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Home My WebLink AboutMiscellaneous - Long Pasture 26Location N o. Date z TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 14 'S Building Inspe r 4 TOWN OF NORTH ANDOVER 4�. BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: /JACC-a SIGNATURE: 1� - Building Commissioner/I for of Buildings Date SECTION 1 -SITE INFORMATION 1.1 Property Address- 1.2 Assessors Map and Parcel Number: a� v1.3 Map Number Parcel Number Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use I Lqt Areas -Frontage(ft) 1.6 BUILDING SETBACKS ft 1 w O vur?. Front Yard Side YarcV VRear Yard Required Provide Required Provided R red Provided 1.7 Water S M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public Private ❑ Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record oft U) Name (Print) Address for Service . r SignatureTelephone t 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ % kAD 1 Or f LicensedCion Supervisor: jI License Number Addr s Expiration Date gignatu'p, Telephone 3.2 Registered Home Improvement Contractor , p p IVLCWLA-1-1 Not Applicable ❑ (S OIR Company Name Registration Number dvc Add s� �-- Expiration Date Si nat a Telephone M lV s O Mn ic M roz 0 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 Descri tijn 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 V�- a a u w- Sup w f bLA SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be C m leted by permit applicant � ,OF CiAL� USE QNLY '' 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction �7 T 3 Plumbing Building Permit fee tel X T - 0('4 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, 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 Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS ( 1 sT XI 2 ND 3 RD SPAN DIMENSIONS OF SILLS DIN ENSIONS OF POSTS Y 41 DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHB4NE IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE M 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. �..........r.........1�..�.."...■.00.0.■■0000..■■.........0.6..0..0.....0.....■ APPLICANT C �lJy�'�'1 C.� ► �' �' `� PHONE ASSESSORS MAP NUMBER b LOT NUMBER SUBDIVISION LOT NUMBER STREET STREET NUMBER �o �r..060............. ■660...■s..■..0.6...0..6..........6.....6■ ■.........■ OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS �. 5.0 .,�-..... ...................■..0.6060...6.....0.0x..0....■ . .0600...... DATE APPROVED �' U CO SERVATION ADMINISTRATOR ^ DATE REJECTED COMMENTS � L DATE APPROVED I TOWN PLANNER DATE REJECTED �~ COMMENTS f VAo V illyur DATE APPRO FOOD INSP TOR -HEALTH DATE REJECTED DATE APPROVED `,.,SE M CSPECTOR - HEALTH / DATE REJECTED CONDAENTS O 'kf �vr rK ax- PUBLIC WORKS - SEWER / WATER�CO INEC NS I 3p -Com/ DRIVEWAY / - 3p -O/ DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE !AN 3 1 2001 tIILL�t DE!�-.►z't�f�Nl Building Value Calculation - for Property at..... Room Length Width Sq.Ft. Cost per Sq. Ft. Total Cost Kitchen o 26 14 364.00 65 $ 23,660.00 Living Room 18 15 270.00 65 $ 17,550.00 Dining Room o 18 15 270.00 65 $ 17,550.00 Family Room 24 16.5 396.00 65 $ 25,740.00 Study t► 15 11 165.00 65 $ 10,725.00 Laundry 12 8 96.00 65 $ 6,240.00 Garage 24 34 816.00 35 $ 28,560.00 Entry 16 15 240.00 65 $ 15,600.00 Basement Finished - 65 $ - Deck - 10 $ - Screened Porch - 35 $ - Breakfast Nook 12 13 156.00 65 $ 10,140.00 Bedroom 1 ° 21.5 15 322.50 65 $ 20,962.50 Bedroom 2 0 15 13 195.00 65 $ 12,675.00 Bedroom 3 p 15.5 14 217.00 65 $ 14,105.00 Bedroom 4 e 19 13 247.00 65 $ 16,055.00 Bedroom 5.. 19 13 247.00 65 $ 16,055.00 Bathroom 1 6 6 36.00 65 $ 2,340.00 Bathroom 2 15 14 210.00 65 $ 13,650.00 Bathroom 3 14 9 126.00 65 $ 8,190.00 Bathroom 4 8 8 64.00 65 $ 4,160.00 Bathroom 5 - 65 $ - 4Ek3:�g_ 14•,:'/:`F ...,.0 ... SIM is ".y SA�.Raa�L:�.'Y� �6M� v^.3{at54.