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HomeMy WebLinkAboutMiscellaneous - 15 MIFFLIN DRIVE 4/30/2018 15 MIFFLIN DRIVE 210/021.0.0040-0000.0 Date.'"!.. �. I...1........................... NORTh TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION 88�CMUg� U This certifies that i......` .......`..."'...:... ............. ............................ has permission for gas installation ................ ....... . .... ..... ......,........ ?. P inthe buildingTt . ............... at .. :....................................................... t�� f� �J.�.................. North Andover, Mass. ......... �...................... Fee .. ..... Lic. No. . 1.�.t�..'.... . ................................................... GASINSPECTOR Check# —# 9204 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY North Andover MA DATE 3124/2014 JPERMIT# JOBSITE ADDRESSI 15 Mifflin Drive OWNERS NAME I Vincent McCabe GOWNER ADDRESS I Same TEL!978 683-6574 IFAX �� TYPE OR OCCUPANCY TYPE COMMERCIAL® EDUCATIONAL ® RESIDENTIAL[] PRINT CLEARLY NEW: RENOVATION:El REPLACEMENT:® PLANS SUBMITTED: YES® NO[j APPLIANCES Z FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER [ __ COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE ------------- INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM I SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WA ER HEATER OTHER ---------------------------------------------- ReN ace Gas Meter x and Pi inp as Needed INSURANCE COVERAGE I have a current liability 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 0 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: OWNERE] 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 and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in o pliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. r �� PLUM BER-GASF ITTER NAME Joseph Marino LICENSE# 8736 SIGNATURE MP EI MGF® JP EI JGF® LPGI® CORPORATION E]# 3285C PART SHIP®# LLC[1# COMPANY NAME: RH White Construction Co ADDRESS 141 Central St CITY I Auburn STATE=ZIPI 01501 TEL 1(508)832-3295 FAX 508-926-4347 CELL 508-832-4614 JEMAILI JMarino@RHWhite.com 1`� ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES =-=: CVIt}li;O�iVi1UEAL.TH OF MASSA_ :UIT '_', --��- -'•�--.a:� � � :.,�: � `• _ -- ` -- PIU[iMBERS AND GASFfTTE-RS ' 1 Y SED AS-F..M.Y�STER P.L70- - •_y.. . SUES TFI£ABOVE, (oENSE `'`:,fARR-INGTQN ST STER MA 0i �J #=3IQ9 QItlMONWEALTH OF MASS{AC!.!.u-gry'r.S`.;. ILUN 'FBERS AND GAS FI7TERS ;''~ ='L ICENSEAS A JOU.RNEYMAN`-:� lltll'�3 Y= =ISSUES THE ABOVE LICENSE _ 'JbSER'H: D :M-ARIND - - --=� W.*O= G' STE RMA ': " 5 05l01l14 I - 04/03/2014 14:04 5088326751 RH WHITE CONSTRUCT PAGE 02/02 AC CORD® �...� • CERTIFICATE OF LIABILITY INSURANCE page of 1 o3/29/2013 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,[EXTEND OR ALTER THE COVERAGE AFFORDED BY T BELOW. THIS CERTIFICATE HE POLICIES R IFICATE OF INSURANCE DOES NOT CONSTITUTE REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED IMPORTANT: If the certificate holder is on ADDITIONAL INSURED,the polioy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsoment(s), PRODUCER CONTACT willia of Massachuoetts, Inc. PHONE c/o 26 CO-Atveyy Blvd. .NQ-EXT,, 877-W-7378 PAX No 888-46_7-2378 R. 0. Box 305191 -MAIL - Naghville, TN 37230-5191 D.Dlz��s cextificate,9(�w•ily�e.G_O_ltt INSURER(S)AFFORDING COVERAGE NAICrt INSURED INSURERA: The ChArtAr Oak Tine Ineuranco Company 25615-001 R. H. White Construction Company, rnc, INSURERS:TraVQ1*rs property Casualty COAWany oi' Am 25674-003 41 Central Street 0. Box P. 0. Box 257 INSURER C:National Union Piro Insuranca Company of 19445-001 Auburn, MA 01501 INSURERD;TraP9yera Indmnut,atyr Company 25659-Dol INSURER F,; INSURER F; COVERAGES CERTIFICATE NUMBER:20297680 REVISION NUMBER; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER CERTIFICATE MAY BE ISSUED O E DOCUMENT WITH RESPECT ALL WHIC I R MAY WHICHTHIS S PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN Is SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE pD' SUB POLICY EFF POLICYEXP VAM POLICY NUMBER LIMITS A GENERAL LIABILITY VTC2000 977RB948-13 9/1/2013 •9/1/2014 EAChIOCCURRENOE F 2,000,000 X COMMERCIAL GENERAL LIAAILIIY pp r� TO RENTF,D PR 18'3(;ecwencnl � CLAIMS-MADE OCCUR MEEDEXP(Anyone arson ..