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HomeMy WebLinkAboutMiscellaneous - 21 MOODY STREET 4/30/2018Date ..541'5. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ... .�..eNQ... S ................................................................... has permission for gas 'nstallation ................................................. ........... inthe buildings f ...'!'................................................................................. at ...... `...........!v. i . ?................ ...., North Andover, Mass. Fee..b.."...... Lic. No.........................!.................................................. GAS INSPECTOR Check # MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY No RT u. n�Do MA DATE JOBSITE ADDRESS — h1on 5 i OWNER'S NAME �, ©� ►NI GOWNER ADDRESS= TE� FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CT'EARLY NEW: Q RENOVATION: C REPLACEMENT: ®'' PLANS SUBMITTED: YES © NO [ APPLIANCES 7 FLOORS- BSM' 1 2T —3 _ 4 5 6 7 8 9 1 10 Ill 112 13114, BOILER T. BOOSTER CONVERSION BURNER COOK STOVE( DIRECT VENT HEATER DRYER FIREPLACE J FRYOLATOR FURNACE GENERATOR I �— GRILLE INFRARED HEATER LABORATORY COCKS MAKEUPAIRUNIT OVEN POOL HEATER OOM / SPACE HEATER ROOF TOP UNIT TEST ONIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER e INSURANCE COVERAGE have a current liabilily nsurance policy or its substantial equivalent which meets the requirements of MGL. Ch.142 YES [WO Ej I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY [� OTHER TYPE INDEMNITY ® BOND F 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 hereby certify that all of, the details and information I have submitted or entered regarding this application are true and accurate to the bes my Wedge and that all plumbing work and Installations performed under the permit issued for this application will be in compliance with erti n ovis! the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME �w ,c, £ LICENSE # I S6�1 SXIATURE MP IMGF ® JPEI JGF D- LPGI ® CORPORATION [af. 3tr,( PARTNERSHIP ®# LLC COMPANY NAME:ee _ Sra Je Sez,, < < e ADDRESS — CITY STATE` /1'l ZIP Z (-----]TEL —1—do FAX CELL EMAIL #eewe 6rALe BOARD OF PLUMBERS G S F.,J TFTERS ISSUES THEFOLLOW T*l tl N E AS A PLUMB I CCORp 0, AV, I W GARF I EL15, ",C), RS--: S ERV I C.E, �c -.ttNEY BROTHE 21 WILLOW ST" J Qt Tb N MA 02301, ` 36TH 5, "Aly -l6-:- '. z-. , � � �`, `221413 0 imc-S. .. Date....`1....'.... ':3........ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ... ....X ::� ::....................................................................... has permission to perform -.�� " - �' - ` `` .....I,......../ ...`................ `................ wiring in the building of .. ................... ..:...-J............................... at .>'/............:...... . L 1 ��� .......,..... , North Andover, Mass. Fee.-.-' J..'`......... Lic. ELECTRICAL INSPECTOR Check #`� ���% 46j-� Ar Commonwealth of Massachusetts Official Use Only % �• Department of Fire Services Permit no. V637`" Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] (leaveblank) 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 INFORMATION) Date: 7-14-2003 City or Town of: North Andover To the jn ect re o{{Wire By this application the undersigned gives notice of his or her intention to perform electricalwor�c delcrtbe bi elow. Location (Street & Number) 21 Moody St Owner or Tenant Heri Raphore Owner's Address 21 Moody St North MA Is this permit in conjunction with a building permit? Purpose of Building home Telephone No. 1-978-618-6655 Yes ❑ No1F`71 (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Overhead Undgrd New Service Amps / Overhead Undgrd Number of Feeders and Ampacity No of Meters No of Meters Location and Nature of Proposed Electrical Work: install outlet in closet, move pool table light over center 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 AboveIn- rnd. ❑ ❑ No. of Emerg�ency Lighting Batter Um s No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones IN o. of Switches No. of Gas Burners No. of Detection and Initiatine Devices No. of Ranges No of Air Cond. No of Alerting Devices No. of Waste Disposers Heat Pump Number Tons KW No. of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area HeatingKWoca MunicOther ipal Connection El Elryers o m Heating pp icances KW Security Systems: No. of Devices or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Si ns Ballasts No. of Devices of Equivalent No. of Hydromassage Bathtubs No of Motors Telecommunications Wiring: HP No. No. of Devices of Equivalent OTHER: Att h addi 'onal detail i e ire , or s re fired b the Inspec r o ares. INSURANCE COVERAGE: Unless waived by the owner, no permit for ale per`ormance �>de�ec`rtcaq w�r`Ic ma� issue uutl°essltlwie licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such covera a is . 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: 7/14/2003 Inspections to be requested in accordance with MEC Rule 10, and upon completion I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME Expert Electrical Services, Inc.LIC. NO.: 17222A a _ Licensee: Stephen Decker Signature LIC. NO.: __1-800-418-3221 (If applicable enter "exempt" in the license number line) Bus. Tel. No.: Address: 44 Stedman St, Unit 2, Lowell, MA 01851 Alt. Tel. 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) L�wner wnees agent. Owner/Agent 25.00 � Location No. LiWo Date NORTH TOWN OF NORTH ANDOVER Certificate of Occupancy $ �sswcNusEt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # V 17.1/36 Building Inspe r W 'I TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR BUILDING PERMIT NUMBER: N SIGNATURE: A G0146( AV -4A^1"- Building Commissioner/inspector f SECTION i- SITE INFORMATION 1.1 Property Address: DATE ISSUED: Date 9� 1.2 Assessors Map and Parcel Number: 08/.0 d c3 y Map Number Parcel Number Zoning Information: 1.4 Property Gong LhAnct Proposed Use 1.6 BUILDING SETBACKS (ft) Front Yard Required I Provide I Lot Area (sf) Side Yard Provided Rear Yard Provided 1.7 Water SupplyM.GI..e.40. R 54) 1.3. Flood Zone Information: 1.8 sewerage Disposal system: Public ❑ Private ❑ 1 zone Outside Flood Zona ❑ Municipal ❑ On site Disposal system ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT c: 7 -flu 2.1 Owner of Record _ Name (Print) Address for Service 0 ti C O K-rM AP -T Q-7/ -- al:�Sc— r:�C 2.2 Owner of Record: QUlj C�j HWi,/ NamePrintAddress for Service: SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: NotApplicable ❑ Licensed Construction Supervisor: Address Signature Telephone 3.2 Re 'stered Home Improvement Contractor XM pT Company Name LJ aRCEs Address 576 License Number Expiration Date Not Applicable ❑ l 2 (&&q Registration Number I S-/�/0(P Expiration Date 1 n 7 s S C Id SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. in the denial of the issuance of the building permit. Si ned affidavit Attached Yes ...... X No ....... 0 SECTION 5 Descri tion of Propmd Workcheckdl a ble New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Failure to provide this affidavit will result Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: `•� ® ' 1�1r1� t P $ "REg,ao SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Com leted by permit applicant OFFICIAL USE ONLY 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1 as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1 (–�) Vl,l.s H p as Owner/Authorized Agent of subject property Herebv declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name nn Si ature of Owner/Agent �— Date NO. OF STORIES SIZE BASEMENT OR SLAB RD SIZE OF FLOOR TDABERS INT2' 3 SPAN DIMENSIONS OF SILLS DM ENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND rc Rr m ntnr: CONNFCTFD TO NATURAL GAS LINE r 0 H H.. O z E N Z N O N m Cts CID O Of C •C N CD t `o Z O co 03 a / J W � •Q. O O L Cl 0 W W W 0 o a O CO,r..