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HomeMy WebLinkAboutMiscellaneous - 247 GREENE STREET 4/30/2018L Date .��11q.......... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies tha...... .k.....M.L..)........Q.....�......�...................�....�....... .......... has permission for gas installation �. c1esV...........� P in the build* sof ..... t;;,,. C.) g e..'t.,.._.................................................................... 1..... North Andover Mass. ...... ..... ........ ...... . Fee.b -- Lic: No. +� GAS INSPECTOR Check # G 5b-4— G TYPE OR PRINT CLEARLY MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY I North Andover MA DATE PERMIT # JOBSITE ADDRESS OWNER'S NAME OWNER ADDRESS I Same I TEr 1FAXF OCCUPANCY TYPE COMMERCIALE] EDUCATIONAL NEW: ® RENOVATION: 0 REPLACEMENT: El APPLIANCES Z FLOORS— BSM 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 / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER RESIDENTIAL El PLANS SUBMITTED: YES® NOO 10 1 11 1 12 1 13 1 14 'y INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES ONO 1 IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY El 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 El 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 pliance with all rPnertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. —1/ 4 1l PLUMBER-GASFITTER NAME I Joseph Marino LICENSE #18736 V U SIGNATURE MP [D MGF ❑ JP[j JGF ® LPGI ® CORPORATION > ✓ #3285C PARPSHIP ®# LLC ®#�� COMPANY NAME:j RH White Construction Co ADDRESS 141 Central St CITY I Auburn STATE MA ZIP 01501=TEL 1 (508) 832-3295Atu FAX 508-926-4347 j CELL 508-832-4614 EMAIL JMarino@RHWhite.com A �,a w E- 0 z z 0 H U W Q, z d z 0* w I� Z o z O W El �' w ~ w a a O u W it z CA a W > a a O W W � Q w co QZO a a a U x H a a a � 2 W F- U. cn H O z � z o U W A. CA z x 0 x v r LL>- WLU uj <Z .U' o 0=1 > .0 CO J-1 L(j x -Z < LU Mtn w. Lul:� No "Al . ....... kv. ge"; �CC7 D® `=-- /9010ERTIFICATE OF LIABILITYINSURANCEPage 2/230 THIb'UERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE. DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the 113060 03)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 notconferrights to the certificate holder in lieu of such endorsement(s), willim of Massachusetts, Inc. C/o 26 co-Atury Blvd. P. 0. Box 305191 Nashville, TN 37230-5191 R. R• White Construction Company, Inc. 41 Cmnttal Street P. 0. Box 257 Auburn, MA 01501 _y%Z-7378 I 'rniP,NO): 8813-467_-237 INSURER(3)AFFORDING COVERAGE NAIL rl A: The Cbartes Oak Fixe Insuranno Company 25EIS-001 e:Traval-ra Property Casualty Cogpany oP Jun 25674-003 D:NnCio>aa1 Union Fir9 Insurance Company o£ x.9445-001 D; Travelers Inflmmrxa ty Compzsay 25659-DO1 - - --� ticRfIrIL;a1lr-NUMI3ER:202EI76B0 REVISION NUMBER, THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAM BD ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED SY 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. IR dD' SUB --- a AA I GENERAL LIABILITY iMr:RDIALGENERAL LIABILITY CLAIMS -MADE OCCUR APPLIES PER; B I AUTOMOBILE LIABILITY ANY AUTO NED AUTOS AUTOSsCHF.D HIREDAUTOS X NON -OWNS AUTOS Co Defl X C4x1 Ded C UMBRELLA LIAR X OCCUR E:XCESa LIAB CLAIMS -MADE DED y RETENTIONS 10,00 VTC2000 97789948-13 19/1/2011 1'9/7./2014 VTJC:AP 977R9SSA-13 9/1/2013 9/1/2014 BE8766140 9/1/2013 9/1/2014 D WORKERS COMPENSATION FiiCUB 82 0 5A18 5 -13 9 AND EMPLOYER8'LIABILITY Y N /1/2013 9/1/2014 D ANY PROPRIETORIPARTNFRIFXECUTIVffY/N NIA VTC2KrIB 920 A71A-13 9/3,/201.3 9/1/a 014 (O(FFICER,MEMBE;R EXCLUDED? I " 1j ITM t, des I lbe �rn dnr U�csUnn• I UN OF UftRATIONS bele, I I" EvidOnce of Inmurance Remarke more apace ny one &ADV 2,000,000 BODILY INJURY(Perperson) 130DILY INJURY(Peracoldont) kACHACCIDENT $ 110001000 DISEASE-EAEMPLOYF_E S 1,000,000 DISEASE -POLICY LIMIT $ 1,000,000 SHOULD ANY OP TWE ABOVE DESCRIBED POLICIES 8E CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE: WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTFIORIZMD AtPRESENTATNE C*11:4197604 Tp1z1694012 Cext:202876$0 ©1988-2010ACORD CORPORATION. All rightsreserved. ,CORD 25(2010/05) The ACORD name and logo are registered marks of ACORD ENCOMPASS® I N S U R A N C E Form of Notice of Casualty Loss to Building Under Mass.Gen.Laws.Ch, 