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Home My WebLink AboutMiscellaneous - 12 AUTRAN AVENUE 4/30/2018 / 12AUTRAIII 210/ UE=_00250000.0 n / `l i i , i I .d IN UPC w No. r YAITIYQ$. MW Liber Mutual. Liberty Mutual Insurance New England Region Central Property Unit N$ R A E 75 Svlvan Street Danvers,MA 01923 Tel:(800)566-0323 July 1,2015 Town of North Andover Attn: Building Inspector 120 Main Street North Andover,MA 01845 Re: Property Address: 12 Autran Ave,North Andover, Ma 01845 Policy Number: H3221221001121 Underwriting Company: Liberty Mutual Fire Insurance Company Claim Number: 032095475-0002 Date of Loss:5/31/2015 Attn: Town/City Official Pursuant to M.G.L. c. 139, S 313, please be aware that a homeowners insurance claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or causes the condition of a building or other structure to render Mass. General Laws, Ch. 143, § 6 applicable. You are required to notify Liberty Mutual by certified mail in accordance with Mass. General Laws Ch. 175, §99, if you intend to initiate proceedings designed to perfect a lien pursuant to Mass. General Laws, Ch. 139, § 3A & B, or Mass. General Laws, Ch. 143, � 9, or Mass. General Laws,Ch. 111, � 127B. This letter should not be construed as a waiver or estoppel of any of the terms,conditions or defenses afforded by the policy or applicable law. Please direct your notice to the attention of the undersigned and include a reference to the above captioned property address,policy number,claim number,and date of loss. Sincerely, Liberty Mutual Support Liberty Mutual Insurance New England Region Central Property unit 1-800-566-0323 Date./0/l�flJ.? Nc°TM,1' TOWN OF NORTH ANDOVER 40 PdRMIT FOR PLUMBING 14 �SS�cMUS� / This certifies that . . . ?'`�'. t�?... ... . . . . . . . . . . . . . . . . . has permission to perform . . . . D.V`''.r. . ... . . . . . . . . . . . . . . . . . . . . . plambing in the buildings of . . . n. y.. .l!'. . . . . . . . . . . . . . . . . . . . . L w- ..._ at . . . .� .? . . .p�'�.�-. . . .j. . .�. . . . X . . .Q. . . �.`,_N.`rth Andover, Mass. Fee.�3..r. .Lic. No.92. . 2 . . . . . . .i1�.. . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check # 7527 MASSACHUSETTS UNIFORM APPLICATION FOR.PERMIT TO DO PLUMBING4 433{Print o Type 1 1 i , Mas .1 Date 20 P [t# - �� a Building Location .Owner's ame i • Type of Occupancy New 0 Renovation 0 i Replacement 0111 Plans Submitted: Yes 0 No 0 _ by FIXTURES B.P.•# ;:SEWER # SEPTIC #" z U) uj z to ¢ lY U(fiO 9 z p C7 to uV) LU �I � JO W to � _ Ln I--' U LLL.I - in to W Z .�-c Z U Z C ml :afto W Z a U X � W O Z= W ¢ vi � ¢ W z a O u_ LU H " i-- a z = Y j O zU . Y wn m(' to 0 0 2 ¢ � t'Ji( ¢7 ¢ ,Y m p �p SUB-BSMT BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR I STH FLOOR nstalling Company Name ;{' OAC— Check Ong: Certificate kd d ress 0 Corporation ZIEI Lese r i 3usiness Telephone In 16 9� y�] 0 Partnership flame of Licensed Plumber or Gas Fitter_ INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch. 142. Yes No .0 If you have checkedes, please indicate the type`eof coverage by checking the appropriate box. T A liability insurance policy Other type of`indemnity 0 Bond 0 OWNER'S INSURNACE WAIVER: I am aware that the Iicensee does not have the insurance coverage required by Chapter 142 of the Mass.Genesi Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent Check one: Owner 0 Agent 0 hereby certify that all of the details and information I have submittedentered)in above application are true and accurate to the best of y knowledge and that all plumbing work and installations performe nd r the permit iss for this application will be in compliance with 1 pertinent provisions of the Massachusetts State Plumbing Code a t 142 of the eras Laws. By ' Si na ure of Licen ed lumber Title i City/Town ` � APPROVED(OFFICE USEONLY) Type of License: fp�IV►aster OJourneyman License Number i y . Z,f, . r, TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Of NORT1t 0- . 'A /v Permit NO: Date Received—z//-- Date Issued . U �'�SSACHUS IMPORTANT: Applicant must complete all items on this page LOCATION IX (-�u,-{r( '� J934 Print PROPERTY OWNER t r- Print INJ MAP NO.: G PARCEL: ra�� ZONING DISTRICT: TYPE AND USE OF-BUILDING ----------._.HISTORIC-DISTRICT _ _YES I] TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building 0 One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: 0 Repair, replacement ❑Assessory Bldg 0 Commercial ❑ Demolition 0 Moving(relocation) ther ❑ Others: ❑ Foundation only DESCRIPTION Of WORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name. l Phone: _ -28- cam ' A Address:-) (9, 243 oy- /1Ler , Lna CONTRACTOR Name: Ny Phone: Address: Supervisor's Construction License: :VT Exp. Date: Home Improvement License: { i+ Exp. Date: r ARCHITECT/ENGINEER �A Name: Phone: Address: 4Reg. No. FEE SCHEDULE:BULDING PERMIT.•$12.00 PER 51000.00 OF THE TOTAL ESTIMATED COST BASED ON 5125.00 PER S.F. Total Project Cost I, ��l�V FEES 3� Check No. d�C) Receipt No.: Page Iof4 Location/./ Pt fl �fv`' 4�- No. Date f' "0 MOR7N TOWN OF NORTH ANDOVER 3: ' °c Certificate of Occupancy $ Building/Frame Permit Fee $ swCHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 11,2" 19777 f..._ v Building Inspector TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ El Art F] � Public Sewer Well 11Tobacco Sales ❑ Food Packaging/Sales El Permanent Dumpster on Site ❑ � Private(septic tank,etc. El Permanent Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ U Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED -----SATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ El COMMENTS r FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit WOOD STOVE INSTALLA HON CHECKLIST 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 Used r• B. Type/radlant V.e Circulating C. Manufacturer — Lab.No. Named Model No. CoIlar size OlmensionslHeight Ts ' t1Ji-14/1 ba.SP Length - Width 2 �� Chimney A. New Existing B. Size(flue area) C. Other appliances attached to flue(Number and flue size) D. Prefab(Manufacturer—name and type) E. Masonry/Lined Flue liner Unlined •OYP•a manulacwnrl F. Height(refer to diagrams) cap OYEZ ICI I �•.