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Home My WebLink AboutMiscellaneous - 29 SARGENT STREET 4/30/2018ro 0 00 0 M ;.Z � q � 6 cn 0--f C� ;u C> M M Date ..... Fl�il I/ ......................... ,TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ... D01.1 ....... AIA=e ......................... v has permission for gas installation .... hP.k4,n ............ in the buildings of ................................... at ... -N, ...................... . Feeoqlp�a... Lic. Noc�'24 .... / .................... Check # 0 ,522 ............ , Northyover, Mass. ....... alla'4T, i ......................................... ,��AS INSPECMR wt 14 10733 Date .... If/Z/// ........... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that Owl.. .... ga&.-a... has permission to perform ........ � 1.4.A ...... pfumbing in the buil ngs of ........ at.... �N ... Y,.q ... I.- ....................... FeegQ ............. Lic. No..? ) ..... Check #";,L) tp— .................................................................................. 7'orth Andover, Mass. ......... ...... 4 V IL L M B h I N * S** P** 'E'* C** *T'*O'* 'R'... I hereby certify that all of the details and information I have -submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this a5Mcation wi be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. C/ L 1 7 LICENSE # PLUMBER NAMEJ A fA G) I bIr e if SIGNATURE COMPANY NAME: JADDRESS:1 CITY: L d d+ jc� STATE: EEZ ZIP: I 01'�Fzfq _T FAX: TEL: ]EMAIL:j CELL: MASTER,g JOURNEYMAN El CORPORATION # = PARTNERSHIP E] LLC F # MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK TYPE OR PRINT CLEARLY CITYLj\.j0r+k A JA v e- r , MA. DATEI q—Lj—jq I PERMIT # JOBSITE ADDRESS OWNER'S NAME 0,ne— mo-r(�Ic_z OWNER AD*DRESS: ---]TEL: 677,697.3�FAX: OCCUPANCY TYPE: COMMERCIAL El EDUCATIONAL RESIDENTIAL;V NEW: El RENOVATION: El REPLACEMENT: PLANS SUBMITTED: YES [:1 NOX FIXUTRES -1 FLOORS— 8smt 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONN DEVICE DEDICATED SPECIAL WASTE SYS DEDICATED GAS/OIL/SAND SYS DEDICATED GREASE SYSTEM. DEDICATED GRAY WATER SYS DEDICATED WATER REUSE SYS DISHWASHER DRINKING FOUNTAIN FOOD WASTE GRINDER UNIT FLOOR / AREA DRAIN INTERCEPTOR INTERIOR KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE/ MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING ZFf? Boile-c INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL, Ch. 142 YES FI -91 NO If you have checked YES, Please indicate the type of coverage by checking the appropria te box below. LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY E] BOND F� OWNER'S INSURANCE WAIVER: I am aware that the Ii * censee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER El AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have -submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this a5Mcation wi be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. C/ L 1 7 LICENSE # PLUMBER NAMEJ A fA G) I bIr e if SIGNATURE COMPANY NAME: JADDRESS:1 CITY: L d d+ jc� STATE: EEZ ZIP: I 01'�Fzfq _T FAX: TEL: ]EMAIL:j CELL: MASTER,g JOURNEYMAN El CORPORATION # = PARTNERSHIP E] LLC F # V MASSACHUSETTS UNIFORM APPLIC;ATION FOR PERMIT TO DO GAS FITTING cityl-rown: JlQaj-+� ayjL-je�4— MA� Date: Permit# Building Location:A% �Qf4e_y)+ S+' Owners Name: 10, VA e- Koff, i 60y� Type of Occupancy: Commercial Educational 7 IndustrialE] Institutional [] Residential New:xAlteration: Renovation: 7 Replacement: Plans Submitted: Yes F7 No V7 � FIXTURES INSURANCE COVERAGE: I have a current liability insurance policy orits substantial equivalentwhich meets the requirements of MGL. Ch. 142 Yes X No If you have checked Yes, please indicate the type of coverage by checking the appropriate