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Miscellaneous - 102 HILLSIDE ROAD 4/30/2018
North Andover Board of Assessors Public Access 1 jA aoRpp OF Sao � Click Seal To Return Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial Page 1 of 1 Nort.hAndovle.r Board of Assessors, Mroperty Record Card Parcel ID :21.0/098.C-0017-0000.0 FY:2012 Community: North Andover SKETCH Click on Sketch to Enlarge PHOTO Location: 102 HILLSIDE ROAD Owner Name: THERIAULT, JOHN D MARY ANN THERIAULT Owner Address: 102 HILLSIDE ROAD City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 6 - 6 Land Area: 0.82 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 1870 soft ASSESSMENTS Total Value: Building Value: Land Value: Market Land Value: Chapter Land Value: CURRENT YEAR 411,200 207,000 204,200 PREVIOUS YEAR 411,200 207,000 http://csc-ma.us/PROPAPP/display.do?linkld=1893988&town=NandoverPubAcc 5/29/2012 Date-3� (-Z ...1.. TOWN OF NORTH ANDOVER f PERMIT FOR WIRING This certifies that .......... ....�-� ..fL�1 has permission to perform .... ►"�{{?!�/i%,�JfT1(<--�1J,(f� wiring in the building of at !Q 2l/LL S/6 . E /CCS North Andover, Mass. �� Fee ......... Lic. No.. t'b �G;��?%�: e ELECTRICAL INSPECTOR ec�> s � 11061 -- � • .- x a.,=„����, AACC IC21L p uue Amennments 527 UAM 12.00 Rule 8: lh accordance -with the provisions of M.G.L. c.143, §. 3L, the p Permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed' on the re -scribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c, 166, § 32, an electrical permit shall he issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. Permits shalLbe limited as to the time of ongoing construction. activity, and maybe.deemed by the,Insp.ector.of_W-ires abandoned.aad.invalid,ifhe—. or she has determined that the authorized worlG has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on the, permit application. ❑ The Permit ]Extension Act was created b�ylSection 173 of Chapter 240 of the Acts of2010 and exteadW�y Sections.74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job:growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four year extension to certain -permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period A / beginning on August 15, 2pf3.and extending1brough August 15, 2012. 911sle 8—Permit/Date Closed: Note:)Reapply for new perA' ❑ Permit Extension Act — Pe rmii/Date Closed: �aA� ��csaQlfs 170* ��o�� s Permit No. d BOARD OF FIRE PRWEPMON REGULATK)NS J& an' -7 and . wwn acammank) - I APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Au,�mt�p isepit� mstca�{�, sn � IZ00 (PLEASEPAW.WMW OR TYPE dUWORBfATIOM _ Date.,:, City or Town o% AI4yL�- To the in�ectriT of Wthes: ' ` f By this application, the underskmd gives notice of his or ter intention perform the ehxttrieai work described beimv. Location (S'tteet &Namheo; /D S Owner or Tenant X,q I Telephoee Na. Owner's Address Is this permit in eonJuncti u wltlz a building pandr. Yes No ❑ (Check Parpose of Building ��riate %x) Utility Authorization No. Existing Service Amps 1 VORS - New Service Amps I Volts Number of Feeders and Ampacity Overhead ❑ Undgrd ❑ No. of Meters Overhead ❑ Undgrd ❑ NO: of Meters Location and Nature of Proposed Electrics[ Work: /�I� �/ CrCDScsi' �f 17 20AJ No. of Recessed Luminaires j -- -----......�F No. Of Oe L-Snsp. (Paddle) Fans �a..arrcu -- ro m -M u of ata liansiormers KVA Mors _ KVA No. of Luminaire Qudets No. of not Tubs No. of Luucfuawes swbmft pool [] ❑FIE o Dmfs No. of Rede Oudds /Q No. of 09 Burners I= ALA MS No. of Zones No. ofNwihim NIL OfGas Burner; No. ofnetection Rod�. Derives No. of Ranges No, of Air Coma. T rig Dewi es No. of Waste D Tt+ SpacdArea Hesf%g Kul+ RKILof Devices No. of Dishwashers ❑ CormectlOa � Ott No. of Dryers - / No. a Heaters Kw Heating Appliances KW. a. of o. Ballasts Naof evf or aen ivIt . Data No, o Devices or Equivalent No. Hydromassage Bathtub No of Motors TOtal HP mmuaica ns .{ N0. Of Deviem or t OTHER: C5 (/4 14 FZ Esru�ted Vahle of i Grrcai �IlotiC dUa�i �Atm7'ifdesb ad ar�s rertaired by Ae luspeefor of wu mss. wodt to Start; When required by i policy.)s'o be ioquested in aaoor imm with h(EC Rule l0, aml upon c wnpkdom INSURANCE COMA(;& iiAWwahod by the ow9w- DO Pmutfordw Pcdmmmm ofdectricd wwk may issue unless the hC==FDYXI= proof of liability ,. mytragO or its =Wtantiai equivalent. The i=ce that such coverage is in force, and has exldbited proffof=nX to flee permit iss ang office. CHECK ONF-- 94SURANCE dj BOND ❑ OTHER ❑ (S ) I certify, ander Ike pa6w=dpetaabd wofperftrr7, th&ifte ii0 mm%manthis Fn M NAME: Oki i P moi. C &T2i C.F. CotiT �}� i'i�-lte true mrd oump. IAC. NO.: Licensee: V c i3 i#s1 E. ta. tL Signature LIG NOS q/app!&nl� eater -ur tlaePaume enar� J Address: R7 fii'KT rs3' JVt iEI ,'}Ni7EY � tom . �} Mm TeL No.``i 7.q 7. -4&;Z b2. *Per M.G.L c 147, s. 57-61, security workof Pnbiie Alt Tel.No::�78- 7 -573 Lic. No. O�'VNER'S INSURANCE WAiYFdi: I am aware that the Lk=see does improve the Ud)g ty innn= ooveragc y rNwrcdbylgw• BY mY l � 1c�w, Iher&ywaive Ehis regemerne IroOwner/AgeStn the (done ❑ owna ❑ owner's t - Signature TelephowNO. PERMITFEE: S �. HomeWorks Residential Energy Analysis K Report DUCT BLASTER TEST on: 102 Hillside R) N. Andover, MA 01845 -- 7� e,'( au q— K Prepared For: Climate Design Systems Methodology: As per MA Code and 2009 IECC, the Total Leakage test was conducted on this newly installed ducted AC system. This test allows 12 cfm/100 sq ft or less for a passing score. This test is conducted with a door or window open to the outside. Registers are masked, duct blaster fan is attached to a central return, and pressure is tested at a supply register. Findings: Attic System: Total sq footage served by this system:2490 sq ft. Maximum allowable, 12 cfin/100 sq ft: 299 cfm@25pa Observed Total Leakage: Results: PASS, BY.- Scott Veggeberg BPI certified Energy Analyst # 5003842 Certified HERS rater, 3081658 125 cfm@25pa HomeWorks Energy -6 Chesterford Terrace — Winchester, MA 01890 — 781-820-3475 e 1 9 6 Date. .�.a /3........ NORTH TOWN OF NORTH ANDOVER pFt.eo ,^,ti0 PERMIT FOR MECHANICAL INSTALLATION 9 s This certifies that f v� ...... �`: :`: � : • . • rhas permission for mechanical installation ..� ..- ............. . in the buildings of . � ' %! ' e.' ......................... at ../OX ... /..... .... ........ • , North Andover, Mass. Fee./7(c.. LAC. No..7. .... � � .................... GASINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer rz? r Commonwealth of Massachusetts Sheet Metal Permit Date: Estimated Job Cost: $ V��3L',oy Plans Submitted: YES X NO Business License # 16 Business Information: ,4 Name: , !� Street: City/Town: Zj%/,�/, Telephone: Permit # —n Permit Fee: $ t� Plans Reviewed: YES NO Applicant License # 445 Property Owner / Job Location Information: r�Name: Street: ILIJ-;t ,76%/S�le Z,0 City/Town: IV. IZMcrZ &,71SI6'� , Telephone: Photo I.D. required / Copy of Photo I.D. attached: YES X NO Staff Initial J-1 / o=1 -u 'cted license J-2 / M -2 -restricted to dwellings 3 -stories or less and commercial up to 10,000 sq. ft. / 2 -stories or less Residential: 1-2 family X_ Multi -family Commercial: Office Retail Condo / Townhouses Other Industrial Educational Institutional Other Sq:uirst..Footage: under -10,000 sq. ft. giver 10.3. 0'8q. ft. Number o -,Ai,-;•ies: Sht,t me& wo f: to be completed: New Work: � Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney / Vents Air Balancing Provide detailed description of work to be done: ,ac,, �,Xgqys, ) 0 A0 I,e 15K- /}A_0 Z z 47Z (V// 7 91 a OuJ N INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes&I No ❑ If you have checked Yes, indicate the type of coverage by checking the appropriate box below: 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 112 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box❑, I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Date Progress Inspections Comments 1, tal< Inspection Comments Type of License: By Master Title ❑ Master -Restricted City/Town Permit # ❑Journeyperson Signature of Licensee ❑Journeyperson-Restricted 0-500,Fee $ License Number: Check at www.mass.gov/dpl Inspector Signature of Permit Approval 'P, The Commonwealth of Massachusetts Department of Indiltstrial Accidents Office of Invadgadons 600 Washington Street Boston, Mass 02111 Workers' Compensation Insurance Affidavit: uilders/Contractors/Electri Applicant Information claas/Plumbers nr--- '• K AW43C rrml Name Address:J' 24% �+—,� City/State/Zip: Phone#:r - 7 X89 Areou an employer? Check the �ropriste boa: lI am an employer with 4. ❑ Type of Prof (repaired): _7 employees (full and/or part time).* 2. ❑ I am a sole proprietor or artner_ P I am a general contractor and I have hired the sub -contractors listed on the 6. ❑ New construction 7.KRemodeling ship and have no employees attached sheet. These sub -Contractors have 1%60Le4&,,al/ working for me in any capaci ty comp. insurance employees and have workers' 8. f 33Demolition required]ers' 3.!] 1 am a homeowner doing all work comp. insurance. $ 5 ❑ We are a corporation and its 9.[2 Building addition 10.0 Electrical repairs myself [No workers' comp. insurance �] t officers have exercised their ri ght of exemption perm MGL or additions 11. 0 Plumbing repairs or additions c. 152, § 1(4), and we have no employees. [no workers' 12. G Roof repairs COMP. insurance required.] 13. ❑ Other "Any aPPticant that checks box #1 mugt also till oat the section below sh , tHomeowners who submit this affidavit indica ' ° workers compensation poticy information ;Contactors that check this box mast attach anadditional shed showingwork and ffim hireotdside contractors must submit a new affidavit hrdicathtg such. the sob contractors have9 p the name of the sab.contractors and state whether or not those entities have em I am an �' °1°� Fide their workers' re number. Ployccs If employer that is Providing workers' compensation insurance for my employees Below is the information, policy and job site Insurance Company Name:. JA � .��_ . �_ , _ / _ I Policy # or Self -ins. Lic. Expiration Date: III /3 Job Site Address: /�� I,/ i�. .... City/State/Zip 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 152 can lead to the imposition of criminal up to $1,500.00 and/or one year imprisonment as well as civil Penalties of fine $250.00 a day against violator. Be advised that a co of this penalties 1n the form of a STOP WOR{ ORDER and a fine of DIA for coverage verification. copy statement maybe forwarded to the Office of Investigations of the I do herby ce nd he �� P�"�" that the info provided above is true and correct Si ature: , Date5 Print Na►ne: Official use only Do not write in this area to be • completed b City or Town Y �Y or town official • PermitAicense #• Issuing Authority (circle one): 1.Board of Heath 2. Building Department Partment 3. City/Towu Clerk 4. Electrical Inspector 5. Plumbing Inspector Contact person: Phone #• IAhMow ";-v M D oic -.vliueujy, Doors'Type: Wood [3T!,,,,Ll'aled El storms P. C Type: 0-t French Dow I 0 4 einisu6Ig T O1 m . �•' Ln Oi. LnLU rte, s O sof ' Ln w S 0. [0LU ro IX CL' N w O O M a J Q s �P. w !q > L LU Q LL' m o 'L) 4c. LA LL G QWZ. .O Lw W Z 0: 'Q lu .. W to UJ .4 E ... ' L L v cr. W N Q tL '-4 o OE 7- � 0 ^ Date. /.7 % 9553 T :��c TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,ssACMUSE� This certifies that v:� . "' !?�^ PIL$`.4 has permission to perform!? ...... plumbing in the buildin�s ofE'.2.�. l u..................... at ...�. 