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HomeMy WebLinkAboutMiscellaneous - 26 PLEASANT STREET 4/30/2018O N O rn � m gD T� O cn N x rn m o 4 Cunningham Lindsey U.S., Inc. P.O. Box 703689 Dallas, TX 75370-3689 Telephone (888) 738-8714 CLCAT@CL-NA.COM Facsimile (214) 488-6766 ***********************AUTO**3-DIGIT 018 762 T3 P1 95000058952 Building Commissioner or Inspector of Buildings 120 MAIN STREET { N ANDOVER, MA 01845 Cunnin ham �% Lindsey Form of Notice of Casualty Loss to Building Claim has been made involving loss, damage, or destruction of the above captioned property, which may either exceed $1,000 or cause Massachusetts General Laws, Chapter 143, Section 6, to be applicable. If any notice under Massachusetts General Law, Chapter 139, Section 313 is appropriate, please direct it to the attention of the writer. Kindly include a reference to the captioned insured, location, date of loss and claim number. Section 3131.t No insurer shall pay any claims (1) covering the loss, damage, or destructions to a building or other structure, amounting to the one thousand dollars or more, or (2) covering any los' ,`damage or destruction of any amount, which causes the condition of a building or other structure to render section six of chapter one hundred and forty-three applicable, without having at least ten days previously given written notice to the building commissioner or inspector of buildings appointed pursuant to the state building code, to the fire department or arson squad of the city or town and to the board of health or board of selectmen of the city or town in which the same is located. If at any time prior to the payment the said city or town notifies the insurer by certified mail of its intent to initiate proceedings designed to perfect a lien pursuant to section three A,,or to section nine of chapter one hundred and forty-three, or section one hundred and twenty-seven B of chapter one hundred and eleven, the said payment shall not be made while the said proceedings are pending; provided, however, that said proceedings are initiated within thirty days of receipt of such notification. Under MASS. GEN. LAWS Ch. 139, Sec 3B Claim Number: 2447432 10 Policy Number: 2447432 10 N Company Name: MERRIMACK MUTUAL FIRE INS CD Cause of Loss: ICE DAM LO Date of Loss: 2/18/2015 o Insured: PLEASANT STREET CONDO TRUST 0 Property Location: 26-28 PLEASANT ST Claim has been made involving loss, damage, or destruction of the above captioned property, which may either exceed $1,000 or cause Massachusetts General Laws, Chapter 143, Section 6, to be applicable. If any notice under Massachusetts General Law, Chapter 139, Section 313 is appropriate, please direct it to the attention of the writer. Kindly include a reference to the captioned insured, location, date of loss and claim number. Section 3131.t No insurer shall pay any claims (1) covering the loss, damage, or destructions to a building or other structure, amounting to the one thousand dollars or more, or (2) covering any los' ,`damage or destruction of any amount, which causes the condition of a building or other structure to render section six of chapter one hundred and forty-three applicable, without having at least ten days previously given written notice to the building commissioner or inspector of buildings appointed pursuant to the state building code, to the fire department or arson squad of the city or town and to the board of health or board of selectmen of the city or town in which the same is located. If at any time prior to the payment the said city or town notifies the insurer by certified mail of its intent to initiate proceedings designed to perfect a lien pursuant to section three A,,or to section nine of chapter one hundred and forty-three, or section