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North Andover Board of Assessors
Sroperty Record Card
Location: 250 ANDOVER STREET
Owner Name: GOULART JR., MANUEL, D.
GOULART, NOEL
Owner Address: 250 ANDOVER STREET
City: NORTH ANDOVER State: MA Zip: 01845
Neighborhood: 5 - 5 Land Area: 0.40 acres
Use Code: 101-SNGL-FAM-RES Total Finished Area: 2406 sqft
ASSESSMENTS CURRENT YEAR PREVIOUS YEAR
Total Value: 409,600 384,600
Building Value: 235,700 204,400
Land Value: 173,900 180,200
Market Land Value: 173,900
Chapter Land Value:
http://csc-ma.us/PROPAPP/display.do?linkld=2253358&town=NandoverPubAcc 3/26/2013
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www.ruskin.com
Doug LaFond
Westford, MA
To: North Andover Building Department
1600 Osgood Street
North Andover, MA 01845
Plumbing Inspector: Jimmy Diozzi
September 25, 2009
Dear Mr. Diozzi,
I'm requesting that the North Andover Building Department remove my name
and any obligation from the three permits (two plumbing and one gas) for 250 North
Andover Street house owned by Manuel Goulart. This job remains incomplete, including
the gas flue. I am no longer working on this job due to a financial dispute over non-
payment.
Sincerely,
Doug LaFond
2ows
Thomas M. Connelly
23 Goldsmith Street
Littleton, MA 01460
September 28, 2009
To: North Andover Building Department
1600 Osgood Street
North Andover, MA 01845
Building Inspectors: Gerald Brown
Brian Legthe
Re: 250 Andover Street
North Andover, MA 01845
I have enclosed a copy of the original structural engineers letter that I delivered to the
building department upon your request in March of 2009. As you can surmise from the
letter there are very important structural footings and lally columns in the engineers plan.
This house was reconstructed from the foundation, first and second level floor joist and
continuing to the roof. All the new loads come down on these points. I don't believe that
this work was ever completed. Also there are many other important items on the four
open permits that have not been completed. I would like to reiterate that I want the North
Andover Building Department to remove my name and any obligation from the four open
building permits for 250 Andover Street, North Andover, MA 01845. I am no longer
working on this job due to a financial dispute over non-payment.
Sincerely,
Thomas M. Connelly
Cc: Ipswich River Engineering, Inc., Donald Peach
Attorney Jon H. Kurland
Mr. Manuel Goulart
f
IPSWICH RIVER
ENGINEERING, INC.
STRUCTURAL ENGINEERS
March 30, 2009
Tom Connelly
Tom Connelly Woodworking
23 Goldsmith Street
Littleton, MA 01460
RE: STRUCTURAL EVALUATION OF LAMINATED VENEER LUMBER MEMBERS
AT THE 250 ANDOVER STREET RESIDENCE
250 Andover Street - North Andover, Massachusetts 01845-5238
Ipswich River Engineering, Inc. Project No: IR -0254
Dear Tom:
r
Ipswich River Engineering, Ines (IREI) has retained by Torn ConnellyWoodworlang (TCW) to view and
evaluate the laminated veneer lumber (LVL) timber fuming that TCW has installed at the above
referenced residence as part of their renovation work at this residence. On March 19, 2009 IREI vii ited
the above referenced residence to view the installation of the LVL umbe'r framing that TCW had in stalled
in the floor and roof framing at the residence. MEI gathered field data on the LVL members, as installed,
and reviewed these members for the floor and .roof loading that they support.
The results of IREI's review of this "as -built" LVL framing completed by TCW indicated that in IREJ's
professional opinion, the LVL roof trimmer rafters at each side of the new skylight rough openings in the
main roof framing appeared structurally suf dent from a strength point of view to .support the demi and
snow loads but appeared to need an additional LVL pry, added to each LVL trimmer rafter member to
provide sufficient member section to accommodate the code required.deflection criteria. IREI also
recommended that lateral bracing gussets be installed at the side of the new Second Floor LVL men fiber
adjacent to the new stairway -opening to.provide laiteral-torsional bracing of the new LVL floor bear -i. On
March 25, 2009 IREI visited the.site to view the completed modifications,to the designated new LV1
framing as recommended by IREI. At that site. observation visit, IREI observed that it appeared thy t TCW
had completed the IRM recommended.modifications to the new LVL framing. MEI takes no exceptions
to the other LVL framing as observed by MEI at the residence at the time of IRErs two site observation
visits at the residence.
During the March 19, 2009 site observation visit at the residence, IREI recommended to TCW that: at
three locations new reinforced concrete spread footings be installed in the Basement Level of the re3idence
to provide support to the bottom ends of the new timber posts supporting the new LVL framing at the
floor framing above. MEI .recommended installing new T -6"x2' -6"x1'-6" thick footings at these di ree
locations with 3 - #4 reinforcing steel bars each wiry at the bottom of the footings (providing 3 inch
162 Park Street -Suite #203, North Reading, MA 01864
t: 978.664.6925 f: 978.664.6926 www.irengincering.com
The dif f erence between the ordinary and the extraordinary is the extra, client service Are provide.
'f IPSWICH RIVER
ENGINEEkING, INC.