}.'�C7/3 aN imF:nwti'k" � 1 �• oma► s 3 .' �3 A1rh.5 � 8 ta- 6 l 0 -*-t CI %t V- Town of North Andover o4 NORTHo �A ,tt6eD '6y 'YO Building Department o 27 Charles Street * _ North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542, 940 °`""' vary' R9TED ' (y �SSAGPIUS�� DEBRIS DISPOSAL FORM 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, sl 50a. The debris will be disposed of in /at: Facility location Signa ,We of Appl ant l/�lb l Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. lllC l�VllllllVllWCdllll UI tV/dJJd(,!IUJC((.Y Department of Industrial Accidents Office of Investigations Boston, Mass. 02911 Workers' Compensation Insurance Affidavit Please Print am a homeowner perrorming au wont mysetr. of am a sole proprietor and have no one working in any capacity QI am an employer providing workers' compensation for my employees working othi job. Company name: w�� nc, -�O Company name: Address City Phone # Insurance Co. Policy # 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 penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. do herby certify under the pains and penalties of perjury that the information provided above is true and correct Signatu Print nam Official use only do not write in this area to be completed by city or town official' Building Dept ❑Check if immediate response is required Building Dept C] Licensing Board p Selectman's Office Contact person- Phone #. � Health Department 0 Other FORM WORKMAN'S COMPENSATION 0, GROWTH MANAGEMENT BYLAW EXEMPTION TOWN OF NORTH ANDOVERB STATEMENT UII,DING DEPARTMENT This form shall be used to assist the Building Department 8.7.6 of the Town of North Andover in their determination of exemption under secti Growth Management Bylaw. The applicant shall provide on necessary information as requested below. all of the Perms � �� " � ' �� N'�✓� t Applicant Property addre � Vs Map /Parcel 2p—pllcant's Phone Number I the undersigned Single Family Two Family �► applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 ofthe Growth Management Bylaw. I also un absolve me or any party to this permit from the requirements ofobtaining other derstand providing this form does not Permit. Further I understand that my interpretation ofthe exemption status is subject to review b thz Bui1�g Depaofthe d is og y officially accepted when the building permit is issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building Permit application and associated attachments, complies with one or more ofthe following sections as indicated by a check mark. This is an application for a building permit for the enlargement, restoration or reconstruction ofthe effective date ofthis bylaw, provided that no additional residential unit is created.of a dwelling in existence as y The lots) was / were created prior to May 6, 1996 and are exempt from the provisions of section 8.7 ofthe Zoning Bylaw. This application is for dwelling units for low and or moe income families or individuals where to senior citizens where all ofthe conditions of 8.7.6 are met and or represents dwelling units fderat or senior residents, where occupancy ofthe units is rest through a properly executed and recorded dead restriction running with the land. For purposes ofthis section "senior" shall mean persons over the age of 55. This application is part ofa development project which voluntarily agreed to a minimum 40 density This lots) below the density permitted under zoning and feasible given the environmental conditions ofthe tract, with the surplus land equal to at least ten buildable acres and permanent reduction in be protected from development