HomeMy WebLinkAboutMiscellaneous - 178 ANDOVER STREET 4/30/2018 (2)Q
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North Andover Board of Assessors
roperty Record Card
Parcel ID :210/059.0-0056-0000.0 FY:2013 Community: North Andover
Location: 178 ANDOVER STREET
Owner Name: CHASE-FRANZ REALTY TRUST
MARY C. CHASE,TRUSTEE
Owner Address: 178 ANDOVER STREET
City: NORTH ANDOVER State: MA
Zip: 01845
Neighborhood: 5 - 5 Land Area:
1.59 acres
Use Code: 101-SNGL-FAM-RES Total Finished Area:
7866 sqft
ASSESSMENTS CURRENT YEAR PREVIOUS YEAR
Total Value: 977,500 978,900
Building Value: 777,700 777,100
Land Value; . 199,800 201,800
Market Land Value: 199,800
Chapter Land Value: 11
http://csc-ma.us/PROPAPP/display.do?linkld=2253870&town=NandoverPubAcc 3/26/2013
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S CHUS
Date ..... .......
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ........... E ....... ..................................................
has permission to perform ....... 0245..Awalm ............ la*.Ilffj .............
wiring in the building of ................ ell,41 .......................................................
-73 A.40
at .... I .......................y ........................................ North Andover, Mass.
Fee Lic. No. 04'� ......
ELecrniC b4kMit
Check #
L
Commonwealth of Massachusetts
OEM
Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
Official Use Only
Permit No. 1
Occupancy and Fee Checked
[Rev. 1/071 leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORW MYON) Date: /
City or Town of- To the Inspector of Wires:
By this application the undersi ed gives no ' of his or her intention to perform the electrical work described below.
Location (Street c& Number) /_7? 4 b o [�tT7L� .
Owner or Tenant M A 2y (!t . Ac Le_ T
Owner's Address
elephone No.
Is this permit in conjunction with a building permit? Yes ❑ Nom BLDG PERMIT #
Purpose of Building tiCLL r�
Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd ❑
New Service Amps / VoIts Overhead ❑ Undgrd ❑
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
rNo.ofDryers
Recessed Luminaires
Luminaire Outlets
Luminaires
Receptacle Outlets
Switches
Ranges
aste Disposers
ishwashers
ryers
Heaters KW
o. Hydromassage Bathtubs
C- ,-VJ X34,
Completion of the
No. of Ceil: Susp. (Paddle) Fans
No. of Hot Tubs
Swimming Pool =gr!:PT�
No. of Oil Burners
No. of Gas Burners
No. of Air Cond. Total
Tons
Space/Area Heating KW
Heating Appliances KW
No. of No. of
Signs Ballasts
o. of Motors Total HP
No. ofMeters
No. of Meters
wing table may be waived by the Ins ectoi
No. of Total.
Transformers KVA
Generators
KVA
o. of Emergency
Batte Units
Lighting
FIRE ALARMS I
No. of Zones
o. of Alerting Devices
Alerting Devices
Municipal El other
Attach additional detail if desirec4 or as required by the Inspector of Wires.
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.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless
the licensee provides proof of liability ' surance including "completed operation" coverage or its substantial equivalent. The
undersigned certifies that such cover a is in force, and has exhibited proof of same to the permit issuing office. j
CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:)
I cert, under the pains and penalties o erjury, that the information on this application is true and complete
FIRM NAME: C/JW 4 n lJ
LIC. NO.:
Licensee: • /� 0---7Signature LIC. NO.:/
(If applicable, enter "exem�e`t" in the license number line.)y�
Address: /�,/3/ A n/ /; Alt Tel. No.:
p IJ Bus. Tel. No.: 3 G�—ys / - 95 �D
*Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" Licen LIC. NO.:
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
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. $
/i.
ELECTRICAL PERM(T NO. INSPECTION REPORT:
ELECTRICAL INSPECTOR - DOUG SMALL
1. ROUGH INSPECTION:
Passed — [ ] Failed — [ ] Re -inspection required ($50.00) - [ ]
Inspectors' comments:
'Signature - no initials) Date
3. UNDER GROUND INSPECTION:
Passed —
[ ] Failed — [ ] Re -inspection required ($50.00)
Inspectors' comments:
(Inspectors' Signature - no initials) Date
DATE CALLED NATIONAL GRID: NAME:
Passed — [ ] Failed — [ ] Re -inspection required ($50.00) - [ ]
Inspectors' comments:
(Inspectors' Signature - no initials) Date
5. INSPECTION - OTHER:
Passed — [ ] Nailed —
Inspectors' comments:
' Signature - no
uired ($50.00) - [ ]
Date
DOOR TAGS ARE TO BE FILLED OUT AND LEFT ON SITE ]F THE AREA TO BE INSPECTED IS NOT
ACCESSIBLE AND A RE -INSPECTION OF $50.00 IS TO BE CHARGED.
