HomeMy WebLinkAboutMiscellaneous - Exception (205)W57
Date......... ......... ...........
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
Tb,is certifies that ...... 9'.'. ............... ..
4 '>"t .. ...........................
has permission to perform. . . .....................•
wiring in the building of ..... .......................................
at ........
..... Z- North Andover, Mass.
l � .......4 ....... ..........
'W
Fee............ Lic. No. ...... ............... ... .... .........
ELECTRICAL INSPECTOR�10
Check #
` DEp1 ME NTOFPUBMSUM Permit No. �C),l
BQAIu)OFFJREPREVEKIIfOIVRBGE1lAT1g 5i7adRl2t
Occupancy & Fees Cltectu d
APPUCATIONFOR PERMIT TO PERFORM ELECTRICALWORK
All. WoRK To BE PERPoRMBD iN ACCORDANCE wrrH THE MAssACHusm ELECTRICAL CoDB, S2% CMR 12:00
(pLEASE PRDff 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 3 Number) 2(0 kwra-o V -4e V,.kcx---
Owner or Tenant t�'Co P �/IJAcSZC•ZvIC..
Owner's Address
Is this permit in conjunction with a building permit: Yea No
purpose of Building Ly- JIZ-1-0,4skcre,4 3 •-
Existing Service Ampa� olts Overhead C
New Service Amps otter Overhead C
Number of Feedets and Ampacity ' 20
Location and Nature of Proposed Electrical Work P
(Check Appropriate Box)
ro1" Utility Authorization No.
Underground No. of Meters _
Underground No. of Meters
Na of Uglift Outlets
O
Na of Hot Tubs
No. of Tnosbrrners
TOW
KVA
Na of Lighting Fulmer
Swirnadng Peri AboveBelow
�-yourw
World^�
Oaoeratats
KVA
No. of Receptacle Outlets
No. of On Burners
Na of Emergency Ughdng Bsttary Units
Na of Switch Outlets
No. of Or Bmums
FIRE ALARMS
No. of Demcdoo d
an
Isitistiag Davlees
� of Device
Self Contsbied
DetecdoolSoneft Device•
Lad0, Municipai
Connections
_
No. of Zones
—
C3 Other
No. of Ranges
No. of Air Cad. . Total
Tool
No. of DisposalsNo.
of Haat Total Ta
Tad
— PUMP Ton KW
No. of Dishwashers �^
Spm Area Hearing KW
No. of Dryer —
Hetsing Devices KW
—�
�IVo. of Water Heater KW
Na of _' SIM di f
Na Hydro Manage Tabs
!
No. of Motors
Toni HP
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' APPLICATION FOR PERW TO PERFORM ELECTRICAL WORK
r
AM Won To BE PERFORMED IN ACCORDANCE Wri'H TM MASSACHUSSTS mzcn ICAL CODE, 527 CMR 12:00 Q
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
C
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) 140 t4e CAI -E- �p
Owner or Tenant t�ts'C� P Z z -C-2---0
Owner's Address - uo K' V—r m.P
Is this permit in conjunction with a building permit
Purpose of Building
Existing Service Arnpa...I� Volts
New Service Amps�� olts
Number of Feeders and Ampacity 47, 1r,
Location and Nature of Proposed Electrical Work fA
M
Yes L%A No u
L3 se�,-VA
Uverhead E]
Overhead
-7.0 A
(Check Appropriate Box)
Utility Authorization No.
