �0 BRADFORD ENGINEERING CO. P.O. BOX 1244 HAVERHILL MA. 01831 TP]_ 1.5ml 171--Ixom Date........'..-?.'.. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .................... ' ►E.t7........ ........................ has permission to perform ........... wiring in the building of ........ DFP...7-0......................................... f at .......... J'....................North Andover, Mass. Fee..yLic. No;?./. -a6,4 ..................... h ��...... ELECTRICALINSPECTo9 Check # 0397 q. Official Use Only Commonwealth of Massachusetts Department of Fire Services Permit No. 2 9 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1107] leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (NEC), 527 CMR 112.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Id — / P A p City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice o�his or her intention to perform the electrical work described below. Location (Street & Number) 99 / TO hA/So A/ 67 — Owner or Tenant /" lA U gee Owner's Address SAME e Is this permit in conjunction with a building permit? Yes Purpose of Building P1A)e/%lN0f' Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity 0 Telephone No. No U (Check Appropriate Boz) Utility Authorization No. No. of Meters No. of Meters Location ]andnNature of Proposed Electrical Work: (Vt le e �� f� L �L//CPQ s' ! G er 4, h O� L JNi2O 2 l�it2 n! Z % Comnletinn ofthe folinwino tnhh, mm) ho wni—d by tho [--tnrr nfW;— No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Tota Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above o In- Swimming Pool nd. grnd. o. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection an Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers eat umpum Totals: . er Tons o. o - e ontame Detection/Alertin2 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 K`,1, Heaters No. of No. of Si s Ballasts Data Wiring: 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 co rage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE bJJ BOND ❑ OTHER ❑ (Specify:) I certify, under the pai s and pe� alo`e-s 'of per jury, hat the information on this application is true and complete FIRM NAME: rQ �/l (!j W Q ), LIC. NO.: O?�p Licensee: s4 w e Signatur LIC. NO.: (If applicable, enter " em ff m the lic a numb line) Bus. Tel. No. J- o� Address: b t ^T & d Alt. Tel. No.. — — / 3' *Per M.G.L c. 147, s. 57-61, sec rity work requires De ment of Public 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE. $ Date .. ;... `.�.... . TOWN OF NORTH ANDOVER RMIT FOR PLUMBING This certifies that .. -::. t ` `'........ .. ............... has permission to perform '-........ ............... plumbing in the buildings of .' t... ..?..!:. ........... c � at ... 5.; ......... r� ? ..... ........ , North Andover, Mass. LNo..1?.Fee . .............. r PLUMBING INSPECTOR Check # 6620 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS nG /7�7 ��U Date � �% Building Location ( �UAWS�/Y StOwners Name �lJ Permit # 6 �}v Amount n Type of Occupancy New 12 Renovation Replacement 1:1 Plans Submitted Yes No FIXTURES (Print or type) c Check one: Certificate Installing Company Name cs 7`cye S of Corp. �DQvx d"JG Address E] Partner. Business Telephone - y �� - o yo y . 0--firm/Co. Name of Licensed Plumber. S 7'LlgOlew or- y X c, / -,5- Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Et Other type of indemnity D 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 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 the Massachusetts S ate PI bing CdeQ and Chapter 142 of the General Laws. By: S—IgnaEure or Licenseam Type of Plumbing License Title /-1_ -' d -d Q City/Town ri=n NumiDer Master Er Journeyman ❑ APPROVED (OFFICE USE ONLY MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTIN (Print or Type) (/V f/y , Mass. Date %Q -a c} 19Permit # �✓ / Building Location `J9/ Owner's Name i —. Type of Occupancy RESIDENTIAL New X Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ No ❑ Installing Company Name BAY STATE GAS COMPANY Address 55 MARSTON STREET LAWRENCE, MA 01840 Business Telephone 5 0 8- 6 8 7 -110 5 Name of Licensed Plumber or Gas Fitter Check one: K7 Corporation ❑ Partnership ❑ Firm/Co. Certificate # 6 4 C INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes [X No ❑ If you have checked Vis, please