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Home My WebLink AboutMiscellaneous - 1276 SALEM STREET 4/30/2018 1276 SALEM STREET / 210/106.A-0 8-0000.0 ��ClRPFY t �r 0 LED p �ey NORTH COVER BULDING DEPARTMENT lip, A'R�TFOF�`y(�✓ 1600 Osgood Street North Andover Tel: 978-658-045 Fax: 978-688-9542 BUS 'SSF01?M FOR TOWN CLERK" D.ATp,- n(,liqla4 ADD M,.�'2`� �� 5a, iov% S's- MVS h4�, c p-,, 0NMGDISTR C : J TY1of BUSINESS,, Qn \ ntSa ( - �►=` BUILD7NGLAYOUT PROVIDED: YES NO A.Y A LABC E-PAR IMM SPAM: rNk3 -Ck^ Claue � .ZONI NG BYLAWMACTE: 'YES NO lop, B JN P TOR SIGNATUM I �I BUSYNESS FORM FOR TOWN CLERK 2,40 Home Occupation(1989132) An accessory use conducted within a dwelling by a resident who resides in the dwelling as his principal address, which is clearly secondary to the use•of the b-Oding for lift pluposes, Home occupations shall. 'include,"but hot'hnited to the following uses; personal services such as funushed by an artist or instructor, but not occupation involved with motor+vehicle repairs, beaAr parlors, animal fennels, or the conduct of retail business,or the manufacturi�g o£goods,which impacts the residential nature of the neighborhood', d. For use of a dwelling in any residential district or multi-family district for a,home occupation, tho following conditions shall apply; a. Not more than a total of fhme (3) people may be employed in the.home occupation, one of whom shall ba-&:ovv ter oftheh6mo c mVpatioa and residing in said di-welfing; b. The use is carried on strictly withinthe,p iacipal building; o. There shall be no exterior alterations, accessory buildings, or display which are not customW with residential buildirrgs; . d. Not more Ilm-twmn ,&o(25) percent of the existing gross floor area of the diveag unit. so used, not to exceed one thousand (1000) square feet, is devoted to'such use. In. comection;with such use,there,is to be,Inept no sfock in trade, commodities or products which occupy space beyondthese Jitah; e. There will be no display of goads or wares visible from the street; f. The building or premises occupied shall not be gendered objectionable or detrimental.to the residential character of the neighborhood due to the exterior appearance, emissioxi of odor, gas, smoke, dust, noise, rhsturbance; or in any other wast become objectionable or def-imental to any residential use within.the neighborhood, g. Any such building shall include no features of design not custb=7 in bindings for residential use. (J 4// (p �igna.-t<zz-e D i Date...I 7. .�.�........ ,+ 3, 2 L; OF r►ORTI�,�O TOWN OF NORTH ANDOVER ° p PERMIT FOR PLUMBING ,sSgCHUs�� This certifies that.............. Q t..!...'` ".`U ............................. ..................................... # has permission to perform....�cAd'-z.. �\ ?r..`.... plumbing in the buildings of............................................................................................ at...... °Z..�.�...��.....�....�...'..................................................... North Andover, Mass. Fee..� .....Lic. No. .1511.7 . ........................ . ... .. . N .SP. .. .O..R. . .... ..S.. .. .. ..................... PLUMBING... . INS Check# • .rj MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY NORTH ANDOVER MA DATE 12/7/2015 PERMIT# I JOBSITE ADDRESS 1276 SALEM ST OWNER'S NAME POWNER ADDRESS _ TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NO 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/OIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN 16HOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES 7J 1 WATER PIPING OTHER BACKFLOW PRVENTOR FOR Ed 1 INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO . IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW 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 Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are truan ccurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compl' n t all P inent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME JEFF HUTNICK LICENSE# 15212 SIGNATURE MP " JP CORPORATION f # 3532 PARTNERSHIP LLC # i > COMPANY NAME CALLAHAN AC AND HTG ADDRESS 91 BELMONT ST / CITY NORTH ANDOVER STATE MA , ZIP 01.845 TEL 978-689-9233 �\\� FAX CELL EMAIL PLUMBING@CALLAHANAC.COM Date...�.7:I .i I'S..................... pORr TOWN OF NORTH ANDOVER 16. PERMIT FOR GAS INSTALLATION l ssgCHUs� This certifies that .. ................................................r ..................................................... has permission for gas installation �.} .