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Home My WebLink AboutMiscellaneous - 30 BELMONT STREET 4/30/2018 (2)CR 110 C13 M r K 0 0 ;U, C) rn, C) rn L Liberty Mutual. INSURANCE January 24, 20.13 Town of North Andover Attn: Building Inspector 120 Main Street North Andover, MA 01845 Liberty Mutual Insurance New England Region Central Property Unit 75 Sylvan Street Danvers, MA 01923 Tel: (800)566-0323 Re: Property Address: 30 Belmont St, North Andover, MA 01845 Policy Number: H3221817255321 Underwriting Company: Liberty Mutual Fire Insurance Company Claim Number: 025447707-0001 Date of Loss: 1/4/2013 Attn: Town/City Official Pursuant to M.G.L. c. 139, 5 3B, please be aware that a homeowners insurance claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or causes the condition of a building or other structure to render Mass. General Laws, Ch. 143, � 6 applicable. You are required to notify Liberty Mutual by certified mail in accordance with Mass. General Laws Ch. 175, �99, if you intend to initiate proceedings designed to perfect a lien pursuant to Mass. General Laws, Ch. 139, § 3A & B, or Mass. General Laws, Ch. 143, § 9, of Mass. General Laws, Ch. 111, 5 127B. This letter should not be construed as a waiver or estoppel of any of the terms, conditions or defenses afforded by the policy or applicable law. Please direct your notice to the attention of the undersigned and include a reference to the above captioned -property address, policy number, claim number, and date of loss. Sincerely, Kristen Hart Liberty Mutual Insurance New England Region Central Property Unit 1-800-566-0323 Ext. 70417 E-mail: Kri�ten.Hart@LibertyMutual.com UNIFORM APPLICATION FOR PER . MIT -T-O-DO-GASFITTING "Int of Type) NORTH ANDOVER, Mass. Date-��3. Building 30 Permit # Location 0 4/,' ) S/ Owner 8 'a SAK Name New [P// Renovation D Replacement D Plans Submitted: Yes D No -1w Check one: Certificate Inslalling Company Name ----)6, 0 "'. Address L ZEIP rdnnershlp /CO. Business Telephon Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE: Chec I have a current liability Insurance policy or No substantial equNalent. Yes �Pw No U It you have checked yAe, please Indicate the type coverage by checking Ilia Ipproptiale box. A liability Insurance policy OX other type of Indemnity 11 Bond El OWNER'S INSURANCE WAIVER: I am aware ftt the licensee does not t1gya the Insurance coverage required by Chapter 142 c�A, a M General taws. and that my signature on this permit applicatio W10ves this requirement. he one. Owner F Agent El S49natui% oT Owner or Owner's AdThT- =9 "meuY uen'rY 'net all of tne details and Information I have submitted (or entered) In above application &to true and accurate to the best of my 10 and that all umbIng work and Installations perform" under the permit issued for this &V�Ilcatlon will be In compliance with all 19provislons of Ive Massachusetts State Oas a a and Chanter 142 of ths Ctly/Town APPF10VED (OFFICE USE ONLY) T of License: 7210,11,10-9, . I !PrL" &A. - Plumber Sighalure 6! 1 033filter License Number "moman 1TT=TTTM - -- - -NNNO NO 0=101910 0 NOUN 0 MEN IMMININ IM oil K1AM,f=NNM1NNNNN MMINNN - 1 ,-.$ MIMMINNAMIN 0 on mum IN CEMMONNONNONNOMIN NNNNNNNNN M1 ON MINIMMIMIMMIN Ion NOON NOWENNNON MMMIMMOMMIN mown a N on 0 mill COMMIMMINNIMMINIMM 0 on 1M IMMIMMINNIMMIN Check one: Certificate Inslalling Company Name ----)6, 0 "'. Address L ZEIP rdnnershlp /CO. Business Telephon Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE: Chec I have a current liability Insurance policy or No substantial equNalent. Yes �Pw No U It you have checked yAe, please Indicate the type coverage by checking Ilia Ipproptiale box. A liability Insurance policy OX other type of Indemnity 11 Bond El OWNER'S INSURANCE WAIVER: I am aware ftt the licensee does not t1gya the Insurance coverage required by Chapter 142 c�A, a M General taws. and that my signature on this permit applicatio W10ves this requirement. he one. Owner F Agent El S49natui% oT Owner or Owner's AdThT- =9 "meuY uen'rY 'net all of tne details and Information I have submitted (or entered) In above application &to true and accurate to the best of my 10 and that all umbIng work and Installations perform" under the permit issued for this &V�Ilcatlon will be In compliance with all 19provislons of Ive Massachusetts State Oas a a and Chanter 142 of ths Ctly/Town APPF10VED (OFFICE USE ONLY) T of License: 7210,11,10-9, . I !PrL" &A. - Plumber Sighalure 6! 1 033filter License Number "moman . 4 -P, :� PAID. BY CH EC� ,�(v a 1990 �!,D r ,dCT,?WN-QF ,,NQRTW ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ............... ......................... has permission for gas., installation in the buildings of 22 .............................. at ............................ 9 North An-doyer, Mass. Fee,..!�. Lic. No... . . . GASINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasuree GOLD: File pal (1) Ol (a CL LL 4-- 0 (A 31 L) (1) �E 'a)4-1 fu in 0 H M 0 ,F'TT (A �Tj 11 o E 5 t: = o 0 9 4- CD E t 14 u 0 c 2 -W 0 u 0 m _ Z 1 "= CL f c 0 V) V) E E 0 u rE3 0 u I _0 E (Q 0 (U rL 0 2 X) ,41 7. Date ......... Cl ........................ T. vkORT" TOWN OF NORTH ANDOVER PERMIT FOR WIRING ji This certifies that ...... ?ql>.T ....... �C�e- ...... has permission to perform .......... . ..... wiring in the building of ................... )Z.Vk1,v ...................... at ......... 3. C.... 6, - EX-.,Ael -57 . ............... . North Andover, Mas s. Fee..11S ...... Lic. No..I.PAYD ............ P-. Check # 00YS- 7q 7 wealth of Massachusetts Deporiment of Fire Services BOARD OF FIRE PREVENTION REGULATIONS 0111einl Use Only Permit No. 6--t=E� Occupancy and Fee Checked ,(Rev. W051 (leave hh;nk-) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work in be perl'ormed in necord-nnee with the fAnssachu.,zetts Elt:ctrical Code (N -1133C). 527 GMR 12 ()0 (PLE,,ISE PR11VT hY hVK OR T�PEALL XFORM4 TION) Date: .Citvot-ToNynof: To the [nspector qI'Vii-es: By this appli�,16011 tile Undersianed aives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Owner or Tenant Telephone No,�� Owner's Address is this perillit ill ej)IIjimetion with it building permit? y es. 0 140 (Check ApproprInteBox) Purpose of Building Exist-nService— Amps Volts New $ervicc Amps I Volts Number of Feeders tind Ampacity Location and Nature of Proposed Electrical Work:— Utility Authorization No. Overhend 1,1.ndgrd No -or Meters Overhead Undgrd No. Meters Completion ol'the f oftenving table maY be waived by tile Inspector olWires. No. of Recessed Luminal . res No. of Ceil.rSusp. (Paddle) Fans No. ot Total Transformers KVA No. of Lu minaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above 0 1 grnd. ot Emergen�y Llghtlnlf�, Battiry Units No. of Receptacle Outlets No. of Oil Purners FIRE ALARMS 114o� of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. or Ranges No. of Air Cond. Total Tons No. of Alerting DeAces, No. of Waste Disposers Heat Pump Totals: I Number . ......... I -rojRl KW No. of Seir-Contuined Detection/Alerting Devices No. or Dishwashers Space/Area Heating KW Local 0 Municippi 0 Other Cdnnection No. of Drvers Heating Appliances KW Security S ms:; No. or Oe'voices or Equivalent No. of Water "ente. KW No. of No. of S;,17 n s Ballasts Data Wiring: Ne. of Devices c. � Eq u;vn ler No. F[Wromassage Bathtubs NO. or tors Total HP —7elecommunica�loi�s ng: No. of Devices or Equivalent OTHER: C�-v �-lttacll adelitional deteld if dusired, or as required.hY 1110 /oS/)0L-for (Jj II'll-LIN. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 4SIt9-f inspections to.be requested in accordance with NIEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance inclUding "completed operation- coverage or its substantial equivalent, The undersigned certifies that such coverage is in.force, and has exhibited proof of same to the permit issuing office. V . g CHECK ONE: INSURANCE 0 BOND E] OTHER n (Specify:) I cer�lfy, under the pahis andpenoltie.v qfperjitry, that the ififorniodoil on this application ;s true wid complete. FIRM NAME. ADT Se6rity SF4viees, Inc. LIC. NO.: I .53" C :Icensee-, SigriatU LIC. NO.. /gZ 6L4 (q'appficabi�, e'nier ex'empt' - i . n tine.) Bus.- Tel. No..� - 603-i94-59QL_ Address: 18 Clinton Drive Hollis N.H. 03049 Alt. Tel. No.: 603-594-5950 *Security System Contractor License required for this work, if applicable, enter the license number here:—<'s !g j!7 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signaturc below. I hereby waive this requirement. I am the (check one) C] owner [I owncr's agcnt� Owner/Agent FE -E. S 'relonlinne. Nn PERNH7 TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that . . . . . . . . . . . . .... . . . . . . . . . . hak permission for gas installation in the buildings of . ) - (- .... ................................ a t 13 ................................... North Andover, Mass. Fee ?-:,� ...... Lic. No -7,3-32 ... ...... . ........ r--�'-6AS INSPECTOR" Check # � -/ 3644 MASSACHUSETTS UNIF(JRM AFFUCATION FOR PERMIT TO DO GASFITTING (Print or Type) 132 —Al o Alw/) Mass... Dat 1,9�,& L Permit # Building Location b 4( Owner's NameZ/,?!�,- je(,eW Type of Occupan Lstalling Company Name :2e-,Ae(ZT ��M M A -I Check one: Certificate Address 30 0-04CH?V%fA,1j i -K1 C3 Corporation E 7,H Ue tj 01 1-1 1 [3 Partnership Business Telephone 6 2- -17 9 -7 2-'Firm/Co. Name of Licensed Plumber or Gas Filter 2 o A I- P- T A zd)?c-D . — New C3 Renovation Replacement 2,-' Plans Submittedi-'Y'eso No C] INSURANCE COVERAGE: I have a current H bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ap No 0 'If you have checked Yes, please Indicate the type coverage by checking the appropriate box A14ability insurance policy Other type of Indemnity 0 Bond 0 V- OW7 NER'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 OwnerEl Agent C3 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 the pe i ed for this application ' be in compliance with all 42 of tj" pertinent provisions of the Massachusetts State Gas Code and Chapter 1 NS BY- 7 T of Ucense: VA, ;� 1 lm,� Plumber 4KhAfure of l5ciiinsed Plu a 1 - or Gas Fitter I We fter er Ucense Number V2L�) Journeyman rim INSURANCE COVERAGE: I have a current H bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ap No 0 'If you have checked Yes, please Indicate the type coverage by checking the appropriate box A14ability insurance policy Other type of Indemnity 0 Bond 0 V- OW7 NER'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 OwnerEl Agent C3 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 the pe i ed for this application ' be in compliance with all 42 of tj" pertinent provisions of the Massachusetts State Gas Code and Chapter 1 NS BY- 7 T of Ucense: VA, ;� 1 lm,� Plumber 4KhAfure of l5ciiinsed Plu a 1 - or Gas Fitter I We fter er Ucense Number V2L�) Journeyman 0 31P 4 0 In z 31b 2 FI -I Z! z 0 z to I rn c (A z Locatio 3 CQ, 49 A/ Dat N,o. e 40RTpq TOWN OF NORTH ANDOVER I A 0� 11* Certificate of Occupancy $ 'A A0, 0- Building/Frame Permit Fee $ �) , CHU Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ lid- Building Inspector -13231 07/09/99 13:08 I 25.00 PAID Div. Public Works A 0!'Z 77 z a 1 17 I rA 11 61 cc I. FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This doe� not relieve the applicant and/or landowner from compliance with any applicable or requirements. *********-********************APPLICA-NT F -ILLS OUT THIS SECTION*****.i***************** APPLICANT \)POiC--<- >- W LOCATION: Assessor's Map Number 18 SUBDIVISION 118�M � Allibb"YA-GAVA RECOMMENDATIONS OF TOWN AGENTS: PHONE 0-& L JG jEY�.7-103'1 PARC15L LOT (S) ST. NUMBER —"-70 USE ONLY* J,q y� 1 (0 J),p_+ac-k,.k dD et^z TS -Z� a� V� . (:4 S -A-11 " - +') f_/ I VVV 1_-V Al) 11 1 -1) -I -r 1 CONSERVATION ADMINIST0A'-TOR DATE APPROVED 61430411i DATE REJECTED COMMENTS 00 VV—�(k4� V\, rk, :--\ � 0 0 TOWN PLANN COMMENTS DATE APPROVED DATE REJECTED FOOD INSPECTORV DATE APPROVED 14 DATE REJECTED SEPTIC INSPECTOR-H[�/ALTH COMMENTS DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT - 01 / RECEIVED BY BUJLDING INSPECTOR 7 Z DATE Revised 9\97 jm Town of North Andover ORTh OFFICE OF 0 0 COMMUNITY DEVELOPMENT AND SERVICES 27 Charles Street North Andover, Massachusetts 0 1845 WILLIAM 1. SCOTT c us Director (978) 688-9531 Fax (978) 688-9542 In accordance with the provisions of MGL 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 MGL c 11, S 150 A. The debris will be disposed of in: !W441190 (Location of Facility) Signature of PerrTRApplIcant (0 IT Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Officeof the Building Inspector BOARD OF APPEALS 688-9541 BLqLDfNG 688-9545 CONSERVATION 683-9530 HEALTH 688-9540 PLAINNIENG 688-9535 The Commonwealth of Massachusetts d -of lndustria4Accidents epartmen gffica J111UYeSff92z(8flS 600 Washina, ton Street Boston, Mass. 02111 Workers' Compensation Insurance Afridavit MIN I MEMMUM REEMM IHI localt.— ELM )�i I am a horneowner ipper�cnrning all wor'k myse; I arn a sole Proprie:cr and 'have no one work;n2 in -n,/ cacac:t-/ 7 L arr. an empiover providLng wcr,-,e,-s' corrjcensac�cn -or mv ei`nctcve�-s working on :h.� jot) C 1) M 0 a flF-1 -.15 1-111 e: C rv:, -bQnc 47 71 a sole propneor, gener-al contractor, or horneowner (c; c!e otte) and have hired te coatracors; ILZed bellow wtio dave d�e *ollow�nz wcrk�rs' ccrn.pe:isacion pcilc�,�;: compirl- nameffi city: ... ..... .... M cqmr)an%, name: addr-- cirv- nhonc ;Ei- imarinc-c v). Failure (a sc * cure coverage as requirea unuer Section 25A OfNIGL 1-9: can lead (a Inc imposition of criminal penainics of a fine up to S1.500.00 anat/orl One years' imprisonment as well as civil penalties in the form of ;i STOP WORK OR -DER and a fine o(5100.00 a day iipixast nac- I understand Chat a co PY Of this V2 tern c.q C m 2 y be forw a rd ed to the 0 MICC 0 C I n VCS 0 �, 3 no ns o f (he D [A for covera gc veri fica rion. I fdohereblyce-mi underth, and enalties aj';7eryur�l that Me inyormaxion.orovided above is,,rue and correm Signacure 4= = Date G - �9-39 P-inc name es Q- CaqL,-,-- Phone 928 -�� -50 3�1 official use only do no( write in this area to be compic'eu by c'ry or (own uffliciul city or rown: C check if immediate rc!ponsc is rcquired contact per -on: V-1— 1;- ':A) p n 0 n c 7: permitilicelse 4 C1 Building Department 7-Licensinig Board 7Scfcc.,Mc.n,3 Office [—Hc2lth Dcpartrncat —Other Sonc (4 Ti Concret Blocks .4 161-01, — -o21-011 -021-011 7 1/2" Risers 12" Treads t 21-6t' t � k 21-011 121-011 t 21-011 f I - ------------- ................... ............................. ...... ........ ....... .......... Existing House FRAMING PLAN Al-� I X 6 P.T. Decking 1 2 X 12 PT BEAM I --*-- 2 X 8 P.T. Joists 4 X 4 P.T. Posts 41-011 12' Dia. Sonotubes L-'-. J SECTION HAND RAIL ELEVATION 12 x 4 Top I x 1 BallastersEo.c. 4 P.T. 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