by an A Permanently designated as open space or farmland. The land to be preserved shall gricuhural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism approved by the planning board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date ofthis Section 8.7 and shall receive a onetime exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for a building permit ( all other commissions have been received and the project is in compliance with those permits from all other boards and accommodate issuing a building permit in that Permits), and the Development Schedule does not the development schedule accommodates issuing buidm building permit will be issued per year per Development until such time as EXEMPTION. g Permits. Applicant must submit an approved FORM U with this PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD DETERASSIST THE BUILDING DEPARTMENT IN MAKING A IVIINATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE EXEMPTIONS. BY SIGNING BELOW I ATTEST TO THE ACCURACY OF THE INFORMATION PROVIDED AND THAT THE ATT BUILDING PERMIT IS ALLOWED AN EXEMPTION AS CITED ABOVE. ACHED FURTHER I UNDERSTAND THAT THE SUBMITTAL OF MISLEADING OR INACCURATE INFORMATION OR THE NOT IKGROOEXEMPTION UNDS FOR REFUSALBy THEFF OF A ABOVE BUILDING DEPARTMENT TO ISSUE B ONE TO MY KNOWLEDGE OR lLD G P RMIT. SIGNATURE �/ �TfHISFO TO BE ATTACHED TO THE BUILDING PERMIT APPLICATION i 1. J.WILLIAM HMURCIAK, P.E. DIRECTOR TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 DRIVEWAY PERMIT DATE �.4 /v LOCATION BUILDER phone OWNER 00, r hone 453-7a3 L�/� 5 THE NORTH ANDOVER SUPERINTENDENT OF OPERATIONS MUST BE NOTIFIED OF THE GRADE AND SETBACK FROM STREET. CALL THE SUPERINTENDENT'S OFFICE BEFORE FINISH GRADING AND SURFACING FOR APPROVAL OF SUCH ENTRY. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. Telephone (978) 685-0950 Fax(978)688-9573 AUTOMATIC LAWN IRRIGATION SYSTEM PERMIT • st.r . +b t TOWN OF NORTH ANDOVER ?' . - « MASSACHUSETTS ALL INFORMATION MUST BE PROVIDED, BY A LICENSED PLUMBER, PRINTED IN INK AND LEGIBLE. IF NOT THE PERMIT WILL BE REJECTED. DATE: LOCATION: 2 LOT #: BUILDER: NAME TELEPHONE NUMBER STREET NAME TOWN/CITY & STATE OWNER: NAME TELEPHONE NUMBER STREET NAME TOWN/CITY & STATE PLUMBER: NAME TELEPHONE NUMBER STREET NAME TOWN/CITY & STATE LICENSE NO. EXPIRATION DATE: SERIAL NO. IRRIGATION INSTALLER IF NOT THE PLUMBER INSTALLER: COMPANY TELEPHONE NUMBER STREET NAME TOWN/CITY & STATE INDIVIDUAL NAME TELEPHONE The plumber, must install the connection to the municipal water supply within the building, the water line to the outside of the building and the backflow device. A registered irrigation installer may then install the balance of the Automatic Lawn Irrigation system. NO irrigation heads will be allowed in -the right of way (near edge of pavement). ALL irrigation heads MUST be at or behind the property line. All heads installed in the right of way will be removed immediately upon notification and said plumber or installer will not be allowed to perform any future work on the municipal water"supply, until the heads are removed from the right of way. Sign below that you have read this paragraph and understand it. SIGNATURE OF PLUMBER DATE THIS PERMIT MUST BE POSTED AT THE CONNECTION/METER LOCATION FOR THE INSPECTOR. INSIDE CONNECTION RAIN SENSING DEVICE METER (IF APPLICABLE) BACKFLOW DEVICE COMMENTS BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR A Number. CS 058114 Birihdati: 02127/1961 Expires: 02/27/2002 Tr. no: 16172 Restricted To: STEPHEN CROWLEY 138 VIRGINIA AVE LOWELL, MA .01852 Administrator DpVV 311 Date .... TOWN OF NORTH ANDOVER RECEIPT This certifies that ....... haspaid ............. ............. ............... ....................... ............. for ..... ............................... . .................... Received by .................... 