HomeMy WebLinkAboutMiscellaneous - 30 MAPLE AVENUE 4/30/20184 >
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TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
1600 Osgood Street, Suite 2-36, North Andover Ma 01845
NOTICE OF VIOLATION
Date: —30 ft.�06
I
jaress:
Building 10 Zoning Bylaw 10 Stop Work Order
Electrical [] PlumbinQ 10 Gas
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10 Certificate of inspections
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Failure on your part to comply with this notice within 10 days may subject you to pena)ties prescribed by Massachusetts Law
780CMR or North Andover's Zoning By law. Please contact the Building Department for further information at 978-688-9545
Inspector V14 /J—,
Home Owner
Contractor w ST-
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7758 Date ... 7.-. ��.T-:. 0 ......
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that .........
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has permission for gas installation . .
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in the buildings of �-.6
at ........... North Andovel. 'ass.
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Fee. 6 ...... Lic. No. ... ... . C ....... C/
GASINSPECTOR
Check # 22- 30
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING
City/Town:-M14--ru A"jQ'e'\ — MA. Date: ( ")—a f-- j I Permit#
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Building Location: 2h L—tAe�( pwl� Owners Name: (-bWAXAn.We,1
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Type of Occupancy: Commercial El Educational [] Industrial El Institutiona ResidentiAA
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New: El Alteration: El Renovation: W Replacement: Plans Submitted: Yes El No 0
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BASEMENT 1_2
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1` FLOOR
2 NuFLOOR
—SR'FF—LOOR
4 IH FLOOR
6 "' FLOOR
-6 TH FLOOR
7'" FLOOR
—6T'—FLOOR
Installing Company Name:
Check One Only Certificate #
Address:J20 City/Town:4
4-A
El Corporation
State:
Business Tel: 6,c) ---) tc�
Fax:
El Partnership
Krm/Company
Name of Licensed Plumber/Gas Fitter:
INSURANCE COVERAGE:
I have a current liability insurance policy or i . ts substantial equivalent which'meets the requirements of MGL. Ch. 142 Yes El No 1771
If you have checked Yes, please indicate the type of coverage by checking the appropriate box below.
A liability insurance policy U4" Other type of indemnity El Bond F-1
OWNER'S INSURANCE WAIVER: I am aware that the licensee 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
Signature of Owner or Owner's Agent owner El Agent
By checking this box E]; I hereby certify that all of the details and information I have submitted (or entered) reaardina this annuratinn mra fr— —1
..L V1 [fly Miulwitw9e anu inat an piumoing worK and installations performed under the permit issued forth 's application will be in
compliance with all Pertinent provision of the Massachusetts State Plumbirjg Cjpde and ChaD$r 14y'of the General Laws.
By Type of License:
El Plumber
Title Gas Fitter jSigne Licen d Plu-mb;-er/G Fitter
R�Iaster
Cityrrown LjJourneyman Lic
Lic se Number:
APPROVED (OFFICE USE ONLY) El LP Installer 5EZ7
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90 49
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SSACHUS
Date.'7 : J-'7 - k I
. ..........
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that
has permission to perform ......
plumbing in the buildings of ............ � C- e �7
at ... 3p ... OAc, * 0� P) Y�� ......... North Andover Mass.
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Fee I �9.0.,� Lic. No. l.t;- .. ..... UF;�,,� ......