' The Commonwealth ofMassachusetis
Department of Industrial.Accidents
` Office of Investigations
600 Washington Street
Boston, AIA 02Y11
www.mass.govldia
Worke& Compensation Insurance Affidavit: Builders/Contractors/>Electriciaus/Plumbers
Applicant Information Please Print Legitbly
Name (Business/Organization/Individual):
Address:�
bSSrL/L/City/Stateip
Z % 7
Are you an employer? Check the appropriate box:
1. ❑ I am a employer with
4. ❑ I am, a general contractor and I
(full and/or part-time).*
have hired the sub -contractors
AImployees
2. am a sole proprietor or partner-
listed on the attached sheet. x
ship and have no employees
These sub -contractors have
working for me in any capacity.
workers' comp. insurance.
[No workers' comp. insurance
5. ❑ We are a corporation and its
required.]
officers have exercised their
3.0. 1 am a homeowner doing all work
right of exemption per MGL
myself. [No workers' comp.
c.152, §1(4), and we have no
insurance required.] t
employees. [No workers'
comp. insurance required.]
Type of project (required):
6. ❑ New construction
7. ❑ Remodeling .
8. ❑ Demolition
9. ❑ Building addition
10. F1 Electrical repairs or additions
If. E] Plumbing repairs or additions
12.❑ Roof repairs
13.❑ Other
*Any applicant that checks box #1 must also fill outthe section below showing their workers' compensation policy information.
p Homeo,ymms who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such.
lContractus that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy # or Self -ins. Lic. #:.
fob Site
Expiration Date:
City/State/Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
X do hereby cert uncles• the pains and penalties of perjury that the information provided above is true and correct.
a % �v-- Date: `' l %
Official use only. Do not write in this area, to be completed by city or town official
City or Town:
PermitlLicense
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. CitylTown Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person• Phone
ssr5
Date. .A/-�
AORth
°�
�'° •�"
TOWN OF NORTH ANDOVER
h S
. 0PERMIT
FOR PLUMBING
,SSACNUS�
This certifies that ... 12�. mac, ..� l�........
has permission to perform ...
.
..�
plumbing in the buildings of
at., ?Q...../2-(�'- (-ri''.... over......
/ North Andover, Mass.
Fee. ..... Lie. No.. ).) .'(
Check # ��..� �
PLUMBING INSPECT R
FIYTIIRFC
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
City/Town: , MA. Date: Permit#
Building Location: l �lJd�'� v Owners Name:
Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential Q�
DEDICATED
New: ❑ Alteration: ❑ Renovation: ❑ Replacement: � Plans Submitted: Yes ❑ No
FIYTIIRFC
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 have checked Yes, please indicate the type of coverage by checking the appropriate box below.
A 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 ❑
gnature of Owner or Owner's Agent
I hereby certify that all of the details a
submitted (or entered) regarding this application are true and accurate to the best of my
Knowiedge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all
Pertinent provision of the Massachusetts State Plumbing Code and Chapter 143Athe General Laws. ,I
By
Title
City/Town
APPROVI
Type of License: Z-4 "
SMmber S' ature of Licensed Plumber
es�sier
.B�ourneyman License Number: ((/
DEDICATED
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Address: City/Town: �r�C tate: Aw—v
❑ Corporation
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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 have checked Yes, please indicate the type of coverage by checking the appropriate box below.
A 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 ❑
gnature of Owner or Owner's Agent
I hereby certify that all of the details a
submitted (or entered) regarding this application are true and accurate to the best of my
Knowiedge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all
Pertinent provision of the Massachusetts State Plumbing Code and Chapter 143Athe General Laws. ,I
By
Title
City/Town
APPROVI
Type of License: Z-4 "
SMmber S' ature of Licensed Plumber
es�sier
.B�ourneyman License Number: ((/
7 548 Date..//?//< .......
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11
FIYTI IRFS
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING
U9CitylTown:
MA.
Date: 7Z11
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Building Location: / 79 4a�� JV
//Permit# /Jo
Owners Name: z lk—'! (`
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Type of Occupancy: Commercial ❑ Educational
❑ Industrial ❑ Institutional ❑ Residential 91—
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New: ❑ Alteration: ❑ Renovation: ❑
Replacement: Z---- Plans Submitted: Yes ❑ No Q—
FIYTI IRFS
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 have checked Yes, please indicate the type of coverage by checking the appropriate box below.
A 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 El Agent ❑
Signature of Owner or Owner's Apent
By checking this box ❑; 1 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
compliance with all Pertinent provision of the Massachusetts State Plumbipg-eode,and.ChttMr 142 of the General Laws.
