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Building Permit #058 - 17 UNION STREET 7/23/2008
BUILDING PERMIT c* NoN DTqti 06 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 155d Date Received 2 X/6,90-- v� 9SSACHUS Date Issued: �l PORTANT:Applicant must complete all items on this page PROPERTY.OWNER C� �.� � �-► -UFS Pant z e"v 'MAP NO;_ PAFtCELZONING Dl RIGT HistocwD�strit yes 1V>actle Shop V�Iage dies' ro TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: h cf- Commercial Repair, replacement Assessory Bldg Others: Demolition Other 5eptie' 1i1/eil 4; Floodplarn llVetlarrds uUatershed D�str�ct V�Fte/Sewer ._.... _ DESCRIP ION OF WORK TO BE PREFORM D: S a r, g f + Q0_►l i n *0 St2 u. 'Fi P-e DQl'hagie- N= P stns, X�SJM t I a I I MW -tUdj `r '�P��n 1 �e• C UtJ pe w c caA1 -�0en Identification Please Type or Print Clearly) 919—3.�.�"a�6 i OWNER: Name: Q4+R.ie-1( L-Ih a U#*-S Phone. Address: q4 LjgS I n n 5-+ 41 CONTRA"GTOFt' slam " Phone.:= Adress x t u Superuls®r's Canstruc�o�a 1 t e 's ` �� p .Date "' , Horne Irnprovnen45`_" . ARCHITECT/ENGINEER L 4400-Z 0544cn Phone: q'!g,T5'0a-5 A 1 o'�I `�"v rnQ-Re 61933 N Address: o. g. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: FEE: $ 0 7-7 T wx�� a1 S4 Check No.: Receipt No.: .3 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature nf.Aj t/� ��^! '� 'gnatta.re o onraetY; i Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF -'U FORM" DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS L CONSERVATION Reviewed on Siqnature COMMENTS . , . • . 'L _ . , - '� _ . 4 - - , : ` . . ; ,_ - HEALTH.. - Reviewed on Signature COMMENTS , Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision." Comments Conservation Decision: s Comments Water & Sewer Connection/Signature•8 Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street F1RE DESA T NT; 7_,'_-_'T el p Duinpster n l e yes'. n Loc'atedat 124 Main-'.Street Rare Department s�gnature7dMeY COIVf11lIENTS�' Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 I Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits Building Permit Application Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses X Copy of Contract X Floor Plan Or Proposed Interior Work �( Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (if Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy an&proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location No. DS Date T MORTM TOWN OF NORTH ANDOVER Of, �•a �,ti F 9 Certificate of Occupancy Building/Frame Permit Fee S y� Foundation Permit Fee $ Other Permit Fee S TOTAL 3 Check # e 2 5 5 2) BuMing Inspector NORTH Town of : Andover 0 S'8 _ . _ LAKE o dover, Mass., COCMICMEWICK y�. ORATEO p'P�` "♦y 1� E BOARD OF HEALTH PERMIT T DFood/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.... NOW .... ... ..v<J' ............................................ Foundation has permission to erect........................................ buildings on ...../7---/y (�"/Yzl ;Oy . SY ...................... Rough to be occupied as............ E �c-.... <.!'f>.......b4:5.�t +. �............ �'............. . ... .. ...........1 Chimney provided that the person acce ting this permit shall in every respect onform to the terms of,the app ion on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSTRUCTI STARTS Rough ............ ........ ...... .. .. ..... .. . ...................................... Service BUILD IN CTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. .=f Residential&Commercial Additions,Kitchens, Bathrooms&Decks Fire Restorations IAICOMPLETE HOME IMPROVEMENTS A TO Z All City Remodeling Co. GENERAL CONTRACTOR Insurance Consultant Licensed&Fully Insured GERALD W.CASALETTO Free Estimates Mass Lic.CS066091 Office/Fax 978-535-3563 Home Improvement 121110 Cell Phone 978-815-6357 ALL CITY REMOLDELING CO. Estimate 3 SOPHIE ROAD WEST PEABODY, MA 01960 DATE ESTIMATE NO. OFFICE/FAX (978)535-3563 7/22/2008 1054 CELL (978)815-6357 NAME/ADDRESS PATRICIA LINDQUIST 17-19 UNION STREET NORTH ANDOVER,MA 01845 PROJECT DESCRIPTION TOTAL DEMOLISHING OF ALL INTERIOR PLASTER WALLS AND CEILINGS. BLUE BOARD&PLASTER ALL WALLS&CEILINGS. {INSULATION) INSULATE ALL WALLS&CEILINGS. REPAIR OR REPLACE ALL NESSERCERY FRAMING WORK DUE TO FIRE. ELECTRICAL REWIRE OUTLET&SWITCH CIRCUITS FRAME CEILING / 2"X6" 16"0/C WITH 1"X3"WOOD STRAPING WERE NEEDED. KITCHEN RENOVATION COMPLETE/WITH BASE&WALL CABINETS&COUNTER TOPS. (4 UNITS COMPLETE) BUY AND INSTALL RERFIGERATOR 30" STOVE UNIT FAN HOOD UNIT.ALL 4 UNITS INSTALL LAUNDRY&DRYER HOOKUP COPMPLETE DRAIN&WATER AND VENTING. ( ONE HOOK UP IN EACH APARTMENT) INSTALL ALL NEW VINYL THERMOPANE TILT OUT DOUBLE HUNG WINDOW UNITS. INSTALL ALL NEW 6 PANEL INTERIOR DOOR UNIT&TRIM IN ALL 4 ARPARTMENTS. BATH ROOM RENOVATION INSTALL NEW BASIC WHITE FIXTURES TUB&SHOWER UNIT/TOILET/ VANITY&MED CHEST UNIT BASIC FLOOR COVERING.(ANY PLUMBING/ELECTRICAL/BUILDING CODE UP GRADE WILL BE ADDITIONAL COST) ALL 4 UNITS INSTALL HOT WATER BASEBOARD HEAT AND ALL SUPPLY AND RETURN LINES BACK TO BOILERS ALL 4 UNITS. INSTALL POWER VENTING FOR BOILER AND HOT WATER TANKS FOR ALL 4 UNITS INTERIOR PAINTING OF WALL&TRIM WORK (I PRIMER COAT 1 FINISH COAT) INSTALL COMMERIAL CARPETING AND PADING IN ALL ROOMS AND STAIR CASE ONE COLOR TRUOUT.AND SHEET VINYL IN BATHS&KITCHENS. INSTALL VINYL SIDING DOUBLE 4" WIDE CLAPBOARD WOOD GRAIN STYLE. TOTAL COST OF JOB 410,000.00 Thank you for your business. TOTALf1 1 $410,000.00 SIGNATUR Phone# Fax# E-mail Web Site (978)535-3563 (978)535-3563 GERALD.CASALETTO@VERIZON.... REScheck Software Version 4.1.3 Compliance Certificate Project Title: Linquist Report Date:07/16/08 Data filename:C:\Program Files\Check\REScheck413\Casaletto-17 union St-N Andover.rck Energy Code: Massachusetts Energy Code Location: North Andover, Massachusetts Construction Type: 1 or 2 Family, Detached Heating Type: Other(Non-Electric Resistance) Glazing Area Percentage: 11% Heating Degree Days: 6322 Construction Site: Owner/Agent: Designer/Contractor: 17 Union Street Patricia Linquist Scott Golden North Andover,MA Golden Designs 9 Chestnut Street Danvers,MA 01923 978-578-1568 goldendesigns@comcast.net Compliance: Compliance:4.9%Better Than Code Maximum UA:638 Your UA:607 Gross Cavity Cont. Glazing UA Assembly Area or R-Value R-Value or D.. Perimeter Ul-Factor Ceiling 1:Cathedral Ceiling(no attic) 1150 30.0 0.0 39 Wall 1:Wood Frame, 16"o.c. 4050 13.0 0.0 285 Window 1:Vinyl Frame:Double Pane with Low-E 456 0.350 160 Door 1:Solid 120 0.210 25 Floor 1:All-Wood Joi st/Tru ss:Over Unconditioned Space 2080 19.0 0.0 98 Furnace 1:Forced Hot Air80 AFUE Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the Massachusetts Energy Code requirements in REScheck Version 4.1.3 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist.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 bshall be no greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. uilding 71 Com[..!/ �GN> 7_ 1(0-0g Name-Title Signature Date Project Title: Linquist Report date: 07/16/08 Data filename:C:\Program Files\Check\REScheck413\Casaletto-17 union St-N Andover.rck Page 1 of 4 CREScheck Software Version 4.1.3 NJ( Inspection Checklist Date: 07/16/08 Ceilings: ❑ Ceiling 1:Cathedral Ceiling(no attic),R-30.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame, 16"o.c.,R-13.0 cavity insulation Comments: Windows: ❑ Window 1:Vinyl Frame:Double Pane with Low-E,U-factor:0.350 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1:Solid,U-factor:0.210 Comments: Floors: ❑ Floor 1:All-Wood J oist/Tru ss:Over Unconditioned Space,R-19.0 cavity insulation Comments: Heating and Cooling Equipment: ❑ Furnace 1:Forced Hot Air:80 AFUE or higher Make and Model Number: Air Leakage: ❑ Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ When installed in the building envelope,recessed lighting fixtures#meet one of the following requirements: 1• Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2• Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfm(0.944 L/s)air movement from the the conditioned space to the ceiling cavity.The lighting fixture has been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder: ❑ Installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: ❑ Materials and equipment are identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ❑ Insulation R-values,glazing U-factors,and heating equipment efficiency are clearly marked on the building plans or specifications. ❑ Insulation is installed according to manufacturer's instructions,in substantial contact with the surface being insulated,and in a manner that achieves the rated R-value without compressing the insulation. Duct Insulation: ❑ Ducts are insulated per Table 6106.4.4.3. Duct Construction: Project Title: Linquist Report date: 07/16/08 Data filename: C:\Program Files\Check\REScheck413\Casaletto-17 union St-N Andover.rck Page 2 of 4 All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces used to transport air,are sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions.Mesh tape may be omitted where gaps are less than 1/8 inch.Duct tape is not permitted. F1 The HVAC system provides a means for balancing air and water systems. Temperature Controls: ❑ Thermostats exist 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 is provided. Heating and Cooling Equipment Sizing: ❑ Rated output capacity of the heating/cooling system is not greater than 125%of the design load as specified in Sections 780CMR 6106.4. Circulating Hot Water Systems: ❑ Circulating hot water pipes are insulated to the levels in Table 1. Swimming Pools: n All heated swimming pools have an on/off heater switch and a cover unless over 20%of the heating energy is from non-depletable sources.Pool pumps have a time clock. Heating and Cooling Piping Insulation: ❑ HVAC piping conveying fluids above 120 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2. Project Title: Linquist Report date: 07/16/08 Data filename: C:\Program Files\Check\REScheck413\Casaletto-17 union St-N Andover.rck Page 3 of 4 Table 1:Minimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runouts Heated Water Temperature(°F) Up to V Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2:Minimum Insulation Thickness for HVAC Pipes Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range(°F) 2"Runouts 1"and Less 1.25'to 2.0" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD:(Building Department Use Only) Project Title: Linquist Report date: 07/16/08 Data filename:C:\Program Files\Check\REScheck413\Casaletto-17 union St-N Andover.rck Page 4 of 4 Board of Building Regulations and Standards Board of Building Regulati ns and Standards HOME IMPROVEMENT CONTRACTOR Construction Supervisor License Registration: 121110 License: CS 66091 Expiration: 4/8/2009 Birthdate: 10/9/1963 Tr# 128514 " Type: DBA Expiration: 10/9/2009 Tr# 4666 Restriction: 00 ALL CITY REMODELING ' GERALD CASALETTO GERALD W CASALETTO 3 SOPHIE RD 3 SOPHIE RD PEABODY,MA 01960 Administrator PEABODY,MA 01960 Commissioner 00-35,000 cf enclosed space License or registration valid for individul use only lA-Masonry only before the expiration date. If found return to: IG-1.2 Family Homes Board of Building Regulations and Standards One Ashburton Place Rm 1301 Failure to possess a current edition of the Boston,Ma.02108 Massachusetts State Building Code is cause for revocation of this license. N t valid without signature Residential&Commercial Additions,Kitchens, Bathrooms&Decks Fire Restorations COMPLETE HOME IMPROVEMENTS A TO Z All City Remodeling Co. GENERAL CONTRACTOR Insurance Consultant Licensed&Fully Insured GERALD W.CASALETTO Free Estimates Mass 13c.CS066091 Office/Fax 978-535-3563 Home Improvement 121110 Cell Phone 978-815-6357 00-35,000 cf enclosed space License or registration valid for individul use only IA-Masonry only before the expiration date. If found return to: 1G-1 2 Family Homes Board of Building Regulations and Standards One Ashburton Place Rm 1301 Failure to possess a current edition of the Boston,Ma.02108 Massachusetts State Building Code is cause for revocation of this license. r f/1 j N t valid without signature The Commonwealth of Massachusetts Department of Fire Services Office of the State Fire Marshal P.0.Box 1025 State Road,Stow,NU 01775 PERMIT Date: North Andover Permit No (City of Town) (if Applicable) Dio Safe Number In accordance with the provisions of NL G.L] Li$ Chap.ter_L(�as provided in sect•,ion 52 7 ('MR 34 This Permit is anted to Date� Ilzv- Start Full name of person,Finn or Corporation Peraussionto locate dumpster for construction/renovation/demolition of building. Comments: dumpster must be . 