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HomeMy WebLinkAboutMiscellaneous - 23 IPSWICH STREET 4/30/2018 23 IPSWICH STREET ` 210/023.0-0045-0000.0 ` /. �i Claim # Advantage Claim Services Adjuster Assigned: Glenn Guarente 522 Chickering Road #B North Andover, MA 01845 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec. 3B To: Building Commissioner (V/ Board of Health or Inspector of Buildings Board of Selectmen Town Hall Town Hall North Andover, MA 01845 North Andover, MA Re: Insured: Richard H. Harrington Property address: 23 Ipswich St. North Andover, MA 01845 Policy #: 0125703 Loss of: 2015/02/13 File or Claim No. AD 1649 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass._Gen._Laws,_Chapter_143, - Section_6 to be applicable. If any notice under Mass_Gen_Laws,_Ch._139 Sec. 3B is appropriate please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number,. date of loss and claim or file number. Glenn Guarente Title: Adjuster On this date, I caused copies of this notice to be sent to the persons named at the addresses indicated above by first class mail. 02-17-15 Signature and date 75 f Date.. . .-.z.!.:..11.. NORTH 3?Oyi�.ao ,6OL TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION y �9SSACHUSEt'( This certifies that . . . . . . . ./'f .y . . . . . . . . . . . . has permission for gas installation . . . . .6,l 91.4 4-4. . . . . . . . . . . . . in the buildings of . . . . .P10146 tvy.Tprl./. . . . . . . . . . . . . . . . . . . . } at3 . . �i C.fir/. . . . 5?� . . . . .. North Andov r, Mass. Fee. 349� Lic. No.!s7IAZ.. . . ./ 1w- . �. . . P� GAS INSPECTOR Check 4 -7 0,? 7 MASSACHliSEM LNHDKN1 APPUCATON FOR PMNIff TO DO GAS FrrMG (Type or print) Date 4, NORTH ANDOVER,MASSACHUSETTS Building Locations it 3 ,t iyl,- $ / Permit# Amount$ Owner's Name New❑ Renovation ❑ Replacement � Plans Submitted ❑ w � E-4 w x U z z a E, a 0 O 27 W Ski E tA7 rt" "" C4 CW7 H z F pZ H 4 W C7 pOH� 0F`+ a •] W O [� $ A U` a 0 U Cd CAC a F D SUB -BASEMENT BASEM ENT 1ST. FLOOR 2ND . FLOOR 3RD. FLOOR . 4T I3 . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 4 8TH . FLOOR (Print or type) Check one: Certificate Installing Company NameDy.Z C l G ��� !f�(� � /� FI Corp. Address Partner.. n Business Telephone 9 y z - 515'1 V,,5 ' rl Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes [j No 0 If you have checked yes,please indicate the type coverage by checking the appropriate.box. 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 NIP). General Laws,and that i si ature on this pe it application waives this requirement. t Com, Check one: Signa ure of Owner or Owne 's Agent Owner 13 Agent 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 m} knowledge and that all plumbing work and installations perforniod under Permit ISSUed for this application will be in compliance with all pertinent provisions of the NIaSSachuSCtts State Gas Code and Chapter 143 of the Gencral Laws. By: Signature of Licensed Plumber Or Gas Fitter Title 0 Plumbcr / 1-</- 0 1- CityiTuwn 0 Gas Fitter tce—ns e iN um 'r Master APPROVED(-OFFICE USE ONLY) � Journeyman -62U9 k Date / a3 "' NORTH 3j 0.�^...�'.e`•,e�OpG TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,4 ,SSACNUSE� This certifies that .....................v! ...... ................................... has permission to perform .....!?oa e-51 ,,5g�2!✓�C E R ' .w Ta�-t wiring in the building of /� � i .� at.........;..�........... ..........................North Andover,Mass. . Fee..✓ ..`.':' Lic.Ndo.'� t;1�............ ..41 ........ ELECTRICALt PEC�OR ' Check # �,.. Commonwealth of Massachusetts Official Use Only -- :. ��� :a ,• Permit No. Z- _ Department of Fire Services Occupancy and Fee Checked / :J•, BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/991 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK t All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 C R 12.00 (PLEASE PRINT IN INK OR TYPE ALL t O ATION) Date: f / City or'Town of: nsLl To the Insp &tor of Wires: By this application the undersigned gives no ice of his or her intention to perform the electrical work described below. Location (Street& Number) 23 -1 w Owner or Tenant nvz Telephone No. Owner's Address Is this permit in conjunction with a building p mit? Yes ❑ No (Check Appro priate Box) Purpose of Building J�f e r Utilit Authorization No. (1 i� Existing Service 100 Amps [2J) / U Volts Overhead F Undgrd❑ No.of Meters J New Service Zoo Amps / 6 Volts Overhead IG/ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: xv de S ne(it C-e Coni letion of the following table inay be waived by the Inspector ofWires. 