HomeMy WebLinkAboutMiscellaneous - 103 BRIDLE PATH 4/30/2018 (2)N
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Arnica
PO Box 9690
Providence, Rhode Island 02940-9690
Town of N. Andover
Attn: Building Inspector
North Andover MA 01845
File Number:
Date of Loss:
Owner/ Insured:
Street:
Town:
Type of Loss:
To Whom This May Concern:
60000953423
02/28/2011
Thomas Greaves
103 Bridle Path
N. Andover
Ice Dams
Toll Free: 1-888-70-AMICA
(1-888-702-6422)
Fax: 1-888-808-3057
July 13, 2011
Please be advised that we insure the above named individual(s). A claim has
been made for Damage to Real Property and as the insurer; we are presently in the
process of adjusting the loss.
We are mandated to comply with Massachusetts General Laws, Chapter 139 and
as such, if there are any present liens on the above property, please notify us within 10
days of receipt of this letter. If we do not hear from you, we will be under no obligation
to pay you any portion of this claim.
Very truly yours,
WER
Megan Eckstrom CPCU, AIC
Claims Department
888-702-6422 x21131
MECKSTROM@AMICA.COM
AMICA MUTUAL INSURANCE COMPANY AMICA LIFE INSURANCE COMPANY AMICA PROPERTY AND CASUALTY INSURANCE COMPANY
AMICA LLOYDS OF TEXAS AMICA GENERAL AGENCY, INC. WEB SITE: WWW.ANUCA.COM
cap
factory -built chimney 9,
roof support
VA IRS
support bracket
connector pipe
non-combustible -
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-T Figure 2109.4
STOVE INSTALLATION CLEARANCES
Combustible 1/2"Asbesto.sMillbo?rq Concrete: Masonry Spaced Out 1 "
Stove Components Material Spaced Out 1 ' 2. . 'Foundation Wall 4" Brick Veneer
Radiant Stove(1. 36„ — -
-Front
Circulating Stove(i. 24" — —
—Front
A. Radiant Stove 3) 36" 18" 6" 18'
—Sider BackiTop
A. Circulating Stove 12" 6" 6" 6"
—SiderBackiToo
a. Single Wall 18" 12" 6" 8"
Connector Pipe
B. Insulated 2 2 " 2' 2 ^
Connector Pipe
C. Chimney Height Three (3) feet above adjacent roof and
(Metal or Masonry) two (2) feet above any roof ridge within 10 feet..
Q. Gamper If a damper is not included in the stove construction.
it must be installed.in the connector pipe.
1. Eront. Fuel or ash access side.
2. Non•comoustible spacers required.
3. Clearances on each side of a radiant stove with a heat shield shall be measured as if a circulating type.
Note: Clearances shall be measured perpendicular to stove body.
Laboratory verified test clearances permitted.
4. Thimble required for passage through combustible construction.
12
WOOD STOVE INSTALLATION CHECKLIST I'L'I?.MIT NO:
Permit
A building permit is required for the installation of any solid fuel burning appliance. The building permit and
installation inspection are limited to the stove installation and not to the stove construction.
Stove ,
A. New sed
B. Typ radi culating
C. Manufacturer Lab. o. -�
Name/Model No. L 17-� Collar size
Dimensions/ Height Length Width
Chimney
A. NewExisting LL�« I(1 .�IG.t1Abi1
low B. Size (flue area)
,ate C. Other appliances attached to flue (Number and flue size)
D. Prefab (Manufacturers name and type)
E. Masonry/Lined 1 / Flue liner
Unlined itype b manufacturer)
F. Height (refer to diagrams) cap
CHIMNEY HEIGHT
Hearth (non-combustible)
A. Materiais
B. Sub -floor construction
C. Minimum dimensions (refer to diagram)
Clearances and Wall Protection (see stove installation jlearances chpr
A. Type of wall protection provided_%`�
B. Clearances (refer to diagrams)
CORNER
12 MIN
l2"
MIN.
18 it MIN.
FU EL/A_<4-1
�GGE5551�
HEARTH
WALL/CENTER
T
i'� 4102
17
Date... .
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that............... .. ?A—.-- : , , , , , , , . ,
has permission to perform .tom. ....r .....................
plumbing in the buildings of
at. .... ..-� . ,,.... ,North Andover, Mass.
Fee Lic. No... .... .......
PLUMBING INSPtCTdR
08/04/99 11:51 25.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type) olq�
V� MA Date 17'3 193 Receipt# Permit#
Building Location )b3 13 ��e Owner's Name 9R- S
Map: Lot:_Zone:_Type of Occupancy e S UCZ
G
New ❑ Renovation ❑ Replacement ❑ Plans Submitted: Yes ❑ No ❑
Installing Company Name 1 AS6tri :Rspcint= C-,rA'5 s.-rlg--
Address 1.11 W a & r 2-1 t-, ]D s n d F ir' •3 1'11 f3r 01 4 3
EstimateValueof Work:
Business Telephone I- Y00 --
Nameof Licensed Plumber or Gas Fitter
M1
Checkone: Certificate
Corporation
❑ Partnership
❑ Firm/Co.