STRUCTURAL ENGINEERS
March 30, 2009
Tom Connelly
Tom Connelly Woodworking
23 Goldsmith Street
Littleton, MA 01460
RE: STRUCTURAL EVALUATION OF LAMINATED VENEER LUMBER MEMBERS
AT THE. 25o ANDOVER STREET RESIDENCE
250 Andover Street North Andover, Massachusetts 01845-5238
Ipswich River Engineering, Inc. Project No: IR -0254
Dear Tom:
Ipswich River Engineering, Ines (IREI) has retained by Tom Connelly Woodworking (TCW) to view and
evaluate the laminated veneer lumber (LVL) timber framing that TCW has installed at the above
referenced residence as part of their renovation w6rk at this residence. On March 19, 2009 IREI visited
the above referenced residence to view the installation of the LVL timber framing that TCW had in Stalled
in the floor and roof framing at the residence. IREI gathered. field data on the LVL members, as installed,
and reviewed these members for the floor and roof loading that they support.
The results of IREI's review of this "as -built" LVL framing completed by TCW indicated that in IR)"I's
professional opinion, the LVL roof trimmer rafters at each side of the new skylight rough openings in the
main roof framing appeared structurally sufficient'from a strength point of view to support the dead and
snow loads but. appeared to heed an additional LVL ply added to each LVL trimmer rafter member to
provide sufficient member section to accommodate the code reguired.deflection criteria. IREI also
recommended that lateral bmcing gussets be installed at the side of the new Second Floor LVL meixiber
adjacent to the new stairway opening to provide lateral -torsional bracing of :the new LVL floor beam. On
March 25, 2009 IREI visited the site to view the completed modifications,to the designated new LVI,
framing as recommended by MEI. At that site observation visit, IREI.observed that it appeared that TCW
had completed the IRgI recommended.modifications to the new LVL framming. MEI takes noexceptions
to the other LVL framing as observed by IREI at the residence at the time of IREI's two, site observa tion
visits at the residence.
During the March 19, 2009 site observation visit at the residence, IREI recommended to TCW that: at
three locations new reinforced concrete spread footings be installed in the Basement Level of the residence
to provide support to the bottom ends of the new timber posts supporting the new LVL framing at the
floor framing above. IREI recommended installing new 2'-67x2'-6px1'-6" thick footings at these three
locations with 3 — *4 reinforcing steel bars each wily at the bottom of the footings (providing 3 incl-;.
162 Park Street -Suite r20)3, North Reading, MA 01864
t: 978.664.6925 f: 978.664.6926 www.irengineering.com
Thedifference between the ordinary and the extraordinary is the extra,client service we provide.
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Thomas M. Connelly
23. Goldsmith Street
Littleton, MA 01460
978-501-5951
Information Submitted To:
Charles and Andrea Garabedian
6 Keystone Way
Andover, MA
Job Location:
250 Andover Street
North Andover, MA
July 2, 2009
Hi Charles and Andrea,
We just wanted to give you a list of items that need to be completed on Noel's house.
Regardless of who does the work lots of the items are necessary to complete and shouldn't be thought of as cosmetic
extras. If some of these items aren't completed there could be further damage to the work that is presently completed or
could be dangerous for family members. This list is mostly inside the house, I'll send the outside later, with anything else
I remember. This list will help whomever you choose to finish it, but if they need more direction I'll have no problem
giving the individual information to complete the job. I would hope you know that the lines of communication are not
closed. We don't want another family frenzy over this. We're off on vacation so we'll get the bill to you when we
return.
Kitchen:
Install access panels in bottom of two base cabinets
Connect Toe luck heaters to Kitchen heating zone loop.
Anchor Dishwasher: Very Important! Dangerous for kids!
Install Wall Oven.
Finish Mantel.
Repair Refrigerator so that the side panels can be installed, and them finish crown molding.
Remove temporary nail in crown moulding left of kitchen sink.
Finish back of island
Install brackets to support granite counter top.
Water proof end of oak flooring at sliding doors and install eight -foot threshold.
Skylights and windows need polyurethane or paint
Kitchen counter lights need wires to be fixed.
Adjust all cabinet doors.
Plaster return wall at oven and paint.
Install moulding at bottom of refrigerator panel.
Install moulding at base of fireplace hearth.
Finish returns on cabinets.
Install end caps on baseboard heat.
Thresholds:
Bathroom door first floor.
Family room door first floor.
Office/Bedroom door first floor.
Front and side entryway doors first floor.
Master bathroom second floor.
Garage:
Walls around mudroom need insulation and fire code sheetrock installed
Bottom of mudroom needs to be insulated and capped with fire code sheetrock.
Cement needs to be installed under new door side of garage.
Finish door to mudroom, adjust door and support threshold.
Install handrails on garage stairs leading into house.
Family Room:
Install window locks.
Fill gaps where baseboard meets flooring.
Adjust doors.
Install baseboard -heating covers.
Office/Bedroom:
Finish Closet.
Adjust glass doors.
Adjust closet doors.
Install window locks.
Fill gap where baseboard meets floor.
Install baseboard -heating covers.
Living Room:
Install window locks.
Fill gap where baseboard meets floor.
Install baseboard -heating covers.
Dining Room:
Install window locks.
Fill gap where baseboard meets floor.
Bathroom first floor:
Install baseboard heating.
Connect into mono -flow loop first floor. Important!
Finish Baseboard
Install granite counter under electrical outlet.
Install panel in laundry room. (Already made)
Paint
Stairway and Hall:
Detail staircase mouldings.
Fill nail holes in oak stain and Scotia
Install handrails.
Install small piece of landing at '/2 knoll (already made)
r
Master Bedroom:
Install baseboard -heating caps.
Polyurethane or paint skylights.
Install mouldings in closet after closets are finished. (Already made)
Adjust all doors.