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 Above ❑ In- ❑ o. o Emergency Lighting rnd. rnd. Batte Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No. of Switches No.of Gas Burners No.of Detection and Initiating Devices No. of Ranges No.of Air Cond. Tonal No.of Alerting Devices ' No. of Waste Disposers Heat Pump I.Number Tons KW No. of Self-Contained Totals: I i Detection/Alerting Devices �r No. of Dishwashers Space/Area Heating KW Local ❑ Municipal El Other Connection No. of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent ent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation" coverage or its substantial equivalent. The undersigned certifies that such coge is in force,and has exhibited proof of same to the' rn pe -iit issuing office ve . CHECK ONE: INSURANCE BOND [I OTHER [I (Specify:) i9tf{'�j�Cjje.S' ,3 tis ( xp' alio ate) Estimated Value of Ylect ical Work: (When required by municipal policy.) Work to Start: p Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify, under th pa it jidpeizalties of perjury, that, ze info on on this application is true and complete. FIRM NAME: tJ n` t1. C LIC.NO.: LicenseeLq—e.VAPM 00 6,6 Signature LIC.NO.: (If applicable•eat on t the}/cense number line Bus.Tel. No.9-21 Address: /G/� P; IbL �! Alt.Tel. No.: OWNER'S INSURANCE WAIVER: I a 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: $ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with theprovisions of M.G.L,c.143,§,3L,the permit application form to provide notice of installation of wiring shall be uniforin throughoutthe Commonwealth,and applications shall be filed bn the prescribed form.Ager a permit application has been accepted by an Inspector of Wires appointed pursuant to M.CU o.166,§32,an electrical permit shall be issued to the person,firm or corporation stated on the permit application.Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall_be limited as to the time of.ongoing construction activity,and maybe deemed by-the Inspector_of_Wires abandoned-and-invalid.ifhe_. or she has determined that the aufhorized work has not commenced or has not progressed during the preceding 12 month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the.permit application. The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job;growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain-permits-and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008-and extenclingthrough August 15,2012. p4bi ule 8—Permit/Date Closed: _7 G3 l Note:Re ply for new permit 4urmitExtension Act—Permit/Date Closed: �-/ Commonwealth of Massachusetts Official Use Only — -_-- Permit No. ( 2 G7 ! _ ` Department of Fire Services O 7 ! Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/991 leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 C R 12.00 (PLEASE PRINT IN INK OR TYPEALI, I O=�A ION) Date: City or"Town of: To the Insp ctor of Wires: By this application the undersigned gives no ice of his or her intention to perform the electrical work described below. Location (Street& Number) Owner or Tenant G V Telephone No. Owner's Address `-' Is this permit in conjunction with a building p mit? Yes ❑ No (Check Appro riate Box) Purpose of Building Utilit Authorization No. J i _may IS Existing Service O Amps 'Zj/(j Volts Overhead Undgrd❑ No.of Meters New Service 0 t) Amps4t / 6 Volts Overhead EG Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: / C'!�C✓i C Y ' Completion of the ollowin table nitty be waived bZ the Inspector of Wires. 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 Above ❑ In- ❑ t o.o mergency ig ing rnd. rnd. Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No.of Zones No. of Switches No. of Gas Burners No.of Detection and Initiatin onsDevices s No. of Ranges No.of Air Cond. Total No.of Alerting Devices No. of Waste Disposers heat Pump FN­­u`m—b­e-r-J Tons KW No. of Self-Contained Totals: I I Detection/AlertinRDr Devices No. of Dishwashers Munici al l Space/Area Heating KW Local ❑ p El Other 1 Connection _ No. of Dryers Heating Appliances KWSecurity Systems: No. of Water No.of Devices or E uivalent No. of Heaters KW No. of Data Wiring: signs Ballasts No.No.of Devices or E uivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E uivalent Attach additional detail ifdesired,or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for theerformance of electrical P c Heal work may issue unless the licensee provides proof of liability insurance including"completed operation" coverage or its substantial equivalent. The undersigned certifies that such cove ge is in force, and has exhibited proof of same to th'permit issuing office. CHECK ONE: 11�ISURANCE L`1 BOND ❑ OTHER ❑ (Specify:) Estimated Value of 71ect ical Work: ( xp atiot ate) { (When required by municipal policy.) Work to Start: � ' inspections to be requested in accordance with MEC Rule 10,and upon completion. 1 certify, under th pa ltd perttzlties�ojpetjrtry, that/t fie info on on this application is true and complete. FII.UVI NAME: < �h G�{�, C (. _E C'� p LIC. NO.: aj Licensee. d 11 1.t, Cl)� (S Signature ' LIC. N O.: (!f¢pplic¢ble, el "exen:gt y7 the 1 cense number line I Address: �/ti tC./� l yt Bus.Tel. No.q 71 W � Alt. U tNk It S INSURANCE WAIVER: I a aware that the Licensee does not have the liability insurance overage 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.__ PER HIT FEE: $ Commonwealth of Massachusetts Official Use Only =t_: r: Permit No. �/> Z-- ,,=- Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/991 leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 C K 12.00 (PLEASE''PRINT IN INK OR TYPE ALI,JIORZ�A TION) Date:City or"Town of: To the Insp ctor of Wires: By this;application the undersigned gives no ice of his or her intention to perform the electrical work described below. Location (Street& Number) Z 3 -440 L Owner or Tenant y C- ,� /�12Va.I!q C�hn Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No rLZ (Check Appropriate Box) Purpose of Building (6� C �_ /yt-t.�t Utilit Authorization No. � Existing Service 1100 Amps (L�(J Volts Overhead Undgrd❑ No. of Meters _L— New Service 7u l) Amps �I / Volts Overhead EU Undgrd ❑ No. of Meters Number of Feeders and Ampacity r Location and Nature of Proposed Electrical Work: t, SnzLit C{' Can letion of the following table may be waived tiy the Inspector of Wires. 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 Above ❑ In- ❑ o. o mergency Lighting rnd. rnd. Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No.of Zones No. of Switches No.of Gas Burners No.of Detection and Initiating Devices c No. of Ranges No.of Air Cond. Tonal No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons KW No. of Self-Contained Totals: I. I Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection _ No. of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No. of Water No.of No. of Heaters KW N Data Wiring: Si ns Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total tip Telecommunications Wiring: No.of Devices or Equivalent O"rliER: Attach additional detail if desired,or as required by the Inspector of(Vires. f INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless j! the licensee provides proof of liability insurance including"completed operation" coverage or its substantial equivalent. The i undersigned certifies that such cove ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE LL1 BOND ❑ (Specify:) ❑ OTHERt�t/%1J17,131• GS i Estimated Value of 'lect ical Work: (When required by municipal policy.) (Expatiotate) Work to Start: / U Inspections to be requested in accordance with MEC Rule 10,and upon completion. ! I certify, tinder th pa it td penattie sof perjury, that tfte info oat on this application is true and complete. FIRM NAME: � �0 � �?G 1l�• C CQ, 0 LIC.NO.: —fro j Licensee* i1 �'st tj r�_d Signature LIC. NO.: i (If applicable, er' "ezerng�. yyt the license number line Bus.Tel. No. r Address: VH IG/� e �bt. � ' Alt.Tel. No.: +� OWNER'S INSURANCE WAIVER: I a 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. I PERMIT FEE: $