Undergomumd C3
Undergound C
No. of Meters _
No. of Meters
No. of Lighting Oades O
No. of Hat Taber
�^
No. Of Tmftmw
Totid
—�
KVA
No. of Lighting R IUM
Swhnndng Poot Above
No of Oil Hamner
Below
r7lmm,
cw0Mmttn
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No of Ftaergaocy Ughdng Unjig
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No of Reeeptacls Outlw
Na of Switch Oath"
�^
No. a[ OWN Barran
FIRE ALARMS Na of Zona
No. of Rangers ter,
Na of Air Cand. TOW
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No. of Dispw& �_
No. of Had TOW O
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Agent Telephone No. ( 7e- 4v / — �Y
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Location
' No. 1 Date -
HpRT1y
TOWN OF NORTH ANDOVER
O:t�•o :• 7.x.0
Certificate Occupancy
of
$
�'�s'•^" Eta
s�cMus
Building/Frame Permit Fee
$
c
Foundation Permit Fee
$
Other Permit Fee
$
TOTAL
$ //"-:r>
Check #
18550 {�
Building inspector
t r
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIw RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PERMIT NUMBER:/2,9 DATE ISSUED:SIGNATURE:/iq'
Building Commissioner/InEeEtor of Buildings Date
SECTION 1- SITE'.INFORMATION> ;.a,, {' r s,; •; ,' `.T ,F.f i ; ; f� 1
1.1Property Ad�dressss�"�, 1.2 Assessors Map and Parcel Number: J
__ 21a/ ��1�,/►i'[V��{R�+ • �1iC �'Tr� .. t�! !� .��i -II:--4i e� "" _.:. ,,� iii , � i•. .^^ ^'i'- `� e - ^'i' `i
Map`Nuniber Parcel umber
Ai
Nom• 1 o S• _ -
1.3 Zoning Information: 1.4 Property Dimensions:
fes. 4 Q ��o�r�'ii,4c_, 94 412 %0 450
Zoning District Proposed Use Lot Area Isf) Frnnta4e lfll
1 1.6 BIJILDING SETBACKS (ft) - s
Front Yard
Side Yard
` .
Rear Yard
Required
Provide Required Provided
,R" red
Provided
O~
r % ..V -240i
t
1.7 WaterS{pply M.G.L.C.40.
54) 1.5. Flood Zone Information:
Zone
„�. 1.8 Sew a Disposal System:
Public private ❑
Outside Flood Zone
Municipal
On Site Disposal System ❑
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
�� }-.. !r C
IS flC : yes -No V.
2.1 Owner of Record
Company Name
Registration Number
N (t SrtdP44c'i�
Uyl�c�, Z.c, z �!�-
Name (Priptj
%-1 Address for Service:
603. Z'71, (w
?.2 Owner of Record:
Ai�N- �d ►2�[�rt �l-c. -� S2LZ 9,4*44;S
N me Print r / q Address for Service:
�t/��`�C���I/L I��%6"lrQ�q�i,r/�i� ,, °�8✓�t"f�s5'�-�T��(W1
I SF.CTinN 3 - C0NCTRITCT1nN CFRVrCFC I
3.1 Licensed Construction Supervisor:
Not Applicable
Licensed Construction Supervisor:
License Number
Address
Signature Telephone
Expiration Date
3.2 Registered Home Improvement Contractor
Not Applicable
AUG 31 20
Company Name
Registration Number
BUILDING D
Address
Expiration Date
Signature Tel hone
E
'T.
1
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 unit.
Signed affidavit Attached Yes .......❑ No.......
SECTION 5 Description of Proposed Work check au a Bcable
New Construction ❑ 1 Existing Building ❑ 1 Repair(s) ❑ I Alterations(s) Addition
Accessory Bldg. ❑ 1 Demolition ❑ I Other V Specify
Brief Description of Proposed Work:
t0i214 P.4-k%g44 -Df:rMr- Uiti9' ,-MSk LK-*yMt-WkV< CNW-trC
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item • •
Estimated Cost (Dollar) to be,, ,
Completed by pinnifapplicant
OFFICIAL USE OnY
'
1. Building
+w. ^
(a) Building Permit Fee
Multiplier
2 Electrical
f?C)Q.
(b) Estimated Total Cost of
Construction
3 Plumbing
Building Permit fee.(,) x (b)
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, as Owner/Authorized Agent of subject property
Hereby authorize to act .on
My behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
I, e.i1S tz'R. �ykS-uwse. as caner uthorized Agent of subject
property k ,
Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief
(I��Z(,2vjL
Print
Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TINMERS 1 2 ND 3 RD
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DINIENSIONS 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
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Town of
NORTH ANDOVER
BUILDING PERMIT INSPECTION REPORT
jn? /!55&E�
PERMIT NO.: _L' / PROJECT � S SS°�' Qw. � � II��.WZ40 d' DATE:
oy 0 i /tf�iG: T" BUILDING NO.