� 101000 PERSONAL&ADV INJURY S 2 1) _'000 GENERAL AGGREGATE S e}J 000 000 GEN'LAGGREGATFLIMITAPPLIESPER; PRODUCTS-COMP/OPAGO Is ,000 000 POLICY PRO LOG Ir S AUTOMOBILE LTABILITY VTJCAP 977K955A-13 /1/2013 9/1/2014 X OMEDtSNGLE-IMIT $ ANYAUTO cNen g 2,000,000 ALI.OWNED SCHEDULED BODILY INJURY(Per person) `!; AUTOS AUTOS BODILY INJURY(Peraceldent) $ X HIREDAUTOS X NON-OWNED AUTOS X Co Ded tg X Co11 Ded ereccldent 8 C UMBRELLALIAB $ OCCUR 586766140 9/1/2013 9/1/2014 EACHOCCURRENCF, $ 5-1-000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE DED $ RETENTIONS 10,000 $ 5,000,000 WO RS COMPENSATION S D AND EMPLOYERS LIABILITY VTRK JB 920SA105-13 9/1/2013 9/1/203,4 X U - D ANY PROPRIETORIPARTNERIEXECUTIVEY N T�R�Y.W OFFICHRIMEMSEREXCLUDW? Nj NIA VTC2Ki7B 9203A71A-13 9/1,/2013 9/1/2014 E.L.EACH ACCIDENT s 1,000 000 1MarldetoryIn b8gA E.L.D18EASe-EAEMPI.OYEE S 1,000,000 u�z�neill UNa QPURATIONSbelow F,L,DISEASE•POLICY LIMIT S 11000,000 __ 1 -7 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Avach Acord 101.Addltonpl Remarks Schodula,If more sp eco Is rmqulmd) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF TWE ABOVE DESCRIBED POLICIES BE CANCE ILLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Evidence of InrAuzBence AUTHORIZED REPRESENTATIVE Coll:4297604 Tp1:1694012 Cert;20267680 ®1988-2010ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD --cation No. 4 Date r � NORTH TOWN OF NORTH ANDOVER Certificate of Occupancy $ + � Building/Frame Permit Fee $ '"`� Foundation Per $ S4CNUSE / Fe Other ermi Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ �Sr� C.) building Inspector 03/301% 13.5 ` 0 7094Div. Public Works PER34T NOS" D APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. AGE 1 MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE F2-- %.-�OWNER'S E I SUB DIV. LOT NO. F I ATION &�(��i� p11t' PURPOSE OF BUILDINGP!J " �� l2 NAME 1v/// dl NO. OF STORIES /a/ SIZE/ / WNER'S ADDRESS V_ w BASEMENT OR SLAB V ��6 R� -- ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD UILDER'S NAME 1.7�' � I © 1� SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES—SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES T. BLDG. COST le"�— PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS i - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY 7 ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DA jE FILE /� C��C BOARD OF HEALTH SIGtrAATURE OF OWNER OR AUTHORIZED AGENT F E E PLANNING BOARD PERMIT GRANTED OWNER TEL.#.�?- 65`7zg J,-CONTR.TEL.# lz 19 -���-- CONTR.LIC.#//394 BOARD OF SELECTMEN /7 O /5' B ILDINO INtPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE _ 3 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN, B M AREA _ 'h 1/2 °/, FIN. ATTIC AREA _ N_O B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN I 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARD"J D _ ASBESTOS SIDING _ COMIACN VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I I POOR ADEQUATE NONE Y 5 ROOF 10 PLUMBING GABLE HIP BATH )3BATH FIXE— GAMBRELMANSARD TOILET RM. (2 FIX.) FLAT I SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 3 COLS. STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL j B'M'T 2nd ELECTRIC 1st 13rd I NO HEATING T i 'OFFICES OF: . ..\ TONY O ::= 120 Main Street � APPE.-\LS a, NORTfi ANDOVER North Andover. Massachtsetts o 1845 BUILDING L17 CONSERVATION DIVISION OF -47 L HEALTH PLANNING PLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON,DIRECTOR In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licctucd solid waste disposal facility as dcfincd by MGL c 111, S 150A. The debris will be disposed of in: �/oue- �J / e �- (Location of f=acility) Signature of Pcrmit Appiimnt 3', A: Date NOT_: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. s ..• LTown of over No. 072 o LA10dover, Mass., &AX .�l 199141 ` COC w[CMEwICK 1' ORATED l� BOARD OF HEALTH Food/Kitchen PERMIT T Septic System _ c THIS CERTIFIES THAT........... f.. . BUILDING INSPECTOR i r, _... . f Foundation LL has permission to erect..f,C. .4............ buildings on .....`, .�.. � Rough to be occupied as..........InArAwelli. .. ....... ,, !.. .1 ­., / ......... . . . .. . .. . ................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final Buildings in the Town of North Andover. � a PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Fina' UNLESS CONSTRUCI7ION ,STARTS ELECTRICAL INSPECTOR Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT