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HomeMy WebLinkAboutMiscellaneous - 296 APPLETON STREET 4/30/2018N) C) -4 Date ...... . )j -/z 7. v�ORTN 9. TOWN'OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ................. has permission for gas installation .......... in the buildings of .2 ................. at .... North Andover, Mass. 6.7 Fee. . Lic. No.. .�. I ' -� —1 . . ..... 946AS INSP CQ Check # 23 2 5354 --,;a IRAI 5 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Prini or Type) rM 20 05 11crinit # 4-dover .. Date Building Location Oq9l� ,RIQ-11M Owlicl*'sNill,IC----g��4�q,�e------ .1 0wnerTcI# New 0 Rellovation 0 Type of- OCCIII).111cy X 'tq' ec 2�' Replacement lllanStibmiued: Yes U No El FIAURES Installing Company Name___ Check one: Certificate Address—... �Y � Corporation /1�-e UJ Partnership Business Telephone 0 Firni/Co., Narne of Licensed Plumber or Gas Filter INSURANCE COVERAGE; I have a curreqViabililly Insurance policy or its substantial equivalent which-meels the requirements of MGL Ch. 142. Y, ej,* No a If you havd 5)ecked Xes, please indicate the type coverage by checking (he appropriate box. A liability insurance pol ' 4 Other type of indemnity a Bond 0 _�AIVER: I am aware that the licensee goes _not have [tic insurance coverage required by Chapter 142 of the Ir OWNER'S INSURANCE Mass. General Laws, and that my signature on this pen -nit application waives this requirement. ovidiure oi L)wner or vwner-s Agent Check one: Owner i_*i Agent i i - to the best of my I hereby certify Iha( I the details and information I have submitted (or entered) in above application are true and accurate knowledge and that all plumbing work a . nd installations performed under the permit issued for this application will be in compliance with all �ertinenl provisions of the Massachusetts Slate Gas Code and Chapter 142 of (lie General Laws. By__� Type of License: T. i I I' n - -Plumber Signature of Licensed Plumber or Gas Fille'r___ -Gas filler -Master License Number �7-7� -4yffown 2, Z5:30umeyman NEESE NONE ONE MEMENUMMEMEM 0 MEMM ONE MEMMEME MENEM NONE 0 MOMMEMEMEME ENO MEMO MEMEMEME No MENEM ENO NOMMON MENEM 0 ENO 0 ENO M 0 OMMM MMEWEEMEMMEME __NMW_ -0 Installing Company Name___ Check one: Certificate Address—... �Y � Corporation /1�-e UJ Partnership Business Telephone 0 Firni/Co., Narne of Licensed Plumber or Gas Filter INSURANCE COVERAGE; I have a curreqViabililly Insurance policy or its substantial equivalent which-meels the requirements of MGL Ch. 142. Y, ej,* No a If you havd 5)ecked Xes, please indicate the type coverage by checking (he appropriate box. A liability insurance pol ' 4 Other type of indemnity a Bond 0 _�AIVER: I am aware that the licensee goes _not have [tic insurance coverage required by Chapter 142 of the Ir OWNER'S INSURANCE Mass. General Laws, and that my signature on this pen -nit application waives this requirement. ovidiure oi L)wner or vwner-s Agent Check one: Owner i_*i Agent i i - to the best of my I hereby certify Iha( I the details and information I have submitted (or entered) in above application are true and accurate knowledge and that all plumbing work a . nd installations performed under the permit issued for this application will be in compliance with all �ertinenl provisions of the Massachusetts Slate Gas Code and Chapter 142 of (lie General Laws. By__� Type of License: T. i I I' n - -Plumber Signature of Licensed Plumber or Gas Fille'r___ -Gas filler -Master License Number �7-7� -4yffown 2, Z5:30umeyman j4 t 1 Date. ........... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that has permission to perform ... PC f-% ..................... plumbing in the buildings of . . . . . . . . . . . . . . . . . . a t "/ ..... ...... r, North Andover, Mass. Fee Lic. No.. ......... � ........ 