1/d Department .....................Fv)KJ 1..(,-.....®4. N— ..................... WHITE: Applicant CANARY: Department PINK: Treasurer HONE INPROVIKENT CONTRACTOR Registration: 114187 Expiration: 0/11/01 Type. 'BEA ri CROWLEY CONSTRUCTION a GIX STEPHEN CROWLEY 138 VIRGINIA AVE ADNINISTMOR LOVELL 01852 f YJAScheck COMPLIANCE REPORT Ylassachusetts Energy Code 14AScheck Software Version 2.0 CITY: Lawrence STATE: Massachusetts HDD: 6235 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE:"Other (Non -Electric Resistance) DATE: 3-2-2000 DATE OF PLANS: 3-2-00 TITLE: New Home PROJECT INFORMATION: Lot. Long Pasture Dr. COMPANY INFORMATION: Crowley Construction 138 Virginia Ave. Lowell, MA 01852 Permit # Checked by/Date COMPLIANCE: PASSES Required UA = 949 Your Home = 700 Area or Insul Sheath Glazing/Door Perimeter R -Value R -Value U -Value UA ------------------------------------------------------------------------------- CEILINGS 1840 30.0 0.0 65 WALLS: Wood Frame, 16" O.C. 3924 19.0 2.0 222 SLAZING: Windows or Doors 695 0.350 243 DOORS 80 0.350 28 FLOORS: Over Unconditioned Space 2998 19.0 142 HVAC EFFICIENCY: Furnace, 94.0 AFUE --l!,. ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 1256 of the design load as specified in -sections 780CMR 1310 and J4.4. Builder/Designer Date It, MASch4ck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.0 New Home DATE: 3-2-2000 Bldg Dept Use CEILINGS: 1. R-30 Comments/Locati WALLS: 1. Wood Frame, 16" O.C., R-19 + R-2 Comments/Location WINDOWS AND GLASS DOORS: 1. U -value: 0.35 For windows without labeled U -values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: 1. U -value: 0.35 Comments/Locati FLOORS: 1. Over Unconditioned Space, R-19 Comments/Location HVAC EQUIPMENT EFFICIENCY: 1. Furnace, 94.0 AFUE or higher Make and Model Number THERMOSTATS: Adjustable thermostats required for each HVAC system. AIR LEAKAGE: Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air -tight assembly with a 0.5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R -values, glazing U -values, and heating equipment efficiency must be clearly marked on the building plans or specifications. DUCT INSULATION: 4 Ducts in unconditioned spaces must be insulated to R-5. Ducts outside the building must be insulated to R-8.0. DUCT CONSTRUCTION: All ducts must be sealed with mastic and fibrous backing tape. Pressure -sensitive tape may be used for fibrous ducts. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: Rated output capacity�of the heating/cooling system is not greater than'i256,of the design load as specified in sections 780CMR 1310 and J4.4. MISC REQUIREMENTS: Refer to 780"CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building Department Use Only)------------------------- h Cf) 7) Cf) 0 m m Q �m m m 4 0 y .O C � � d CA CO) O MZ CO) CLO n. 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'. r Xt 0 C o VO CO m Mi 0 MI 6 I Location ko4c� �C)A-7Ce -?Wurv- No. —5(0 Date Aidmillillik .4 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ 89 Foundation Permit Fee $ Other Permit Fee TOTAL Check # 16c[3 &S 17 147315 fic-G��- Building Inspector LOT 2 1s5v5-D �- ►a ® f 40sre 4 a fo Twja Q0 fed f)I � EASEMENT I EASEMENT co EXIST. FND. T.O.F.