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Home My WebLink AboutMiscellaneous - 30 ANDREW CIRCLE 4/30/2018I North Andover Board of A-,,sessors Public Access Click Seal To Retum Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial 4 Page I of I North Andover Board of Assessors W.1) Agiproperty Record Card Parcel ID :210/047.0-0131-0000.0 FY:2013 Community: North Andover Location: 30 ANDREW CIRCLE Owner Name: SEK, DAVID Owner Address: 12 COTTAGE STREET City: PEABODY State: MA Zip: 01960 Neighborhood: 5 - 5 Land Area: 0.07 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 1152 sqft ASSESSMENTS CURRENTYEAR PREVIOUS YEAR Total Value: 205,600 209,800 Building Value: 72,200 72,800 Land Value: 133,400 137,000 Market Land Value: 133,400 Chapter Land Value: http://csc-ma.us/PROPAPP/display.do?linkld=2253458&town=NandoverPubAcc 3/26/2013 CO) T- 40 LL LU -j L) Lx L) z 4 CD �i U) '2 cf) co LU (.) Of 20 00 w C) a) ,- 0� 2 Co CD ci CD -0 CD U) CD (D �-: ly 0 i .r. 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M a) w 0 LL cll�2 i� 4� 2 < 2A -.5 ±'.� r_ a - LL < .9 E _0 < C: m =1 = 00 N z C!C: LL LL "12-0-0 o LLJ C, a c tt-- a) 0 Z) Z) 4 LLJ >- (D L) d - z 0 z LLI LO C4 2 M LL w in, W LL E E C6 m i� m m (n 0 0 ,t :s = 0 :s D 0 0 M 15 =3 m CY COL c D 0 LL I -- m X 2 co co = 0 70 W CD = 76 a) -r< cn cn m W to M LL M w m y w m M;� LLI CD Z' u ce N IM U mooz Ix w 0 0 jjj i6o 16 - 5, (-) — F- L) L: �e U) w 2 C', w -0 F- .2 T c CL -2 0 w U) 'D � CL 00 8 Q) (D 0 C/) —0 :0 :c C/) U) cr w LL M LL LL (L 0 CD Cl) co cli i-15 0 to w CD 9 9 v .9 Li e This "T/16 certifies that .......... I ........ w ........ 6: ........ r ......... has permission to perform .... .. �'.Ak ................ Date...J.//o .... /.5 ....... ....... ... ... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING plumbing * the buildings of ..... ,�n ...... ....... ........ a ..... ............. Fee ...... Lic. No. 'g -3 7. Check# .......... r\ ...... N6 A h Andover, Mass. I. -i;�U F1 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY 1 1 .--I MA DATE 6 PERMIT# A JOBSITE ADDRESS OWNER'S NAME POWNER ADDRESS TEL __JIFAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAZ PRINT CLEARLY NEW: 01 RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES NO F -I FIXTURES I FLOOR- BSIVI 1 2 3 4 5 6 7 8 1 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS10IL/SAND SYSTEM _J1 --Il- J ----I ---I DEDICATED GREASE SYSTEM ji DEDICATED GRAY WATER_SYSTEM DEDICATED WATER RECYCLE SYSTEM --- DISHWASHER ---- DRINKING FOUNTAIN —i FOOD DISPOSER -.-JIF-77T FLOOR/ AREA DRAIN INTERCEPTOR (INTERIORT F f KITCHEN SINK -j LAVATORY ROOF DRAIN SHOWER STALL SERVICE / MOP SINK -.--J==== TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING �-Q—THER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COV'ERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICA OTHER TYPE OF INDEMNITY D BOND 0 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance cove rage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this uireme . E O� CHECK ONE 0 T R -J 1�1� SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this lication are true an cc teto eb tof knowledge and that all plumbing work and installations performed under the permit issued for this application w nFom -all ro on of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. NAM&E - 4 q 4 ----] PLUMBER'S /1 0/ LICENSE #F�( --KGNATURE MP 0 ip RD CORPORATION E K#=PARTNERSHIP F-1 LLC COMPANY N ADDRESS[ CITY ZIP TEL j STATE FAX CELL EMAIL-=- _J4, .... .... o r -I z LU CL Lii LIJ LL The Commonwealth ofMassachusetts DepartmintoflndustrialAccid�nts Office of Invesfigations 6#0 Washington Street -Hoston., MA 02111 -wwwmass.gov1d1a Workers' Compensation Insurance Affidavit: Buffders/Contractors[FIectricians/Pl�dmbers City/State/Zip: WC) Phone#: z AR/ou an employer? Check the appropriate box: Type of project (required): 1 am a employer with ) _.. _ 4.E] I am a general contractor and 1 6. EJ Now construction employees (M and/or part-time).