box below, A liability insurance policy 01,11 ar ty'ri e of 1 nderrin ity I:] Bon d r] 'XI L -j OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required b,,, Chapter 142 01 the Massnclhusa-ts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner Agent 7, S ionatu re of Owner or Owner's Agent By checking this box []; I hereby certify that all of the details and information I have submitted (or entered) reqardinq this application are true and accurate to the best of my Knowiedge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. -T7-pie-ot 1 -ice rise: "gPlumber y v1'r1,0116 12 PI jlblj�— Title Gas Fitter Sign-atu� of Licensed Plumber/Gas Fitter gMaster City/Town 5j�ourneyman License Nurnber:.. P L LLI 'il 6 APPROVED (OFFICE USE ONLY) F� LP Installer z L) z = Lu 0 Lu W 0 U W 0 in z I`- 1-- 0 z -1 of It Lu z U) 0 Z LU 12� I-- = 0 - Z Lu U) LU 0 z (L 0 0 1-, U) W > 1-- 0 uj U -7 - Lu 0 Ul 2: z LLJ W Lu LU > L) 0: Lu < z 0 -.1 UJ 0 0 z 0 0 0 Co Z LLJ W z 0 U) < z U<1 >W 0 z 0 W > z z LU < LU) a 0 LL 1 0 0 1 0 a. ILI > 01 S U —BS S M T. I BASEMENT 11'�'FLOOR —ZO-F—L 0 0 R 3"" FLOOR 4"' FLOOR 51H FLOOR 6TR —FLOOR I r I 1 1- 7 "' FLOOR 8'm FLOOR Check One Only Certificate 9 Installing Company Name:. -Owb'P-C, Milk I n El Corporation Address: own: State: Ma Zba V CC S`7�ItYIT f Partnership Business Tel: Fax: Firm/Company Narne of Licensed Plumber/Gas Fitter: �)(Sk)eIU4, 10e, tO, INSURANCE COVERAGE: I have a current liability insurance policy orits substantial equivalentwhich meets the requirements of MGL. Ch. 142 Yes X No If you have checked Yes, please indicate the type of coverage by checking the appropriate box below, A liability insurance policy 01,11 ar ty'ri e of 1 nderrin ity I:] Bon d r] 'XI L -j OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required b,,, Chapter 142 01 the Massnclhusa-ts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner Agent 7, S ionatu re of Owner or Owner's Agent By checking this box []; I hereby certify that all of the details and information I have submitted (or entered) reqardinq this application are true and accurate to the best of my Knowiedge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. -T7-pie-ot 1 -ice rise: "gPlumber y v1'r1,0116 12 PI jlblj�— Title Gas Fitter Sign-atu� of Licensed Plumber/Gas Fitter gMaster City/Town 5j�ourneyman License Nurnber:.. P L LLI 'il 6 APPROVED (OFFICE USE ONLY) F� LP Installer 60�- PL16100-M License No. Commonwealth of Division of Registr, Board of Plumbina DOUGL 15 THA METHUE Master PI 05/01/20! �J7005358 Expiration Date. Serial No. 0 , C Location No. Date 41- C� C) 0 ,401tTot TOWN OF NORTH ANDOVER ,90 "... 0 0 0 Certificate of Occupancy $ Do -Its S Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 3,38-3 17201 /M Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REEA RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: 41 — ;�2 0 SIGNATURE: ' 1114 BuilEng Comnlissioner/Inspector of Buildings Date SECTION I -SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Diaiic_t Proposed Use Lot Area (sf) Frontage (fi) 1.6 BUIELDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 4- 1.7 Water Supply M.G.L.C.440. 54) 1.5. Flood Zone Information: Public 0 Private D Zone Outside Flood Zone 0 1.8 SeweMe Disposal System: municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT historic District: Yes No 2.1 Ownerof Record ROL e/j 1eq 00-7 L Name (Print) Address for Service: Signature Telephone 2.2 Owner of Record: A Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable 0 Licensed Construction Supervisor: 0 License Number Address xee4r,�t L��/e q �� - Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable 0 S, CIA/ Company Isla -me Registration Number Address / �4— Expiration Date' Signature Telephone T M X z 0 96 %:�6 0 z M 90 0 mn M z Q I SECTION 4 - WORKERS COMPENSATION (MG.L C 152 § 25c(6) I Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. SiRned affidavit Attached Yes ....... 