25 from structure if unable to place with required Restrictions:clearance dumpster musstom be covered with plywood or tarp end of work -day at (Give location by street and no.,or deacnbe m such m e as to prCT6adequate identification of location) FeePaids . 50.00 `�����1 � Fire Chief This Permit will expire%�/_/�G (Signature of offical granting permit) Oftical granting peanit (Tide) ov N FD 6067 Date .7.>4.2.. . .... 0000 00 00 s � 1- 0pORT/i* ONaN TOWN OF NORTH ANDOVER Cq aw b ° p e °¢ ' #;'`�`• ,oP• J`'* RECEIPT C<_ ` "�R!a + fin ppp CHUF. 5E g' ��� This certifies that ... .. ✓Gi!...CCC///...../T ".l. �....'.............. lu Q QQ has paid...(5...1? . >...................................................................... w for. r. b �' 1 oReceived by�. ,✓�............ .......... z � z Department ..., . ............................................................ 1 WHITE: Applicant CANARY:Department PINK:Treasurer Lt. Andrew Melnikas The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ;i�•' 600 Washington Street Boston, MA 02111 F www.mass. ov/di g a Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name Business/Or anization/Individual : , ARX 1 J Address: 3 SCA I e R-� City/State/Zip: @q _M41c 01�w Phone Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. <I am a general contractor and 1 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7. )(Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers'comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.E] Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 l.❑ Plumbing repairs or additions myself.[No workers' comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.❑ Other +Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. Homeowners who subtiiit this affidavit iiidicatiiig they are doing ani work and then mire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. �1,14A,11105- / Insurance Company Name: /, 4A, 1 vS 601 Policy#or Self-ins. L'ic. #: 9O�l �O' �Aa0 Expiration Date: Job Site Address: I /+ V h yah S+ N-Anc6vr_yL City/State/Zip: M0.,, 0/01 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the p ins and penalties of perjury that the information provided above is true and correct Signature: — .--Q� Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual, partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house.of another,who employs persons to do maintenance;construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit4o operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Qfce of Investigations has to.contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference.number. In addition,an applicant that must submit multiple permit/license applications*in any given year,need only submit one affidavit indicating current policy°information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to.thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,.telephone and fax number: F' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-7274900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia :`1-19-2007 FR i 110:,15 R1'1 H[.LAN J NS ACINC FAX 110. ;lfi+745+,4D3 P. ri 1 (dA!,trUDrYVYI A CORD CERTIFICATE aF LIABILITY INSURANCEJ�,'.Ajl 12/2A�17 TH15 CERTIFICATE IS ISSUED AS A MATTER OF INFOR11AtICN ! INSURANO ' AGENCY INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIO RTiMCATE DUES NOT At-REND, EXTEND OR li3 .I 7effexs�>xY Av�rnL�e 2nd T ALTER THE LOVERA E AFEORCED BY THE POLICIES BELOW, 71 :I_ .Pox 511 I __. MA 01970-0511 INSURERS AFFORiS{NG COVERAC?R I NAIL„ - - -- —--T---_ —.. I!1:_r='' rINSUHFI,A; t11.x �.�.t251 T]]RlI Z_i�Y1C.A 4'G- - TTY RmAol EII-T.NG CO. nL--. 3 Sr :.`liSl. ROAD frlsuR€R c; ---�_�_.--- �� I 1 INSUR-i M. INSULER E: cS GF H,1SURANCtE LIG rED 84LOw HAVE PEEN ISSUED TO THF INSURED NAMED AI3bVE FQri."HE POW'Y FC-:RIG7 IND(CAT17D. 01Y - '-IL-i,'FN T.TERM OR CONDI T IQrJ OF MY COfJTRACT OR QTHER DGCuMEN-I WITH RESPFC T Tr';WHIG;hI THIS CERTIFICATE MAY EE I' ;UEI-),�R I'I,AY FT:PTN\ -', gW(:E AFFQRQEO 6Y THE P'OLICAES DESCRIHFD 'HEREIN IS sUB,IECT TO A0- THF TEAMC, EXCI_l.;$I(:1t1S AIVU (GIJ7ITIOIJ5 OF 6Ui".f-i PC')LICi 7:LI j T�SFIQVvTd JAVF!sG-FN REDUCED 3Y rAl�CLAIMS, I POLICY EFFFCTIVF PO_•Cr FXPIRATIONI i TVPC Of ING IRANCF_ _ •_ POWC1 'r!uu'."R�._ DATE IAM/aDJYY nATF(MJM1g0rvV1 .,FNERALLIAFII-ITY 9Q24d8P,-E-122040 0H/�4/2(107 Oft/411�408 ��-_--- - - '—, I EACH GC(,UF{RFI OMMAG= RFN Eii� i'�>1N,EP,CIAI.GF"JEFIAI.I.IAFfiLITY A SI-p F r� I J C:LA!M'MA(IE �GC"URI I / / / / �MTFD EXP Anv nna nelcl;n) . 1 UR,IiONAI_;..At)V It IJi JRY f, ' � M-.. ----••ter---_....�---_. ; / / / / Gf_NERALAGGREC:\ic__ S_ l,l}(}Cl.CiCI':�'I, CFMI-A.66.IRFGATF_LIMITAPPLE i I PfidpLlCT^-C(t>•dP;nl'AGCz R 1.,000,t)G U i PRG. _ T._.. _ h0L1G'? J_C7 LOQ — AUYOMOPILF.,LIABILITY _1� 1 -----) �, / / / / a�MalalEn F LItJ,r r Mss AUTG (Ga acrld�np AL1,OWNa O AU70S / / / / �---"'i BC1niLV IbIJIJ(aY _.�.lHEUULCD AUTOS (Par(Iyrso,T) '•'' HIPRO AU COS ! / I / / AGOILY)NJUF r --- NCEN-OV VEl7 AUTOS (Per acoior) r —�{I (Per eceidFm) i j G1AFIAGE WASIOTY hI111<_Ai;"' -.-'. 1^ .-• ANY AUTO16EN'Y `+ - �• -- I AI,ITp}iFR(JNLh Y; I f-XCf;$CirU'�1RRELiA!I lEIM_IYY I / / / / ... ...._. 6AC-l0 .LIRREM1Ir�,I=�T �, '.�oCr✓UFl F-1 c;l.Altw'.^,raADE AGh F!( GATE 1 -�'IIS COhlPENSiATION AND I •• Loy!'QS'L!AHIUTY / / / / ' ^^T-•q'--- I � ^i;r.