4UMBING INSPECIOR Check # //)-/, .. 5034 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NO . RTH ANDOVER, MASSACHUSETTS Date Permit # Building Location OwnersName X'02 Amount of New Renovation Er Replacement Plans Submitted Yes No NJ laul U. op (Print or type) Check one: Installing Company Name L�k�c- Corp. ) Mic" �Ie 0" 0, C" - El Address Partner. 'S--'.)w-xS , a Busine§-s-l'elephbne -) I - S V,:, q - -7 6� 9 q 0 Name of Licensed Plumber - Insurance Coverage: lndicat�. �he of insurance coverage by checking the appropriate box: Liability insurance policy F-1 Other type of indemnity El Bond Certificate Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner El Agent 11 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 perfon-ned under Permit Issued for this application will be in compliance with all pertinent provisions of the Yfa-s- u ing Code and Chapter 142 of the General Laws. �hchusetts I By: SignifLure or Mcensea FlumDer Type of Plumbing License Title I a' 9 ula( City/Town 1-Tuense IN unioer Master meyman APPROVED (OFFICE USE ONLY lj--�Jou Location C�:?, Ln A A) S4 - No. Q�0. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ CHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 41 � 15076 Building inspector TOWN OF-WORTIM AN—DOVE �BUILDPNGIDEPARTMENT REPAM RENOVATE,_,OR_.DEMOLISHA ONE OR TWO FAMILY -W BUILDING PERMIT NUMBER: DATE SIGNATURE! Building Commissioner/1 tor of Buildin2 Date SECTION I- SITE INFORMATION 1. 1 Property Address: 1.2 Assessors Map Z 0) �P ARL E To A) 6 T9L E, T (D No. AnOOVQ_r IV) Map Number Parcel Number: )71 Parcel Number M z 0 1.j Lljnmg 1.4 Property Dim sions: P _�,Lot Area (sf) Frontage'(ft.) Zoning District 1.6 BUHDING SETBACKS (ft) Front. Yard... .__,Si&Y Rear Yard Req#ired Providc Aeqtjjj6j Tr_(Oyviid� ed RNuired PrOvided'' 1.7. Water Supply MGJ-C.4o. 54) E-5. Fl -zone S—erag6 M4.6salSysteur Public , b �,Pri,.w 0 zone Outside Flood Zone 0 Municipal 0 On Site ]DIS06'.4 SECTIO . N 2 - �PROPERTY�-OWNERSECIP/ATJTHORIZE,D,.Ai��'. M 2.1 Owner of Record myy\() V% .N 14 44 5 Name (Print) Address for Servi& I Signature Telephone 2.2 Owner of -Record: Name Print Address for Service: z Signature e . T I It . one SECTION 3 - CONSTR UCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable --A );,Y\ L) +61 L) 0 -icensed Construdion Sup"sor: Co n A License Number Wdre ------------- 791 qSS Expul.41011 Date �ign re., Telephone OEM row a"i, .2 Registered Home Improvement Contractor Not Applicable 0 C 25-1, M ompany Name Registration Number el Y' Y) IA r10 z ddre 7 's natuVre Telephone Expira G) U ESECTION 4 - WORKERS COMPENSATION (NLG.L C I - 52 Workers Compensation Insurance affidavit must be completed and submitted with this a- 1� 4 , P0 ication. Failure to provide this affidavit will result in the d enial�ofthe issuance ofthe building permit. $igned affidavit Attached Yes ........ SECTION 5 - Desere6i"iyt"16h *rMp- dkd. New Co'nstructi6h 0 Eidsting 8dilding 0' -ons( terati S) 0 Addition 0 Accessory Bldg.- 0 .-Demolition 0 Other 0 Speci fy Brief Description of Proposed Work: C�' SECTION 6 - ESTIMATED CONSTRUCTION-C-OSTS J, Item Estimated Cost (Dollar) to be I - ", 'A Completed by permit licant 1. Building (AY 'Bu'dding Pd t F ee 2 Electrical� ),!,,Estim46d' TotaY.Cost-of -construction Building. Permit fee (a) x (b) 4'� Mechanical,!2E!�q 5 Fire -Protection. 