indicate the type coverage by checking the appropriate box. A liability insurance policy M 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. Check one: Owner❑ Agent ❑ Signature of Owner or Owner's 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the G La Type of License - Plumber Signature of Licensed Plumber or Gas Fitter X Gasfitter Master license Number M-429 City/Town_ _ Journeyman APPltOW-D (Of IICF US[.: ONI Y)-- ■■■■■■■■■■■■■■■ ■ ■■■■ ■■■ ■■■■■■■■■■■fit■■■■■■■■■■■■■■ ... ■■■■■■■■■■■■■■gin■■■■■■■■■ ... ■■■■■■■■■■■■■■■■■■■■■r■■■■■. FLOOR= now6TH =MEN ■■■■■■■■■■■■■fit■■■■■■■ Installing Company Name BAY STATE GAS COMPANY Address 55 MARSTON STREET LAWRENCE, MA 01840 Business Telephone 5 0 8- 6 8 7 -110 5 Name of Licensed Plumber or Gas Fitter Check one: K7 Corporation ❑ Partnership ❑ Firm/Co. Certificate # 6 4 C INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes [X No ❑ If you have checked Vis, please indicate the type coverage by checking the appropriate box. A liability insurance policy M 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. Check one: Owner❑ Agent ❑ Signature of Owner or Owner's 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the G La Type of License - Plumber Signature of Licensed Plumber or Gas Fitter X Gasfitter Master license Number M-429 City/Town_ _ Journeyman APPltOW-D (Of IICF US[.: ONI Y)-- z 0 0 ,, CL z 2 O n - u, to U_ 9 O a tl x• r w N tl O a O r _r cc w IL crO W z O a U J a a a a W r z a cc tl cc r_ W a cc O 1- w IL N _Z �n a 0 Date ... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ...-GI `'. has permission for gas installation,ly in the buildings of /� ... il.�: s=lii!C �� .................. at ... With,Andover, Mass. Fee./.-:57.-� Lic. Notr/. V, 9... ......................... . (�C' 4 GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File As 2 8 z1a. Date....l TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............VlLC4 ........... C...(PA�..1.( ....... (s). .............. ,�l '57 - has permission to perform ............... .................................................... wiring in the building of ......... ............................................ at ..... 79...e Sd -7 S41 orthd iFee ....75.......... .......... Lic. NoA.M.? ............ . ........... ;ELECCAL INS V Ec� Mo Check # MECO[YMONWE9LTHOFMASSACCHUSEM Office Use only DEPARTM1AT OFPUX 1CSAFETY BOARD OFFJREPJZEVLVRO1V Permit No. It'�s'GUTATIONS527CNIRl2.� Occupancy & Fees Checked APPUCATIONFOR PERAIRT TO PERFORM ELECTRICAL 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) Date 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)�j�1 Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes " No (L/ J (Check Appropriate Box) Purpose of Building Utility Authorization No. _ Existing Service Amp 'Volts Overhead O Underground g No. of Meters New Service Amps / Volts Overhead Undergiound No. of Meters Number of Feeders and Ampacity —_—• n -- Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total No. of Lighting Fixtures Swimming Pool Above BelowKVA Generators KVA round round to. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners No. of Ranges No. of Air Cond. Total FIREALARMS No. of Zones Tons No. of Disposals No. of Heat Total Total No. of Detection and Pum s Tons KW Initiating Devices No. of Dishwashers Space Area Heating KW No. of Sounding Devices No. of Self Contained Detection/Sounding Devices No. of Dryers Heating Devices Key Local Municipal � Other No. of � No. of Water Heaters KW Connections No. of Si ns Bailasis No. Hydro Massage Tubs No. of Motors Total HP r OTHER ilst==Cowmga PumxffttothewWitan wdAgawd»tts Clafelm Laws have aamatLa3dityhmuancePbhyjAxjlgt m-plole Covgagecritssubstarrialaquivalat YES/ NO haw sttlxrldledvalid proofof totheOffit� YES rn ffyouhave YES,p ttyp heeofcovt�age g LJ d VSURANCE Ea BOND MIER (�, (tea may) FiTiratim Date k&lostart fi EstirrtamclVahteofElecfricalWotk $ ignedLmda'TiePtrlaltiesofpoltuy. /%tel `� Final RMNAME kid `�U G 1 �f 1 I�oa>seNo. oa>sae Signahue ' LieffmNo B[19 X; Tel No, R'N13�'S II�iSURANCE W Ah Tel No. ANER;Iama t CLi=Wdoesnothaveth-fiMarx:ecova2geor al equivalatulegt WbyMWsaChu sells CuIxal laws Idlatmystg UtMeondmpemmapp) � thislapt ,,rrlmt lease check one) Owner Agent 0 Telephone No. PERMIT FEE Signature o caner or gen