11-1A.W00 r-A.J e R-
REMARKS:
11 -
Excavation - depth and soil conditions
Framing -
Other:
Date:
Date:
Date:
Inspector
Inspector
Inspector
Footings and foundations and drains -
Insulation -
Other:
Date:
Date:
Date:
Inspector
Inspector
Inspector
Electrical - rough -
Plumbing and/or gas - rough -
Other:
Date:
Date:
Date:
Inspector
Inspector
Inspector
Electrical - final
Plumbing and/or gas - final
Other:
Date:
Date:
Date:
Inspector
Inspector
Inspector
ire Dept -
oil burner, tank, stove, smoke detectors
Final inspection
Certificate of Use and Occupancy
Date:
Date:
Date: -Cof 0#
Inspector
Inspector
Inspector
Form #995 Action Press, 885-7000
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
APPLICANT l , �1 S"b�k�c1�- (/U ZL"L' - PHONE 16 - O t:9k —4" (
LOCATION: Assessors Map Number
O2� PARCELy
SUBDIVISION% l�-O�K b 1��1nJ LOT (S) �-
STREETJ�¢1 ��L��-� ST. NUMBER 2O
OFFICIAL USE ONL
CO SERVATION ADMINISTRATOR DATE APPROVED "` ` -T /--IV V�,2—
DATE REJECTED
TOWN PLANNER
COMMENTS
FOOD INSPECTOR -HEALTH
SEPTIC INSPECTOR -HEALTH
COMMENTS
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED
PUBLIC WORKS - SEWERIWATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT RECEIVED
RECEIVED BY BUILDING INSPECTOR DATVG 31 2005
Revised 9%971m BUILDING DEPT.
NORTH ANDOVER BUILDING DEPARTMENT
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordpme with the provision of MGL c 40 S 54, a condition of Building Permit
at: '24 1 Tuka 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.
Also, note Permits are required under Fire Prevention laws Chapter 148 Section
10A.
The debris will be disposed of in:
Fire Department Sign off:
Dumpster Permit
(Location of F
7i ' )
Signa o Permit Applicant
Date
D. Robert Nicetta,
Building Commissioner
Please print
TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
400 Osgood Street
North Andover, Massachusetts 01845
HOMEOWNER LICENSE EXEMPTION
DATE: 0 31 0 cj
JOB LOCATION
2(d, 1A
Telephone (978) 688-95454
Fax (978)688-9542
Number Street Address
Map/Lot
HOMEOWNER 9116-Cb1-449( 4ou3-2,�t-���c,
Nam6 Home Phone Work Phone
PRESENT MAILING ADDRESS 26 MAiAE
• A
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 requiremeyls andhe/she wij!-eenly with said procedures and
requirements. � 1.1 ,/
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
ROARD OF APPEALS 688-9541 CONSERVATION 6989530 HEALTH 688-9540 . ' PLANNING 688-9535
LOCATION MAP
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Date ..... . 17 • 16
2584
A
EE
TOWN OF NORTH ANDOVER g
F�o6,..•.,�aop ECECfYC�G'VL r.:
PERMIT FOR 4= INSTALLATIONN
�SSAC MUSE` pOH�
O
This certifies that ..... l4. e. f � V .. �'` � : r �. ` � ` t 1 C
ld
has permission for f installation .....� .��'. cmlE
in the buildings of ....C. Q cl : �t f -......................
at ... A- (r.. AC( kA M6U ...... North Andover, Mass.
FeeA:V% Lic. ..........................
C. 1t if 4—a 17 SMINSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File
Office Use only
01 4C &mutMEHIfll of MH53 lusff 5 Permit No.
Eeportnttnt of Public lzufttq occupancy ,& Fee Checked
3190 peeve blank)
BOARD OFPRE PREVENTION REGULATIONS 527 CMR 12:00 3
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WOR
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00
(PLEASE PRINT I ' INK OR TYPE ALL INFORMATION) Date 1
�p
To the Ins ector of Wires:
_ O JWN OF ' - �� •�Y�ipDv�v
III
The udersigned applies for a permit ttto perform the electrical work described below.' l
Location (Street &(Number) 2C ttR4ri )1DYlh, E LANE � �11 F � 1
Owner or Tenant e Q (� --
Owner's Addressy 1 Q `�
Is this permit in conjunction with a building permit: Yes No l I tGheck Appropriate Box)
Purpose of Building S) H L LE f An) of UtiliEy Authorization No. V ��
Existing Service Amos _� VoiIs Overhead ;—.I Undgrnd {_I No. of Meters )
New Service `Zai Amps I� Voits Overhead Undgrnd No. of Meters /
f
Number of Feeders arta Amoacity
Location and Nature of Pr000sed ElecIrical Wcrk W "re 1�tsi �s n
No. of Lignung Outlets) -Jo UTr
ets � I o. of 'lot t:s I No. of ansformers Total
KVA
rt a
.N:Orv 5Y *_ R: t ti r Aitoov:e— !n-
--of-Fixtut P.Coi__-
-- GeneratorsA T . K VA
ra- ' m y 1, 7., r'4 rt No of.EmergenCy';Lighttrig!r
4`" ... 4 t,n '3t 1 r,+ .p/
No. of.Receotacfe-OuUeis'-:: .1`S'*''r? I_ C1o.+p1+Cit i utnyrs ccs z ...�' , ;r.. li':Battery' Units r : €? . , •,a f. a f
No. of Switch Outlets �`5 I No. of Gas ?;:rners FIRE ALARMS No. of Zones
No. of Ranges r.
1 I No. cf Air Ccc. Totat No. of Celection and
111 :cns Initiating Cevtces
Heat Total .Olaf
No. of Oisoosais I I No. of Pu,..bs Tons KIN No. of Sounding Devices
No. of Self Contained
No. of Oishwasners I SoacerArea ileatir.g KV1 Oetect:onrSounaing Devices
— Mumcioaf
No. of Or,ers Heating Cevices KW Local _ Connection
_Other
No. of No. of Low voltage
No. of Water Heaters KW I Sicns Saaas:s Wirrno
No. Hyoro Ma.sagc Tuts I No. ^f !.tctcrs 7ctai Hr i
OTHER:
INSURANCE COVERAGE. Pursuant :o the (eoutremenls of ttassacnL:se,-s general Laws
I have a current Liability Insurance Poticy inc:uctng Corrc:eree Cceratiens Coverage or its substantial eduivaient. YES = NO — 1
have suomttted valid Arcot of same to the Office. "ES -- NC - It you have checxed YES. please indicate the type of coverage by
Checking the aa-Yobnate cox_— Public Service Mutual 4/24/96
INSURANCE _ BOND _ OTHER _ tPlease Scec:!y)
Estimated Value of El e thcal 'Nott S �� d , (Excitation Dotal
rworx to Start �3 1• Inscec::on Case Racues:ec: Rough tJv� C41 I Final
Signed under: WPM
of perjury:
FIRIA NAME WPM Wiring Co., Inc. _ LIC. vo. A-7863
Licensee Henry K—�arzyk,Pres. s;g-a:ire X ' Y 1 LLC, No EL 21142-E
P.O. Dox 1701 - Lowell, MA 01853 ffice = 508-4549993
Address Fax = 50$-452-467
OWNER'S INSURANCE WAIVER: 1 am aware that the L:censee eoes not nave the insurance coverage or its suostantla eautv8lent as re-
ouueo by Massachusetts General Laws. ano :hat my signature on :::is cerrmt aobticatlon waives this redutrement. Owner. Agent
(Please cheex one)
eiecnone No. PERMIT FEE S
(Signature of Owner or Agenn
t -55o5