* 2. El I am a sole proprietor or partner- have hired the sub -contractors listed on the attached shoot. 7. n Remodeling ship and'lava no. employees These sub -contractors have 8. El Demolition I worldug for mein any capacity. workers' comp. insurance : 9. El Building addition [No workols' comp. insurance, S. El We are a corporagon and its 10. [1 Electrical repairs or additions required.] 3.El I am a homeowner Aing all work officers have exerelsed.their right of exemption per MGL I l.E] Plumbing repairs or additions Myself [No workers, comp. ' c. 152, §1(4), andwahaveno, 12.0 Roofrepairs insurancere love6s. [No workers, OMP 1. '' . -her aEl ot comp. Insurance required.] Mryapplicaritthat &ecks boxfil must also filloutthesec - flon beldw showingtheir Workers' compensation policy information. i Tforneowners who submit ihis affidavit fndicaffij thek ke d9ing all worM and then him outside contractors must submit a new affidavit indicaffig such. TContractors that check this box must attached an. 9dditional sheet showing the name of the sub -contractors and their workers' comp. policy information. I anz an em plo .ployer that isprovidl. ""er" compensationinsuranceformyem yees. Below isthepolley andjoh site information. Insurance Company Name: ?(rTCn r -J, Policy # Or S Blf-in& LiG. Expiration Date; lob Site Address: Pity/State/Zip: Attach a copy of the workers' compensation -policy declaration page (showing the policy number and expiration date). Failure to secure coverage.as tKyheduader Section 25A ofMGL o. 152 can lead to the imposition of criminal penalties of a line up to $1,50 0.0 0 and/or -one-year 31umnpriso 0 t well -as Civil penalties in the form of a STOP. WORK ORDER and a fmo of up 1p,$250:00 day against *oviolator. ca ise that a copy of this statement maybe forwarded to the Office -of a Invers-th-,ations of the forAlburance, c era cation. I do hereby certljy Mat the informationprovided above is true and correct. Date: ? - a - ZC) ( -T official use oply. -Vo not write in this area, to be completed by city or town official City or Town: PermitffAcense 0 Issuing Authority (circle one): 1. Board of Health 2. Building)Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Phone Information and Instruction' -s Massachusetts General Laws chapter 152 requires all einployers to provide workers, compensation for their employees. Pursuant to this statute, an ernployee is defined as '�..evcry person in the service of another imder any contract othire,_ eWess orimpJ14 oral orwritten." An employeils defined as "an individual, partnership, association, corporation or other legal entityor any two or more Of the fbr�jokugengaged in ajoint enterprise, and includingtho legal representatives of a: deceased employpr, or the receiver ortrustee'Of an individual, partnership, as�ociatlom or other legal entity, employing employees. itwevcrtb.6 owner of a dwelling house having notmore 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 workon such dwelling house or on the grounds or building appurtenant thereto shall not because, of such employment be deemedto be an employer." MGL chapter 152, §25C(6) also states that "every state or lo'cal lie-ensing agency shall withhold the issuance 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 requiried?' Additionally, MGL chapter 15�, §25C(7) states "Neither the commonwealth nor any of its political sub(ivisioms shall enter into any contract for the performance of public work until acceptable evidence of complipce with the insurance requirements of this chapter have been presented to. the contracting authority." plicants Please.fill out the workers' compensailon affidavit completely, by checking the boxes that applyto your situation ancL if n6cegsaty� supply sub-contractor(s)name(s), address(es) and phone number(s) along with their certificate(s) of b=ance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are notrequired to cany workers' compensation insurance. If an L_TC orLLP does have. employees, a policy is required. Be advised that thii affidavit maybe