�� in the buildings of ..................................... ..................................................................... ......................................... North Andover, Mass. at...................... ................... Fee... �U-.... Lic. No. .. `�.Z 12-... GAS INSPECTOR Check#�(. � I • r Q�l MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK -Ulf CITY NORTH ANDOVER MA DATE 1217/2015 PERMIT# JOBSITE ADDRESS 1276 SALEM ST OWNER'S NAME DISTELBRINK_ y' G OWNER ADDRESS TEL 'FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW:r/— RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NO v APPLIANCES 7 FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER 1 BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE _ INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN - - POOLHEATER ROOM 1 SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER ,WATER HEATER :OTHER INSURANCE COVERAGE I Oave a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES _�_ NO I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY -, OTHER TYPE INDEMNITY BOND 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 AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true nd cc to the,best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compl' th II Pe ' ent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME JEFF HUTNICK LICENSE# 15212 ANATURE MP v MGF JP JGF LPGI CORPORATION v # 3532 PARTNERSHIP # LLC # COMPANY NAME: CALLAHAN AC AND HTG ADDRESS 91 BELMONT ST CITY NORTH ANDOVER STATE MA ZIP 01845 TEL 978-689-9233 FAX CELL EMAIL PLUMBING@CALLAHANAC.COM �11 � � _._ �1 The Commonwealth of Massachusetts Department of IndustrialAecidents d I Congress Street,Suite 100 Boston,MA 02114-2017 " www.mass gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Apnficant Information Please Print Le:ribly Name (Business/organization/individual):Callahan A/C&Heating Services, Inc Address:91 Belmont Street City/State/Zip:North Andover, MA 01845 Phone M 978-689-9233 Are you an employer?Check the appropriate box: Type of project(required): L[D I am a employer with 2- employees(full and/or part-time).* 7. []New construction In I am a sole proprietor or partnership and have no employees working for me in 8, E]Remodeling any capacity.[No workers'comp.insurance required.] ❑ 1[]I am a homeowner doing all work myself[No workers'comp.insurance required.]t 9. Demolition Q4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 1 Plumbing repairs or additions 5.❑I am a general contractor and I have hired the suh-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance i 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[]Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AmGUARD Ins Co Policy#or Self-ins.Lic.#: CAWC604073 Expiration Date: 9/25/16 Job Site Address: 12 -1 >-&—U cel City/State/Zip: Attach a copy of the workers'c mpensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct s Signature: ! Date: Phone#: 978-689-9233 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License#. Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: . ..:� ..:: ):.,.: r:... r:. ;: .a �•' ,r•;�'+i,i r ,.. ., + ., w s '.r' 1 :.r } 3"; "�` }'q 'T ,:.#.,;: , ,.3� ;<_ward .4. ,:ar..r •.,.ar±.v �''�.f�. :,+'.:` °s ,�t�.,# '�'inv-gs+,e�:fu,F" �, '� 1 a•#,:,ti4 rr a ;�Y , '� !<:.s,r,� :it.:o-- r .a Mate+ of how' 'M a , Z yr:. A'.y k• 1 � ii.. 1 1:. .� v �, 'J I '.` t{ .'}4S �;h 2��Ct�'rT ;{y,4 , ,l �1,.,�•G� '�'Y' k}c Y�' '�,.. HA trr �`,��}�.; r?",v^i� i ?� b r:..':•f .A r '�. R �(1' YR NAME ay� R�Y hi�TN ,) , �., rt �_•a�, �,.:.� ,� ,� ,.�, 4� .,, 1 '�, � 7� r x ! t$ . ti awarnesAl pATIC►IY Nr. 3 4.. 'i '`''i�i;`'`r.n, r,y,:"r.,�, .,r z ':.t,t3 •.a ,�,?-. -[y ',N, ,`•: Y r. � .d, 4�('' STFL ;$ #'n a �.# �X,`�..'Fx � °+!:;'`.,,.,Y t17`F �3 '•'' y°:�..-k pBi,kd�t'`. � � N� f;".tiw� f kcf 6�x �^`� '�"k's�,r 8ERVIG- M !ea -+ .r > * q� Y 4 '-4-'425' 'Tf h "`'thy �'',. '��");i k�iY 'r �� 'a+�'"'i� t.�w� � !•$�. 1k� :^' .4. - n:.. 4 Ao "AMPS" STATE Orr NEW Q .. ® ` ' FYI 9 •}iY.i'a a •i F ' , . • a 6UFtEAU OF BUILDING SAFETY &CO x N 0 0 • 1, 7 aIQ. " !?.I:U�1ER AhI1. G{tS .IT'CERS . PLUM SApETY gECTI{�N r ! i •F �� S. Y yY` b ISuEs NAME: JEFFREY P HUYNICK �aL� A joURNEYMAN PLUMBERi - fu. "' LIC #,4519 M C fr Y F' HO fiN•I O I< � ' P L.YM4UTM' ST " � b EXPIRES: 1213112015 F ' Mlf1N :MA 01844-4256 21$ ` /1;b 2040,53 X5/0 a o w'M ' commWp►�L O � ASHI`y %` � F ' d yr, Y I aR�v Res ' 1.uM�t~ p�N��:aa5�1:TT�R� trL�w l ray Ns . ,- t.ICSE h) ;a ' 155UES. THE' > 0 oc..Mq f A5 p .P I.UMB VIAL .GC1RP ' ;'.� GI i S"1't , ,c re. r naEriP 4d NUilfoE; �' `� f. „ NONE S:�OS2606.6.':' s iil• f r ,>1 CK l UT . Y H RE . • JE F s t i " . a . r ANS F'E'AT i NG•� ��RV 1� ,• r r rasez.lw� GALI�AWAN pry's ic p p LYMttJ 1 r "CliU E N I�ipl 4 a0Q RI.'fM0U7W STREMT ° r Mfg Hltl,MA'09944•A58 35 3 !j'�1�11116�7(114�QV'U74, 09