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes af No ❑
If you have checked yes please indicate the type coverage by checking the appropriate box.
A liability insurance policy Ul' 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.
Checkone:
Owner ❑ Agent ❑
Signature of Owner or Owners Agent
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of
my knowledge and that all plumbing work and installations performed underthe permit issued for this application will be in compliance with
all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the IGe eral Laws.
By Type of License:
Plumber Si na re of Licensed Plumberor,�as Ftter�
Title Gasfitter (a` CL
Master License Number
City /Town U Journeyman
APPROVED (OFFICE USE ONLY)
�o�anom�uwnnm�m
�o��oa��oommnonn
�mo�om�mmn��onn
Installing Company Name 1 AS6tri :Rspcint= C-,rA'5 s.-rlg--
Address 1.11 W a & r 2-1 t-, ]D s n d F ir' •3 1'11 f3r 01 4 3
EstimateValueof Work:
Business Telephone I- Y00 --
Nameof Licensed Plumber or Gas Fitter
M1
Checkone: Certificate
Corporation
❑ Partnership
❑ Firm/Co.
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes af No ❑
If you have checked yes please indicate the type coverage by checking the appropriate box.
A liability insurance policy Ul' 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.
Checkone:
Owner ❑ Agent ❑
Signature of Owner or Owners Agent
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of
my knowledge and that all plumbing work and installations performed underthe permit issued for this application will be in compliance with
all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the IGe eral Laws.
By Type of License:
Plumber Si na re of Licensed Plumberor,�as Ftter�
Title Gasfitter (a` CL
Master License Number
City /Town U Journeyman
APPROVED (OFFICE USE ONLY)
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r
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OR
NTH w
of • TOWN OF NORTH ANDOVER
0 ; PERMIT FOR GAS INSTALLATION
s o a
y,SSACMu
This certifies that ....r..
has permission for gas installation .... i ............ CU
'^S
in the buildings of .. E. 11e �` ; , . �. .........................
at�� ..3 . l?,: ' .� .. ;/. �,! +. ....... , North Andover, Mass.
Fee:?.,. 7... Lic. No..7 `a.... I ...(:.. ;:r .r-� ...... .
V GAS INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type)
MAP
PARCEI.
ko An c,,UF v-- ,MA Date f I , 1919 Receipt# Permit# > AZ2
Building Location td 3 Ryy- Alp_ —f:k*�h owneesName_bAA)ygrr Gr'6a-QF_S
Map: Lot: Zone: TypeofOocupancy C��S i-cnc
New ❑ RenovationA Replacement ❑ Plans Submitted: Yes ❑ No ❑
Installing Company Name EAs6-rn pre oan>= - AS i irlL
Address 131- 1,t92.1Et' ��'� �arwt=�� Y»I'� of 4 a7-6
EstimateValueof Work:
Business Telephone 1- 4 00 — 3 :L a.
Nameof Licensed PlumberorGas Fitter
2
Checkone: Certificate
Of Corporation
❑ Partnership
❑ Firm/Co.
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes Wr No ❑
If you have checked yam, please indicate .the type coverage by checking the appropriate box.
A liability insurance policy if 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.
Checkone:
Owner ❑ Agent ❑
of Owner or Owners Agent
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of
my knowledge and that all plumbing work and installations performed underthe permit issued for this app tion will be in compliancewith
all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the An&l Law
By Type of License:
Plumber Signature of tensed PI r or Gas Fi r
Title Gasfitter '72 9
Master License Number
City /Town Journeyman
APPROVED (OFFICE USE ONLY)
III■III
I�III���I���II����III
Installing Company Name EAs6-rn pre oan>= - AS i irlL
Address 131- 1,t92.1Et' ��'� �arwt=�� Y»I'� of 4 a7-6
EstimateValueof Work:
Business Telephone 1- 4 00 — 3 :L a.
Nameof Licensed PlumberorGas Fitter
2
Checkone: Certificate
Of Corporation
❑ Partnership
❑ Firm/Co.
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes Wr No ❑
If you have checked yam, please indicate .the type coverage by checking the appropriate box.
A liability insurance policy if 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.
Checkone:
Owner ❑ Agent ❑
of Owner or Owners Agent
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of
my knowledge and that all plumbing work and installations performed underthe permit issued for this app tion will be in compliancewith
all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the An&l Law
By Type of License:
Plumber Signature of tensed PI r or Gas Fi r
Title Gasfitter '72 9
Master License Number
City /Town Journeyman
APPROVED (OFFICE USE ONLY)
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Location / C ,` - /h fL,
No. �"'1 �• D Date /
X,01504. .
,,. TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
ACMUSEt ,Foundation Permit Fee $
Other Permit Fee $ -�
Sewer Connection Fee $
Water Connection Fee $
TOTAL, $
" �• 1 /qj,
Building Inspector
Div. Public Works
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OFFICES OF:
APPEALS
BUILDING
CONSERVATION
HEALTH
PLANNING
OF ryORt ,
3? "°°
o Town of
m
a
NORTH ANDOVER
4C.0 st I )IVISION OF
PLANNING & COMMUNI'T'Y UEVELOPMENI'
KAIZEN I I.P. NF-LSON, I)IIU1J:TOIL
120 M�)in Street
North Andover,
MW;SFIchusetls 01845
(6 1 7) G85 4775
In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit
Number Q� Q ' is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S
150A.
The debris will be disposed of in:
oc
syr e -J
Location of Facility)
haver At//) //IA
'
Signature of Permit Applicant
2�-/ /-- C
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector.
Location fix,
>. Date _
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee
Peer Permit Fee
Seonnection Fee
WaterUwction Fee
Building Inspector .r
Div. Public Works
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OFFICES OF:
APPEALS
BUILDING
CONSE-11VATION
HEALTH
PLANNING
O . NOHi
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3� ` Town of
NORTH ANDOVER
;�SS�cNun°�4e DIVISION 0F
PLANNING & COMMUNITY DEVELOPMENT
KAREN H.P. NELSON, DIREC COR
120 titain Street
North Andover,
Mi1SSiWIIUSCIIS O 1845
(61 7) 685-4775
In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit
Number X%/ is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S
150A.
The debris will be disposed of in:
(Location of acility)
V
K1,
Signature Of Permit Applicant
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector.
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BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200
Office Use Only fir/ 7 1
Permit No.
Occupancy b Fee Checked
3190 (leave blank)
=17 -
Area
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR1 Op
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date l9
H"
City or Town of 6 AltuyC-77To the Inspector of Wires:
The undersigned applies for a permit toperforrr
Location (Street & Number) 10-� 61?1,01
Owner or Tenant � 1' �'VGn>C/1�*j2
,;,I M! CSS
Owner's Address - a ^ l� Q
is this permit in conjunction with a building permit:
Purpose of Building
Existing Service Amps — I Volts
New Service Amps _I Volts
Number of Feeders and Ampacity
electrical work described below.
Yes ❑ - No ❑ (Check App(opriate Box)
Utility Authorization No.
Overhead ❑ Undgmd ❑
Overhead ❑ Undgmd ❑
No. of Meters
No. of Meters
Location and Nature of Proposed Electrical Work Installation of alarm system
No. of lighting Outlets
No. of Hot Tubs
Total
No. of Transformers KVA
No. of Lighting Fixtures
Above In -
Swimming Pool gm& ❑ gff_ ❑
Generators KVA
No. of Emergerxy Lighting
No. of Receptacle Outlets
No. of Oil Burners
Battery Units
No. of Switch Outlets
No. of Gas Sumem
FIRE ALARMS No. of Zones
No. of Detection and
Total
No. of Ranges
No. of Air Cond. tons
Initiating Devices
Heat Total Total
No. of Disposals
No. of pumps Tons KW
No. of Sounding Devices
No. of Self Contained
No. of Dishwashers
Space/Area Heating KW
Detection/Sounding Devices
MunicipalOther
L nection El
No. of Dryers Heating Devices KW
No. of No. of
Low Voltage
No. of Water Heaters KW
Signs Ballasts
Wiring
No. Hvdro Massage Tubs
No. of Motors Total HP
OTHER:
INSURANCE COWRAGE: Ptxsuant to the requirements of Massachusetts General laws t have a curtest liability Insurance Poticy includ-
ing Completed Operations Coverage or Its substantial equivalent. YES O NO O t have submitted valid proof of same to the Office.
YES O NO O if you have checked YES. please indicate the type d coverage by checking the appropriate bort.
INSURANCE= BOND O OTHER O (lease Specify) (Expiration Date)
Estimated Value o lectr 1 Work S t\O �BQ0
Work to Start Q Inspection Date Requested: Rough Final
Signed under the Penalties of Perjury: 12 31 C
LIC. NO.
FIRA1 NAME
Licensee Signature r LIC. NO.
Bus. Tet. No. 617 – 4 31– 5
A 60 William St./Wel I*P-qlev a MA 021 Al AIL T61. No.61
OwNER*3 MU RANGE VWUVEft I am aware that the licensee does not have the irounance ow4w& s or its substantial equivalent as re-
AQWA
gt*ed by Massadxftft Gerwilil taws. and that ny signatme an tib perrrtlt application waives uda regtnirernent. Owner
�•`�!.�i.aTifwi�4.�� r`r'!+SY"V ir✓�?".rrJ. )'u.Y.r,� TelGphorls_ No. PEf1MrT FEES
TO Date ......
391
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ...... A ..... R. -J ....... ..... Ll c
has permission to perform ........... !..C.k ....... ........
wiring in the building of ...... ......................................................
at ... ...... eiA..A(.t ..... f3.4j. k ...... rk ............ . North Andover, Mass.
Fee.... Lo.o ..... Lic. No. .. ...............................................................
ELECTRICAL INSPECTOR
WHITE: ApplicOVIY% f M&RY: Buildinj&Cftt. PAID PINK: Treasurer