=114.2 35 31' 32�l0 OF�ygssq 0 M AEL CyG N v S GI = o NO.3 1 u T (� L LA SJP 0 92 i �► FOUNDATION LOCATION PLAN CLIENT. CROWLEY CONSTUCTION ` THIS CERMCATION IS AMDE AND LIMITED TO THE ABOVE CLIENT. �k LOCATION: NORTH ANDOVER,MA. I CERTIFY THAT THE PRIMARY STRUCTURE SHOWN CONFOW TO THE NOWIlWX SETBACK Jis6QMMEMEIM/3 OF THE LOCAL APWLMeM" ZONING B1= -LAWS RM EFFECT WHEN CaN57RUCTED. On CEIPAFC A7XW DOES NOT CONS/QER ANY OTHER M37WCMZ SUM AS COYENAM5,WEnAMMEASEYE1 M WinD M aF CONWTIWMZEM) RM MWRMO MIALL Nor HE USED Br "K CUENT FOR ANY PrMOSE OTHER MN THAT OUTLINED ABOVE;EX VT WIM ME WR/17E1M PENUMSM OF CHOMMINN i SERC/ MC. FURMEMWOAE INS DRAWRMO IS WE COP1NORE'D PROPEW OF CIRiY MAWN & SEROL Mr. AND ANY UWAMMOMM USE 6 PRGHRA/ED.CIIMIMMEN t SERO/ TAKES NO RESPONISItJ01LITr FGR THE UNAUI OR® USE of THIS GRAWRMO OR ANY OMFGR- MATK1N CONTAINED HEREON. SCALE. l'=B0' DATE: 4/5/00 CHRISTIANSEN & SERGI "DS"� IN summ ST. HAVE"U.MA. 01BJ0 TEL. 078-371-0310 ®soon BY OIRISflANSETM t SERGI Mr. DWG. N0. 94080025 LOT 2n�s� a r_ I PAW S rnLP - i D t I � EASEMENT I EASEMENT � I L \ \ V EXIST.M. T.O.F.=114.2 35 � FOUNDATION LOCATION PLAN CLIENT.• CROWLEY CONSTUCTION THIS CERTIFICATION IS MADE AND LIMITED TO THE ABOVE CLIENT. LOCATION: NORTH ANDOVER,MA. I CERTIFY THAT THE AWMARY snm cnNAE SHOWN CONFORM TO THE HMONTAL SEMCK REQUlREA&M OF THE LOCAL APPLCABLE zONW B! =LAWS IN LSFMT WHEN COMMCM. MW CBMFICATION DOES NOT COMM ANY OUMT 6371 17MW SUCH AS COYETrANmwinANMEASEML9VT3, ONOM OF CMWMG $EIC.) FM DRAWING SHALL NOT BE USED BY "K CLIENT FOR ANY RA POSE OPM THAN THAT OUTLINED ABOW�ER M WITH THE WITnm PERNSSN7N OF CNR/STUNSEN & SL7NYi MM fURTHER OW TNLS DRAWNG X THE COPYRN HIM PROIPE'RTY OF CIAIP MAMEN t SENN NIH. AND ANY LINAM MOMM MSE IS PROMM07MCAVUSIMAW N t SMW MATS NO RESPONAWLffr FUR THE MUINOMM USE OF THIS DRAWING. OR ANY INFOR- MATAON CONTAINED RE EON. SCALE. 1 "=Bom DATE: 4/5/00 CHRISTIANSEN &SERGI ��s 100 SUMYEIP Sr 1UYE1iVIIUAL 010o TEL 678-375-010 05000 BY CHAIISTUTAMN ! SOW Mr. DWG. N0. 94080025 W LA (n U 0 z� o CA tzo rA V w Ol�z O tv i� v :moo C2 ca J C CCU `• h m CD CL :Ern Q cwi C.3 � � t 4D= E C CD CD � L m;O = ` N W co = C C ID Z -0 cm b, CM C meCM ca 'O O Is : m v ti O O Z CDCD oac c S m�p,+�..p N •tyA a =Z E ��v .o v .y O O� C CL CA.0 A O F- = �awm ZIP v --1 z 0 z 0 U N �' a� as y CDco .� Q h c a M m CL O w ~ �... UF G O� fl. cc Q d O C cc ca C Z � C..7 t/2 o m ° 0 x v- co a w CO2 w Q v z ° 0 U w zo cn a rw cq V)cf v :moo C2 ca J C CCU `• h m CD CL :Ern Q cwi C.3 � � t 4D= E C CD CD � L m;O = ` N W co = C C ID Z -0 cm b, CM C meCM ca 'O O Is : m v ti O O Z CDCD oac c S m�p,+�..p N •tyA a =Z E ��v .o v .y O O� C CL CA.0 A O F- = �awm ZIP v --1 z 0 z 0 U N �' U) W LU crW uj U) a� as y CDco .� Q h c M m CL O w ~ �... 3� G O� fl. cc Q d O C cc ca C Z � C..7 t/2 � C C� c CO2 0 U) W LU crW uj U) N° 3435 Date . ///jZ/. 0K" ° '° "o TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that /..}...... y has permission to perform..... %' �-{d� ............................................................... wiring in the building of .......... ........................J ......................................... / U' `/ a .. c. jJ ........ „North Andover.-Masg/ Fee Lic. No„14. Z%�� 1... .................. ... ELECTRICAL INSPECTOR t Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer TIM C0.1LVf0,N E4I77-1OFMASS MU.SE77S Office Use only DEPARTAZEAT0FPUB0C&4FM �7 _ Pamit No. BOARDOFF7REPRET EV77ONREGUTA7TONS527CMI2-00 c OccupancY Fees Checked APPLICA HONFOR PEST TOPERFORMELE=CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:170 (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- AP PARCEL Location (Street & Number) o .17 IOwner or Tenant H o Owner's Address 13 F-- .„ - '7 a Is this permit in conjunction with a building. permit: Yes [�o a (Check Appropriate Box) Purpose of Building Utility Authorization NoG- ?' z-3�/ Existing Service Amps / Voltserhead a Undergro d [D No. of Meters NeW Service '2— Amps/Z ,z2 eVolts Overhead Underground ®--'No.ofMeters S Number of Feeders and Ampacity Lobation and Nature of Proposed Electrical Work G✓� /'!