Attach sash cords to windows.
Master Bathroom:
Repair shower and install grabber and shelf.
Install moulding and trim around shower.
Install access panel to crawl space.
Insulate cold space.
Polyurethane or paint skylight.
Install closet door after closet is finished.
Cut and adjust door.
Basement:
Three new footings and lally columns installed according to Ipswich River Engineering instructions dated March
30,2009. Very Important!
Insulate all pipes necessary.
Insulate ceiling R-30
Finish stairs and handrails.
Miscellaneous:
Insulate ceiling behind knee walls over Bathroom, Family room Dining room and Kitchen.
Insulate, water proof, flash- and support thresholds at 8 -foot slider. Very lmportant!
Install roof flange and three-inch vent pipe.
Grading necessary around house to prevent water problems.
Fix grading around heating system exhaust vent. Very Important!
Be very careful before starting up heating system a professional should check system before purging. Very Important!
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Thomas M. Connelly
23 Goldsmith Street
Littleton, MA 01460
978-501-5951
Information Submitted To:
Charles and Andrea Garabedian
6 Keystone Way
Andover, MA
Job Location:
250 Andover Street
North Andover, MA
July 2, 2009
Hi Charles and Andrea,
We just wanted to give you a list of items that need to be completed on Noel's house.
Regardless of who does the work lots of the items are necessary to complete and shouldn't be thought of as cosmetic
extras. If some of these items aren't completed there could be further damage to the work that is presently completed or
could be dangerous for family members. This list is mostly inside the house, I'll send the outside later, with anything else
I remember. This list will help whomever you choose to finish it, but if they need more direction I'll have no problem
giving the individual information to complete the job. I would hope .you know that the lines of communication are not
closed. We don't want another family frenzy over this. We're off on vacation so we'll get the bill to you when we
return.
Kitchen:
Install access panels in bottom of two base cabinets
Connect Toe -kick heaters to Kitchen heating zone loop.
Anchor Dishwasher: Very Important! Dangerous for kids!
Install Wall Oven.
Finish Mantel.
Repair Refrigerator so that the side panels can be installed, and them finish crown molding.
Remove temporary nail in crown moulding left of kitchen sink.
Finish back of island
Install brackets to support granite counter top.
Water proof end of oak flooring at sliding doors and install eight -foot threshold.
Skylights and windows need polyurethane or paint.
Kitchen counter lights need wires to be fixed.
Adjust all cabinet doors.
Plaster return wall at oven and paint.
Install moulding at bottom of refrigerator panel.
Install moulding at base of fireplace hearth.
Finish returns on cabinets.
Install end caps on baseboard heat.
Thresholds:
Bathroom door first floor.
Family room door first floor.
k,
Master Bedroom:
Install baseboard -heating caps.
Polyurethane or paint skylights.
Install mouldings in closet after closets are finished. (Already made)
Adjust all doors.
Attach sash cords to windows.
Master Bathroom,
Repair shower and install grabber and shelf.
Install moulding and trim around shower.
Install access panel to crawl space.
Insulate cold space.
Polyurethane or paint skylight.
Install closet door after closet is finished.
Cut and adjust door.
Basement:
Three new footings and lally columns installed according to Ipswich River Engineering instructions dated March
30,2009. Very Important!
Insulate all pipes necessary.
Insulate ceiling R-30
Finish stairs and handrails.
Miscellaneous:
Insulate ceiling behind knee walls over Bathroom, Family room Dining room and Kitchen.
Insulate, water proof, flash and support thresholds at 8 -foot slider. Very Important!
Install roof flange and three-inch vent pipe.
Grading necessary around house to prevent water problems.
Fix grading around heating system exhaust vent. Very Important!
Be very careful before starting up heating system a professional should check system before purging. Very Important!
Date.... ......
f NORTH
4,,o� TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
s oma+ �,�•' a
Thiscertifies that........................:y..................................................................
has permission to perform ....................................................
12
wiring in the building of .............. .U.L'.f.....'................................
at ..... . �:5044eaW....................................... . North Andover, Mass.
Fee l 5T ... Lic. No....: /�J� ..........�.. �/.r ....
LECTRICALINSPEM R
Check # /tile
�
8473
'�- N Commonwealth of Massachusetts Official Use Only
_ W Department of Fire Services Permit No.ef
z/ 7
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev. -1/07] (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 WINK OR TYPE ALL INFORMATION) Date: cc + Act p g i
City or Town of: NORTH ANDOVER To the Inspector of Wires:
By this application the undersigned gives notice of his or.her intention to perform the electrical work described below:
Location (Street &Number) a�0 rq►1�a�V�t` V-eod
Owner or Tenant �qn UP -1 Gov aa- + Telephone No. '7
Owner's Address
tet,
Is this permit in conjunction with a building permit? Yes No ❑ (Checpropriate Box)
Purpose of Building V P OA�TF E:te+ Utility. Authorization NV—
Number
i
Existing Service jtoo Amps lto /,ZO Volts Overhead ® Und rd
g ❑ No. of Meters (r
New Service ' d- Amps /2a /2e f- Volts Overhead ❑ Undgrd [9 No. of Meters
of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: ��•de t+a �� nth
RgrgR,00m Fa•N.,•Iy t%06"2
No. of Recessed Luminaires /S
— •..�...•...�•.•
No. of Ceil: Susp. (Paddle) Fans
use taut' tie wu,veu Uy ine ins eetor of Wires.
No. of Total
Transformers KVA
No. of Luminaire Outlets
No. of Hot Tubs
Generators KVA
No. of Luminaires
Swimming Pool Above ❑In- E]
r`nd. grnd.
No. of Emergency Lighting
Battery Units
No. of Receptacle Outlets AD
No. of Oil Burners
FIRE ALARMS I No. of Zones '
No. of Switches �s
No. of Gas Burners
No. of Detection and
InitiatingDevices
No. of Ranges
No. of Air Cond. Total
Tons
No. of Alerting Devices
g
No. of Waste Disposers
Heat Pump
Totals:
Number
Tons
KW...
No. of Self -Contained
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local ❑ Connection ED
No. of Dryers t
No. of Water
Heaters KW
Heating Appliances KW
No. of No. of
Signs Ballasts
Security Systems:*
No. of Devices or Equivalent
Data Wiring:
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
Telecommunications Wiring:
No. of Devices or Equivalent
OTHER: su'6 e,
I1 e -
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start:, Nov • O$ 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 insurance including "completed operation" coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE (a BOND ❑ OTHER ❑ (Specify:)
I certify, under the pains and penalties of perjury, that the information on this application is true and complete.
FIRM NAME: H Lt�Qt'�1'1•t LIC. NO.: 09� h.
Licensee: tenee le pqy Signature
LIC. NO.:
(If applicabl , enter "exempt" in the license n mber line.) Bus. Tel. No.'®i
Address: - swftse+ �gtMG Wj*40,jaC 1`114 d 1 ¢l0 Alt. Tel. NoA7P'i4/9 ?S'* I/
*Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: 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 ry
Signature Telephone No. PERMIT FEE: $ %/O
e.%
The Commonwealth of Massachusetts
Department of Industrial Accidents
fn
... Office of Investigations
600 Washington Street
Boston, MA 02111
{ i www.niassg
. ov/dia .
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
A�pIicant Information Please Print Lembly
Name (Business/Organization/Individual): acs i 9th lee-�rtc
Address:_ I Suns e 4' Iwo, Pd • __
City/State/Zip:- dt ei oV C r 14 Phone.#:. c9 7 q 9 `S—o y
Are you an employer? Check the appropriate box:
1. C3I am a employer with
4. ❑ I am a general contractor and I
employees (full and/or part-time).*
have hired the sub -contractors
2.14 I am.a.sole proprietor or partner-
listed on the attached sheet t
ship and have no employees
These suit -contractors have
working for me .in any capacity.
workers' comp. insurance.'
[No worker' comp. insurance .
5..❑ We are a corporation and its
required_]
officers have exercised their
3. ❑ I 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. F-1 Building addition
10.I] Electrical repairs or additions
11.0 Plumbing repairs or additions
12.❑ Roof repairs
13.❑ Other
-Any applicant that checks botf # I must also fill out the section below showing their workers' compensation policy information.
I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
;Contractors 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 9 or Self -ins. Lie.
Job Site Address:
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.
I do her1 certify under the pains and pennaaides r'ury that the information provided above is true and correct.
Si E e. &Z Date: /a a . �
Phone 4: -7 o/ 7
Official use only. Do not write,in this area, to be completed by city or town official
City or Town:
Permit/License #
Issuing Authority (circle one):
1. Board of1461th 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector
6. Other ,
Contact Person
Phone 0:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more
of the'foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6) also states that -every. state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a busiess or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance 'coverage required."
Additionally, MGL chapter 152, §25C(7) states 'Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if
necessary, supply sub -contractors) name(s), address(es) and phone number(s) along with their certificate(s) of
insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the
members or partners, are not required to carry workers' compensation insurance. if an LLC or LLP does have
employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage.. Also 'be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, notthe Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy, please call the Departunent :;t the nurnber listed below. Self-insured companies should enter their
Self-insurance license number on the'appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant
that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current
policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or
town)."//A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit.
The Office of investigations would like to thank you in advance for your cooperation and should you have any questions, r
please do not hesitate to give us a call
The Department's address, telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. # 617-7274900 ext 406 or 1-8.77-MASSAFE
Revised 5-26-05 Fax # 617-727-7744
www.mass.gov/dia
Date.4 .... ...... LI
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ...... ..............................................
has permission to perform .......+t q. de r:z'
wiring in the building of ...... .......................
at .... c?A ...... 61&!4;�. .... (St. North Andover, Mass.
Fee /!� ............ Lic. No.l..69f'�' ......
Check I ll!?7
86+5
L?
Commonwealth of Massachusetts
Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
Official Use Only
Permit No.
Occupancy and Fee Checked
[Rev. 1/07] (leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
(PLEASE PRINT W INK OR TYPE ALL INFORMATION) Date: Fc 1 19 O
City or Town of. NORTH ANDOVER To the Inspector of Wires'
By this application the undersigned gives notice of his or her intention to perform the electrical work described
Location (Street & Number) OLSo ja bo% Aesv, w C4.
— _-F
Owner or Tenant
Owner's Address
Is this permit in conjunction with a building permit? Yes
Purpose of BuildingAnA F1 13 4
Existing Service Amps / Volts
New Service Amps / Volts
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
No ❑
M00
below.
Appropriate Box)
Utility Authorization No.
Overhead ❑ Undgrd
Overhead ❑ Undgrd ❑
No. of Meters
No. of Meters
No. of Recessed Luminaires
�j e.icn
No. of Ceil: Susp. (Paddle) Fans
raoce may be waived by the Inspector of Wtres.
No. of Total
Transformers KVA
No, of Luminaire Outlets
No. of Hot Tubs
Generators KVA
No. of Luminaires y
Swimming Pool Above El In- ❑
o. o mergency ig g
rnd. rnd.
Batte Units
No. of Receptacle Outlets 16
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
Initiatin Devices
No. of Ranges
No. of Air Cond. Tons otal
No. of Alerting Devices
No. of Waste Disposers
Heat Pum
Number
_...........
Tons
......_
KW
No. of Self -Contained
Totals
Detection/Alertin ir Devices
No. of Dishwashers
Space/Area Heating KW
Local ❑ Municipal ❑Other
Connection
No. of Dryers
Heating Appliances KW
Security Systems:
No. of WaterNo.
Heaters KW
of No. of
No. of Devices or Equivalent
Data
Signs Ballasts
No. ofitinDevices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
Telecommunications Wiring:
No. of Devices or Equivalent
OTHER:
.iiiacn aitaznonaI detail Ydesired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: Fp cj 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 insurance including "completed operation" coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE (N BOND ❑ OTHER ❑ (Specify:)
I certify, under the pains and penalties of perjury, that the information on this application is true and complete.
FIRM NAME: �h = CC11
. V t C LIC. NO.: 10/09,P,4
Licensee: w r tKt� �_ 17 Signature ` LIC. NO.:
(If applicable, enter "-em,Pt " in the license n mber line.) us. Tel. No.:
Address: / SWhs t lzyrr k 21J.- 14#,% Alt. Tel. No.:
*Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by layq By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent.
Owner/Age
Signature Telephone No4m"- PERMIT FEE. $ J/��
Y
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
C-1 www.mass.gov/dia .
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leedbly
Name (Business/branni"finn/InAiTv,A—III )e'0 Ir'.
V f
Address: Sywso 12oc-k IZorkc
City/State/Zip: tO "ave e- 1414 01 M Phone #:. 9 7 5l- 7 y g 94—o t/ -
Are you an employer? Check the appropriate box:
Type of project (required):
L ❑ I am a employer with
4, ❑ i am a general contractor and I
6. ❑ New construction
employees (full and/or part-time).*
2. I am a.sole proprietor or partner-
have hired the sub -contractors
listed on the attached sheet. t
7•Remodeling
ship and. have no employees
These sub -contractors have
8. Q Demolition
working for mein any capacity.
[No workers' comp. insurance
workers' comp. insurance.
5. ❑ We are a corporation and its
q. Building addition
required.]
officers have exercised their
l0. ❑ Electrical repairs or additions
P
3. ❑ I am a homeowner doing all work
right of exemption per MGL
I I.[] Plumbing repairs or additions
myself. [No -workers' comp.
c. 1.52, § 1(4), and we have no
12.❑ Roof repairs
insurance required.] t
employees. [No workers'
13.1`7 Other
comp, insurance required..]
-f+ny appucam tnat cnecks bo)[# I must also fill out the section below showing their workers' compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
,Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information.
I ant an employer that is providing workers' compensadon insurance for my employees: Below is the policy and job site
information.
Insurance Company Name:
Policy # or Self -ins. Lie. 4:
Expiration Date:
Job Site Address: 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 DTA for insurance coverage verification.
I do he
=underthepa andpenaltiesof p that the wformadon provided abov is true and correctSi afar .�. _Date: / q,
ip 9
Phone #: / 97 d' — 7 V C/ V
Official use only. Do not write in this area, to be completed by city or town official
City or Town:
Permit/License # _
Issuing Authority (circle one):
I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person
Phone #:
a Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more
of the'foregoing engiged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual, partnership, association or other legal entity, employing employees. 'However the
owner of a dwelling house axing not more than three apartments and who resides therein, or the occupant of the
dwelling house of anotho who en)ploys persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or
renewal of license or permitto operate a business or to construct buildings in the comAionwealtb for any
applicant who has not produced acceptable evidence of compliance with the insurance 'coverage required."
Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any, of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence `of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if
necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of
insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the
members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, notthe Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy; pease cal] the Department at the number listed below. Self-insured companies sl?o!!ld enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the perrimit/license number which will be used as a reference number. in addition, an applicant
that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current
policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or
town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone and. fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 42111
Tel. # 617-7274900 ext 406 or 1-8.77-MASSAFE
Fax # 617-727-7749
Revised 5 -26 -QS www,mass,gov/dia
Date4�� .
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
/41.0This certifies that .. 90.,<j /141.0..... ...........
has permission to perform 4< <!G- .T... '�'�........... .
plumbing in the buildings of .�'!'1 �!... �?� ........
at. Sv...�F`°i� ......S`�..... ,North Andover, Mass.
Fee '.. Lic. No... .4.41- 5 ............................ .
PLUMBING INSPECTOR
Check #
i
I
'! I -e MASSACHUSETTS UNIFORM APPLICATON FOR PERMUT TO DO GAS b'MING
f;jp), (Type or print)
NORTH ANDOVER, MASSACHUSETTS Date �. —27 � �f
Building Lo ations
te� Owner's Name
go I'le A..
New ❑ Renovation it Replacement. ❑
Plans Submitted rl
Name of.Licensed Plumber'or Gas Fitter
Permit #
Amount $
le,
Check one: Certificate Installing Company
Corp.
0 Partner.
Firm/Co.
er
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 my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Mass V� 6 Stte� Code�hap 4 f the Gam► Laws.
AAZ
By: .
Title
City/Town.
APPROVED (OFFICE USE ONLY)
m
®S,gnat'xtre of Licensed Plumber Or Gas Fitter
Plumber
® Gas Fitter License Number
0 Master
® Journeyman
The Commonwealth of j fassachusett ,
Departrnenr o Industrial
, flJ6 OffAccidents.
DfJlce of Investigations
600 Wash Street
-_ Sosta
�, MA 02111
r K'►v►�'-mass-gov/dia
Workers' Compensation Insurance Affidavit: guijders/Contractors/EleeiriciausNfumbers
At►piicant Information
Irby —
Name (B
Address:
City/Stat
Are you an employer? Check the appropriate hoz:
1.7 I an a employer with
employees (full and/or
4. ❑ 1 am a general contractor and I
part-time).*
2. I am a sole proprietor or par}n.er_
`
have hired the sub -contractors
Iisted oo the
ship and have no employees
working for me in
attached sheet 4
These stab -contractors have
any capacity.
[No workers' comp.
.insurance
workers'
j A comp. insurance.
❑ We are a
3. ❑required.]
I am a homeowner doing
corporation and its
officers have exercised.their
all work
Myself . [No workers' comp.
insurance
right of exemption per MGL
c. 152 § 1(4)' and we have no
required.] t
ern la
P yees. [No .workers'
comp, insu
Type of project (required):
.6. ❑ New construction
?• Remodeling .
8- ❑ Demolition
9• ❑ Building addition
10:❑ Electrical repairs or additions
11.❑ Plumbing repairs or additions
12:0 Roof repairs
rance required) I 13 ❑Other
'tiny applicant.thar checks box #I .muse also fill out the section below showing their workers• compensation policy mrormatron.
t 0111cowuers who submil.iilis aludavil indicarin� iitey ars doip,
iConttaetors That check this box must "r e=icr then hiM outside eoniraciurs must submit a
attached an additional sheet showing tit, na_,ne.of th. s el n— amciavie indicting such.
r _ �'t'dCtneS and tient, w
information vj'er uauc tS prOVtdine workers' cn ensatio ante for a !o en -- _ - r�� �y inrocmatton.
mP n incur ny mP Y -s• Below is the oft
� qand job site
Insurance Company Name:
Policy 4 or Self -.ins. Lic. #:
Expiration Date:
Job Site Address:
City/State/Zip:
Attach a copy of the workers' compensation tiecla
p°tic y t'afron page (showin; the policy nu11147 and expiration state).
Failure to secure coverage as required under Section 25A of MGL c. 152 can
fine up to SI,500.00 and/or one-year imprisonment, penalties in the form of a STOP WORK ORDER and a fine
as well as civil ]cad to the imposition of criminal penalties of a
of up to .5250.00 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.
MC �n` to pe of 'urf� �� the injormafion provided above is true and correct
Official use onlp. Do not write in this area, to be completed by city or town octal
City or Town:
Fssuirte Authority (circle one): Permit/License 4
1. Board of Health 2. Building Department 3. CitylTovvn Clerk 4. Electrical inspector 5. Piumbin
6. Other b' Inspector
Contact Person:
Phone -
information and Instructions
Massachusetts General Laws chapter IS2 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute, an employee is definedas"., every person in the service of another under any contract ofhire
express or implied; oral or written."
An employer is derined as "an individual, partnership; association, corporation or other legal entity, or any two or more
of the foregoing engaged in a joint enterprise, and includirxg the legal representatives of a deceased employer, or the
receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than .three apt at- ftnents and who resides therein, or the occupant of the
dwelling house of.another who employs persons to db maim-nance, const action or repair work on such dwelling house
or on the grounds or`buil.ding appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6) also states that "every state a r local licensing agency shall. withhold the issuance or
renewal of a' license or permit,to operate it bnsmen or to consti ucf buildings in the commonwealth for any
applicant who ha`s not produced acceptable evidence of compliance with the insurance coverage required"
Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public wor < until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the coritractfng authority "
Applicants
Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if
necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of
insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the
members or partners, are not required to carry workers' compensation insurance. if an LLC or LLP does have ..
employees, a policy is required_ Be advised that this affidavit may submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The,affidavit should
be returned to the city or town that the application for the permit or license is being requested., not the Department of
Industrial Accidents, Should you have. any questions re-jau-ding iheiaw or, if you are required to obtain a workers'
comaensation policy; please call the Department at the ntt nber:lis+.ed below. Self insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed leeibiv. The Departmenthas provided a space at the bottom
of the affidavit for you to fill out in the event the Office of- Investigations has to contact you regarding the appii=L
Please be sure to fill in the permitricense number which will be used as a reference number. In addition, an applicant
that must submit multiple permitflieense applications in arty given year, need only submit one affidavit indicating current
policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or
town)." A copy f the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Vrhere a home owner or citizen is obtaining a licensct or permit not related to any business or commercial venture
(i.e. a. dog license or permit to burnleaves etc.) said person is NOT required to complete this affidavit.
The Office of investigations would like to.thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone and fay, number:
The Commonwealth of Massachusetts
I3egartment Of l mdustmal Accidents.
Office of Litvesfiptions
600 Washng-ton Street
Boston; MA 02111
Tel. 4 617-727-4900 C= 406 c r 1-8-7 MASSAFE
Revised 5-26=05
Fax 4 617-7-7-7749
V0w'-mass.gov/dia
Date ... !/ : /-5-!, A
TOWN OF NORTH ANDOVE
�/
04..•0 ,�,ti
PERMIT FOR PLUMBI
This certifies that/'�=�`"` :. ...... -/... �. .
has permission to perform . '"� ........ �t�`y. .
plumbing in the -buildings of ..................... ............ .
at ......... ... ,North Andover .Bass.
Fee ..,�-/V... Lic. Nor.-. . . ... \: ...:..............
tPU MBING INSPECTOR
Check # �a
MASSACHUSETTS UNIFORM ,AppLICATION FOR PERMIT T
(Type or print) 0 DO PLUMBING
NORTH ANDOVER, MgSSACHUSETrS
Building Location ), S ,o 4 n do t/,e..., j' •�
� # 4,4 At" V-Vg\w
New
Renovation z
of Occupancy Y/Yf
Replacement 'M
FU'URES
�p Date��
" ✓4- Permit # u c��
Amount
Plans Submitted Yes
(Print or type)
Installing Company Name �Q v/Check one: Certificate
Address 1r>✓" w®� /� /J E3 Corp.
Q 0 Partner.
Business alephon
` Firm/Co.
Name c Licensed Plumber �6i✓ � � � �, q 74
Insurance Coverage: Indicate the type of insurance coverage by checkm
Liability insurance policy Other ty g the appropriate box:
type of indetnru ❑ Bond
Insurance Wa
ar er. I the undersignQ
ed have de aware L.1
insur at the lice f this application does not have any one of the above
r re Owner
Agent
I hereby certify that all of the details and information I have submits
best of my knowledge and that all plumbing work and installations ed (or) m above application are true and accurate to the
compliance with all pertinent provisions of the Massac e� sta Perf°rtned under permit Issued for this application will be in
Plua!!!g_Cco an Chat 142By: P y� of the General Laws.
Jima urt ofpili('
!Title 'YP-- Of Plumbing License
City/Town —
A.PPRO 1 -kens` IN moer �� El
VED (OFFICE U5E ONLY
Journeyman /
�f J
4
I he Go►nmonwealth of MassachusehZ,
Department. of Industrial flccltlentc.
Office of investigations
600 Washineoton Street
Boston, M4 02111
w"YKI-1?z44S.e ov1dia
Workers' Compensation Insurance.A:ffiday.ji , g><alders/Coniractors/EleetriciansJPi
Aca.nt Information umbers
amt (Business/Organization/Individual):
Address:
City/State/Zip:
Phone #:
Are you an employer? Cheek the appropriate box:
l ❑ I
. am a employer with
4,17 I am a o
em Io ....s roll and/or par-enm .
PY"�(� p )�
2. [] i an a sole
have hired the sub-traCt
conotr�ors
proprietor or partner_
ship and have no employees
Iisted oto the attached sheet 2
These subcontractors
working for me in any capacity.
have
workers' comp. insurance.
[No workers' core . insurance
P
5 ❑Weare .a corporafion
3. ❑required.]
I am a homeowner doing all
and its
officers have exercised. their
right
work
myself. [No workers' comp,
insurance
of exemption per MGL
c. 152 (4), and we have
required.] t
C. lQ' e no
P Y s [No workers
comp. insu
N
Type of project (required):
'6• ❑ New construction
7. ❑ Remodeling .
8. ❑ Demolition
9. ❑ Building addition
10:[] Electrical repairs or additions
11.❑ Plumbing repairs or additions
Roof repairs
'Any applicant that checks box # 1 .must also "fill out the section below showi 18T1ce required.] 13 ❑Other
t ` ng th„-ir work
numeowners who submii.this eiadavil indicating they e Juin , aN �,,,�.. �` eompcnsation Policy
'Contractors that check this box m�iat attach— an additional sheet showir p c1' ibmii ion.
ai3ci Enen him outside conire�;iors muni su'omii a new affidavit indi,:*ting s::ch.
the nine of the s::b-conn=tors and their wnr,o.
..wav vci [rardt [S' prOV:4',.r a-Orkers' co --i, rnrormuzon.
information. mP on insurance for ng' employees. Below is theoft
P cy and job site
Insurance Company Name:
Policy # or Self -.ins. Lic. #:
Expiration Date:
Job Site Address:
Attach a copy of the workers' compensation'poficy deciamtion a Cuty/Stat /Zup.
Failure to secure coverage as required under Section 25A of pabe (showing the policy number and expiration date).
fine up to 51,500.00 and/or one-year im MGL c. 152 can lead to the imposition of criminal penalties of a
Y- prisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
in es to tions 00 a day against the violator. Be advised that a copy of this statement may be forwarded to the OffiEce,R a
Investigations of the DIA for insurance coverage verification.
__. J. — I ..fe pamv and penalties of pe{jury tizal the information f rrwfinn provided above is true and correct
Official use on1p. Do not write in this area, to be completed.b3, city or town ofcia(
City or Town:
Permit/License 4
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Towla Clerk 4. Electrical Inspector S. Piumbiuo
h. Other a Inspector
'Contact Person:
Phone#:
��.r.._�/ : �
_ \�,
s,
IPSWICH RIVER
ENGINEERING, INC.
Ad STRU"CTURAL ENGINE.ER.S
March 30, 2009
Tom Connelly
Tom Connelly. Woodworking
23 Goldsmith Street
Littleton, MA 01460
RE:. STRUCTURAL EVALUATION OF LAMINATED VENEER LUMBER MEMBERS
AT THE 250 ANDOVER STREET RESIDENCE
250 Andover Street North Andover, Massachusetts 01845-5238
Ipswich River Engineering, Inc. Project No: IR -0254
Dear Tom:
Ipswich River Engineering, Inc's (IREI) has. retained by Tom Connelly Woodworking (TCW) to view and
evaluate the laminated veneer lumber (LVL) timber framing that TCW has installed at the above
referenced residence as part of their renovation work at this residence. On "March 19, 2009 IREI visited
the above referenced residence to view the installation of the LVL timber framing that TCW had installed.
in the floor and roof framing at the residence. IREI gathered field data on the LVL -members, asinstalled,
and reviewed these members for the floor and roof loading that they support.
The results of IREI's review of this "as -built" LVL framing completed by TCW indicated that in IREI's
professional opinion, the LVL roof trimmer rafters at each side of the new skylight rough openings in the
main roof framing appeared structurally sufficient from a strength point of view to support the dead and
snow loads .but appeared to need. an additional LVL ply added to each LVL trimmer rafter member to
provide sufficient member section to accommodate the code required deflection criteria. IREI also
recommended that lateral bracing gussets be installed at the side of the new Second Floor LVL member
adjacent to the new stairway opening to provide lateral -torsional bracing of the new LVL floor beam. On
March 25, 2009 IREI visited the site to view the completed modifications,to the designated new LVL
framing as recommended by IREI. At that site observation visit, IREI observed that it appeared that TCW
had completed the IRpI recommended modifications to the new LVL framing. IREI takes no exceptions.,
to the other LVL framing as observed by IREI at the residence at the time of IREI's two site observation
visits at the residence.
During the March 19, 2009 site observation visit at the residence, IREI recommended to TCW that at
three locations new reinforced_ concrete spread footings be installed in the Basemen_ t Level of the residence
to provide support to the bottom ends of the new timber posts supporting the new LVL framing at the
floor framing above. IREI recommended installing new 2'-6"x2'-6"xI'-6" thick footings at these three
locations with 3 — #4 reinforcing 'steel bars each way at the bottom of the footings (providing 3 inch
162 Park Street- Suite_#203, North Reading, MA 01864
t: 978.664.6925 f: 978.664.6926 www.irengineering.com
The difference between the ordinary and the extraordinary is the'extra.client service we provide.
Date..
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
f - ���P��
This certifies that ........... �... .
�...................
has permission to perform ...... .
plumbing in the bu-ildings of .... . :........................... .
at ...... .... ....`'`..... .. North Andover, Mass.
Fee n...... Lic. No�e,.P� a
........�./. ................
PLS By G INSPECTOR
Check #
7932
(Print or type)
Installing Company Name l O `U P\«. Lkro `7 'P` 6 n C� Corp. Certificate
Address _ (-c e n w G 0 D
01 �6 Partner.
usmess elephone �'�, 5 17'7 *7 3
Lai
Firm/Co.
Name of Licensed Plumber: U 1. g I C'
htsurance Covera e: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy ❑ Other type of indemnity ❑ Bond ❑
Inr ce Waiver. the undersign!q, have been made aware that the licensee of this application does not have any one of the above
e ' surance
Lult
ignature Owner El Agent LSI
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 my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachuse State P Bing C �d Chaf 142 of the General Laws.
a
By: ignaure of Licen um er
Title
Type of Plumbing License
2, �, 0
City/Town iL cense um er Master ❑
APPROVED toFmcs usE ONLY Journeyman R
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building Location 2,
S
� ��I�
(O Ar\. -c- �T
`
�nId
Owners Name/ V 1�
Type of Occupancy
''-3 —Q
G00 161—TDate permit# 17 '--
Amount
New
Renovations
Replacement '1:3
Plans Submitted Yes No
FTX7'TTi? �c
(Print or type)
Installing Company Name l O `U P\«. Lkro `7 'P` 6 n C� Corp. Certificate
Address _ (-c e n w G 0 D
01 �6 Partner.
usmess elephone �'�, 5 17'7 *7 3
Lai
Firm/Co.
Name of Licensed Plumber: U 1. g I C'
htsurance Covera e: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy ❑ Other type of indemnity ❑ Bond ❑
Inr ce Waiver. the undersign!q, have been made aware that the licensee of this application does not have any one of the above
e ' surance
Lult
ignature Owner El Agent LSI
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 my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachuse State P Bing C �d Chaf 142 of the General Laws.
a
By: ignaure of Licen um er
Title
Type of Plumbing License
2, �, 0
City/Town iL cense um er Master ❑
APPROVED toFmcs usE ONLY Journeyman R
m
14
s
cmy
n fnr-
mE {
ClC2
0)
of
#p 3
D
O d cZa
n' 0
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ao
m
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Ln ,,6L -A
ll, - At
PATRICK J. DONOVAN ASSOCIATES, INC.
aim and Foss Adjustments
P. O. BOX 110
WAKEFIELD, MA 01880
TEL. (781) 245-5540 — FAX (781) 245-7016
December 28, 2000
Building Commissioner
City or Town Hall
North Andover, MA 01845
Insured
Property Address
Insurer
Policy Number
Type of Loss
Date of Loss
Our File #
: John & Eileen Walsh
: 250 Andover St, No Andover, MA
: Safety Insurance Co
: H000003175
: Smoke/Flue Damage
:12/25/00
: WAP31650
Claim has been made involving loss, damage or destruction of the above -captioned
property, which may either exceed $1,000 or cause Mass. Gen. Laws, Chapter 143,
Section 6, to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section
313 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 file number.
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.
i
5ai�J
it Spano,Yjuster
J /so
OF INDEPENDENT INSURANCE ADJUSTER'S
of Massachusetts