one hundred and twenty-seven B of chapter one hundred and eleven, the said payment shall not be made while the said proceedings are pending; provided, however, that said proceedings are initiated within thirty days of receipt of such notification. Any lien perfected pursuant to section three A, or to section nine of chapter one hundred and forty-three or section one hundred and twenty-seven B of chapter one hundred and eleven, shall extend to and may be enforced by the city or town against any casualty insurance policy or policies covering any loss, damage, or destruction pursuant to which the proceedings to perfect the lien were initiated. No insurer shall be liable to any insured owner, mortgagee, assignee, city or town, or other interested party for amounts disbursed to a city or town under the provisions of this section, or for amounts not disbursed to a city or town under the provisions of this section. 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. Cunningham Lindsey Catastrophe Department cicat@cl-na.com 800-867-3885 V4 1 V1 1�' ro offal P°9° of ; Fr tlmates 105 Haverhill Street Fully Insured Methuen, MA 01844 (978) 691-1355THONWsON's ROOFING Shingles — Slate — Rubber Roof Z Single Ply — Copper Work PROPOSAL SUBMrITED TO PHONE DATE • E Baillar eon —E 8-9-05 STREET JOB NAME 26 Pleasant Street CrrY. STATE AND ZIP CODE JOB LOCATION North Andover Ma 01845 ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: Strip off all roof Shingles on hour ,F Install aluminum drip edge, white all along roof line 'Oe L/ Cb-- Apply ice and water shield 6f t.upall along edge Apply 151b. felt paper on rest of roof area �.0 � Reshingle with a 30 year Architect shingle Z � Ci( Install ridge vents G VV Remove all work related debris I / C7 30 warranty on material year 5 year guarantee on labor b I C7, constructionlic. #060112 � �7 improvement #128612 E propOgt hereby to furnish material and labor— complete in accordance with above specifications, for the sum of: Payment to be made as follows: dollars($ 6,800-00 $2,300.00 down balance upon completion All material is guaranteed to be as specified. All work to be oo nplabd in a woriarmnlike Manner according to standard practice. Any Awstion or deviation from above spedfieati m VNOMg i extra costs will be executed only upon wkten orders, and will beoane an oft cherp over and � above the estimate. All agram. wla cottripM upon strikes, accidents or delays beyond our control. Owner to carry fire. tamed; and other necessary insurance. our woriws we fully Note: This proposal mpy be ..w.w�.11w. IIM.Irrwann NNnnaw.Jl�w V..�� __y.�__-. 21tLEptance of aPr " — The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made u outlined above. Date of Acceptance: Vr YS 11'"t W6AMFWN da J s. m m m m m M CO) Cl) CD C Z CO) CD 06 O CZ =) MW t= o v CD cr �d CD CD O CD C CDCD y� =0 CO) co C C cc C = 0 m = O a iA c m CD os y O y ag a n m Z o g MR O .4 0 O 0 o f m a a 0 o Z ,c 0 N. C? 0 �. H •��► r N aim oCD ��:�:• R;0 1" 0 we".* O H cm Q UP V J C CAm m P-oE H o A mC A � n m 3 �m z C =� �- �mo Cn V Zm O :� `~?D I* Oq ? r: m d; d d a� ce o Gca C:l b: c V 1 m�140 cn cn o w C� r, H x r M .0 0 a r Wrbtz R g yO 9 C •C M m m m m m M CO) Cl) CD C Z CO) CD 06 O CZ =) MW t= o v CD cr �d CD CD O CD C CDCD y� =0 CO) co C C cc C = 0 m = O a iA c m CD os y O y ag a n m Z o g MR O .4 0 O 0 o f m a a 0 o Z ,c 0 N. C? 0 �. H •��► r N aim oCD ��:�:• R;0 1" 0 we".* O H cm Q UP V J C CAm m P-oE H o A mC A � n m 3 �m z C =� �- �mo Cn V Zm O :� `~?D I* Oq ? r: m d; d d a� ce o Gca C:l b: c V 1 m�140 cn cn o w C� r, x r M n 0 a r Wrbtz R g yO 9 M y 7d 0 y 0 9 - Location ���A5''d'�'� J— No. 010 47 Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ S� Foundation Permit Fee Other Permit Fee TOTAL Check # so/& to 18685 '44.4 ( %--- Building Inspector t -- 1.1 Property Address: 2-4 y{ l 1.2 Assessors Map and Parcel .. Map Number Number: Parcel Number i {/ia�ner Signature T lephone 1.3 Zoning Information: Zoning District Proposed Use 3.2 Registered Home Improvement Contractor �~ i1 CtC 11� E1 1.4 Property Dimensions: Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Expiration Date Front Yard Side Yard Rear Yard ReqWred Provide red Provided Re red Provided 1.7 Water Supply M.G.L.C.40. § 54) Public ❑ Private ❑ 1.5. Flood Zone Information: Zone Outside Flood Zone ❑ 1.8 Municipal Sewerage Disposal System: ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHW/AUTHORIZED AGENT Historic District: Yes _ No _ 2.1 Owner of Record ( V.-104 Name (Print) Address for Service : Signature 2.2 Owner of Record: Name Print -SECTION 3 - CONSTRUCTION SERVICES I Address for Service: 3.1 Licensed Construction Supervisor: To M �, a y1r Licensed Construction Supervisor: Not Applicable 0 C� '�-- License Number Address i {/ia�ner Signature T lephone Expiration Date 3.2 Registered Home Improvement Contractor �~ i1 CtC 11� E1 Not Applicable ❑ Corfm�pany Name 0 C— ,�/�� � �� � � � Address ` a�� /T �'4 Si nature gTel.—ho.. Registration Number Expiration Date SECTION 4 - WORKERS COMPENSATION (XG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failf in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......0 No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building { Repair(s) Vr"` Alterations(s) ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: S y-' N ►A 1.1 �L (a IR -0 a I cT: d rinN r _ Ti cTi UATI Tl rnNv.TP1Td TinN Cne.TC I f to provide this affidavit will result Addition ❑ Item Print Nameawm'w-�- 14 signature of Owner/Agent NO. OF STORIES Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building 2 N13 3 (a) Building Permit Fee Multiplier 2 Electrical DM ENSIONS OF POSTS (b) Estimated Total Cost of Construction d 3 Plumbing THICKNESS Building Permit fee (e) Y (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE Q UMPLE 1 E D W HEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 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 OT /'.TiAM �� ^%X7%T1VD/A1rTT1LT/A1DT7V1N ACTiNT lr%l?d i ADATinN I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief 79 PN4,. v I [--- Print Nameawm'w-�- 14 signature of Owner/Agent NO. OF STORIES 0 A � Y � Date SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 N13 3 SPAN DIlv ENSIONS OF SILLS DM ENSIONS OF POSTS DIN ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CIRMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Page of Drovoga I Free Estimates — iuo rtavernm street Fully Insured Methuen, MA 01844 THOMPSON'S ROOFING (978) 691-1355 Shingles - Slate - Rubber Roof Single Ply - Copper Work PROPOSAL SUBMITTED TO PHONE— j)71 DATE Eric Baillar eon 8-9-05 STREET JOB NAME 26 Pleasant Street CRY, STATE AND ZIP CODE JOB LOCATION N rth Andover Ma 01845 A77CT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: Strip off all roof sizingles on houne: Install aluminum drip edge, white all along roof line Apply ice and water shield 6f t.upall along edge Apply 151b. felt paper on rest of roof area Reshingle with a 30 year Architect shingle Install ridge vents Remove all work related debris I l 30 year warranty on material 5 year guarantee on labor construction lic. #060112 improvement #128612 e iropoOt hereby to furnish material and labor — complete in accordance with above specifications, for the sum of: , 8 0 0 0 0 dollars ($ 6 . Payment to be made as follows: $2,300.00 down balance upon completion All material is guaranteed to be as specNied. All work to be oanpMW In a worlaymWike manner arcading to standard practiom Any aI Ion or deviation from above tpedflcations ktvoNktg Sfprtaturo a v* costs well be executed ony upon wrlaen orders. and"becn an extra over and above the estimate. All agreenrnb con*gW upon strikes, s�cclderd a delays beyond our Note: This cw*mL Owner to carry ff e, tornado and ether necessary haurance. Our workers aro fully proposal may be ry—Awi by VA-dk rvm'x rAvywi matin Inraanna_ withdrawn by us if not annantad vrithin .�s... Zirceptame of 10ropgar — The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Date of Acceptance: MEN W.." � BF1 DATE(MM/DD/YYYY) AC-ORD,CERTIFICATE OF LIABILITY INSURANCE 1 06/20/2005 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DOES NOT AMEND, EXTEND Pelham Insurance Services, Inc. ALLTERTHE COVERAGEOLDE. THISICATE AFFORDED BY THE POLICIES BELOW.OR P.O. Box 960 122 Bridge Street Pelham NH 03076 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Nautilus INSURED Thomas Doyle dba INSURERB:Associated Industries Thompson's Construction & INSURER C. 6 West St INSURER D: Salem NH 03079 INSURER E: :OVERAGES NCE LISTED THE POLICIES OF INS RA CONDITION OF ANY/ HAVE BEEN CONTRACT OR OTDHER DOCUMENTTO THE EWITH RESPECT TO WHICH THIS D NAMED ABOVE FOR THE ICERTIFICOATIE MAY BE ISSUEDIORSMAY PERTAIN, REQUIREMENT, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. pni ICY F.FFFrTIVE 001 ICY FY. aIRATION LIMITS `SR AD. L TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDIYY) DATE (MM/DD/YY) .TRINSRD 04/15/2005 04/15/2006 EACH OCCURRENCE S 1,000'000 A GENERAL LIABILITY INC 330578 DAMAGE TO RENTED 50,000 PREMISES Ea occurrence $ X COMMERCIAL GENERAL LIABILITY 1,000 MED EXP An one person) $ CLAIMS MADE � OCCUR 1,000,000 SONAL 8 ADV INJURY 5 GEN'L AGGREGATE LIMIT APPLIES PER: AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY 7 ANY AUTO EXCESS/UMBRELLA LIABILITY cccur DEDUCTIBLE B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? II yes, describe under SPECIAL PROVISIONS below OTHER AWC7012214012005 04/21/2005104/21/2006 DESCRIPTION OF OPERATION SILOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Job: Various roofing and construction CERTIFICATE HOLDER Wynwood Associates 19 Basswood Lane Andover ACORD 25 (2001/08) �- INS025 (o108).05 PER GENERAL AGGREGATE S 2 , 000 , 000 1.1— _ nw>ir)P Arr.s 2 , 000 , 000 COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY $ (Per person) BODILY INJURY 5 (Per accident) PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY AGG $ EACH OCCURRENCE $ AGGREGATF. ''S 5 S 5 WC ST TU OTH- X TORY LIMITS ER E.L. EACH ACCIDENT $ 100,00( E.L. DISEASE - EA EMPLOYEES 100,00( E.L. DISEASE - POLICY LIMIT $ 500,00( CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZEq REPRESENTATIVE r IA_ MA 01610 l� � yl C ��GL 11 ©ACORD CORPORATION 19 Page I ELECTRONIC LASER FORMS. INC. - (800)327-0545 T" \ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street �is > Boston, MA 02111 i `\ /_4 , t www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibiv Name (business/Organization/Individual): TA ,,o'=•e%6 V"A' M / f Address: City/State/Zip: M q Phone #: 3 �g Are you an employer? Check the appropriate box: . ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ 1 am a homeowner doing all work myself. [No workers' comp. insurance required.] r have hired the sub -contractors listed on the attached sheet. These sub -contractors have workers' comp. insurance. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § ](4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions 11.0 Plumbing repairs or additions 12.0 Roof repairs 13.❑ Other *Any applicant that checks box # I must also till 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. 1 am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 41 ,575, .7�4 S' Policy # or Self -ins. Lic. #:-Q we- -24V Expiration Date: 619 Job Site Address: zy- P II V-0 oks vv,� % " City/State/Zip: 1w,i a 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 tine 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. 1 do hereby certify ugder the pains and penalties of perjury that the information provided�ayi above ,% trite and correct. Signature: �S Date: ty e- / !' t 0 1 � Phone #: "�� Official use only. Do not write in this area, to be completed by city or town q ficial. 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 #: 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 withholdtheissuance or renewal of a license or permit to operate a business 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-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, not the 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 Department at the number 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 till out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pen-nit/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 burn 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 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia 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 at: is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL 11, S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section I OA. The debris will be disposed of in: Fire Department Sign off: Dumpster Permit (Location of Facility) In Signature of Permit Applicant Date CA m m m YI m y m v y .p — CO) o CD St Z CA CL ? O C. = y O C09 CD o p CDCL O Q CD CCD O 00 w C CDCD y O y CD I S v CA O CD Z 0 �CD C CD C w 10"0 10C 2:210 0 = O — y 0 ✓Q y aO:mCL y C2 y C a o 3 m Z =r -o N 0? O O y O y N O Im m = > >ma ®m % o n o. �ytoT a CD m IF C/) y C/) nm l'� o y �' dl y . • O y 0• d Q C a c„ f� O y CD O �o z IL ,- cn p �A ` Z m t tom+. co y r: CD y 0 9 0 c CD w o :r a Ci7 poi w �- o C o oa n 0 c CD The Commonwealth of Massachusetts tltffce Use Only Department of Public Safety Occult c _ Occupancy b Fee Checked ' BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All Work to be performed in accordance With the Massachusetts Electrical Code. 527 CMR 12-00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date./ City or Town of//�t�.��C' To the peetor of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 7,(, L F�k 11' TT" Owner or Tenant i%„✓�f��/�' ��/� � /�/' Q � 0 IV Owner's Address Is this permit in conjunction with a building permit: Yes 121 No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization NO. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters ” Nev Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and A--pacity Location and Nature of Proposed Electrical Work4%1114 10-1 No. of Li Lighting Outlets 8 8 No. of Hot Tubs Total No. of Transformers KVA No. of Lighting Fixtures 8 8 Above In - Swimming Pool grnd. ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of SoundingDevices No. of Self Contained Detection/Sounding Devices Local El Municipal ❑ Other Connection 'To. of Ranges B - Total No. of Air Cond. tons No. of DisposalsINo. of Heac Total Total Pumps Tons KLL No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW �No, of No. o= Signs Ballasts Low Voltage Wirin No. Hydro Massage Tubs itNo. of Motors Total HP `" OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YESK NO F] I have submitted valid proof of same to this office. YES ® NO If you have checked YES, please indicate the type of�rage b checking the appropriate box. INSURANCE AJ BOND ❑ OTHER 1� (Please Specify) 71, �I Estimated Value of Electrical Work S (Expiration Date) Work to Start Inspection Date Requested: Rough Final Signed under the enalties of perjury: FIRM r1A:� v/ -��� I.T.C. NO.�.3 3 Licensee S • Xf, �/ 4lA- � Signature LI N0. 14 59 3.3 Addres Jmay' j A_0 a /f4eus. el. No. OIJNER'S IN -J � AI G Alt. Tel. No. �: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature.on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S k (Signature of Owner or Agent 3509 Date . TOWN OF NORTH ANDOVER " PERMIT FOR GAS INSTALLATION This certifies that.�/............... has permission for gas installation . .............. . in the buildings -of .. ...................... at : ;` ........ .. ,%/�. , North Andover, Mass. FeelC.. Lic. No..3... j ,p�!�.-� ...... . GAS INSPE YDR WHITE: Applicant CANARY: Building Dept. (/PINK: Treasurer _��...•.r,,,.K�r,,,f.�,+---t,s�-aL.�,ro-�'ir�ci^/ieWt..rG"�°isw..l�.,..-++.z7min'r''..�.p':..-tcK�i:�i�``�n-�sy'.c-+*-�.F •. .. r � • qqy( Rm T --T0 cJ 6 Date .... .,!.r . t, ,,ORTH 1 TOWN OF NORTH AN -DOVER pF etio ' p PERMIT FOR INSTALLATION • ( ftc fit "Y '9SSACMUSEt4 This certifies that .K �?4 .% G#'e . has permission forov15stallation .. G- ..... t ........ . in the buildings of'. 1 C4` �� �. e Q , at ...� ��`? R.... North Andover, Mass. Fe .. Lic. N..... ..... . (/� ,/ff PAIS �,ASTNSPECTOR WHITE: APPOAAt�f CANARY: Building Dept. /PINK: Treasurer GOLD: F" �IA.SSA t APPCATON FOR PERMIT TO GAS FITTING or print) .PARCEL Date ��� �� 19 11 V n f H ANDD y� q Building Locations // � Permit 4 Owner's Name Amount S New Renovation D Replacement �� Plans Submitted (Print or type Name Address ness I eieonone Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company Corp. Partner. L3 ` irTn/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. ❑ Liability insurance policv 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 Agent Owner ❑ Agent 13 tr,nt'Ir M7tk'Iarndc nnri infnrmntinn I have suhrnitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and compliance with all pertinent provisions of the Massa( By: Title Ciry/Town APPROVED wi,riCF LJSc fm -y) performed under Permit Issued for this application will be in Gas Cade apil Chapto9l42 of the GeneralLaws. Signature of Licensed Plumber Or Gas Fitter Plumber 3 - Gas Fitter License INumoer �(aster r7 Journevman • j: (Print or type Name Address ness I eieonone Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company Corp. Partner. L3 ` irTn/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. ❑ Liability insurance policv 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 Agent Owner ❑ Agent 13 tr,nt'Ir M7tk'Iarndc nnri infnrmntinn I have suhrnitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and compliance with all pertinent provisions of the Massa( By: Title Ciry/Town APPROVED wi,riCF LJSc fm -y) performed under Permit Issued for this application will be in Gas Cade apil Chapto9l42 of the GeneralLaws. Signature of Licensed Plumber Or Gas Fitter Plumber 3 - Gas Fitter License INumoer �(aster r7 Journevman Date./C-" �a - �/o N2 4225 TOWN OF NORTH ANDOVER 'A PERMIT FOR PLUMBING This certifies that . . . . . . . . . . . . . . . . has permission to perform . ............ . plumbing in.Ahe buildings ofx` at . z"?(,'... .... ver, Mass Fee,-. ....... Lic. No.. ... ....... PLUM G�N S PECTO R WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR (Type or print) NORTH ANDOVER, Building Location New ❑ Renovation ❑ TO DO PLUMBING v Date Owners Nam Amount e of Occupancy e /�1d747-/ Replacement 1VTVT1T1D1 C Plans Submitted Yes ❑ No ❑ Orint or type) Check one: Certificate Installing Company Name N/ ❑ Corp. Address ❑ Partner. Business Telephone — ❑ Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicateth� f insurance coverage by checking the appropriate box: Liability insurance policyEr Other type of indemnity ❑ Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature 7 Owner ❑ 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 my knowledge and that all plumbing work and ins 'ons performed tinder Permit sued for this application will be in compliance with all pertinent provisions of the Massa tzZto Plu in a and apter 142 of the neral Laws. �n By: lgvjydm 01 LlcenSeaum er T�e of Plumbing License Title 3 City/Town icense um er Master E Joumeyman ❑ APPROVED (OFFICE USE ONLY • ------------------------- • ' - --.---------m----.-----.m • • • 0MOMMr)WWM1NMMMMMMMMMMWW=WW Wig I.., • ------------------------- Orint or type) Check one: Certificate Installing Company Name N/ ❑ Corp. Address ❑ Partner. Business Telephone — ❑ Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicateth� f insurance coverage by checking the appropriate box: Liability insurance policyEr Other type of indemnity ❑ Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature 7 Owner ❑ 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 my knowledge and that all plumbing work and ins 'ons performed tinder Permit sued for this application will be in compliance with all pertinent provisions of the Massa tzZto Plu in a and apter 142 of the neral Laws. �n By: lgvjydm 01 LlcenSeaum er T�e of Plumbing License Title 3 City/Town icense um er Master E Joumeyman ❑ APPROVED (OFFICE USE ONLY Location `d _ No. _.,�� Date 96 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ 4)W rPermit Fee $ g Sewer Connection Fee $ Water Connection Fee $ TOTAL �)$ Building Inspector 9858, Div. 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CD O '0 CL r n Cm C a. CO! �C O CD CEO O CD CD O CD C" a. C O vi CD CZ O y O Cfl O CD � v CO) O � z CD O CD a O C CD cW w Irl pQ d N = CA po :v C O C m y T "rf Cn —i CL 0 . m n CDto C7 G gi Z = �2 to 'O O o. ? Ci = m w G m < CDo CD y G CA w o mac: CD -i n O ro _ _-0 oCD cli � � Com" 0c= a' `� T CL to O 0O N n CD C, CL o VJ � O O N . �.� r � V J f- 4 �] O � O CD CD -� y '—j "— CD N H C z- Cs �o ^ � y .� r CD �ci C ►•a.i ry, CD idF1 >O cn CDCD CD LU CA ' to � O C3 O 1 CD CDo D r.« CD U c cD cc CD x n Imd: � Cz � CC. n _ 0: CA CDG C2 0 = CD cW w Irl ;U -X CA po :v T "rf Cn al G gi C 'O O w G m < w C O ro `; � � Com" a' `� T CL y H z- d >O x n � W, 0 c 01 r� Lf f L 818759 UNIT DEED GRANTOR: Joanne H. Shawcross of North Andover, '.Aassachusett3. GRANTEE: Joanne A. 3aillargeon Unit: s2 PERCENTAGE NTEREST: 30r AP?ROXIXATE AREA: 1,080 aq. ft UNIT ?OST OFFICE ADDRESS: 26 ?leasant Street, ?forth Andover, Massachusetts CONSIDERATION: $98,000.00 GRANTOR, owner of the UNIT described above in THE ?LASANT STREET CONDOMINIUM (the "Condominium") created by :gaster Deed ("'gaster Deed") dated November 17, 1981, and recorded on November 18, 1981, with the Essex County North District Reg43tr�,� of Deeds, in Book 1546, Page 1i0, in accordance with the provisions of :Massachusetts General Laws Chapter 132A, grant the UNIT to GRANTEE with QUITCLAIM COVENANTS for the consideration stated above. The UNIT contains the approximate area l )tad above and is laid out as shown on a pian recorded with saidRegistry in Sock 1587, ?age 197, which is a copy of the plans filed with the Master Deed and to which affixed a if ver_ed statement in the form provided for in Massacnusetts General Laws Chapter 133A, Section 9. The UNIT is conveyed together with: The ?ERCENTAGE INTEREST iin the Common seas and facilities of the Condominium enumeratad above. 2. The Common Areas facilities lescribed in Paragraph 5 of the :Master Deed. The UNIT is to be used only _or _-isidential ?urposes. The UNIT is also conveyed subject to and with the benefit of the restrictions, easements and conditions contained in the :Master .Deed and the Condominium Trust, :which are hereby incorporated by reference completely as if each were fully set forth her=in. GRANTEE acquires the UNIT with the benefit of, and subject to, the provisions of :Massachusetts General Laws, Chapter 133x, relating to condominiums, as that statute is :written as of the date hereof and as it may be amended in the future, the igaster Deed, the Condominium Trust and the 3y -Laws therein contained and any rules and -regulations From time to time adopted thereunder including Without limitation the provisions for assessment of common charges, and all matters of record stated or =efarred to in the Master Deed as completely as if aach were fully set forth herein. GRANTEE also acquires the UNIT subject to real estate ,axes attributaple to the I BK3769 UNIT which are not yet due and payable, with GRANTEE by acceptance of this deed hereby assumes and agrees to duly pay. Being the same premises conveyed to me by deed of Joseph P. Swain and Lee Swain dated August 13, 1984 and recorded in the Essex North District Registry of Deeds in Book ia53, Page 100. EXECUTED UNDER SEAL THIS 26th DAY OF June, 1993. k �2 J anne H. Shawcross s COMMONWEALTH OF MASSACHUSETTS Essex, 3s June 26, 1993 Then personally appeared the above-named Joanne I. Shawcross and acknowledged the forsgoinq instrument to be her frae act and deed befors me. 1,M c. amon-Rey, Not ?ubilc My Commission Expir3 : 1/4/94 0 d -qr ESSEX NORTH REG TRY OF DE LAWRENCE, MASS: A TRIBE COPY: EST: c 11 Pao - REGISTER of DEED II7a 3_/Ycel� FORM U - VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fit s out this section***************** APPLICANT: i Phone LOCATION: Assessor's Map Number Subdivision Street 1�0( ************************O ficial RECOMMENDATIONS F AGENTS: ,�.64 a Conservation Administrator Comments Town Planner Comments Parcel Lot (s) St. Number �- Use Only************************ Food Inspector -Health �I� Ian eptic Inspector -Health Comments Public Works - sewer/water connections - driveway permit Fire Department Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Received by Building Inspector Date ..I Aw v H 'v C d CO)CD C•7 C-) z y CD CD -� co CM C O O• C CZ �` y n co -v � o o v CD CD o CD CD O CD C O Vf� a: v y _• o � v CC CD CA O z CD O Crt O CD O CD n Q -. y O Q N C3 CD C7 O H A d n Mm Z CD03 w ?'O y � C� .-► O .-+ CD o. T r --* a m CD -I p O H C -i O CD CD CCD n > > -0 C CD t C O O H n W O Co c �o co) 7 CL tC7 O CD CA CD CD N cCD7 o CD CL CD N ad. ,W C3. �CD �CD mac: w y CDrte^\ !D .� tC � , (� o.o co oCA .OCD O '� CD Hyl. OCD r CU LU `CS t1�_ C") Cl) a 0,� O CA O : C O ; O CD CD O : Cn (p7 '� 1 7d �7 Cn '9 :v 71 (j jo r1 Cn ty 0T. w oCG w pip w pipaGa V �7 �y ^ p rt d yCyT�1 .T 9 y" r r a C' o O z 0 x O C CD 9 ,-N2 4C62 Date. G . /,- . - - TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SSACHUS This certifies that ........................................... has permission to perform plumbing in the buildings of: ..................... " at ....... I North"Andover, Mass. Fee,5!!- . Lic. No.......... PLUMBING INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) J,5 U NORTH ANDOVER, MASSACHUSETTS Date Building Location /I- (//e Pjl'/4 seN-1 Sr -Owners Name !�Pd iq 'rk Z Permit # 1-a—P Amount Type of Occupancy New Renovation ReplacementEIL,--Plans Submitted Yes No FIXTURES (Print or type) Check one: Certificate Installing Company Naine b A c e 41"WA-quo- �,�eA��;�� E' Corp. Address !94 A Nofv UPI, /t, A- Partner. Business Telephone Firm/Co. Name of Licensed Plumber IldIhAl d VAAld P /L-e,+14V Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 0 Other type of indemnity 1 Bond ❑ Insurance Waiver. I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance _, Signature Owner 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 my knowledge and that all plumbing work d installations performed under Permit Issued for this application will be in cJmpliance with all pertinent provisions of the sa s e tubing Code and Chapter 142 of the General Laws. By'3 ighature ot Eicens r Type of Plumbing icense Title City/Townice❑ eIlumoeer Master ® Ioumeyman APPROVED (OFFICE USE ONLY LLU