't,ttl _ ............".O.rt o ass. Fee .�7`0�,� . Lic. No.'���`?� !C%. PLUMBING Check .0 �I MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY MA DATE 2 _SLI PERMIT # JOBSITE ADDRESS OWNER'S NAME POWNER ADDRESS0 Z i Dom_ --Ij TEL Y J - P' 7Y .-_ FAX —J TYPE OR OCCUPANCY TYPE COMMERCIAL Q EDUCATIONAL Q RESIDENTIAL PRINT CLEARLY NEW: 0! RENOVATION: REPLACEMENT: D PLANS SUBMITTED: YES Q NOD FIXTURES Z FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM =11-1-1- f-_-_-.___): _.___J .._.._..-. I _[ _,.___-. ------- __.._.. DEDICATED GREASE SYSTEM _ ___...I i .__._..._.__i J J _.-1 DEDICATED GRAY WATER SYSTEM [ _..._ _I III I ...__._...._ I --_ .J J DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN ._-1 _J FOOD FOOD DISPOSER FLOOR /AREA DRAIN INTERCEPTOR INTERIOR) KITCHEN SINK --#---.-__-.[1 _---__ _.. _.._.._..1 _._..__! ._____l _-----_-_J ..___._.I _ .___I __......__!-__.-._E _[ .1-I LAVATORY ROOF DRAIN SHOWER STALL ___1 .___J SERVICE/MOP SINK —IL -i ____-I TOILET URINAL [ ! ._..__I J _1 1 -J WASHING MACHINE CONNECTION WATER HEATER ALL TYPES _ 1, ,_._ [ - __._ _ I __-1 _T# ..-- ( ..._._ _ € I __- { -_ _1 WATER PIPING OTHER ._._-....--i _ 1 _._..1 _I INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YESA NO OF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY © BOND E OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER 0 AGENT SIGNATURE OF OWNER OR AGENT F hereby certify that all of the details and information I have submitted or entered regarding this application are true and a rate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in complianc it II Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. ' PLUMBER'S NAME LICENSE # _!��„ I SIGNATURE MP 69 JP Q CORPORATION Q#PARTNERSHIP D# _ LLC COMPANY NAME P� e%ry�,,,,� t .9Ti:�y ADDRESS /Z 5- - CITY—STATE ZIP TEL 97� FAX 04 /o8 CELL EMAIL !Dc w 1 E !V 0 v U W a w z❑ }El o w cn a Z u LLJ _ ~ Q w co a LLJ W � w cn p o a a W a U J IL a Q cn w x w I-- LL rA w z 0 H u w � a z z � a a o a The Commonwealth of Massachusetts Department of IndustrialAccidihts Office of Investigations UV 600 Washington Street Boston, MA. 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leafty Name (Business/Organization/Individual): .��C /(ii✓!/_�� pv /, e �¢ V:�/, Address: / 2 Co0Ila 3- City/State/Zip:ZtZE/-,?/ar.Ail,17.f o/P7VY Phone #: Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ® I am a sole proprietor or partner- listed on the attached sheet. ship and'have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ® Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12. ❑ Roof repairs 13.❑ Other *Any applicant that checks box 41 must also fill out the section below showing their workers' compensation policy information. I Homeowners who submit this affidavit indicating they ire doing all work and then hire 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. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company N Policy # or Self -ins. Lie. Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder 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 t violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for ,tance coverage verification. I do hereby certio un�oi ypains and penalties of perjury that the information provided aboe is tyue and correct. Phone #: 9,V- 3 f G Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # I/z 7112- Official 11i 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 permit to 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 Office 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 bum 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: The Commonwealth of Massachusetts Department ofladustrial Accidents Office of Investigations 600 Washington Sixeet Boston, MA 02111 Tel, # 617-72.7-4900 ext 406 or 1-877rMASSAk'B Revised 5-26-05 Fax # 617-727-7749 w�w.znas$,govfdxa