submitted to the Department of Industrial Accidents for confirmationof insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to 1he city or town that thic application for the. permit or license is being requested, not the Dep'artment of Industrial Accidents. Shouldyou have any questions regarding the law or if you are required to obtain a*orkers, compensation -policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance icenso number on the appropriate line.' all City or Town Officials Please, be sure that the affidavit is complete and printedlegibly. The Department has provided a space at the bottom ofthe affida-vitfatyouto fill outinthe eventthe Office Of 1nVostigatiolishasto contact you regarding the applicant. Please be -sure, to JM into permifflicenso number Whichwill be used as a reference number. In addition, an applicant thatj�ust submitmultipla parmit/license applications in any givenye . ar, need only submit one affidavit indica&g curr6nt policy information (if necessaty) and under "fob Site Address?, . the applicant should write, ,all "A6 . locations in (City or tov&). opy of the affl. davit that has been officially stamped or marked by t .he city ortownmaybopro dedtoihe' applicant as -proof that a valid affidavit -ii Oil Me for future ennits or licenses. Anew affidavit ' p must be filleLd out each Year.'Whero alloma owner orcitizenis obtaining alicenso o4permit not related to anybusiness or commercial -venture (i.e. a dog license orpiermit to bum leaves etc) saidperson is NOTrequiredto complete this affidavit. The Office of Investigations . would like to thankyou in advanceforyour cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone a-hd fax number: ThoCommonwoalthLofyo��achv t.s , _�c.t. M,pafteiat ofWastial Aeddeas Ofte Qf 111vestiga-u0na 60 Wakfiigtoa Stwa TQ1, # 617-7-21-7-4900 at 406 ox 1-877-MASSAFE Revised 5-26-05 Fax, 0 617-727-7749 — , 1114 Uate '/- �-- '�A ... OR'r" L10w0VN- 0 N OF NORTH ANDOVER 0' AL PERMIT FOR PLUMBING This certifies that f ........................... has permission to perform ..... ............. plumbing in the buildings of .................................. at. .:� '. . . � CL -11 ......................... I North Andover, Mass. Fee 3 Lic. No ......... ......... ................. PLU WING INSPECTOR Check # -? " I 6 7 54" MASSACHUSETrS UNIEFORM APPUCATON FOR PERNHr TO DO GAS FMING (Type or print) Date /01 -01 r NORTH ANDOVER, MASSACHUSETTS Building Locations 3o # Amount $ Ow r's Name New Renovation Replacement Plans Submitted U U cc 0 0 o A rA E4 1 1 U 0 0 0 PQ go g 0 U 1 0 SUB -BASEM ENT BASEMENT >< 1ST. F L 0 0 K 2ND.FLOOR 3RD. F L 0 0 R 4 T H . F L 0 0 R 6 T H . F L 0 0 R 8 T H . F L 0 0 R (Print or type) Check one: Certificate Installing Company Name 114 A 0, f , W 0OZ-VAf 13A4tJ L1 Corp. Address /00 12,0'e 0 Partner. Z,9,w,e e.0,V.,e, ness Telephone 9"75, e�, A 5- - 5p_�a Firm/Co. Name of Licensed Plumber or Gas Fitter Check one: INSURANCE COVERAGE No[] I have a current liability Insurance policy or it's substantial equivalent. Yes 0 if you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy Ea. Other type of indemnity ED 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 Agent 0 I here:)y certify that a tails 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 Massachusetts State Gas Code and Chapter 142 of the General Laws. -1 , —.0 �0 Z_ ts y: Title City/Town (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber A yy 33 Gas Fitter License Number Master Journeyman Date !< ...... 0 x TOWN OF NORTH ANDOVER 0 PERMIT FOR GAS INSTALLATION SA -15 This certifies that ...................... has permission for gas installation .... 1:4. . �/7� ................ in the buildings of ............................... at C. North Andover, Mass. Fee..). -(,t-'-- Lic. No..1-4.� ............. i ........... GAS INSPECTOR Check # 5393 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUM1BPqG (Type or print) NORTH ANDOVER, MASSACHUSETTS Date -a? Building Location —?JP qA14,f e_Xa C/ Owners Name 1'o4 111-4 Permitk-6 7.