• Q CJ U C C O O W CD o O L L m �.. ci �+ z x o E N Z N O N m Cts CID O Of C •C N CD t `o Z O co 03 a / J W � •Q. O O L Cl 0 W W W C O � C H O CO,r..• Q CJ C C O O CD o O L m �.. O �+ d. r0.. N E S � om O O s cm _c o m O � • Q! C gyp O m C C � a ._ m � cc C A N �E m o v� - a O m G •=-+v OQ C H :CD 0 S. Cam VC cc d� co H c CL - Vi W 'r c A = �0+ LLJ •H •t O W �E fi C Cos C-3 .0 CO3 CLS Vi CL m O A 2 42 �=�a� m E N Z N O N m Cts CID O Of C •C N CD t `o Z O co 03 a / J W � •Q. O O L Cl 0 W W W 0 W W W North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision 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 licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: (4-) - Q b -7Li c-rbIU ( HA 0 1-7,-),V (Location of Facility) Signature of Permit`Applicant ,) , Date' NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector Nov 23 04 11:29a J. Tristen Fletcher 9788872462 p.4 HOME IMPROVEMENT CONTRACT Di Sold, Furnished and Installed b � Branch Name: Date•��� THD At -Home Services. Inc. d/b/a The Home Depot At -Home Services 345A Greenwood Street, Worcester, MA 01607 Branch Number: Job #: Toll Free (800) 657-5182: Fax: 508-756-2859 Federal IDA 75-26994611 ME Lic # C 02439 RI Cont. Lick 16427 CT Lic# 565522; MA Home Improvement Contractor Reg. #126893 Installation Address: Z� cJ " ' ����� �✓ y+f� City State Zip Purchnseris): nriverc Lic. # &- Exn. Date: Work Phone: Home Phone: Home Address: (lf different from Installation Address) City State Zip 661s - Project Information: I/We/You ("Purchaser"), the owners of the property located at the above installation address, offer to contract with Home Depot U.S.A., Inc. ("Hon Depot") t furnish, deliver and arrange for the installation of all materials as described on the attached Spec Sheet #:i `f 07 incorporated herein by reference and made a part hereof. Home Depot reserves the right to cancel this contract if, upon re -inspection of the job, Home Depot determines that it cannot perform its obligations due to a structural problem with the home or because work required to complete the job was not included in the contract. CONTRACT AMOUNT $�Q� *LESS DEPOSIT $ 3.t7 BALANCE DUE �^"�r— ON COMPLETION $ t; J lm�s inimuo of Contract Amount due upon execution this contract. Indicate Payment Method For BALANCE DUE ON COMPLETION: i e�l 0. DEPOSIT PAYMENT OPTIONS (Subject to fund verification und/or credit approval.) I. Check, Cashiers Check or US Postal Service Money Order (Made payable to The Home Depot). 2. Credit Card* and/or other payment options - Circle One Below Visa MasterCard Discover Atriven • press The Horne Depot Home Improvement Loan The Home Depot Credit Card Available Credit: S ( HIL & HDCC ONLY) Aceto.: Exp. Date: _!/ 3.7 /7 2 c7_;b0 Z Name as it appears on card: *By my!our signature below, ].,'We agree to allow Home Depot to charge the above rcic;�= d r, the deposit indicated. r/ff 0 Cardh dcr's Signature Date HIL or HDCC Authorization Codes Deposit Final Payment # # Purchaser agrees that, immediately upon satisfactory completion of the work.. Purchaser will execute a Completion Certificate and pay any balance due. Purchaser also agrees to be jointly and severally obligated and liable hereunder. Entire Agreement: This agreement and its attachments, including any financing agreement, contain the complete agreement eUveen the partics and can not be amended or modified unless in writing in a separate agreement signed by both parties. NOTICE TO PURCHASER Do not sign this contract before you read it. You are entitled to a completely filled-in copy of the contract at the time you sign. Keep it to protect your rights. Do not sign any Completion Certificate or agreement stating that you are satisfied with the entire project before this project is complete. Law prohibits home repair contractors from requesting or accepting a Completion