PLUMBING INSPECTOR
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BASEMENT
Iff FLOOR
-i �FLOOR
Y5FLOOR
�� FLO—OR
FLOOR
��FLOOR
il�H FLOOR
iNF—LOOR
MASSACHUSETTS UNIFOMM APPLIC�ATIoN �FOR PERMIT TODO P—LUMBI—NG
City/Town: fkjr�ia:TQ 1Q6&UQ-7bjCfAA, MA. Date.7��— Permit'#
Building Location: 27,) �,Apea Owners Nam'
e: r C
Type of Occupancy: Commercial El EducationaIE] Industrial[] InstitutionaIE] Residentia
New: Lj Alteration:
FIXTURES
ent: LJ Plans Submitted:
Installing conrip&ny Name:."%AAW1 4 Prar#k-
Address& avx-* I —
City/Town: &-,y6r7,-Q State: t -^1n17
Business Tel: —I &
Aa--la-19Q-11 Fax:1.1 nt,%2
Name of Licensed Plumber:
No
DEDICATED
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Installing conrip&ny Name:."%AAW1 4 Prar#k-
Address& avx-* I —
City/Town: &-,y6r7,-Q State: t -^1n17
Business Tel: —I &
Aa--la-19Q-11 Fax:1.1 nt,%2
Name of Licensed Plumber:
No
DEDICATED
Check One 0;-fjv� Certificate ;�
El Corporation
0 Partnership
11�lrm/Company
INSURAN
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes [] No El
If you have checked Yes, please indicate the -type of coverage by checking the appropriate box below.
A liability insurance policy. Other type of indemnity Bond F1
OWNER'S INSURANCE WAIVER: I am aware that the licensee goes _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.
Owner Check One Only
best of rnly
all
By Type of LiceInse:
Title
Sign of
'RY/Town El Plumber, LIF L' e PI ber
fiaster
NPPROYE�D(OFF�ICEUSE�ONLY) Nourneyman Lic nse Number:
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Check One 0;-fjv� Certificate ;�
El Corporation
0 Partnership
11�lrm/Company
INSURAN
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes [] No El
If you have checked Yes, please indicate the -type of coverage by checking the appropriate box below.
A liability insurance policy. Other type of indemnity Bond F1
OWNER'S INSURANCE WAIVER: I am aware that the licensee goes _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.
Owner Check One Only
best of rnly
all
By Type of LiceInse:
Title
Sign of
'RY/Town El Plumber, LIF L' e PI ber
fiaster
NPPROYE�D(OFF�ICEUSE�ONLY) Nourneyman Lic nse Number:
1�
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D G W 'S
"E10M - ATWN
CE-�.SED As AiMASTEWPLUMEER
..IS�UES THE ABOVT LICENSE -'TO:
MICHAEL E MCCAFFLRY
60 PEARSON RD
SOMERVILLE MA 02144-131
15589 05/01/12 78 9 038\
cONTROL #,,G 0 2 14 2 5
IMPORTAW
If this license is lost or destroyed,, notify your Board at the:
Division of Professional Licensuie; 1000 Washington St.,
7th Floor, Boston, MAO 118.
if your name or address shown is changed, notify your board
of correct name or address to insure proper mailing of next
Renewal Application. Always refer to your licqnse number.
This license is subject to the provisions of the tp-eneral Laws I
as amended. It is a personal privilege, and must not be loaned il
or assigned to any other person. Keep this license on your it
person or posted as required by law.
HNiNG i.�
N(ED S'
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,r 10 1 6 5
Date .....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that .............
.........................................
IV
has permission to perform .............. /zrp'o ... . ..........................
wiringin the building of ...................................................................................
at ..... T.(::� ... .... ;L ...... Zo �hAnd;oer,mm
�P c�r
7 1 O—Lic. No. -1-0135.� �- ...........
Fee/ .. ...... .. ... ... .....
EL cmicAL MpEcroe
Check # V/ U
mmon-wealth Of Massachusetts
Pepartment of Fire Services
B ARD
OCO OF FIRE PREVENTION REGULATION8
Official Use only
Permit No.
Occupancy and Fee Checked
Lev. 1/07]
APPLICATION FOR PERMIT'TO PERFOR' 1jeave blan
All work to be performed in accordance with M ELECTRICAL WORK
SZ pflWM,8W 0j? ry the Massachusetts Electrical Code E
PE'aL'Mop e CA 527 CMP, 12.00
(PLEX JM7,
City or Town ofi NORTH ANDOVER j0A9 Date:
By this application the unders' Totheinspectoro Wires:
1911 J i! :ves notice of li� or her intention to * V
perform the electrical work described below.
Location (Street& Number) dAiWIR, A. n
Owner or Tenant
Telephone No.
Owner's Address
Is this permit in con iii.-"
'In th a bui v g permit? Yes No LJ (Check Appropria Box
Purpose of Building k!,�_
Utiflty Authorization No.
Existing Service Ain
Amps volts Overhead UndgrdEl N�o. of m
e . eters
aew Ser -Ace 2q� Amps
��2001ts Overhead r2 TT -1 M
number of Feeders and-Ampacity
Location and Natu
. re of Proposed Clec�:Ical
61 � 1140. of Meters 4-1
No. of Recess ed Luminaires
IN!
L-om letion Of thef011owin table may he waived by the 177ec.
No. of Ceff-SUSP. (Paddle) Fans �or Of Wir".
No. of L111ninaire Outlets
No. of Hot Tubs
otal
KVA
No- of Luminaires
Swimming Pool Above
Generators KVA
0. 0 mergency 9
'El
No. of Receptacle Outlet
2rnd. d.
INo. of Oil.Burners grn
Batt units
No. of Switches
FLP—F AUTAURMIS No.'Of Zones
No. of Gas Burners
0- -of Detection and
No. of Ranges
No. Of Air Cond. Total
hiltiating Devices
No. of Waste Disposers
Tons
mber Ons
No. Of Alerting D i
''I evices
1� UT
lotalls: I ...... ......... ...... ...... I ......... ... N S111-1 1111 Hmed
No. Of Dishwashers
Space/Area Heating Kw
Detection/Alerting Devices -
Loca1E] unicipal
No. of Dryers
Heating Appliances KW
Coim,ection El Other
Se 1
'1' :
No. of Water
Heaters KW
No.. of No. of -.
-
No. of bevices or E uivalent
I
'ice'ns Ballasts.
Data Wiring:
No. Hydromassage Bathtubs
No. of Motors Total HP
No. of Devices or E nivalent
Teleco * c tions Wiring:
OTHER:
NO. of Devices or Eunivah-nt
Estimated V lue OfTlectrical Wiork.AYOL .111 desired or as required by the Inspector of Wires.
Work to st�: a— (When required by municipal policy.)
INSURANCt. C IfIsPections to be requested in accordance with MEC Rule 10, and upon completion.
i_7�c. V. 2 - T T,
the licerisee E: 'Unless waived by the owner, no Permit for the performance
provides proof of liability insurance including 94 of electrical work may issue unless
completed operation" coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of to
CHECK ONE: INS BOND 0 OTHER . El Opecify.) . san2e the permit issuing office.
CerltO, under the ;-n�sa
FIERM NAME_ erju , hat 077nation o th e and complete,
Licensee: Signature LIC. NO.2*2�
(Yapplicahle, r e -Te t " in e license n r Lin LIC. NO.:
Address: e * I BUS. Tel. No.:
LIA 174 Cl
*Per M-G.L c. I , s. 57-61, security work qui s Departmr Alt. Tel. No.:
OWNER'S rit of Public Safety "S" License: Lic. No - — — — — —
required by JINSURANCE WA1WR: 1 am aware that the Licensee does not have the liability ins ------
aw. By MY Signature below, I hereby waive this requirement. 1 am the (c urance coverage normally
Owner/Agent heck one) El owner El owner's agrent
Signature Telephone No.-----. PERM UU
.IT FEE. $ h
F-LF-CTRICAL PERMT NO. INSPECTIONREPORT:
ELECTPJCALM:8_PF,�CTOR- DOUG SMALL
1. ROUGH CTION:
Passed — Failed — Re -inspection requirecl (s%oo
Inspectors' comments:
(Inspectors' Signature - no initials) Date
2. FINAL INSPECTION;
Passed — f I Failed — r I T�,,_;f,-_._requ1red ($50.00)
Inspectors' comments:
(fuspectors' Signature - no initials) Date
3. UNDER GROUND INSPECTION:
Passed — [ ] Failed L f I Re -inspection required ($50.00 f
Inspectors' comments:
- no mitials) - Date
4. INSPECTION—SERVICE:
DATE, CALLE D NATIONAL CRID:
Passed — f ] Failed —
Inspectors' comments:
(Inspectors' Signature no initials)
n 5. INSPECaTION - OTHER:
nMj
Passed — Failed — ( 'I
P
r
bspectors' comments:
(fnvectors'S! uature--noiniN21.0
NAAM:
Date
Date
DOOR TAGS ARE TO BE LD _0UT AND LEFT ON SITE IF THE AREA TO BE INSPECTED IS NOT
ACCESSIBLE AND A RE-INSPEcTION OF $50.0().jS TORP. CWA D d7v"n
-V
The Commonwealth of Massachusetts
Department Of Mdustrial Accidents
Office of Investigations
..600 Washington Street
Boston, M4 02111
WWW.mass.gov1dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Aimlicant Infhrmniian
Name (Business/organization/Individual):
Address:
City/Stat
Are u an employer I ? Check the appropriate boxi
Mn
I -L -Al am a employer with
4. E] I am a general contractor I
employees (fall and/or -part-time).*
2.[:] 1 am a sole proprietor or
and
have hired the' sub -contractors
listed
partner-
on the attached sheet t
ship and have no employees
These sub--�contractors have
working for me in any capacity.