6 To,�al,. Q+2+3+4+5) L 7hebk"K SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERNHT L as Owner/Authorized Agent of subject property Herebyauthorize to act on .My behalf, in all matters relative to work authorized by this building permit application. �Siinature of Owner Date - Donavan-Ducatt Ineurance Agy go 11GITS UPON TIS CUT F1 ATZ auku , T 13 " MILA11 UW" WWI an"u, 2119ID OR 111 - - - WE Ifyoul; BY in POLIcill BLOV, fi 7 s" Street -- ------------------------------------------------------------------------ 8, NA COMPANISS AFFORDING COVZRACE fs".18.7 - 101 - 9 7 79 . ............................................ ................ ----------- *­ --------------- * ............ CONPANY LETTER INSWUw= COMPANY .... ..... .. ----------- ---------------- ------------- LOVII LILLO Di A iPAIY LETTER 9 ZURtCH INSURANCE COMPANY CONTU ........................ I -------------------------------------------- 111c fill 8TIMET CONPANY LETTER C 8AM, MR .. ................................................................ 1 KPJJY LITIRI D ------------------ PW LETTED Z > COVERAGES TaIS IS to CISTITY THAT POLICISS Of IISUUICI Ll 110 BILOV BAR 6191 ISSUED 10 121 INSUIRD 11110 AIOVI PON VII POLICY PERIOD INDICATED. NOTWITHSTANDING ANY ISQUIRIM? TIN 01 CONDITION Of MY COIMCT 11 191 DOCUOT VITI 118FICT TO VITC1 Mis C1111FICATE MAY 19 WORD 01 MIT PRI1,11i vu INSUIUCI 11101018 By 7 1 L I DISCIIIII Bills Is SUBJECT To ALL WKS, 11CLUSIONS, AD CONDITIONS Of SUCH POLICtES- L111113 U011 Iff 1111 Ha an By fill cum. ..................................................................... - ------------------------------------------------------- co TYPE or asowd POLICY loan POLICY "I POLICY ZIP ALL UNITS it TIOVOUDI LTR Dill Dill --- --- - ------ .......... GENERAL MOUG"I 100000 -W 00 A PQ tOMICIAL ON LIABILITY BCP3?09759 )8/29/01 P9/29/01 -p-ii-complops mg. Nii j I CLAIMS NADI it) OCC. OVIERIS i CONTRACTORS PIOTICTIVI ............. LIAR ANY A010 ALL OVID AUT0$ SCMULD AUTOS HIRED AUTO$ NOR-OVIRD AUTO$ SANAGI LIABILITY ................................ 11, LIABILITY T-1 Ull LU 011 OTHER ?BAN UMBRELLA FORK --------------------------- VOHXXRS' COMP AND XMPl,OTMtS' LIA9 .. ................... i . VC50009SIS01 _�8/29/01 8/29/01 ........................... ......... ........... . . ... .. .............. ........ ........... . ..... -ii CRUT10i OF OPIRAIIOIB/LCCitlCIS/VSiICLES/SPECIiL ITINS fit$. avc, IIJQRY 100000 i iii Rculklicl 1 00000 ..................... ........... FIN DANAGS (ANY oil Fill) S0000 ----- ----------- (BIT on PERSON) 2000 --------------------- ----------- C8L -- ------------------ ----------- BODILY INJURY (Pit PRISON) DUY INJURY (?IN ACCIDENT) .. .................. .......... PIOPIRTY ........................ RACI occ I IGGIEQTI ...................... RICK Acc DISRISI-POLICY Lill? DISIA81-110 RIPLOTH --------------------------------- CIVIVICATI HOLDER CANCILLATION SHOULD ANY Of 19 ABOVE DESCRIBED POLICIES It CAICILLID BEFORE THE El- PIRAtION DATE ?BUOY THE ISSUING COMPANY VILL INDRIVOI TO NAIL 10 TOWN OF NORTH RRADING DAYS VII111I NOTICE i� THE Clff IFICITI 30091 KIND TO THE LEFT IV FAILURE TO NAIL SKI NOTICE SIILL INPOSI 10 OBLIGATION 01 LIAsiftif or NOMM RRADING, NA ANY ZIND UPON TIM CO1711Y, ITS AGIN?$ 01 VIRISISTITIVES, .. .............................. 5:�� ............................. 101111D REPRESENTATIVE ikCX)RD 25-9 (31891 V / A - � A I A k f BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR . . . . . . Number:.CS 067585 Birthdate- 12/06/1967 0 Expires' 12/06/2001 Tr. no: 11810 Restricted To.- 10 TIMOTHY B JOYCE 89 FERNDALE ST MANCHESTER, NH 03103 Admiwls-trator Uoor,J of Building Rtgulations 2nd, Standards HOME #MPROVISMENT CONT PACTOR Uwe Registritkin: Ex p; ra ( 1 u n-:' 0-2"/2 12 0 0:� iypt.-. --RECIS:ON CONTRACTOR$ TIMOTHY JOYCE 3 CONN -ST MA 0 1801 Ad.-nini.stratoi ........ 4p a N 6 z ca C/) z C/) : C4 :0 t C/) u 0 CD Cl E CD Cl W U3 CA .9 co cm co ca m CL CO3 C) CL. CO3 CD cc "a V3 r.-Ew L.: CD ts CD CL CD CM CD CL.) W Q co Lft CD C:j A— CL CD = cm< 0.-0 c cc CO ts CD CL CO2 uj 0 U) w U) CC w w cc LU LLJ U) rQ5 0 �2 Ei B C/) .2 4� 0. v U) 0 Z. �Z j 9 or z co -6 * c :j 0 x - :� W r- . 9 x u —Cd x PQ -a C2 —. X. d -a �2 g U) x bn :I C2 C', X. ZW o C/) z C/) : C4 :0 t C/) u 0 CD Cl E CD Cl W U3 CA .9 co cm co ca m CL CO3 C) CL. CO3 CD cc "a V3 r.-Ew L.: CD ts CD CL CD CM CD CL.) W Q co Lft CD C:j A— CL CD = cm< 0.-0 c cc CO ts CD CL CO2 uj 0 U) w U) CC w w cc LU LLJ U) C3 co, CO2 C-3 gco Sc EcC ci, 2 co 0 CL %4 C., CD cm CD E CA C, GO 0 Cc E co CL.C.7 C:,D. cm CD C" cm CD.9 Pv- 0 a L cc g co CM. COO CD Lu :1 LD 'M cc 2L , E C.LC- I.— ca = 4D = LU Ca CD .9 COD W CO2 cc C2 :E *- CL... Cc �lm C/) z C/) : C4 :0 t C/) u 0 CD Cl E CD Cl W U3 CA .9 co cm co ca m CL CO3 C) CL. CO3 CD cc "a V3 r.-Ew L.: CD ts CD CL CD CM CD CL.) W Q co Lft CD C:j A— CL CD = cm< 0.-0 c cc CO ts CD CL CO2 uj 0 U) w U) CC w w cc LU LLJ U) NQ- 2406 Date ...... .. 71�� (-) TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ... 1:�.C.J . (,?. �. -.k ..... CQ ...... :Z.11. � ........... has permission to perform ........ ............................................ wiring in the building of ...... //:q. �,.q ................................................... at ....... .... 5/�:..��orth AndcLy-er-, NaV Fee ...... .... Lic. No. .......... ..... Check # Z�-w 1,1-96CTRICAL INSPEcrOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 4 Official.Usc Only Perrnit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS rRev. 11199] (leave blank) --- ---------------------- APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to bc perflornicd in accordance with the Massachusctis Electrical Code 0-113c) .52'CNIR 12.00 (PLEASE PRJiVT LV INK OR TYI-'L--,,i L IiXOR�L'l 7YOjV) City or Town ol &XYA To the Insp to,- o' Wires: By this application die undersigned gives 110tice of III orlichitqi1tiouto rform the electrical, work described below. o to Location (Street & Number) Z9( a .7& (� Z="' , 'er Owner or Tenant Owner's Address Is this perinit in co"junction with a building permit? I'Ll"110se of Building Existing Service 2:1 Anips N'Olts New Service Anips Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Yes [I No Telephone No. (Clieck Appropriate Box) Utility Authorizition No. Overhead 0 Undurd t. El No. orAleters OverheadEl UndgrdEl No. of.Nleters." Cumnletion ofthp fnih—q— No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Faus uy "Ic ", oi rtres. No. of �ROC-E�1-101' Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA 17-0. -0TYm—ergency Li- iting No. of I Lighting Fixtures Above Swimmina Pool ffl'rnd, 0 2rnd. Battery Units No.'of Receptacle Outlets No. of Oil Burners FIRE ALAR.L%'IS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devic es No. of Ranges No. of Air Cond. TotaF Tons No. of Alerting Devices No. of Waste Disposers He2tPuII]PJjjN -qE KW .......... . - - ------ - -N-0— -Contained N -of Sell Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW b Local Nlujilcip?l — Connection 0 Other No. of Drvers Heating Appliances Securl*EV bliStems: No. of Water -%V INO. of f 1 No:ofbevices or Equivalent Heater's K 'o Siglis Ballasts Data Wirino: - No. of 6�viccs or Equivalent No. Hydroinassage Batlitubs No. of Motors Total I -IP I elecommunications Wirina- - No. of Devices or Eguivta'len OTHER: Allacil aaanionai delaij ydesired. or as required b,Y the Inspector of ;Vires. INSUF,1A.NCE COVERAGE: Unless waived by the o,,%-ner, no permit for the performance of electrical work may issue unless the licensee provides proof of Ii bilit ' r nce including "completed operation" coverage or its substantial equivalent. The -tied certifies that such Y2'� "a force, and has eNhibited proof of same to the p rmit issuing office. undersi, cove s CHECK ONE: INSUI�ANC ND El O'1'I-IER [] (Specify:) ��01 In E 1�xens— �A I (When required by municipal policy.) (Expiration Date) Work to Start: -- Uv-�11 Iiispcctioiis to be reques ted in accordance with IVIEC Rule 10, and upon completion. I certifj,, linder the pains and pena I es o perjury, t tat t te ill orillatioll oil this application is trite and complete F110I NANIE: L/ LA LIC. NO.:AL5 3 -3 Licelisee: 6 10A Si-naturea, LIC. NO.: (If applicable. entcr 111PCI I/ h ense number hnc.,)�g LT 3 —;T 37 - Address :_ '0 L. -FZW"2 2 Bus. Tel. N 5 K0 Z7?*q Alt. Tel -No.: OWNER'S INSURANCE NVAIVER: I ani -aware that the Licensee doey a 21 have the li�—bility insurance coverage normally required by law. BN-,iiy signature below, I hereby waive this requirement. I am the (check onc) E] oxvncr [] o-vnicr's zil-,ent. Oiviier/Ag,ent Signature Telephone No. LLij--Rilf _fT 1--E- E: S Estimated Value ofElcctrical Work: Date... 04 "ORT" TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ................ has permission for gas installation ........................ .......... in the buildings of .......... ...................... - q at Cz). . 1� ... (�aJ44A, North Andover, Mass. FdeAoe e- . Lic' 6/ GAS INS ,PEar,OR Check# Ili -J7111 01 5330 RASSACHUSEY11S LNEFORNI APPUCATON FOR PEMIrr TO DO GAS FrMNG (Type or print) , Date NORTH ANDOVER, MASSACHUSETTS Building Locations Z 9 APPLE TO t-� Permit # Amount Owner's Name New Renovation Replacement Plans Submitted 0 (Print or type) one: Certificate Installing Company Name,11214L, AIK e��Y511 M3 10-1 C, Cff Corp. Address - _L10 mAlt--s ST� 01 �� 4q Partner. t..3. KkM0jt--N(, rV1 A BusinessTeleptione . vi -7 gi 6Cli So -&3 Firm/Co. Name of Licensed Plumber or Gas Fitter — N-I�rj Auf�. 71 *(- I T� —1 INSURANCE COVERAGE - Check one: No [3 I have a current liability Insurance policy or it's substantial equivalent. Yes In If you have checked ves, please indicate the type coverage by checking the appropriate box. Liability insurance policy 1:1 Other type of indemnity 0 Bond 13 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 0 Agent 0 I hereby certify that all of the details and information i nave suonuttea kor entereu) in avuve appjicauon are true anu accurate LU Me 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 Massachusetts State Gas Code and Chapter 142 of the General Laws. ty/Town (OFFICE USE ONLY) E3Signature of Licensed Plumber Or Gas Fitter Plumber SIZI MI Gas Fitter License Number 0 Master [3 Joumeyman 1--TH. FL (Print or type) one: Certificate Installing Company Name,11214L, AIK e��Y511 M3 10-1 C, Cff Corp. Address - _L10 mAlt--s ST� 01 �� 4q Partner. t..3. KkM0jt--N(, rV1 A BusinessTeleptione . vi -7 gi 6Cli So -&3 Firm/Co. Name of Licensed Plumber or Gas Fitter — N-I�rj Auf�. 71 *(- I T� —1 INSURANCE COVERAGE - Check one: No [3 I have a current liability Insurance policy or it's substantial equivalent. Yes In If you have checked ves, please indicate the type coverage by checking the appropriate box. Liability insurance policy 1:1 Other type of indemnity 0 Bond 13 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 0 Agent 0 I hereby certify that all of the details and information i nave suonuttea kor entereu) in avuve appjicauon are true anu accurate LU Me 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 Massachusetts State Gas Code and Chapter 142 of the General Laws. ty/Town (OFFICE USE ONLY) E3Signature of Licensed Plumber Or Gas Fitter Plumber SIZI MI Gas Fitter License Number 0 Master [3 Joumeyman