139.Sec.3D TO: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectmen CITY/TOWN HALL: NORTH ANDOVER BUILDING DEPARTMENT 1600 OSGOOD STREET NORTH ANDOVER ,MA 01845 RE: INSURED: Jeffrey I Costello PROPERTY ADDRESS: 247 Greene St North Andover, MA 01845 POLICY NO.: US 281189409 DATE OF LOSS: 10/16/2010 CLAIM NUMBER: Z6085850 encompassinsurance.com 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, Chapter 139, Section 3D is appropriate, please direct it to the attention of the undersigned and include a reference to the captioned insured, location, policy number, date of loss and claim number. TITLE: Claim Service Adjuster On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. SIGNATURE AND DATE: Daum McComcack 10/18/2010 BUYER: COstello, Assaf P, Morin k J' o)I4l the wow ioi of►, ILI s r � i LOT 3 I Ipoe� �Lo 0' - I �->Tclz 0 i 4 Z`4? 6 M? - 5; i SFA 3A i S©:ate, i) !--•- -- - Z -t T 7� 3���' Revised 2-28-01 TO THE ( Romeside Lending AND ITS TITLE '"SL" MOk700 AGE INSPECTION PLAN I CERTIFY THAT THE BUILDINGS AHOUN DO ( )CONFORM TO SETBACK REQUIREMENTS r�An\)�I.E (FRONT. SIDE. is fiEAR rE'iBACK ONLY) aPrb� 1••1 /�4.1b'V V44EN CONSTRUCTED, OR ARE E)MdPT PROM VIOLATION CEMENT ACTION UNDER MASS. G. - TITLE All CHAPTER 4OA, SE07ION 7, UNLESS OTHERWISIL NOTED. j MASWHUSI`TTS I FURTHER CERTIFY THAT THIS P"TY IS NOt LOCATED IIN 0T E dESTAB ROUSHED ROOD HAZARD AREA' OOMMUNITY PANEL NO.: 250098 0r03C DATE: 6-2-93 DEED THIS COMPANY IS NOT R£SPONSN" FOR ANY INDENTURES MADE SUBSEQUENT TO THE RECORDED BOOK A O'�E5 DATE OF THE LATEST DEERECORD .PAGE OF RECO. Z g PApE 04ENEVER BUILDINGS ARE SHOVM LESS THAN ONE FOOT FROM THE PROPERTY UNE IT IS ADVISED THAT A MORE PRECISE SLOW BE MADE To VERIFY THESE MEASUR€UENTS CERT. NO.NOTE�------- -- THLS CERTIFICATION IS BASED ON T}E LOCATION OF SURVEY MARKERS OF 7PLAN BK. PACE _-- T A PROPERTY $Uft%tY. V AgCATION OF SURVEY MARKERS U q _ MA TE ACCOMPUSHED ONLY sY AN AWJRATE, INSTRUMENT SURVEY p{pT PLAN •2 � DATED B / Z THIN CERTIFlCA110N TO BE USED FOR MORTGAGE PU S ON tt,,�� OFFSETS AS SHOWN ARE NOT TO BE I JKAE. USED FOR THE ESTABLISHMENT OF PROPER 'N No 462r SCALE: I"., ho �yo�. BRADFORD suav GINEERING CO. -• P.O. NX 1244 Location 24-1 S _ No. i l Date 784` TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Pern Fee $ Other Permit Few $ Sewer Connection Fee $ Water Connection Fee $ TOTAL do$ o Building Inspector Div. Public Works m NO. 0 U APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 AP d40. DNE LOT NO. I 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE SUB DIV. LOT NO. A -)CATION ! PURPOSE OF BUILDING WNER'S NAME �C NO. OF STORIES E WNER'S ADDRESS N T BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN -- DISTANCE TO NEAREST ILDING DIMENSIONS OF SILLS POSTS DISTANCE FROM STREET 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 SEE BOTH SIDES PAGE 1 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 PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED SIGI"'rURE OF OWNERoOR AUTHORIZED AGENT FEE PERMIT GRANTED I I i I 19_ 3 PROPERTY INFORMATION LAND COST si EST. BLDG. COST R EST. BLDG. COST PER SG. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY NUILDING INWFKCTOR OWNER TEL. # c- / �'` C/— CONTR. CONTR. TEL. # , &Z3.7 CONTR. LIC. # H.I.C. # �� 3 3 :4,-(rcvf 9 BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY ORIES MULTI. FAMILY r—Ol"CEs APARTMENTS _ CONSTRUCTION 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE PINE 3 1 2 13 CONCRETE BL K. BRICK OR STONE HARDW D PIERS PLASTER DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN, B M AREA _ '/ 1/2 '/ FIN. ATTIC AREA NO B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS B t 2 3 _ DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ ,ARDVI D COMMON ASP,. TILE STUCCO ON MASONRY STUCCO ON FRAME _ BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIORI� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE GAMBREL FLAT HIP BATH (3 FIX.) MANSARD TOILET RM. 12 FIX.) 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 1.1 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 H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd ELECTRIC _ tsr 13rd NO 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. ON h 43 h w A O o w° T a cn p U z Q o z°�'° o w o a: , v s U m G w O U � Ci)u m o a! G w cY W u U w 0 w > ;, cn a O U °�° o G H W A w E ° z v b cn Q o E cn E ID N O i N C O m C: cm C m L 0 CD C �C N CD t 0 Z O g O cd :O W J� .A � Me GD O c 0 O O v Z CLO O y w+W � CM I O CD O �O .P m m O.. I.