0 No ....... 0 SECTION 5 Description o Proposed Work (check applicable) New Construction 0 Existing Building 0 Repair(s) 11 Alterations(s) Addition 11 Accessory Bldg. 0 Demolition 11 Other 11 Specify Brief Description of Proposed Work: 7-ArJ V I SECTION 6 - FSTIMATM CONRTRUCTInN CMMIZ I I-IOV- /11) /J Item Estimated Cost (Dollar) to be Completed by ennit applicant p I Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical (HVAC) -5 Fire Protection .6 Total (1+2+3+4+5) Check Number , '5Ls HE -iivr4/aVWfNEKAU1HUKlLA11Ur4 MISEUUMPLETEDW N OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERAUT as Owner/Authorized Agent of subject property Hereby authorize to act on My behalL_L%all matters reZlt5've to work authonzed by this building permit application. 51�' 20 Zzdl'.' &4 - Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, 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 Print Signatu�e of Owner/Agent Date C) i -age OT Free Estimates 105 Haverhil�Street�� Fully Insured Methuen, MA 01844 THOMWSON'S ROOFING (978) 691-1355 0 Shingles — Slate — Rubber Roof Single Ply — Copper Work PROPOSAL SUBMITTED TO Dianne Morrison Robert Seablom PHONE (978) 689-2600 DATE April 9, 2004 STREET JOB NAME 29 & 31 Sar,-ent Street CITY, STATE AND ZIP CODE JOB LOCATION North Andov5�r, MA CT DATE OF PLANS BPHONE We hereby submit specifications and estimates for: - Strip off all roof shingles on house Renail -all loose boards Install aluminum drip edge around roof line Apply ice anu water shield 6 ft. UD all along edge and in valleys Apply 30 1b. felt paper on rest of roof area Reshingle with a 30 year Architect sbingle Pewter Grey Install new flange around soil -Dipe Waterproof chimney area flashing Cut in a rid6e vent 0 On flat roof fasten down �2 inch insulation 4x8 sheets(plywood $55.00/shee-t Apply .060 Manville rubber fully ad.her ed, glue and caulk all seams install .032 al UITILLUM metal around edge and flash to roof Remove all work related debris 30 year warranty on mat.erial 5 year guarantee on labor -2, Constructior, licens-e # 060112 —IraproveminO.-licease 4-1 3612 You are responsible to.cover all thingS in the attic. We pull permits T.his c.ont-.-act is valid for sixty days.( '00 days) Wr Vropogt hereby to furnish material and labor— complete in accordance with above specifications, for the sum of: Nine 1housand Six Hundred Dollars.- dollars ($ 9,600.00 Payn*nt to be rinade as follows: $3,000.00 down balance upon com�lation Ail material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications Involving Authorized 4 extra costs will be executed only upon written orders, and will become an extra charge over and Signature— above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are, fully Note: This pi witiviravin hv ant If rknt ar--PntpA %Arithin Rcreptattre of j9ropogat— 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: North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of IVIGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by IVIGL c 11, S 150 A. The debris will be disposed of in: .6 �7z (Location of Facility) Signature of licant 0 3, Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector C E R T I F I C A T E 0 F PRODUCER PELHAM INSURANCE SERVICES INC 122 BRIDGE STREET 122 BRIDGE STREET PELHAM L I A B I L I T NH 03076 - INSURED Thomas Doyle DBA Thompson's Contruction & Roofing 8 West St. Salem NH 03079 muCDAI'17C Y I N S U R A N C E I DATE 7/10/03 (MM/DD/YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALT THE COVERAGE AFFORDED BY THE POLICIES BELOW. I N S U R E R S A F F 0 R D I N G C 0 V E R A G E INSURER A: Western World INSURER B: Liberty Mutual INSURER C: INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY [XI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE FIRE DAMAGE (Any one fire) $1,000,000 $ I CLAIMS MADE EXI OCCUR NPP770609 04-17-03 04-17-04 MED EXP (Any one person) $ 50,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $2,000,000 $2,000,000 [XIPOLICY [ ]PROJECT E ILOC AUTOMOBILE LIABILITY I ANY AUTO COMBINED SINGLE LIMIT I ALL OWNED AUTOS (Each accident) BODILY INJURY $ I SCHEDULED AUTOS I HIRED AUTOS (Per �erson) $ NON -OWNED AUTOS BODIL INJURY (Per accident) PROPERTY DAMAGE C (Per accident) $ GARAGE LIABILITY I ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ 1 , AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ I OCCUR E I CLAIMS MADE AGGREGATE $ I DEDUCTIBLE $ I RETENTION $ $ WORKER'S COMPENSATION AND [X1 WC STATUTORY [ I OTHER B EMPLOYER'S LIABILITY E.L. EACH ACCIDENT $100,000 WC2-31S-314995-013 04-21-03 04-21-04 E.L. DISEASE -EA EMPLOYEE $100.000 E.L. DISEASE -POLICY LIMIT OTHER .$500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Job: Various for Kevin Murphy Construction. IN I I 110URLU LL I I LM Kevin Murphy Construction 169 Boxford Rd. N Andover MA 01845 UANULLA11UN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MALL -a DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED E LEF , BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION ABILITY ANY KIND UPON TH� INSURER. ITS AGENTS OR ';� r"A — OR LI TY REPRESENTATIVE . AUTAORIZED REPRESENTATIVE/) t-� 1.,d 06 (7/97) I,,� 1�,� — / P�ge I of 2 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit rN—a m e Please Print ,-,> c—,-, � / 6 �,, Location: �z CitV k- -e-A Phone F] I am a homeowner performing all work myself. F--] I am a sole proprietor and have no one working in any capacity F7 I am an employer providing workers' compensation for my employees working on this job. Company name: '�-77(70-1"— 0 Address EWA FF pl� � 2 — 3 / L — -�,) Z--7�FS— — 0/ 3 Company name: i Address City: Phone #: Insurance Co. Policv # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to $1,500.00 and/or one years' imprisonment-as.-w.eh-as-civ.il,penaftles in -the form -of -a.-STOP WORKORDER-and-a fine -of -($1D.0.00.)..a �day against -me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. do hereby certify unde�Me pat . ns and penalties of pedury that the information provided above is true and coffect. Signature- Date Z-( Print name Phone.# Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing Building Dept rICheck if immediate response is required F-1 Licensinq Board F-1 Selectman's Office Contact person: Phone #.- E] Health Department 0 Other 6 z 4.. 43 M 0�0' CCD im lco Mr - cc C43 r CE ts Klbi CL ts cm Ivi s JO ccDL E C2 0 a cm oM. cc M C93 M ]5; = *%, ce CM = Co a cm =0 cm qpi -,o o< rA 02 = ca cm C2 ts CL= (D CD ar, 3: No 0 0 40. Uwi AD -M 1=6 Ma CLs ej e C42 ci 0 Cl* 0 C, C:, :a = 0. CL.- Cc :10 C/) z 0 U rA3-' Cf) z 0 u C/) C/) 4-J W 9 E L: z CL 0 CO) 4 Lo cm CA MA r= CD 0 CD L- I. = CL CL CL 0- CM< C4) cc ca CD CL CO) CO2 ul w U) 19 LU LU 19 LU LU U) 0 �2 0 pq u x co r. U) LL. C2 ZW V) U) CCD im lco Mr - cc C43 r CE ts Klbi CL ts cm Ivi s JO ccDL E C2 0 a cm oM. cc M C93 M ]5; = *%, ce CM = Co a cm =0 cm qpi -,o o< rA 02 = ca cm C2 ts CL= (D CD ar, 3: No 0 0 40. Uwi AD -M 1=6 Ma CLs ej e C42 ci 0 Cl* 0 C, C:, :a = 0. CL.- Cc :10 C/) z 0 U rA3-' Cf) z 0 u C/) C/) 4-J W 9 E L: z CL 0 CO) 4 Lo cm CA MA r= CD 0 CD L- I. = CL CL CL 0- CM< C4) cc ca CD CL CO) CO2 ul w U) 19 LU LU 19 LU LU U)