�nf?IETUP,IPAaTNER'RXE^IITI\•,=_' I _�..1R�LIA�I�a�J�'��I I•Ji:rirV_!RF_R EWM LIJDEfJ' E,�EAOHA(,:ClOEhIT he — ` -Qlr;.c!O:VS - i ---------- IONS -------ION S AM?DED F..V ENAOp3EMFNTiSPECIAL PRDViiICJN$ -- crI nrI ATFHo •-_- ,__�_--- �__ __�. SHOIiLp AM1IV fir 'i IRE h96vE pE.9CR16EC1 POL,IC1F:d UE CAn11;GLLGr` 9F_FO(•?r.�-.. tiXPiRATION DATE THC FO'r, r. Tr,r_ R' TF!_ ISSUING 0,rLjRC-;j WII,1.. LAV;' -,n !.',AIL pAVG WRIYTEM1:tG OT1C6 TO 71 IF CERTIFlrATE I-IOL IV VI FMAfd C[i 1;7 iFlf?LCIT,RI i FAILURE TO DO_-t:l::;HALL 1'JIPOSE NO 1)131-I0-ATICIN CIR LIA.F11 tw OF gp,iv KINU UPUpI T'r!I: . INSIMER IY AGENTL-OI3 r --•�.� .,ESEf RJE9, AUTHORl2E RE CSr.t r c �f/,,'�j�_—_• yl ACGRCI cc) HPORA-1 T rI CREScheck Software Version 4.1.3 NJ( Compliance Certificate Project Title: Linquist Report Date: 07/16/08 Data filename:C:\Program Files\Check\REScheck413\Casaletto-17 union St-N Andover.rck Energy Code: Massachusetts Energy Code Location: North Andover, Massachusetts Construction Type: 1 or 2 Family,Detached Heating Type: Other(Non-Electric Resistance) Glazing Area Percentage: 11% Heating Degree Days: 6322 Construction Site: Owner/Agent: Designer/Contractor: 17 Union Street Patricia Linquist Scott Golden North Andover,MA Golden Designs 9 Chestnut Street Danvers,MA 01923 978-578-1568 goidendesigns@comcast.net Compliance: Compliance:4.9%Better Than Code Maximum UA:638 Your UA:607 Gross Cavity Cont. Glazing ILIA Assembly Area or R-Value R-Value or D.. Perimeter U-Factor Ceiling 1:Cathedral Ceiling(no attic) 1150 30.0 0.0 39 Wall 1:Wood Frame, 16"o.c. 4050 13.0 0.0 285 Window 1:Vinyl Frame:Double Pane with Low-E 456 0.350 160 Door 1:Solid 120 0.210 25 Floor 1:All-Wood Joi st/Tru ss:Over Unconditioned Space 2080 19.0 0.0 98 Furnace 1:Forced Hot Air80 AFUE Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the Massachusetts Energy Code requirements in REScheck Version 4.1.3 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist.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 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Name-Title Signature Date Project Title: Linquist Report date: 07/16/08 Data filename: C:\Program Files\Check\REScheck413\Casaletto-17 union St-N Andover.rck Page 1 of 4 Y CREScheck Software Version 4.1.3 NJ( Inspection Checklist Date:07/16/08 Ceilings: ❑ Ceiling 1:Cathedral Ceiling(no attic),R-30.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame, 16"o.c.,R-13.0 cavity insulation Comments: Windows: ❑ Window 1:Vinyl Frame:Double Pane with Low-E,U-factor:0.350 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1:Solid,U-factor:0.210 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-19.0 cavity insulation Comments: Heating and Cooling Equipment: ❑ Furnace 1:Forced Hot Air:80 AFUE or higher Make and Model Number: Air Leakage: ❑ Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ When installed in the building envelope,recessed lighting fixtures#meet one of the following requirements: 1• Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2• Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfm(0.944 Us)air movement from the the conditioned space to the ceiling cavity.The lighting fixture has been tested at 75 PA or 1.57 Ibs/ft2 pressure difference and shall be labeled. Vapor Retarder: ❑ Installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: ❑ Materials and equipment are identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ❑ Insulation R-values,glazing U-factors,and heating equipment efficiency are clearly marked on the building plans or specifications. ❑ Insulation is installed according to manufacturer's instructions,in substantial contact with the surface being insulated,and in a manner that achieves the rated R-value without compressing the insulation. Duct Insulation: ❑ Ducts are insulated per Table 6106.4.4.3. Duct Construction: Project Title: Linquist Report date: 07/16/08 Data filename: C:\Program Files\Check\REScheck413\Casaletto-17 union St-N Andover.rck Page 2 of 4 All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces used to transport air,are sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions.Mesh tape may be omitted where gaps are less than 1/8 inch.Duct tape is not permitted. F1 The HVAC system provides a means for balancing air and water systems. Temperature Controls: Fi Thermostats exist 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 is provided. Heating and Cooling Equipment Sizing: ❑ Rated output capacity of the heating/cooling system is not greater than 125%of the design load as specified in Sections 780CMR 6106.4. Circulating Hot Water Systems: F1 Circulating hot water pipes are insulated to the levels in Table 1. Swimming Pools: ❑ All heated swimming pools have an on/off heater switch and a cover unless over 20%of the heating energy is from non-depletable sources.Pool pumps have a time clock. Heating and Cooling Piping Insulation: ❑ HVAC piping conveying fluids above 120 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2. Project Title: Linquist Report date: 07/16/08 Data filename: C:\Program Files\Check\REScheck413\Casaletto-17 union St-N Andover.rck Page 3 of 4 *Table 1:Minimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runouts Heated Water Up to 1" Up to 1.25" 1.5"to 2.0" Over 2" Temperature(°F) 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2:Minimum Insulation Thickness for HVAC Pipes Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Rangeff) 2"Runouts 1"and Less 1.25'to 2.0" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD:(Building Department Use Only) Project Title: Linquist Report date: 07/16/08 Data filename:C:\Program Files\Check\REScheck413\Casaletto-17 union St-N Andover.rck Page 4 of 4 4 � <; V ACORD�„ CERTIFICATE OF LIABILITY INSURANCE TDATE(MM/DD/YYYY) 5/27/2008 PRODUCER (978) 745-5905 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ALLAN INSURANCE AGENCY INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 63 1/2 Jefferson Avenue 2nd F ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. BOX 511 SALEM MA 01970-0511 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:NORFOLK & DEDHAM INS. COM Nally Plumbing & Heating INSURER B: PO BOX 431 INSURER C: INSURER D: Malden MA 02148— INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR WScD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DnNY DATE(MM/DWYY). LIMITS GENERAL LIABILITY R0620378A 04/10/2008 04/10/2009 EACH OCCURRENCE $ 1000000 X COMMERCIALGENERAL UABILITY DAMAGE TO RENTED 50000 PREMISES Ea occurrence $ A CLAIMS MADE a OCCUR / / / / MED EXP(Any oneperson) S 5000 PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2000000 POLICY D JE LOC AUTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS / / / / BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS / / / / BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ �4 ANY AUTO / / OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY / / EACH OCCURRENCE $ OCCUR F1 CLAIMS MADE AGGREGATE S DEDUCTIBLE RETENTION S S WORKERS COMPENSATION AND / WC STATU- OTH- EMPLOYERS'LIABILITY X TORY LIMIT I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100000 A OFFICER/MEMBER EXCLUDED? WEND4991 06/10/2007 06/10/2008 If yes,describe under E.L.DISEASE-EA EMPLOYEES 100000 SPECIAL PROVISIONS below OTHER E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF 0PERATION S/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION ( (978) 535-3563 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Gerald Casaletto EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT DBA: All City Remodeling FAILURE DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 3 Sophie Road INSURE I S AGE S OR REPRESENTATIVES "! AUTHORI REPREMENfATI E Peabody MA 01960- ACOR ° ©ACORD CORPORATION 1988 INS025 25(2001/08) NS025(otoe).os i Page I o1 2 0520/2006 13: 46 FA); 781 933 9445 MARTINI INSURANCE ZOO 1/002 coRD CERTIFICATE OF LIABILITY INSURANCE OP ID 8 DATEIM►AfDO/MY) J PASAM-1 05/20/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ! Martini Insurance .il.gency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 6 Common Streat HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO Pox 565 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Woburn MA 01901-06E5 Phone: 781-935-022( Faa:781-933-9445 INSURERS AFFQRDING COVERAGE NAILj INSURED INSURER Hartford Insurance Com an IN$UREF.E: Liberty Mutual Ins Co Passamonte Plastering, Inc. Joseph Pas:aamonte INSURER C. Travelers 17 Stone 0 o)376gd INSURER D: Pelham _ INSURER E: COVF-RAGES THE POLICIES OF INSURANCE LIST EA BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONATION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AF F DRDED BY THE POLICIES OESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SH,)NN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EFFECTIVE POLICY EXPIRATION LTRNSR TYPE OF INSUP I NGE I POLICY NUMBER I DATE MM1DD DATE MPINY) INY LIMITS !' GENERAL LIABILITY I EACH OCCURRENCE $1000000 - Pa COMMERCIAL GENE IAL LIABILITY PREMISS{Eaoccurrncv� $300000 CLAIMS MAGE Yj OCCUR MED EXP(Any one person) $1,0000 X Business Ctmers 08SIBAUL2311 03/25/08 03/25/09 PERSONAL EADV INJURY F'1000000 GENERALAOGREGATE s2000000 GE N'L AGGREGATE LIMT APPLIES PER, PRODUCTS-COMP/OP AGG s2000000 X POLICY 7 JEG7 LOC ^! AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT g Z 000 ANY AUTO (Es D=ICBnt) 0 00 ALL OWNED AUTOS (. BODILY INJURY S C X SCHEDULED AUTO,' BA-9188L923-013 02/09/08 02/09/09 (PerPeroon) I X HIRED AUTOS X NON-OWNED AUTO. BODILY INJURY (Per eccldanp PROPERTYDANIAGE 9 4 (Per aaltlenl) GARAGE LIABILITY — AUTO ONLY•EA ACCIDENT ANY AUTO —' OTHER THAN EA ACC 5 AUTO ONLY: AGO $ —..— EXCEMMBRELLA LIN31LITY OCCUR 'LAIMS MADE EACH OCCURRENCE 9AGGREGATE IS^ _� --- s i DEDUCTIBLE I�RETENTION $ I� IO' COMPENSATION Alli EAP,PLOYE X TORY LIMITS ER _ LOYL'RS'LIABILITY P I ANY PROPRIETORIPARTNERIE<ECUTIVE WC53IS354862017 07/07/07 07/07/08 j E.L.EACH ACCIDENT $100000 I OFFICERIMEMBER EXCLUDED'I f! E.L.DISE4SE-EA EMPLOYEE 8100000 yP9 CI4PCrIbY undOr _ Si9P6AL PROVISIONS boo- E,L,DISEASE•POLICY LIMIT $500000 OTHER DE3CRIPTION OF OPERATIONS I LCI:ATIONS 1 VEHICLP$I EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS t3p�rations usual t-,) Cirywall/pIaLstering. CERTIFICATE HOLDER CANCELLATION ALLCI-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIDII'c DATE THEREQF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAY$WRI71'6.1r NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALs- All City ReurtDd®ling FAX 4979-815-6357 IMPOSFNOOBLIGATION ORLIABILITY OFANY KIND UPON THE(NSURERITS AGENTS OR 3 Sophie Rad REPRESENTATIVES. Peabody, M;. 01960 A ED REP ESEN111A27VE ACORD 25(2001108) @ACORD CORPORATION 1w r, =;'! 21 / 2008 9 : 26 : 4-0 F,1M 8868 A 02 /12 �9y�MAN ®, (\ {y i �. TSS,rr T)ATF i AVER,R. THC>C13RTiT T(. \T F.TS TSSUI.P AS A MATTER Ur 174FC>P.ytA"I'(ilid ONT,`r"AST) R alrmCe Agency CONTERS NO RiOWS UMN OIL CER'i 1T T 'ATFH.OLDER THIS CER.'I CF I,( Ari-, DOEI S NOT AP.ETQD.E.TE'`rD('IR!,L ER T'HTC'OVERAGE,\LT ORDiiI)Tat 'T1Fi \v"illi A Wet POT..T IUST31..',T.i)W. 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CONIPANIES 1-TORDINiG COVERAGE him,;:;R l,;-Itch (Ihn J L}iictl Electrical Contracting Co COMPANY A AlNd.Nd. N/lUtU21 (nsuranCe Co LETTER N.) 30`:963 l?_lhlim,SIH 03016 i _ --- — - - - s 1'1 1t101-)TINT)TC.ATED NOTWiTHSI A1�MfNf CT ANY RFQUiRETdENT.TERM OR CONT)iTiON OF AiT)'(':)NTR 1C'T OR OTHER DOi IT\TiiN[ WITH4 TI[IS[ TO CERTIFY THaT THE POLICIES OF PJSUR4.NCF T.TSTED BFLO�I TI,\1T BEEL ISSUED TO TT INSURED N 41vIED IAJ3O\T.F if Tl ft POT[I Y RFSPF.("T I HICH'i ITIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDEI)b Y THE POL[CIE.S:DESCI 1Bl 1)HI REIN IS:UI-I JEC'I' -1 All,TIE TERNIS E u LUSIONS AND CON'DITIO'NS OF SUCAPOLICIES.LINUTS SHOWN JNIA i HAVE BEEN REDUCED BY PAID("T LIE45 _.. ('!I PO LIC\EFFECT TV POLIC'1'EXPIRATION i.11< TYPE OT IvSCIRANCF 1 PpLll'1'NUIIRER EA Cc4WF,i, r) DAT I I,i1(•fl LIMITS (;ENI.IL,L LI;CRII.ITI` �EII EPAI_��.GGREGATE 1. 