— CD � � L CL �a C 0 � C C A J -o .c 0 CO Z co V CO) C CL O CO) J z LL P� cr- W a_ � cc: Z F— C) Z � w Q w LU c/1 > O U M t}' c c m c c � o ` OC_ *co,) C V V �a'fl O O •s o teF E Q L CD ci• 4� J •`VRFT m a C ca oD O 0 co c CL= CO) A N c m 3 m� _ ca C N ev CO) m Q ate N O � Z O N Q gtrC Q C.CZ o 0 o yZ v C c CL o Q N O C oCL COD rr Wm m W LLcan W rE v -0C7 a. cm O � C CO) F211 Z -. ca m:g o a.4m E ID N O i N C O m C: cm C m L 0 CD C �C N CD t 0 Z O g O cd :O W J� .A � Me GD O c 0 O O v Z CLO O y w+W � CM I O CD O �O .P m m O.. I.— CD � � L CL �a C 0 � C C A J -o .c 0 CO Z co V CO) C CL O CO) J z LL P� cr- W a_ � cc: Z F— C) Z � w Q w LU c/1 > O U M t}' •% u J C � Date. . ..... . �l NORTH pf ,4, TOWN OF NORTH ANDOVER z i 'e p J 4. , PERMIT FOR GAS INSTALLATION; Thio nortiiiae that �/ it �/ /'� ! C/� /7 'r has permission for gas installation .. �.. S .................... . in the buildings of .'... r . N. { e r � . ...................... . at .........., North Andover, Mass. Fee. . ?.... Lic. No. J. .'.. ........................... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer OPM-FIVOC I IQ u1v1t-UKM ANN (Print or Type) PERMIT TO DO GASFITTING rf o w 0 - . Mass. Date /-'--c3 - 19� Pennit # % v Building Location—&2 Yi f"r Owner's Name 4f,&,S7-6uA Type of Occupangy� 'TIrJ�ti New ❑ Renovation ❑ RepiacementD Plans Submitted: Yes[] No�j Installing Company Name. BAY STATE GAS COMPANY Address 55 MARSTON STREET LAWRENCE; MA 01840 Business Telephone 5 0 8— 6 8,7 =110 5 . Check one: 10 Corporation ❑ Partnership ❑ Firm/Co Certificate # 1862 Name of Licensed Plumber or Gas Fitter Francis X. Corker INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes K No ❑ If you have checked Yes. please indicate the type coverage by checking the appropriate box. A liability insurance policy X 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 Mass. General Laws. and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's /gent Owner[] Agent ❑ I hereby certify that all of the details and information 1 have submitted (or entered) in abo knowledge and that all plumbing work and instailatioru performed under the permit mss f r this application are true and accur to to the best of my Pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene application Wil U n mpiiance with all � Tywi of License: Title Plumber Gasfdter Smgnature o cen umber or Gas CityiTown y 1,tatl Master y UyxVcenWx�se NumbNah=e r haC' 8697 r 0 Journeyman 0 W 0 0 A z W < tv 0 z 0 Oa %w W Q Wp p, r}�f.- ra W y Jx aW aW tlW azm Lt1 h x W-4= H t`° °> o u. m wY< ay.. °xtl xW a' O ,F- V r= 3-- cm a �y F O SUB—BSMT. BASEMENT 1 ST FLOOR 2ND FLOOR 3RD FLOOR _ 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR , STH FLOOR Installing Company Name. BAY STATE GAS COMPANY Address 55 MARSTON STREET LAWRENCE; MA 01840 Business Telephone 5 0 8— 6 8,7 =110 5 . Check one: 10 Corporation ❑ Partnership ❑ Firm/Co Certificate # 1862 Name of Licensed Plumber or Gas Fitter Francis X. Corker INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes K No ❑ If you have checked Yes. please indicate the type coverage by checking the appropriate box. A liability insurance policy X 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 Mass. General Laws. and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's /gent Owner[] Agent ❑ I hereby certify that all of the details and information 1 have submitted (or entered) in abo knowledge and that all plumbing work and instailatioru performed under the permit mss f r this application are true and accur to to the best of my Pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene application Wil U n mpiiance with all � Tywi of License: Title Plumber Gasfdter Smgnature o cen umber or Gas CityiTown y 1,tatl Master y UyxVcenWx�se NumbNah=e r haC' 8697 r 0 Journeyman 0 W 0 0 A Z - 0 v W CL , N _Z N N W a n O c ID. Z�O JI a 7- U. LL n z• w N y. Q J n � O O O O ~ W V � • a 0 n. 0 z • a Ir 0 0 ti ti � z O o ., w a m cs J CL CL a w W W Z�O JI a 7- U. LL