Certificate signed by the owner prior to the actual completion of the work to he performed under the contract. You may cancel this transaction at any time prior to midnight of the third business day after the date of this contract. See Notice of Cancellation for an explanation of this right. There will he a service charge equal'to 25% of the contract amount if the job is cancelled by Purchaser AF'T'ER the third business day. BY %1y.,O1JR SIGNATURE BELOW. I: WE AGRIA; TO 13E HOUND BY THE TERMS OF THIS CONTRACT. UW E ACKNOWLEDGE RECEIPT OF A COPY OF THIS CONTRACT AND TWO COMPLETED COPIES OF THE NOTICE OF CANCELLATION. BY MY/OUR SIGNATURE BELOW. UWE UNDERSTAND THAT THE AGREEMENT IS SUBJECT TO REVIEW OF MY/OUR CREDIT HISTORY AND IIWE AUTHORIZE" HOME DEPOT AUTHORIZED CONTRACTOR, TO VERIFY AND REVIEW MY/OUR CREDIT RECORD WITH AN INDEPENDF-,NT CREDIT REPORTING AGENCY AND RELEASE THEM FROM ALL LIABILITY yuan 26Pla I �� a: x �ogel'as1W r: C m s]ayau� d a6P3 dYd PotuaA I a , :azlS 16Ws Irt 0 w 11 v� c = w Q W yuaA atUad Mol I J N I m y J w Q m — c a NuoP�os LU Q m U O ru W o a ~ 0 1°- uJ cn Q LU I .I yuan 26Pla I �� a: x �ogel'as1W r: C m s]ayau� d a6P3 dYd PotuaA c :azlS 16Ws Irt 0 w au!gynl = w Q W yuaA atUad Mol yuan 26Pla I �� Gi Iff UO�yaaj I Q N I V O i W I LL � _ aJ N 6'd Z9bZLBBBL6 .Aaya-4at� ualsiul -C E6Z=TT i7O EZ ^oN I r: C Irt 0 W J N y J Q m — c a °1 o uJ Gi Iff UO�yaaj I Q N I V O i W I LL � _ aJ N 6'd Z9bZLBBBL6 .Aaya-4at� ualsiul -C E6Z=TT i7O EZ ^oN rl'61v 23 04 11:29a J. Tristen Fletcher Branch:jO,ell/ ROOFING SPEC SHEET Branch #:T% DESCRIPTION OF WORK 9788872462 P.1 Spec Sheet #:... Job #: CUSTOMER INFORMATION f� Home Phone #: p 2-5 7WS' Customer Name: Cell Phone #: (4�) Z72— .S`JDy Job Address: 2/ 1"00% Work Phone #: ( } Street Address Email Address: O Drop Location: City slate Zip Code Dumpster Location: (A) SHINGLE APPLICATION AND REMOVAL SHINGLE SPECIALTY ROOFING REMOVAL METAL FLASHING Product Color Product Color Check all that apply Timberline 30 Low SI e Asphalt Step Royal Sovereign Timberline Ultra 2CU�¢' Fl Tile Wood Shingles Tile Counter Base Grand Slateoo Metal Modified Chimney Grand Sequoia Price Includes: Shingles (field, starter, hip & ridge), Leak Barrier and Class IV Other' Tar & Gravel Skylight \/ Drip Edge /\ Undedayment. 'Name: "# Layer s Other Peace of Mind Installation fres No System: 'Style: See add'I charges below Color (B) VENTILATION (C) SOFFIT, FASCIA & GUTTERS (D) MISCELLANEOUS Exhaust Ridge Vent Turbine Vent Low Profile Intake Soffit Vent Vented Drip Edge Product ffit & Fascia Wrap Fa Only Cover Frieze Boa Gutter & Downspout Color Cricket Storie A ess >ReplFascia Color: • Color: f Cover Frieze B PV fm CollYes with: Tuck "a under Gutters: El Vertical Soffit - INSTALLATION NOTES List locations of metal flashinglgutterslsoffit & fascia to be installed and any other special considerations. tt/l%r7� No T -- 77 a 4/ G a 2 �� v2 /i M/l r PRE-EXISTING CONDITIONS Descr be any pre existing conditions (stains on ceilings, bent or damaged gutters, etc.) and list locations below: Walls Ceilings Windows Siding Gutters Driveway Landscaping ADDITIONAL CHARGES If rotted or damaged wood is discoveredAFTER removing the existing roofing, or cowl not be identified at the time of sale, there will be an additional charge of $ per sheet of 4x8 sheathing and/or $ per linear foot of dimensional lumber. "If additional layers of roofing are discovered AFTER removing the first layer, or could not be identified at time of sale, there will be an additional charge per square to remove each additional layer based on product to be removed: S for composition shingles, $ for wood shingles and $ for low slope roofing. I have reviewed and agree a job Sppejcifications described above: ` Customer Signature: !/ Date: ! X27 —ad 5-13-04 SFC -R Ix V , 0 0 V O .fl i L y � � a >• rn h 16A n Sb o � i o Y ,z Y w1 • L 7 G _]ataOtYt is v