workers' comp. insurance.
[No workers' comp. insurance
5. We are a cOrporation and its
1reA 1
requ _j
I am a homeowner doing
officers have exercised their
all work
right Of exemption per MGL
myself [No workers' comp.
c. 152, § 1(4), and we have no
insurance required.] t
emPlUees. [No Niiorkers,
comp. msurance required I
;�k`RY al?Phic-aat ffiatt chc�cks box #1 must also 4; OLI the seddon bellow sl,
tr howLng their wory—*
Type of project (required):
6. El New construction
7. ZJ�Remodeling
8. EJ Demolition
9- EJ Building addition
10 - n Electrical repairs or additions
I Ln Plumbing repairs o r additions
12.0 Roof repairs
13.n Other
oulpensatloa poucy =cr_�atlon.
omeownerswhos mit this affidavit indicating they are doing all work and then hire outside contractors must submit anew 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.
lam an employer that isproviding workers, compensation insUrancefor my employees. Below is thepolicy andiob site
informadom
Insurance Compahy
Policy # or Self -ins. Lic. #:
Expiration.Date:
Job Site Address:..
City/State/Zip:
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 M-GL c. 152 can lead to the imposition of c . riminal penalties of a
fine 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.
I UU nerevy cey naer the pains andpenalties ofperjury that the information provided
,--,I
OffIcial use only. Do not write in this arei4 to be completed by city or town off
IcW
City or Town:
Pernlit/License #
suing Authority (circle one):
L Board of Health 2. Building
, Department 3. City/Town Clerk
6. Other
�6 and correct
4. Electrical Inspector 5. Plumbing Inspector
Contact Person:
Phone #:
N2 2 102 Date...
TOWN OF NORTH ANDOVER 9
PERMIT FOR WIRING
Ui
g�
This certifies that ... oq..Q.�.A ....... .............................
has permission to perform ... k tw�o.,�
C
wiring in the building of ......... ...................................... t�
at ..... 21) ....... M .. q -1k ...... ..................... . NorthUdover, Mas7s
"- 0 Lic. No . .... . ................
Fee .... L� ........... *iiLi;�� R*I*C*A'* L,,I'N—S'P—E' C*'T'O'* R—
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
I
6
— U famirwnwtzillh af �Hafizir#qltts Oaks use a" d
k Per" ft—
Et.partmrnt af 'PubLic 2-afztq O=Pmq A Fee Chociffed
BOARD OF FIRE PREVENTION REGULATIONS 527 CM11 1;.00 3M Pam W"
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordancewith tne Massacnusetts Electrical Code. 527 QAA 12--00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION)
Q* or Town of NORTH--ANnO ER
The uldersigned applies for a permit to perform the eie4
Location (Street & N"er) _3 0 /---/ /� Pl- �e
Owner or Tenant 4!f -e /— 51
Oats
To the linspoictor ot Wirso:
work described below.
C111 I
------------
Owner's Address , 30 11-7
13 this permit in conjunction with a buil(ling permit:
Yes No C' (Check Annfonri2ta A--'
PUrPQ3Q of Building
Existing Service Amps —Voits
Now Service Amps —Volts
Numoor of Feeders and Ampacity
Utility Authorization No.
OverheaO 11 Unagirna C1 No. of Motors
Ovemeac Unagrric C No. of Motors
Location and Nature of Proposed Eleciricai WorK
NO. at Lignting Outists No. of 4ot 7-zs No. of Transformers Total
I KVA
NO. Of Lignting Fixtures n
Swimming local Aceve— no
grra gr Generators KVA
No. at ReciffolaCle QuIlgIs
No. of Oil Etfriers
No. of Emergency Lighting
Sattery Units
No. Of Switch outlets
No. of Gas �-.�rrers
FIRE ALARMS No. of Zones
No. Of OilleCtIon and
Initiating Cievices
No. of Sounding Covicas
No. of Sell Contained
10stactiordSounaing Daiinicas
Local lislunscialiti
Connection 'Other
No. at Ranges
No. Ct Air Czr.C. - 013,
'Cris
No. Of OiSCO3411113
Heat -6-31 --otal
No.ol Rufrzs -ons KV4
No. of Clianwasners SoaCe#A(ea -4eaiirq
No. at OrVers Heating Cov,ces KW
No. 01 Water Healers KW
No. at NO is
Signs ea-lati:s
Low Voltage
Wiring
No. Hyaro Massage 'swas
No. of Moicrs -.alai HP
OTHER., �-� a, 10 U /D�
114SURANCE CCVERAGE. Pursuant -,a ine reouifemen(s --t .'-taSSiC7LS6r3 ;eneral Laws
I have a current Liaciiiiiiii Insurance Policy incluaing Czrrlc�etec CCeraiians Coverage of its suostantial equivasens. YIES = No
A&VO SuGminso valid proof at same to the Ottics. YES It You nave CnecKea YES. plasse inoicate Me type at GoveirstiI OV,
Cneciting the attoroariate cox.
INSURANCE = aCNO = CTHER = (Please Szoc-�-4)
�l
Catif"ateld Value of Vectncai Work S
Want to Start Insoec:son 0ai4 ;;,ic6as:ec:
Signed uncer no Penalties o(parjury I
FIRM NAME
Licenses
S-Gra:��re
Rougn Final
UC. NO.
Lic. No. _,;I,
Bus. Tel. No.
Address All. Tel. Na. -&A`-a.X q !F�
OWNER'S INSURANCE WAIVER: I am aware trial 11`1111i I-Xenle* e:ces �nt mave ins insurance coverage or ;is 51.10alannall equivalent as life.
quartets My Mass"nutielts; Genstas Laws. iisna trial my siqnaiure on 7nis _-g(mil A0011C2910n waives this reaustrientionsf. Ossensiffir 411011
.00
(5.9nalUla at Owner of Agen(i elecinone N 0 PERMIT FEE S
49
-,9 T\ mm�
Location OU
No. Date 10101a
40ftTh TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
C1.4's
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL
ILL Jv ccc,�—
Building Inspector
12 0 5 C
10/27/98 09:27 25.00 RQTI) 0 Dy. Public Works
r'"� —11hIr
Location
No.
Date
,&OIIT#q
TOWN OF NORTH ANDOVER
4,
jqj*
Certificate of Occupancy
Building/Frame Permit Fee
$
$
CHU
Foundation Permit Fee
$
Other Permit Fee
$
Sewer Connection Fee
$
Water Connection Fee
$
TOTAL
$
4
Building Inspector
09.27 25.00 PAIL
44x v. Public Works
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TOWN OF NORTH ANDOVER
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGL c. 142 A requires that the "reconstruction, alteration, renovation, repair, modernization,
conversion, improvement, removal, demolition, or construction of an addition to any pre-existing
owner occupied building containing at least one but not more than four dwelling units ... or to
structures which are adjacent to such residence or building" be done by registered contractors,
with certain exception, along with other requirements.