/� •-� /,fv ✓s -C— No. L No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground El ground No. of Receptacle Outlets No. of Oil Bumers No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total P Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other I No. of Dryers Heating Devices KW Cormccuons r No. of Water Heaters KW No. of No. of Sitars Bailasis j No. Hydro Massage Tubs No. of Motors Total HP OTIER- hsL== Cbsn e pixsiot to the:• n : c • :a. • q s haw • qi Lohlity1wx•^'•1 I .1 •n .. •• •:1- O•: .11.• . • : • 14s Sj1q ai :• i .:1 •E► • IhawstftniWd-,a1idpudof=m1oihe0ffim••ti • . 1 • s • :• i• •J• • sc 1 u•sl: 1 • •• : • • :• ! 1 .1 • sn •• INRRANa : • I• MIER ftase i•1 Esbm&dVEdwof0acbcalWoik •1 oSu q•:•1• •:1; ':• :CIH Rough '•: Aahm OWNER S IINRJRANC•E WAIVEP l amaware t o the Lzam dots nt kr andtlmrm Wmat eonthispmi ii ww*m�sthism9me ift (Please check one) Owner F-1 Agent a ttutaturc o %kmer or Agent _ LioarseNo � y y � 3 ..e.�•.1 s• lis ••... is _ �Iti_• •. ui`...:AII, i Telephone No. PERMIT FEE $ 1v1 .• „oR1R o� •,40 o ;off Town of �`�_=;�„�st`'• NORTH ANDOVER O BUILDING PERMIT INSPECTION REPORT PERMIT NO.: PROJECT:8/X Ram DATE: UNIT NO.: M/06 'e FLOOR: ®Z WING: BUILDING NO.: �"-t a Y*'Z6 /""Y A. Ju it s- W REMARKS: L l.� v` '�/ /�� ✓� J) 0o o ms 134 -As 0 1 - 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 eire Dept - - it burner, tank, stove, smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: -Cof 0# Inspector Inspector Inspector Form #995 Action Press, 685-7000 Date .... 3 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .............. f �il... ...5 .................. has permission to perform ........ 5 .4.1..................................................... wiring in the building of ..... . .. .......................... at ....... it, ,e v..k� ............... North Ando M ... .................. ver, Mass. Fee.' -�6 ............. Lic. No./ -v. . f....... LE R INSP Check # � *)a- 4537 Commonwealth of Massachusetts Official Use Only t Permit No. Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 GMR 12.90 (PLEASE PRINT IN INK ORT YPE ALL FORM ATION) Date: p City or Town of: To the Inspect- of W' es: By this application the undersigned gives qoti)o of his or heAntention to perform y#e electrical work described below. Location (Street & N Owner or Tenant Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security system Completion of the followin table maybe waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures AboveIn- Swimming Pool rnd. [3rnd. ❑ o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners o. o Detection and Initiating Devices No. of Ranges g No. of Air Cond. Total Tons No. of Alerting Devices PumNo. HeaTotals Number Tons KW of Self -Contained No. of Waste Disposers Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW p g Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security No. ofDevicesor Equivalent No. of Water Kit No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total IIP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. 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 coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify) (Expiration Date) Estimated Value of Electrical Work: — Q — (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under t e ains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: LIC. NO.: 1 rya _j0 Licensee: John S. Bassett Signature LIC. NO.: 1533C (If applicable, enter "exempt" in the license number line) Bus. Tel. No.: 603 594 5928 Address: Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Li see 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 agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ fT )