�—E Amount Type of Occupancy 0 W'e tj -P Ren New ovation Replacement Plans Submitted Yes No r 1:1 . 1:1 M FIXTURES (Print. or type) -r r �-kl Installing Company Name 1 14 P, LL o -,�APJ Check one: Certificate 11 Corp. ElPartner. 0 FUMVC0. Name of Licensed Plumber: 77-/0 ol g S Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy : F1 Other type of ind . emnity 0 Bond El Insurance Waiver L 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 and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Pbimbing Code and Chapter 142 of the General Laws. By: SIT =aure ol LicensealliumDer Type of Plumbing License Title 1103 City/Town Tricense TIMM Master Journeyman APPROVED (OFFICE USE ONLY a, 9 Date., '?. -. e, 2.- P.,/ ....... 10,0 X TOWN OF NORTH ANDOVER '�!O* PERMIT FOR GAS INSTALLATION This certifies that . jm.'?!". !, . . jo f . � . ( ............... has permission for gas installation .... 14. '. f � ............. in the buildings of e ...................... at . . 3 j� . .14 �'. �A C . ........ I North Andover, Mass. Fee.30..—.. Lic. No..W.Q.X? .. ..... I- -. ........ J3 i ASINSPECTOR-4 Check# 4615 "V 3c) — MASSACHUSE17S UNIFORM APP (Print or Type) Mass. NP Building FOR PERMIT TO DO GASFITTING Permit # Owner's Name /6 M ILL Type of Occupancy New [] Renovation E] Replacement F1 Plans Submitted: Yes[] No [] Installing Company Name Zv&," Address ro - C Business Telephone 7T-/ 13f 725/S Name of Licensed Plumber or Gas Fitter Z— .44 Check one: Corporation Partnership Firm/Co, Certificate INSURANCE COVERAGE: I have a current liability insurance.,policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 0 No &--"' If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy El Other type of indemnity Bond OWNER'S INS URANCE WAIVER: Lam aware that the licensee does not have the insurance coverage required by Chapter 14 of the Mass. General Laws, and that my signature on this permit application waives this requirement. one: Ovvnerl�� Agent El ]�Si �atu,,of ner 4 Owner's Aqent I hereby certify that all of the details and information I have submitted (or entered) in abovSapp I i cation are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit iss�ed .Wr this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the G Laws. P By Ty2a-ef-t:icense: 1-1 ej ignature of Licensed Plumber o as Fitter Plur�b Title G er -jra `si�r License' Number City/Town Journeyman APPROVED (OFFICE USE OKL—Y) I W Z cc tn W U = = (n X 0 Z 0 W LU X 0 U W M 0 >- Lj z z 0 0 0 C3 W 0 > W 0 z z W 0 LLI 0 W W = LU W V) Z X LU W 0 Ld > W Ir- j W W > E 4 W = n :; >- Ln a2 — -�( = < , z 0 o o 0 0 CA %U 0 0 U. D a 0 j U io a. li,- 0 SUB—BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name Zv&," Address ro - C Business Telephone 7T-/ 13f 725/S Name of Licensed Plumber or Gas Fitter Z— .44 Check one: Corporation Partnership Firm/Co, Certificate INSURANCE COVERAGE: I have a current liability insurance.,policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 0 No &--"' If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy El Other type of indemnity Bond OWNER'S INS URANCE WAIVER: Lam aware that the licensee does not have the insurance coverage required by Chapter 14 of the Mass. General Laws, and that my signature on this permit application waives this requirement. one: Ovvnerl�� Agent El ]�Si �atu,,of ner 4 Owner's Aqent I hereby certify that all of the details and information I have submitted (or entered) in abovSapp I i cation are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit iss�ed .Wr this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the G Laws. P By Ty2a-ef-t:icense: 1-1 ej ignature of Licensed Plumber o as Fitter Plur�b Title G er -jra `si�r License' Number City/Town Journeyman APPROVED (OFFICE USE OKL—Y) I ok > > -4 m rn 0 -4 0 V m 0 -1 0 z V rn —1 r, 0 > c 0 r > m > C7 m 0 0 z 0 -M 0 0 m V z 0 FM 0 > 0 -n "n rm -4 r cu 0 CA 0 0 C) (A V m 0 -1 0 z V 0 rn W V m 0 z rn —1 0 rn V 0 rn W V m 0 z rn "a > C7 m z -M 0 0 V z 0 FM 0 -n -4 rm -4 C: 0 CA 0 0 C) (A V 0 rn W V m 0 z