Est. Co 4t��
Type of Work:_ VIAI D / Ay 6
Address of Wo
Owner Name: fil / C,
Q
Date of Permit Application: � f
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
--Job �Oef-$1'000
I;Wming not owner -occupied
4�-Owner pulling own permit
Other (specify)
Notice is hereby given that:
For office Use Only
41V
Pernit No.
Date L:4�w � -�o
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS
FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION
PROGRAM OR GUARANTY FIND LINER MGL C. 142A.
Signed under penalties of perjury:
I hereby apply for a permit as the agent of the owner: ,
Date
Contractor Name
Registration No.
OR:
Notwithstanding the above notice, I hereby apply for a permit as the owner of the above
property:
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Date Owner Name
N2 21 02 Date...z.
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
This certifies that ... ....... N.S'Vo.f'o.1 . ..............................
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has permission to perform ... ....................... ,
wiring in the building of ......... ........ �.-t .........................................
.. .... .... ....
? q /. North Andover, Mass.
at .. 0 ....... 0
'� do Lic. No. .. ............
Fee ..... ...... K zi;�P-ECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
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This certifies that
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Date. �0 �A .
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
...................
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has permission to perform ... ...........................
plumbing in the buildi ngs of ................
a It hl. North -Andover, Mass.
Fee.?e-�. 7 . Lic. No..
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PLUMBING INSPECTOR
Check # /0 / L _
7754
9
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLLMIN(;
x6 C) (Type or print)
NORTH ANDOVER, MASSACHUSETIS
Building Location 0 AW" 0 Date
wnersNarneM/C64AU SiffLale) S,(Permit,#
Type of Occupancv Amount
New ri Renovation 13
Replacement , 0
VYVTTT1Dimo
Plans Submitted Yes No fn
. 1:1 La
(Pnnt or type) Check one:
Instalag Company Name 0 Corp. Certificate
IAI
Address L ano
A Partner.
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BT s In e. 's -!
.SS lelephone jr2. AW Firm/Co.
Name of Licensed Plumber:
Insurance Coverage: Indicate the type of insurance coverage by cliecidng the appropriate box:
Liability insurance policy Other type of inderrimty Bond
Insurance Waiver. L the undersigned, have been made aware that the licensee o
three insurance f this application does not have any one of the above
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 Sta le d of the General Laws.
1�;,',.mbi Coc
By: 07 Ic
Ure icensecl
City/Town
APPROVED (omcE USE ONLY
Type of Plumbing License
310
7777F.Fsellun-roer— Master r-1 Journeyman
Date.
t o '6��o
6
TOWN OF NORTH ANDOVER
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PERMIT FOR GAS INSTALLATION
SACH
This certifies that ... 5�X f�' .1 .....................
has permission for gas installation .........
in the buildings of / ...........................
at ... 3. (�. . A;!-7 .. ........ North Andover, Mass.
Fee..3.2 ?-;�Lic.
iG�INSPECTOR
Check#
6445
MASSACHUSETTS UNIFORM APPUCATON FOR PERNffr TO DO GAS FTrnNG
(Type or print) Date
NORTH ANDOVER, MASSACHUSETTS 1 6, h
Building Loqations V r --
Permit # 1:6 lel---
Owner's Name Amount $ -3
New Renovation Replacement rM Plans Submitted[] All)
LU
Name of Licensed Plumbeior Gas Fitter q Wert !r, C L',
Check one: Certificate Installing Company
0 Corp.
Partner.
Firm/Co.
INSURANCE COVERAGE Chec�one:
I have a current liability Irsurancepolicy or it's substantial equivalent. Yes Z No 13
If you have checked Yes, please indicate the type coverage by checking the appropriate box.
Liability insurance policy W Other type of indemnity 13 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 13 Agent 171
1 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 Gas"de anal Chnnt4 I A0 n0#6.
-j.
Title
City/Town,,
APPRIbY ED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber
0 Gas Fitter License Number
1:3 Master
KA Journeyman
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Name of Licensed Plumbeior Gas Fitter q Wert !r, C L',
Check one: Certificate Installing Company
0 Corp.
Partner.