Ty License:
By ff Plumber
Tithe Waster sFitter nature of Licensed P umber/Gas Fitter
City/Town rneyman License Number:
APPROVED (OFFICE USE ONLY) ❑ LP Installer
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7 FLOOR
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QliA /WCheck One Only Certificate #
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Installing Company Name: d 2 Wtj4 -AJ I-'r�i ,�"
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Address: !p 6ydlz S7& City/Town: 1^A FV� State:
-
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Business Tel: 9TH Yty 6 1ax:
/� ❑ Firm/Company
Name of Licensed Plumber/Gas Fitter: /fA-/
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 have checked Yes, please indicate the type of coverage by checking the appropriate box below.
A 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 El Agent ❑
Signature of Owner or Owner's Apent
By checking this box ❑; 1 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
compliance with all Pertinent provision of the Massachusetts State Plumbipg-eode,and.ChttMr 142 of the General Laws.
Ty License:
By ff Plumber
Tithe Waster sFitter nature of Licensed P umber/Gas Fitter
City/Town rneyman License Number:
APPROVED (OFFICE USE ONLY) ❑ LP Installer
4 Location It Q
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N 1 Date
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40RTh TOWN OF NORTH ANDOVER
Certificate of Occupancy
$
L Building/Frame Permit Fee
0 —941—
$
S rep
sSACHUSEt�%�,un tion Permit Fee
ll tt��CC Permit Fee
$
$
_
C
Sewer Connection Fee
$
Water Connection Fee
TOTAL
$
G(�
$
Iding Inspector
759
Div. Public Works
PERMIT NO
APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
PAGE 1
MAP 4d O. LOT NO.
2 RECORD OF OWNERSHIP IDATE
BOOK ;PAGE
ZONE �' I SUB DIV. LOT NO.
LOC TA IOT': 17 Y
PURPOSE OF BUILDING / w
`�
OWNER'S NAME
NO. OF STORIES SIZE
OWNER'S ADDRESS �CJ� S: CrC�
BASEMENT.OR SLAB
ARCHITECT'S NAME
-
SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME
SPAN
DIMENSIONS OF SILLS
POSTS
DISTANCE TO NEAREST BUILDING
DISTANCE FROM STREET
DISTANCE FROM LOT LINES — SIDES REAR
"' GIRDERS
AREA OF LOT FRONTAGE
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW
SIZE OF FOOTIAG X
IS BUILDING ADDITION
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE
i
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
SEE BOTH SIDES
PAGE I FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
LANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED�� 16
PERMIT GRANTED
Oce - H 19_
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST
EST. BLDG. COST PER dQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BUILDING INGPECTOR
OWNER TEL. # / (�
CONTR. TEL. # R(1 —4-
CONTR. LIC. #. 113 0 /
H.I.C. # /o 3.31 7
BUILDING RECORD
1 OCCUPANCY 12 *,%%
SINGLE FAMILY SORIES
MULTI. FAMILY OFFICES
_
APARTMENTS
CONSTRUCTION
2 FOUNDATION
CONCRETE
B INTERIOR
FINISH
PINE
HARDW D
PLASTER
DRY WALL
UNFIN.
CONCRETE BL'K.
BRICK OR STONE
PIERS
—
3 BASEMENT
AREA FULL
FIN. B TAREA
_
1/1 1/1 t/
FIN. ATTIC AREA
N_O EMT
HEAD ROOM
FIRE PLACES
MODERN KITCHEN
_
_
4 WALLS II 9 FLOORS
CLAPBOARDS
DROP SIDING
WOOD SHINGLES
CONCRETE
EARTH
B
_
1
2
�_
3
_
ASPHALT SIDING
ASBESTOS SIDING
VERT. SIDING
_
HARDW D
COMMON
ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
_
BRICK ON MASONRY
ATTIC STRS. & FLOOR
BRICK ON FRAME
I_
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR I� POOR _
ADEQUATE NONE
$ ROOF
10 PLUMBING
GABLE
GAMBREL
HIP
MANSARD
BATH (3 FIX.)
TOILET RM. (2 FIX.)
_
FLAT
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 II
11 HEATING
WOOD JOIST
PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. &COLS.
STEAM
STEEL BMS. & COLS.
HOT W'T'R OR VAPOR
WOOD RAFTERS
_
AIR CONDITIONING
_
RADIANT HTG
UNIT HEATERS
7 NO. OF ROOMS
GAS
OIL
B'M'T 2nd
ELECTRIC
_
isr j,
NONO HEATING
THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
LOT LINES AND EXACT DIMENSIONS OF BUILDINGS, WITH PORCHES, GA-
RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
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