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EACH,-CclJFPIIi'E ��'NiHEP,S e,r.JIIT?AGTr P.S PPCA' �INEC�J.AUE iAnyo t ) C HED E%PElfSE(Myune p,,m,) 'I' AIIT()\,IOR1I E 1,IARII,ITV - MIT ' �nl'If AIITi� F�EPrI}'onIJI!R1- _—�ALL LIW I I ELI AUTO`; I y — S-'IHENN EI-Atir-S r HIHEDAIIIOS �Ti::�Id.II'railfFC'ANTOS ^TAL ILI` �JAF-I,GF:IAPI LIT`; 1 cP.r.yr,I;lent;� It pE Tl i i.LS.S LIARII,Ir\ .'NFF.5UA FIRM E ... j TrIFP THa171JIJ BR FT l\'Ol IB,hS C'.tllllT'TNTSATTON AND I FAFUJORI'LtIMITS nlT]IiR F:QPL0%TRSTd ARTT,TI'`' L - � 'THE PF.FTRIET,Rt r_L-EACH.acclDENr FA P'i FF S1E;i F.i".'TI V F --''IERI:-ARE _a TY-8964H1''007 A7/116/2007p7 1(i;'?iliiS LLlxseasE--roLlcS�l.a.i`1rr ;, �iilii,r_t.ill r? 1111C:L NESCL I I - EL DISEASE--EACTI ---- —– EbJI?LOYEE I) (' yIM ENTS%DESCRIPTTON OF OPF,R.ATiONS OR LOC'ATiONS: --� _-- -- i[A-M?S R 1,VNCTT IS NOT COVi:RP:D RS''l-FTE\A'ORJ�FRS'(-:OiViPFNSATTON POIACV. i — — – reInI♦ari;lc>(15xTF IaDhCT,1t`<`lON SHOL7 D 4N-Y OI TIS'ABORT DFSC`RTPFI)1 OLIGO S BT C'ANCFI LFD BEFOR!TI7F'Fel TR 1T ION D 171 THERFOF'I HE ISSUiDv(,C'ORTPAN- \b-I1 L 1,NTiEAV OR TO I"IU11( IO R7ZlTTFN vU Fl('F 1 O TTI'('ERIT(7C'ATE O,L T)FR SiAhIED TO TIS'LEFT,BLrT FAII_lU F TO Df,TL 9?I('A NOTICF ULALL Iin>� JSL NO OBLTGATION OR I.IATIQ,TTF OI A\,FTAir)I'PON'I-III (Qb1PAN\'.!7 S A(;P;N I S OR RRPRl-SRS I A'I'tl l`S. >.i'.i.C'ITV RF.A`10DELTNG 3 St WTIT17 RD j \'[A 07,960 -- _.__ --ALITH()P.J.ZISD REPGESENT:Y`l'IVE — ------------ 1059 • 1 ACORD,, DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 6/30/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION R.L.Tennant Insurance Agency I ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 600069 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Newton, MA 02460 INSURERS AFFORDING COVERAGE _ NAIC# INSURED INSURERA:Main Street America Grou Ederval Tristao DSA INSURERB: Tri Star Painting wsURERC: _ 157 Chelsea Street #8 INSURER D: Everett, MA 02149 INSURERE: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'RD TYPEOFINSURAN POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERALUABILITY l EACHOCCURRENCE S 1000,000 _ DAMAGE T O RENTED A �COMMERCIAL GENERAL LIABILITY 598883 6/19/08 6/19/09_F8�d1SElEaoccueRce) $ 500.000__ _L CLAIMS MADE OCCUR MEDEXP(Anyone person) _I0 OQO PERSONAL&ADVINJURY S 1,QQQ,QQQ GENE RALAGGR MATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-CONP.OPAG3 jS 1,000,000 - POLICY I PRO- 71LOCJECT —— AUTOMOBILE LIABILITY CCMBNEDSNGLEUMIT ANY AUTO (Ea acddenl) I$ ALLONMED AUTOS BO CI LYNJURY S SCHEOULEDAUTOS (Pnr person) f— HIREDAUTOS BOLTLY INJURY NON-OWNEDAUTOS ( (F2 asci pnt) $ ' IROFE cTY[AMAGE (Per S GARAGE LIABIUTY PIJTOOWY-E_AACCIDBJT S ANY AUTO OTHER THAN EA ACC S ACJ TO 0 NLY: AGG S — EXCESSIUMBRELLALIABILITY EACH OCC UR RE NCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE g RETENTION S S WORKERS COMPENSATION ANDX M STATU OTH-' EMPLOYERS'LIABILITY TORY LIMITS LER E ANY PROPRIETOR/PARTNER/EXECUTIVE 598894 6/19/08 6/19/09 ELEACHACCIDENT 100,000 OFFICERIMEMBEREXO_UDED? ELDISEAg-EAEMPLOfEE $_ 500,00_0 If yes describe under I EL.DIAg-POLICYLMIT $ 100 QQQ SPECIAL PROM SIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY EN DORSEMENTI SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Walter F. Tennant ACORD 25(2001/08) ©ACORD CORPORATION 1988 Page 1 of 7 Gerald Casaletto From: "Golden,Scott"<sgolden@northeast.tec.ma.us> To: <call iopegold @comcast.net> Cc: <gerald.casaletto@verizon.net> Sent: Friday,June 06,2008 3:09 PM Attach: Overview.jpg;1st floor plan.jpg;1 st floor plan-overview.jpg;2nd floor plan.jpg;2nd floor plan-overview.jpg;3rd floor plan.jpg;3rd floor plan- overview.jpg Subject: 17 Union Street-N Andover Pat, Attached are the changes we talked about.I am going to need final approval to move forward and complete the set of Architectural and Structural Plans. Regards, Scott Golden I he tiecrrtary of State has determined that all a-mails are a public record and may not be kept confidential. I IIMMriuN., '=— 7/23/2008 Page 2 of 7 5N-0• 1a,e• 7B ga• 9r 7�6` 1a.a• Y8 1-7 7 28 2-e 1 1.7 B'8 a a v: UMIt# UNIT - IT 02 NIT#2 q BEOROO #2 e•BAtr•a. s•p 11 B ROOM#2 id'•0'z 1 i'•d' 1ad'x 11'-d' �� 1 sN I I•I I a� i I I = i UNIT#1 i UNIT#2 ry —uv-- -- KI CHEM 1 I KIPGNEM ur 1"' 11•-8•ri!'S• "6p I 11'•�'xta'-5' "'S A i• Pit^ I # I' •I y D 6'•7 xa'•a• A b b h kw ew � h UNIT#1 UNIT#2 I WHO RM. LN1RM. h ia'-d`x 7#'•1 P ta•-d•x 16R I• 14 n e m m UNIT 01 -- - UNIT#2 r 13 ER ROOM#1 ul ur BEVROOM'-5'#1 m ENTRY ENTRY m 'd 7-y -y 7-y 6. _ __ _ _ -y ,_y 7d ,•yWINS AREA 'If A 9.4 8 B4 78 'N 70Y tq A 7/23/2008 Page 3 of 7 N! a. A. 41.. 7/23/2008 Page 4 of 7 I 1 d I I I IT#3 I. N11'#9 AT,9 -- UNIT- � H - B R}�OM#7 -�x�''0 6 DROdMN r4i I U air t I it I. I 0 ue mn Ell NI BB i g k -I UNIT#B j KITCHEN I -r.. iT'-1•x lb,S' ° I i.. I� UNIT#4 N r r KITCHEN I h DECK I W R-3'x6•-e: 1 I e•a xa•.3• � r �. 5'tP Oil. _ •I 0$• '04, I n h UNITO L V IN61RM. UNIT#4 15'-O'xtA'-tt• � � D1NIN6 RM. UNIT#4 LIVING RM. a BEbPA k'i -vi-- 11'•1'x15'5' It'-1•xt5'T�' UNIT a BATH ;y '-7 7-Y -Y Ill 9•Y 9d 9 ? '•Y 7.7 '•Y LIVING AREA '$' 1 9'9', - $.b.it' 9.10'" @ 9R 78 •N MR2egA 5s'$• 7/23/2008 Page 5 of 7 114 l 7/23/2008 Page 6 of 7 ya y.o —_�-- - ----- ----- i I I 1 i I I I j UN&,44 I tl GPOM44 I 7B'-D'x31'•0^ I I i I I I 1 SY I I 1 h I I I I i I I I I I I I I sl I 1 I I I I � 1 UNITI `---`-- M I ATTIC I � tf•B'xt'•B I i i * ---`--Ice 0 gib..... \4� i �a .._ t ¢ i I h I UNIT#4 h SEDROOMM p I UNIT#4 e•o'x+e•+o a. I m-iBxa'-5' I m ' I I t; ATTIG b I 1 --.....aa-,,------_- ---- 1 BD-p - LIVINGAIZEA I taB,y ri 7/23/2008 Page 7 of 7 �4h ^#a 7/23/2008 Date .. .. . . .. .. ... . NOFTry 3j0ry`t.5. ,e1tiOL � TOWN OF NORTH AND R T y� PERMIT FOR GASANLLATION SACH^' ^ h SACHUSE�S This certifies that . . �.f .C � .? . . . . . . . . . . . . . . has permission for gas installation . . . /.-/. l3. . . . . . . . . . . . . . . . . . . in the buildings of . . .,�.! ti � '. ! . . . . . . . . . . . . . . . . . . . . . . . . . t at .j0. . .