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Home My WebLink AboutMiscellaneous - 1213 SALEM STREET 4/30/2018 1213 SALEM STREET i 210/106.A-0119-0000.0 I / i o� �� s,��1 ��. �� w Willis Larson (Homeowner) To:Gerald A. Brown (North Andover Building Dept.) (19786889542) 03:28 12/0115 GMT-05 Pg 2-2 F taoRT" TOWN OF NORTH ANDOVER ° ,,` '.. 0 OFFICE OF -2- BUILDING DEP.A,RTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover, Massachusetts 01845 SSACHU5E Gerald A. Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: November 23, 2015 JOB LOCATION: 1213 Salem Street Lot 4, Plan # 8181 Number Street Address Map/Lot HOMEOWNERLarSon, Willis 978 685-7844 Retired Name Home Phone Work Phone PRESENT MAILING ADDRESS 1213 Salem Street Borth Andover MA 01845 _____ 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"homeowner"certifies that he/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. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption BOARD OF APPLALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9510 PLANNING 688-9535 MetLife Auto&Home® Homeowner Operations Field Claim Office Attention:Claims P.O. Box 6040 Scranton,PA 18505 (800)854-6011 'rLL0lor May 4, 2015 North Andover Building Inspection 1600 Osgood St, Suite 2035 North Andover, MA 01845 Our Customer: Gertrude G. and Willis A. Larson Claim Number: JDF13686 04 Date of Loss: January 26, 2015 Dear North Andover Building Inspection: Pursuant to M.G.L. 139 § 313, please be advised that a property loss at the address referenced below has been estimated to have damage to the dwelling or other structures that will exceed one thousand dollars. Please let us know within ten(10) days if there is a pending or existing lien against the property as provided by M.G.L. 139 § 313, or if there is an intent to initiate proceedings to perfect such a lien. Loss Location: 1213 Salem St, North Andover, MA Sincerely, Home Ops CAT Team Michael Scott Metropolitan Property and Casualty Insurance Company Senior Claim Adjuster (800) 854-6011 Ext. 7440 Fax: (855) 411-6689 Email: MetlifeCATteam@metlife.com MetLife Auto&Home is a brand of Metropolitan Property and Casualty Insurance Company and its affiliates,Warwick,RI. MPL MA-REGDEPT Printed in U.S.A 0698 a Date.,l. t- /.5. .�. . ..... . r. ll NORTH _ 3? TOA OF NORTH ANDOVER . o n PERMIT FOR GAS INSTALLATION I'-- SSACHUSE F' F This certifies that . .<�-.�? .��< . 'r. . . . . . . . . . . . . . . . . . . . . . . . . r has permission for gas installation . . .F. L. ... . . . . . . . . . . in the buildings of . . . L. �' .l.. `.` . . . . . . . . . . . . . . . . . . . . . . . . . at . .P /.3, j� . . . �"�`. . . . . . . . . . North Andover, Mass. Fee. . . . Lic. No..J C. �e . . . . . . ��' . . . . . . . G I ' S INSPECTOR Check# t ) Y 'r 5366 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) Date 12 , — il 20 ®Sr x Permit # S^3 BuildingOwner' ' " ATs,,. Location 13 Name Type;-of,-Occupancy:;: GNew ❑ Renovation ❑ Replacements Plans Submitted Yes ❑ No N ¢ Y W N N tL N O W J to W OQZ Q O V O Z O W O O Z W ¢ O I- W W W LU 4 N Ic W Z V W Z N ,Zp Q O D > W W W N 1 Q .Y W CC t7 LY W .W V = Nft O Z W O N S Q yt > !r W 2 Q W Q Q O O WO W F- oc s 0 �7 Y W 3 o Cly j v cc > o a r o SUI;—BSMT. BASEMENT 1 ST FLOOR 2ND FLOOR J 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR (Print or Type) Check.One: Certificate Installing Company Name UPtack Plumbing & Heating, Inc [X Corp. 1415 Address 32 Rochambault Street ❑ Partnership Haverhill , MA 01832 ❑ Firm/Com Company Y Business Telephone 978 372-8503 Name of Licensed Plumber or Gasfitter Leonard A. Hall 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 under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Sigmture of Owner/Agent I have a current liability insurance policy to include completed operations coverage. [� BY TYPE LICENSE: Title ❑ Plumber Signature of Licensed Plumber or Gasfitter City/Town ❑ Gasfitter APPROVED (OFFICE USE ONLY) ❑ Master 8678 El Journeyman License Number I FINAL INSPECTIONS SKETCHES BELOW FOR OFFICE USE ONLY PROGRESS INSPECTIONS Y FEE NO. APPLICATION FOR PERMIT TO DO GASFIMNG NAME & TYPE OF BUILDING LOCATION OF BUILDING _ PLUMBER OR GASFITTER UC. NO. v PERMIT GRANTED •A Date 19 Gas Merc. Final Insp. ---- ---- — ---- ... L.. In•.p.•i lur h W Date.� �7. .!. ..... . s.: .NOa oT PI � , °fli TOWN OF NORTH ANDOVER R : : PERMIT FOR GAS INSTALLATION 1. ► �> ,_�_.- -.�'y' �>.�,,�.,<,> CHUS This certifies that . . .U—P. (:. . .' 1 s . . . . . . . . . . . . . . . . . . . . . . y J . x has permission for gas installation . . . �� . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . .IA. 1. 3. . .5/1.. 4,. . . . . . . 1,/ . . . . . ., North Andover, Mass. Fee.5.4. . . . Lic. No. Z1 t.&� . . . . r /GAS INSPECT02 Check# 11 t# 1f 5-363 1VIASSACHUSErIN UNIFORM APPUCATON FOR PERMrr TO DO GAS FTrrING nn (Type or print) Date g NORTH ANDOVER,MASSACHUSETTS Building Locations GA I g V Permit# s1 C 3 Owner's Name v V\� Amount$ New❑ Renovation ❑ Replacement Plans Submitted ❑ tw F a z O E W a F Fir rc�� SUB -BASEM ENT a B A S E M ENT j 1ST. FLOOR i 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR �'" " 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (� (Print or type `U V4, b �� Cffeone: Certificate Installing Company Name V l% V Corp. Ad ss kif ` ❑ Partner. 1 1k D usrness Telephone Firm/Co. Name of Licensed Plumber or Gas Fitter (� INSURANCE COVERAGE Check on : I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked yes,please i dicate the type coverage by checking the appropriate box. Liability insurance policy Of 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 submitte ��(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations p ffo d u ermit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts o=andChapt142 of the General Laws. Signature of Licensed Plumber Or Gas F tter By: Title Plumber City/Town Gas Fitter License Number Master APPROVED(OFFICE USE ONLY) Journeyman