Firm/Co.
INSURANCE COVERAGE Chec�one:
I have a current liability Irsurancepolicy or it's substantial equivalent. Yes Z No 13
If you have checked Yes, please indicate the type coverage by checking the appropriate box.
Liability insurance policy W Other type of indemnity 13 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 13 Agent 171
1 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 Gas"de anal Chnnt4 I A0 n0#6.
-j.
Title
City/Town,,
APPRIbY ED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber
0 Gas Fitter License Number
1:3 Master
KA Journeyman
LQ1
, "fl
000
TOWN OF NORTH ANDOVER
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
27 Charles Street
COMPLAINT FOR INVESTIGATION
DATE:
-e
FROM: , W, . _ff
66 z (jogLile, , �) , - , �,� /
ADDRESS:
Complaint Against: 4� 4 r 1�e
Telephone (978) 688-9545
FAX (978) 688-9542
Tel #: 25 , ro - *3 - S--9� (0/'
/V -e
ELECTRICAL:
144 01 -e,
5;) 00/
P TUBING:
LL
GAS: REC EIVED
BUILDING CONTRACTOR,
PROPERTY OWNER:
OTBER:
o I C-- u- I--/— - )
Y,OL— f
Signed:
JUN 1 1. 2002
BUILDING DEPT.
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WILLIAM V. DOLAN
Chief of Department
NORTH ANDOVER FIRE DEPARTMENT
CENTRAL FIRE HEADQUARTERS
124 Main Street
North Andover, Mass. 01845
To: Lt. Ken Long Date: 12/19/95
Robert Nicetta, Building Inspector
Sandra Starr, Board of Health
From: Fire Chief Dolan
RE: 30 Maple Ave.
Tel. (508) 688-9593
Fax (508) 688-9594
Last evening the fire department responded to 30 Maple Ave. to investigate the probable illegal
use of a Kerosene heater. This ca ' 11 was prompted by notification by Dr. Bums at the Lawrence
General Hospital that the first floor resident of 30 Maple Ave. was being treated for CO poisoning
with a blood level of 10.2 which is considered mid to moderate.
Lieutenant McCarthy requested that I respond to the scene since the second floor tenant initially
refused entry. Upon making an investigation of the premises several conditions were found which
required further action.
We were allowed entry to the second floor and an illegal unvented kerosene heater was found to
be in use. This heater was shut off and taken to the earaize at the rear of the house for storage.
Duning this time we also had 2 propane cylinders, one oxygen cylinder, a second kerosene
heater, and a plumbers torch relocated to the garage.
I'liere are no smoke detectors in the hallways of this building. The battery powered detectors
wkich were present were in poor condition with the covers removed. We did not test them.
I n the cellar there is an accumulation of a variety of ma!erials including, rugs, car body parts,
reffigerators and many other items stored from the cellar floor to the ceiling.
One of the two main electrical panels has no cover and wires are exposed. Some electrical cover
plates in the cellar are not present and bare wires are present.
I -lie is an oil fired hot water heater which has a supply line running across the ceiling from the
tank, distance of twenty feet or more with two separate mechanical connections. This did not
look to be a professional installation and is in violation of the fire code.
They are in the process of installing a new gas heating system and I have concerns that this work
niay not be in compliance with the permitting process.
The owner of the property is Mr. Michael Sibeleski - 683-0815.
1 am recommending that there be a joint inspection of this property by the Town and Lt. Long
will be in contact with the other inspectors to coordinate this inspection. I have notified the
owner that such an inspection would be taking place within the week. This inspection should be
arranged as soon as nd possibly on Friday December 22.
William V. Dolan
Fire Chief
nEC 2 0
1921 - 75 YEARS OF SERVICE - 1996
Town of
NORTH ANDOVER
BUILDING PERMIT INSPECTION REPORT
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PERMIT NO.: PROJECT: INSPECTION DATE:
UNIT NO.: FLOOR: WING: BUILDING NO.:
a/w"' V,/ T ( �n e-1 0 aP?