�� ' I T !Z't hlll'1. 2' k Z .Ilrt. 3 MIK o t — Mac SLG°r;�lGt^ n HEARTH CHIMNEY HEIGHT i Hearth(non-combustible► A. Materials B. Sub-floor construction C. Minimum dimensions(refer to aiaoraml Clearances and Wail Protectlon('see stove in=;zllat:cn c!e rances chart) A. Type at wall protection provided B. Clearances(refer to diagrams) i I� I r FIREPLACE � ORriER WALLrCENTER. NORTH c TO'" Of : Andover No. 3 7 '-_ T C% �- - o dover, Mass.,/o• ` '4 2O LAK COCKICMEWICK V ORA TE D BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT........ ..t. lir. ....... ......... .. ........................... ....................................... Foundation has permission to e ....................... ......... buildings on..,�X...... .. .. ......... ....... trough Il41 IfAt� 40.x►.. • to be occupied as.. ... S Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application 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 L' f PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRU S Rough ' ..... Service . . ... ......... .... .......... BUIMTRINSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. "r" TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-64 9•,`'�^ °''E,�`' North,Andover, Massachusetts 01845 A U5 Gerald A. Brown Telephone(9778)688-9545 Inspector of Buildings Fax ��) Iq_ HOMEOVb'NER LICE'VSE EXEMPTION Picas J)rint DATE: S 161 JOB LOCATION: la -- A C_ Number Street:Address ' S HOI�tEOVVNER C�,(l ((I��1 ,�y�� Zp' othOYr�Q Name Home 9-7 oho Zi Cell- Work e Phone Phone PRESENT MAILING ADDRESS 1 a 4YM � NO(IA ( S City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be,a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other .Applicable codes, by-laws, rules and regulations. The undersigned"homeoivner"certifies that Im'she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. 11OJMEOW-'gERS 516 NA FURE_ 1PPR0V,AI.OF RCIf-DING OFFICIAL rwi! in qui;s --------- --._..— --- ---- �' rm Hnmu�vnccs E�an�-�i�,n C..'P,0C;f',',PF�-„i.. L Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides —Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA— For department use Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created IMC.Jan.2006 I I Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. t Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses { ❑ Copy of Contract ! ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit I ❑ Photo Copy of H.I.C. And C.S.L. Licenses 1 ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) 1 New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ 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 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 and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Pae 4 of 4 S i 1 Date...# TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING "SACHUS This certifies that .... .......... .............................................. has permission to perform .................... .......... wiring in the building of...... ............................................ .................... at .. ................. Nart Andover,Mass. Fee./...-!�L*........ Lic.No. ...... ...... ........................... ELECrRICAL IN R- Check ,, 5548 _ Commonwealth of Mass1he Official Use Only Permit No. 3 Department of Fire S Occupancy and Fee Checked BOARD OF FIRE PREVENTION RS [Rev. 11/99] leave blank APPLICATION FOR PERMITRM ELECTRICAL WORK All work to be performed in acco dance witElectrical Code(MEC),527 C R 12. .0 (PLEASE PRINT WINK O AL ADate: City or Town of: /I hrAAJ Iff JP To the Inspector of Wires: By this application the undersigne rve n tc of 1 is or er' tendon to perform the electrical work described below. Location(Street&Number) Owner or Tenant C� Telephone No. - f Owner's Address Is this permit in conjunction with a building permit? :-Yes,[:]., No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security system Completion of the followin table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ In- mg grnd� rnd�❑ o.o Batte Emergency igUnits _ No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No. of Switches No. of Gas Burners o.ot Detection and Initiating Devices No. of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW LocalConnection ❑ Municipal ElOther No.of Dryers Heating Appliances KW Security Systems: / No.of Devices or Equivalent No. o Water Kms, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail ifdesired,or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: — (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify, under the pafns an penalties ofperjury,that the information on this application is true and complete. FIRM NAME: ^n t LIC.NO.: 153�� Licensee: John S. Bassett Signature LIC.NO.: 1533C (Ifapplicable, enter"exempt"in the license number line.) Bus.Tel.No.: 603 594 5928 Address: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Lic; see does not have the liability insurance coverage normally A required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $