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HomeMy WebLinkAboutMiscellaneous - Ardmore Court, 21Aate. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ....... GL r ................. 17 has permission to perform ...... /7 (............... plumbing in the buildings of ... Le4—. P.o. � .(.J -i .................. at. c6. . . . . . . North Andover, Mass. Fee. Lic. No../.� zf.5 . ...... PLUMBING INSPECTOR Check # 6768 ✓~ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING 111111, (Type or print) NORTH ANDOVER_ MASRA(-T-Tr.I.cFITc menivrrauon_�jn• F%Plans Submitted. No ■ FIXTURES _ .i I i il ----MON ---------- MMM ---- ,. MMMMMM�■WOMMOMMMM��MM����� - t MMM MMMM ■ mmmmm MM MM tre�MM MMMMM MMMMMMMMMM���MM t �, MMMMMMMONEWN MMM ==��� t M■�WMMMMMMMMWMMMMMMMIMMMEMM t t. MMMMMMMWWMWWWMMMMMWMMMMM� (Print or type) Installing Company Name_ Address Busmess a ep one Name of Licensed Plumber: Insurance Coverage: Indies Liability insurance policy Insurance Waiver: I, the un( threeinsurance Check one: Certificate ``x�1��___ ►1 type of insurance coverage by (kKecking the appropnate bo&,Y. Other type of indemnity 0 Bond ❑ ed, have been made aware that the licensee of this application does not have any one of the above Signature Owner 0 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 perf e�A----- 3ignafW Issued for this application will be in compliance with all pertinent provisions of the Massach setts Sta iapter 142 of the General Laws. By:or LICenePluintier Title p of Plumbing License City/Town License um e '�' Master Journeyman ❑ APPROVED (OFFICE USE ONLY I R. H WOLF PLUMBLNG d HEATM6 P. 0. BOX 0 3229 SALEM, N.M. 03079 TEL: 603•A9$ -650S I:AX:SAME CALL AHEAD INVOICE NUMBER: WP.1 20 INVOICE DATE: 24-AU"s- MA. MASTER PLUMBER # 12299 CUSTOMER: WOODRIDGE HOMES CO-OP TELEPHONE: ADDRESS: 10 WOODRIDGE DR. FAX: C", STATE, POSTAL Com- NO. ANDOVER, MA. 01$45 PO NUMBER: 21 C ARDMORE ORDER DATE GARY: ®START ENDDATE i RANDY 5.50= $90.Oo 3=AUG 4 95.00 0.00 $0.00 TOTAL ACTIVITY COST: $495.00 Invoice 1. 1) TOR TIPPER WASTE 17 0A. BRASS REMOVE/INSTALL TUB 65.00 3) 1/2 C 90 DRAIN/ SHOWER VALVE 1.05 2) 1/2 CXMA 2.00 2) 1/2 C COUP a 1.00 1) 1 /2CXFE DROP 90 3.25 101 1/2 COP TUBE L 10.00 4E.) 1/2C MIL HANGER 6.00 2) 1/2C CLIP 0.30 0.00 0.00 TOTAL MATERIALS COST: NET. 10 DAYS THANK You TOTAL BILLING: $5$3.60 Invoice Location �f /� A No. d "% Date 4- b 40WTN TOWN OF NORTH ANDOVER • �0. Certificate of Occupancy $ orb+;yam �`,• a �-- sCHUSE<� Building/Frame Permit Fee $ a' Foundation Permit Fee $ Other Permit Fee TOTAL Check # e? 135'[5 6, - Building Inspector 4 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICAx.T,ION TO CONSTRUCT REPAI RENOVAT&2 OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Af 11, Building CommissiorkrAnspector of Buildings Date SECTION 1- SITE INFORMATION LI Property Address: re- C.- 1.2 Assessors Map and Parcel Number: a 3 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 I Provided Re red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone lnfomnation: Public ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record �► I 0-re,J� rz koo 0 r6 0(0C A CT_ Name (Print) TID/VA 6--'-s Address for Service : c' Qa-Jg7 S- 83-21 tgna ak Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Lice psed 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 k�eeVp� 1�1 O k, J� i { �V O z M 00 0 Mn p� M 0 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. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work cheek all a ticable New Construction V4 Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: 1Z x 16 A pPfO x � m ct+P— k/ - 3 1 iych ies AG rad SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit a licant° W-0,74" �"� � � � (3FFTCL�.Y �� x USE ONLY � � �2,�� .r 1. Building o.f, (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (e) X rbc 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 I, (;d61 as Owner/Authorized Agent of subject property Hereby authorize 6yle-V 1 X12. to act on My 9f, i 1 afters relative to work authorized by this building permit application. :1,U Y1 r: 101 , 2-000 S' e of Owne Date ECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, 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/Agent NO. OF STORIES Date SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 ND3 RD SPAN DM ENSIONS OF SILLS DMIENSIONS OF POSTS DIWNSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHEVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all -necessary approval / permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements.. �\ APPLICANT Cre—Vim PHONE . ASSESSORS MAP NUMBER C> OT NUMBER SUBDIVISIONLOT NUMBER %{ STREET A-rJN6ye_ &or -l- STREET NUMBER ..................................................... ... ............... . OFFICIAL USE ONLY- RECOMA, ENDATIONS OF TOWN AGENTS Y) Tihr�5-SSS DATE APPROVED CO S�1 ERVATION ADMINISTRATOR DATE REJECTED COMMENTS DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR - HEALTH DATE REJECTED SEPTIC INSPECTOR - HEALTH COMMENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT DATE APPROVED DATE REJECTED DATE APPROVED I�4i:81:00M01 COMMENTS RECEIVED BY BUILDING INSPECTOR DATE -Z_oa Town of North Andover Building Department 27 Charles Street North Andover, MA. 01845 s,ro''i{g ,Se D. Robert Nicetta K,Hj Building Commissioner (978) 688-9545 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print. DATE _� O hE 61, 2ZOO JOB LOCATION _ z i q k r8 YV bre.. CT. . AA An do Q -r 2 '�) — 2 - Number Number Street Address Map / lot "HOMEOWNER d0., I Ore—ll1tiYLas 9719- 9%19' 998'-411gl Name Home Phone Work Phone PRESENT MAILING ADDRESS I Arolm6rc eT /V ,4melpVicer MA - City Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of 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 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 or two family dwelling, attached or detached structures ac- cessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. 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 SIGNA APPROVAL OF BUILDING OFFICIAL Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978)688-9545 Fax(978)688-9542 DEBRIS DISPOSAL FORM r%ORTy Q* •fit l.EO �6 �� 0 o m4t ®� 9 <ocwiiwiw�cw �• In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in /at: w t l \ AJC? 'PoS- Facility location o ig ture ofApplicant y Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. 101 00 N .y 0 kd 0 W :P-7%3 fR A a 0 CN N O A Will N x O� fD tD CL A �i N >4 00 A O CD A O� Cit O A CD A v. O 0 0 0 P- CD r� t _ Wood Ridge 10 Wood Ridge Drive North Andover, Massachusetts 01845 Telephone 682-7093 TDD Line 1-800-545-1833 Ext. 143 May 31, 2000 RE: Gail Crevier, 21A Ardmore Court, North Andover, MA 01845 Installation of Patio Deck To Whom It May Concern: This letter is to confirm that the above-mentioned resident has submitted a request for approval by the Board of Directors to install a deck at the rear of her unit. Since she has procedurally provided the requisite information to our office, we have given approval to proceed with the permit process through the Town of North Andover for the installation of a 12' x 16' deck. Should you require any further information, please feel free to contact me at 682- 7093. Sincerely, SANDY LARSEN-SOUZA Property Manager a 4 0 cl O z cz �o a¢ x w C v u o O w E i a v V) w � z Z A ] CQ .- O P. O w v G E U _ C w w L� (� p w G x aa W ,.a w -� °�° p c2 v y V) G w O U a zct p rx C w d Q w v C as z cn Q O cn :04 O W A rn z 0 U 0 s Q) y M E CLL co C O a) 0 CL CO) 0 0. CO2 C t� .0 O_ y L O V co Q. CO) C O 07 C O •C G :2 CD On m �D O 0 CL CL �Q C 6-0� O O CD CL CIO C W C) LU Cn W LU crW 0 c i CD 0 c • o � c Cc cv v : ac ev co :s o Q R O N E ECDa CD L o t o a Ec • � o 0 �: mL2 cf C i V: CD a o �Ca N C m 3 m z y. c , C m O wNC=u C C m E " •m ♦ o S CCDM m ocm�: �•" 0 C acs ` m CD •o m Q •N o `c Z cm co o c Q m CL i m C •O = m m 03 a N wc 0 CMI, m 0~ ev t o m t tJJ p 'ra � MD ' o r �.N am c o N Z O V m p m C COD a oho o y•� O _ F- A t $ o. � m :04 O W A rn z 0 U 0 s Q) y M E CLL co C O a) 0 CL CO) 0 0. CO2 C t� .0 O_ y L O V co Q. CO) C O 07 C O •C G :2 CD On m �D O 0 CL CL �Q C 6-0� O O CD CL CIO C W C) LU Cn W LU crW ) '380: \ _ L•omrnonwea[Ih o� ///a��ac�uc�efE� Official Usc Only ._�T� ryry,� cc77 Permit No. ' _CJaparfnrsnf o�,}ira �dwicad ' - Occupancy -and Fee Checked - BOARD OF FiRE PREVENTION REGULATIONS Rev. 11/991 (Ica Le blank) APPLICATION FOR PERMIT TO- PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code. (MEC), 527 CMR 12.00. (PLEASE PRINT LV INK OR TYPE .(LL INfORM.•t PION) Date: City or "Town of. Aj.pli•Pi2. To the Iii,s ci ot:01f By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street -17, Ntuuber) �6 �•o%� Q-1ZOIhiOtZ F,� �►,} Owner or Tenant U)&34 &2 4f�t�tvrlr~ C ��— Telephone No. �7B,�F • -�0�3 Owner's Address _11 Ur�ddrla5,= 2�2oA Is this permit in conjunction with a building permit? Yes No ,,1 ❑ � � .'(Check Ahpropriale Box)I'urliosc of Building•{K�/9�,Q Utility Authorization No. ©[,��� 36 Existing Scr, ice Vae) Antps 12/j / Volts Overhead ❑ Undgrd1,8jNo. of Meters . L I_ Nc„ Scrcicc 5A!&F_ Amps / Volts Overhead ❑. Undgrd ❑ iYo: ofMeters. ' Number or Feeders and Ampacity �- Location and Nature of Proposed Electrical Work: ER -[t hU-e fiMA+ b fVjC.-e 1� J Completion o%the folloiviae [able may be naivecI b , !/re /ns' ector onvires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans 1 0.0 otal Crartsformcrs KVA No. of Lighting Outlets No, of I -lot Tubs Generators KVA Lighting Fixtures Swimming Pool A ove ❑ lit- ❑ i o. o mergency ng n rng NO. rnd. rnd. Batte Units Heaters K1V Receptacle Outlets Lo. No. of Oil Burners FIRE ALARMS No. of Zones 1I 3Viriugc Switches No. of Gas Burners No. o Detect -1011 and Initiating Devices t uivaleut No. oC Ranges No. of Air Cond. Tot Tons No: of Alerting Devices Total ?IP No. of Waste Disposers Heat Pump i`lumber Tons KW Totals: �� t Q. of Sel - ontained No. of Devices or E Detectiot>/Alertin� Devices No. of Dishi*•ashers Space/Area Heating KNVLocal ❑ n' untcipa ❑ Other �Onnorf inn No. of Dryers Heating Appliances KW Security Svstems: 110. of Water t`lo. of NO. No. o[Devices or Equivalent Heaters K1V Sions of Ballasts 1I 3Viriugc No. of llevices or E uivaleut No. Hydromassage Bathtubs No. of tllotors Total ?IP 1 elecomm�umcatrons 1 irttag; OTHER: No. of Devices or E uivalent Attach additional derail if desired, or as required by the Inspector of Wres. IivSURAINCE 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 exhibited proof of same to the permit issuing office. CHECK ONE: INSUR kNCE [Y BOND ❑ O'I'1-IER ❑ (Specify:) / jj&//7/ 0 3 Estimated Value of Electrical Work:' (When required by municipal policy.) (Exp• tion Date) Work to Start: ' ^Z Inspections to be requested in accordance with MEC Rule. 10, and upon completion. I cer•tifj•, under the !mains andpenallies ofperjuzy, that the hiferntation ntr tiris afrplicatiorr is true and conrpte/c.. FIRM NAME:-rJ i ud ..� LIC. N1 0.: t�! —A - Licensee: �1,tG Signature ee� LIC. ir0.• . (lfappficabfe. enter• "excilrpt" in the license n anberGrre - ao53U Address: 3ay� . ( O 3 Bus.Tel.�io:- AIt. Tel. No.: Y 0 NVNER'g 1NSU R.ANCE NVAIVER: I am aware that the Licensee does not have the liability insurance coverage normally requires by law. 13� my signature below, l hereby waive this requirement. I am the (check onc) ❑ owner ❑ o,vncr's agent. Owner/Agent Sienaturc Telephone No.P!?Rt1IIT FEE: KS (,4),17