REMARKS:
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Date: 1:-, to 4) k- .1, )(�
LN LLA4-. U,0,.iPa, i),PA.-ItaP
Date:
inspect"'oe). Mo &: 6 -f
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Excavation - depth and soil conditions
Framing-,,.,—
Other:
Date: 1:-, to 4) k- .1, )(�
Date:
Date:
inspect"'oe). Mo &: 6 -f
Inspector
Inspector
Footings and foundations and drains -
a
t
Insula io
Other:
Date: cok�
Date: codt
Date:
Inspector
inspector 6 4fL:L — A
Inspector
Electrical - rough -
Plumbing and/or gas - rough -
Other:
Date:
Date:
Date:
Inspector
Inspector- -
Inspector
Electrical - final
Plumbing and/or gas - final
Other:
Date:
Date:
Date:
Inspector
Inspector- -
Inspector
Fire Dept -
oil burner, tank, stove, smoke detectors
Final inspection
Certificate of Use and Occupancy
Date:
Date:
Date: —Cof 0#
Inspector
Inspector-
Inspector
r-orm ffWJO ACuon rress, tmo-/uuu
Town of
NORTH ANDOVER
BUILDING PERMIT INSPECTION REPORT
PERMIT NO.: PROJECT:- Joh 6 F -3 — o k INSPECTION DATE: /L A
UNIT NO.: FLOOR: C4 4J WING: BUILDING NO.:
<X M " -T '')? C
REMARKS: C
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Excavation - depth and soil conditions
Framing -
Other:
Date: i:. 1 00 iZ -1, )e �
:1
Date et,k� i
Date:
Inspecto(r) 76) s
Inspector
Inspector
Footings and foundations and drains -
LA 11
Insulatiod- 1,-
Other:
C/ 0"'A
N
Date:
Date:
Date:
Inspector CP
Inspector t, -7
inspector
Electrical - rough -
Plu mbing and /'or ga sj- rou'h -
9
Other:
Date:
Date:
a t�_
Inspector
Inspector-
Inspector
Electrical - final
Plumbing and /or gas - final
Other:
Date:
Date:
Date:
Inspector
Inspector
Inspector ---
Fire Dept -
oil burner, tank, stove, smoke detectors
Final inspection
Certificate of Use and Occupancy
Date:
Date:
Date: —Cof 0#
Inspector
Inspector-
Inspector
Town of
NORTH ANDOVER
BUILDING PERMIT INSPECTION REPORT
e
C -L
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Excavation - depth and soil conditions
Framing -
PERMIT NO.:
Date: t-- 1 0 0 1� 1, Y, (0
PROJECT:-
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Inspectdn t* 'j-:
INSPECTION DATE:
UNIT NO.:
Footings and foundations and drains -
FLOOR:
L
WING:
BUILDING NO.:
Date:
CA, wl
Date:
Inspector
T
A
REMARKS:
Other:
Date:
Date:
Qat6_1
Inspector
Inspector
L;
7
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Other:
Date:
Date:
Date:
Inspector
Inspector-
Inspector
Fire Dept -
t)
tv
Certificate of Use and Occupancy
Date:
Date:
Date: -Cof 0#
Inspector
Inspector-
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Excavation - depth and soil conditions
Framing -
Other:
Date: t-- 1 0 0 1� 1, Y, (0
Date: ---
Date:
Inspectdn t* 'j-:
Inspector
Inspector
Footings and foundations and drains -
Insulatiq4-
Other:
C
Date:
Date:
Inspector
Date:
Inspector
Inspector
Electrical - rough -
Plumbing and/or gas - rough -
Other:
Date:
Date:
Qat6_1
Inspector
Inspector
Inspector
Electrical - final
Plumbing and/or gas - final
Other:
Date:
Date:
Date:
Inspector
Inspector-
Inspector
Fire Dept -
oil burner, tank, stove, smoke detectors
Final inspection
Certificate of Use and Occupancy
Date:
Date:
Date: -Cof 0#
Inspector
Inspector-
Inspector