�/�+.c . . . .`'�. . . . .� ( . . . . . , North Andover, Mass. . cl Fee.3�4).- . . Lic. No..�.�`.'.�.: . . . . . . . . ... .. . . . GIBS INSPECTOR Check# 7 4 ? 5B ] 6 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) IID U 11 AM D nlf e . Mass. Date Permit Building Location- 17 U A) I n�A S 1FL Owner's Name � PAS LID� fk")121"1 I ��S UE9 MA Type of Occupancy n New ❑ Renovation ❑ Replacements Plans Submitted: Yes❑ No ❑ N ' fA OC Y W N N N V Z CC U) a y �; C O N = H J N W V m z o w '' Q �- z z o r o: Q m N F- Q ¢ � 0 0 O FW- H N 0 V W x z r y p > W W W N J = Q Z Itcc lu W H W F' x Ix 3- O > xWzQ W H m z0 z o Q W > CC W = QJ Otl U. a 3 G O SUB-8SMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR _ 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name BAY STATE GAS COMPANY Check one: Certificate # Address 55 MARSTON STREET )C7 Corporation 1862 LAWRENCE, MA 01840 ❑ Partnership Business Telephone Q 7 b—6 8.7—' l 10 5 ❑ Firm/Cs Name of Licensed Plumber or Gas Fitter Francis X. Corkery o. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes K No ❑ If you have checked res, please Indicate the type coverage by checking the appropriate box. A liability insurance policy 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: Signature of Owner or Owner's Agent Owner❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in abo pplication are true and accurpte to the best of my knowledge and that all plumbing work and installations performed under the permit iss f r this application will Kin compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene s. T e of License: . Title Plumber Signature of Licensed Plumber or Gas Gasfitter City/Town Master License Number_374'S APPROVED O FIC SF ONLY Journeyman BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. - APPLICATION FOR PERMIT TO,DO GASFITTING NAME ilC TYPE OF BUILDING LOCATION OF BUILDING_ PLUMBER OR GASFITTER LIG NO. PERMIT GRANTED DATE _.19 GAS INSPECTOR �v Town of North Andover f 110RTIy OFFICE OF O e° ,,ED 3� a00 COMMUNITY DEVELOPMENT AND SERVICES ° 27 Charles Street _ _ North Andover Massachusetts 0184 ,�y��— LIAM J. SCOTT ,�� O�NOR+' ANDOVi_< ! No Z7 /$t1tD0�Er 9sSgcN�eEtc Director BOARD OF HEALTH 60.4RD OF�''EALTM (978)688-9531 ! Fax(978)688-954: M)Vfin _1. 710 ( : COMPLAINT FORM DATE: N.UC-n 0 70 2001 �,� li5cence� e�ec(�-uah /eZ✓��rn� ���._ �o,,��/eX� rhv�f�,le days�I vi�+o.,f 11S41-S ;�r'COMPLAINT ,,,,d -0 sone 4e' „c- •a„^y oUf/e u,,�h9ce,ceJ e%c+;,, �7•,� ��e1 7 fepeKfe/ Ie�✓es-}� fn s{vp ;,.eek ADDRESS: 1-7 U n i o Alo. Rndcvv- r PHONE: �) C 9q 9 y 2 COMPLAINT AGAINST: 11 '.4 L,,,jU l sf ADDRESS: i2eu�`'�5 AA ''/,?67 PHONE: (76- qq - yyg7 OMPLAINTgn A l �„ Lo�rw�x c.{. v cJ kTGWN OF NORTH ANDOVER/ ! BOARD OF HEALTH N 4� BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 N° Date....A /. �............ '� f iaORTN 1 TOWN OF NORTH ANDOVER ' PERMIT FOR WIRING ��sS�cHusE� This certifies that s l V f'. a ,i2 ,has permission to perform � ...................................................... ... ................... wiring in the building of....................................................... .... .........` at.....`.... .. ..t^...0?. 1......... .................................... .North Andover,/Mass. Fee. . �.. .. Lic.No.1..: ✓TvG.... , . /.r.., .. / ELELTRICAL INSPECTOR Check # WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. BOARD OF FIRE PREVENTION Occupancy and Fee Checked REGULATIONS [Rev. 11/991 (leave 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 IN INK OR TYPE ALL INFOR&MTION) Date: 11 //0/I>/ City or Town of: A- A-yupoyC2- To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) r::7 V't?t 0,Y1 S Owner or T- t 421i--r Li IP)7 Q V 15 Telephone No. —M— oI Y L/_ Y1 57 Owner's Address ( I url t U•✓I ST Is this permit in conjunction with a building permit? Yes ❑ No t2r— (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: 12�PA-l w Sd Vt�.v�t_ L:1-1t73 -F— I� Com letion of thefollowing table maybe waived by the Inspector o Wires. J 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 ' Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting rnd. gmd. Battery Units No.of Receptacle Outlets 3 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices Palo.of Ranges No.of Air Cond. Tom No.of Alerting Devices Tons Ilio.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Tot I Detecdon/Alertin Devices r als: 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 V No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent Heaters No.Hydromessn„a Bmthtubs 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. 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:) ON FILE 01/2002 (Expiration Date) Estimated Value of Electrical Work: 4 a— Kj} (When required by municipal policy.) Work to Start: jt Ito/o/ Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under thepains anaIpenauies o perjurry,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Kelly M.Casey Signature VALM VALIC.NO.: 37200 (I.fapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: 978-697-4453 Address: 38 a Bay Ridge Drive, Nashua,NH 03062 Alt.Tel.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 agent. Owner/Agent PERMIT FEE:S Signature Telephone No. 1/2/2002 5:51 PM FROM: TO: 1-978-688-9542 PAGE: 001 OF 001 38E Bay Ridge Drive ' Nashua, NH 03062 To: Town of North Andover Fax number: 1-978-688-9542 From: Kelly M. Casey Electrical Services Fax number: Business phone: 978-697-4453 Home phone: Date&Time: 1/2/2002 5:51:03 PM Pages: 1 Re: Electrical Inspection Request Dear Mr. Decola, The electrial work for permit no. 3449 is complete and ready for your inspection. The owner of the apartment house @ 17 Union St., Pat Linquist,can be reached at the following numbers: Home 781-944-4997 Cell 978-273-6409 Sincerly, Kelly M. Casey Electrical Services 978-697-4453 t "v N2 � � _ 3 � � Date........... ......... .1..... Of NORTF�,4, 3? <;�``...,•.. TOWN OF NORTH ANDOVER PERMIT FOR WIRING CHusf This certifies that ... :.::..... `t ........................................................ s has permission to perform wiring in the building of...............`.... .. y. .......... .�. ........ '............... . . /,9 --'i at...................................::::.:..: ................................ .North Andover,Mass. Fee-.L............... Lic.No.............. ........................ :.......................... ELECTRICAL INSPECTOR Check # l� WHITE:Applicant CANARY: Building Dept. PINK:Treasurer \ 77EQ0MM0NWEAL1HUFM4Si. CHUAV7►S' Uttice Use only DEPARTAIWOFP MCSAFETY permit No. �!5 BOARD OFMEPREYEWONRWUTATIOAN5270MR12.00 Occupancy&Fees Checked S5�� APPUCATIONFOR PERAW TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRII4T IN INK OR-TYPE ALL.INFORMATION) DatU/ Town of North Andover To the Inspecto of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) Owner or TenantTiiT/G Owner's Addressr�_� �^l+� Is this permit in conjunction with a building permit: Yes No ® (Check Appropriate Box) r Purpose of Building �GJ�G� iNCr Utility Authorization No. Existing Service G U Amps /S% Z Volts Overhead Underground No.of Meters New Service Amps/ Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground No.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 FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps 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 KW Local Municipal Other � Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER 46 fi]9" eCaaage R>SU3tiD hem m entsollmdzseltGffwALaws Iha%eaametLiartlilY3tlard=PCIiLyniJ&gCM4Ade C vaagecritssl3slartialeWi%a YES NO ED Iha%est bm&dm&lpcdcf§mneloftOffm YES M NO r Ifywha%edtiac WYES,plemein hcalethetypecfwmaWbydrd�gthe bcx INK RANCE qn BOND O fflER r-1 ftmSpo*) Fs' dVahtedEledricalWodc$ Wa11 kiDStxt hi)eMmD*Raquestad Rao Final FIRMNAME o S' ic/v•c/ Q Lioa>SeNa -Qf7��� Lioasee S�/'/ Si7,- I�oer>seNo , BusinessTdM TwO 0� N/ � � A1tTel.No. OWNER'S MLRANCE WAIVER;IalnawateihattheL mmdm uatt>me$tei m aneoaeFords WA3ddeglrivalatasm*in dbyMmdaset CaxialLaws and that my sigs�aeonthis pem�app�at this taquQartat. (Please check one) Owner a Agent d/ Telephone No. PERMIT FEE$ _C�.S P7.UTION STREET 014.0-0028 Complaint Detail Report Printed On:Wed May 23,2072 Complaint#: CT-2012-000065 Status: Closed GIS#: 415 Violator: LINDQUIST,PATRICIA A s ; Address: 17 UNION STREET _ Map: 014.0 Address: 17 UNION STREET • Date Recvd.: May-17-2012 Time Recvd.. 03:26 PM Block: 0028 NORTH ANDOVER,MA 018 Category: Housing Lot: Type: Residential GeoTMS Module: 113oard of Health District: Trade: Recorded By: Michele Grant Zoning: Structure: Description: Complaint' On Thursday,5/17/2012,Michele Grant took a call around 12:30 from a Lenny Severino-978-204-6363 regarding a complaint he has of seven(7)people living in a 2-bed1oo1L1 apartment. The address is 19 Union Street,and caller states it is owner occupied. Mr.Severino stated that there are too many people living in this 2- bedroom apartment. Please follow-up as necessary. Comments: I Inspector Assigned to Complaint: Contacts Contact Type Date Time Name Phone Best Time To Reach Recorded By Response Caller May-17-2012 3:26 PM Lenny Severino (978)204-6363 Q Michele Grant Actions Taken GeoTMS Module Status Date Time Response Type Action Taken Comments Board of Health REFERRAL May-23-2012 1:47 PM Follow-Up by Health Friday-May 18,2012. This is what I sent Lenny on May Director Susan Sawyer contacted 23,2012 after speaking with the caller-Lenny Severino— NA schools. Discussed issues.Renter is Hello Lenny, unhappy with the current I spoke with the schools about the situation.The number of procedure regarding pupil tenants is more than when he residency complaints. moved in and is annoyed. All complaints go to the Principal They have complained to the of the school that the child owner.It was noted that the attends.Must submit all details; owner could investigate and complainants information,child's take action against the parry name,child's address and reasons for breaking their lease if of concern. more people live there than Good luck, they rented to. The Health Susan Dept.does not regularly check the occupancy No additional action needed at numbers of rental units.Also this time. has concerns about legality SS of the children attending N. GeoTMS®2012 Des Lauriers Municipal Solutions, Inc. Page 1 of 17 MON STREET 014.0-0028 Complaint Detail Report Printed On:Wed May 23,2012 Andover schools;sees them Susan Sawyer dropped off in the mornings. Public Health Director I took his email and said I Town of North Andover would pass on any information onto him on who checks this out. Lendawg56@yahoo.com I GeoTMS®2012 Des Lauriers Municipal Solutions, Inc. Page 2 of 2 17 UNION STREET 014.0-0028 Complaint Detail Report Printed On:Thu May 17,2012 Complaint#: CT-2012-000065 Status: jIn discovery GIS#: 415 Violator: LINDQUIST,PATRICIA A Address: 17 UNION STREET Map: 014.0 Address: 17 UNION STREET • Date Recvd.: May-17-2012 ITime Recvd.: 03.26 PM Block: 0028 NORTH ANDOVER,MA 018 • Category: Housing Lot: Type: Residential GeoTMS Module: Board of Health District: Trade: Recorded By: Michele Grant Zoning: Structure: + Description: Complaint: On Thursday,5/17/2012,Michele Grant took a call around 12:30 from a Lenny Severino-978-204-6363 regarding a complaint he has of seven(7)people living in a ' 2-bedroom apartment. The address is 19 Union Street,and caller states it is owner occupied. Mr.Severino stated that there are too many people living in this 2- bedroom apartment. I Please follow-up as necessary. Comments: Inspector Assigned to Complaint: r Contacts Contact Type Date Time Name Phone Best Time To Reach Recorded By Response Caller May-17-2012 3:26 PM Lenny Severino (978)204-6363 Q Michele Grant Actions Taken GeoTMS Module Status Date Time Response Type Action Taken Comments Board of Health REFERRAL GeoTMS®2012 Des Lauriers Municipal Solutions, Inc. Page 1 of 1