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Home My WebLink AboutMiscellaneous - 31 ALCOTT WAY 4/30/2018 31 ALCOTT WAY 210/025.0-0016-0031.F i i 1�s o prur:ll a l..,: a. Pat ud.warol 9w fa- ti f,1'G.P—A#2o926'NewP...xMaura u Town of North Andover,MA 4 searcr'. - Home 2Q92fimy Prorile *Gas Permit-Replacement of Existing Fixtures/Appliances(Commercial of Residential Records 7/MEL/NE zs %f Approvals Submission received 'o •obCrn War,en•s case Inspections Jul 14,201fi ec3d Spm t Gas Permit Review i.s, i`,uCi�'�~ \yep d�r�'!,hn Pio Documents A:pGc,;n: Loa:icn 0 yy Permit Fee Robert Sammataro 31 ALCOTT WAY,i :,NORTH ANDOVER, 603-593-0515 MA samataror@comcastn o""t, 0 Penmi"'uanct JONES,SARAH W Attachments yy, `S ry Primary Contractor eNr,5e... Fry' a« f �if I !4 QR fife Ss Q 0 in:1 p. '3 L-14»rb 7i14f2n16 . Thursday,Jul 14,2016 03:16 PM 7/15/2016 Date:July 15,2016 20926 This is an e-permit.To learn more,scan this barcode or visit northandoverma.viewpointcloud.com/#Yrecords/20926 •CKTtiEU�� . TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION frn AV�� This certifies that Andrew Robert Leighton has permission for gas installation Replacement of Dryer in the buildings of JONES.SARAH W at 31 ALCOTT WAY 31.F,North Andover,Mass. Lic.No. 1/1 IL` MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK I CITY MA DATE PERMIT# JOBSITEADDRESS,��D OWNER'S NAME e OWNERADDRESS` —' v TELMjAX-----_. TYPE OR OCCUPANCY TYPE COMMERCIAL PRINT Y EDUCATIONAL RESIDENTIAL CLEARLY NEW;v„ RENOVATION, o REPLACEMENT; PLANS SUBMITTED; YES N0 APPLIANCES T FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER - - - � BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER — f DRYER - I�_- f� FIREPLACE - FRYOLATOR FURNACE GENERATOR 1 -` GRILLE - INFRARED HEATER _ LABORATORY COCKS MAKEUP AIR UNIT OVEN T � f POOL HEATER ROOM 1 SPACE HEATER __,_._ ROOF TOP UNIT TEST - UNIT HEATER =.—� _n _, —I UNVENTED ROOM HEATER WATER HE AJER OTHER INSL CE GE I have a current Ilabili Insurance policy or its substantial equivalent whichmeetsis he requirements of MGL.Ch.142 YES /f I.,1/NO� I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY V OTHER TYPE INDEMNITY BOND OWNER'S INSURANCE WAIVER:I am aware that the licensee g2g ofav the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and-hat my signature on this permit application waives this requirement. SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY; OWNER ;, AGENT ! I hereby certify that all of the details and information I have submitted or entered regarding thisapplication are a and accurate t e best of my knowledge and that all plumbing work and Installations performed under the permit issued for this application will be in m Iia wit Il P ' ant provision cf e ; Massachusetts State Plumbing CcdA and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME ew � _,( —.LICENSE# _ ATURE MP a MGF JP JGF_ _ LPGI CORPORATION PARTNERSHI P-# _ LLC COMPANY NAME. . x'11=VYI Cril'Y _jGADORESS '" r { CITY :1 1 a — STATE XaZIP TEL 11 FAX CELL; EAI O G� �/y)� r COMMONWEALTH OF MASSACHUSETTS • • •• • • BOARD OF PLUMBERS AND GASFITTERS ISSUES THE FOLLOWING LICENSE LICENSED AS A JOURNEYMEN PLUMBER ROBERT A SAMMATARO 8 DUNRAVEN RD WINDHAM,NH 03087-1263 18214 05101/2018 4039 COMMONWEALTH OF MASSACHUSETTS • •I OK 610• • • I=I• BOARD OF PLUMBERS AND GASFITTERS ISSUES THE FOLLOWING LICENSE LICENSED AS A MASTER PLUMBER ROBERT A SAMMATARO 8 DUNRAVEN RD WINDHAM,NH 03087-1263 9333 05/01/2018 403 COMMONWEALTU OF MSSACHU E7TS • • • • • • BOARD OF PLUMBERS AND GASFITTERS ISSUES THE FOLLOWING LICENSE REGISTERED AS A PLUMBING CORP ROBERT A SAMMATARO ROBERT A SAMMATARO P&H,INC 8 DUNRAVEN RD WINDHAM,NH 03087 3373 05/01/2018 34142 i The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Stree4 Suite 100 Boston,MA 02114-2017 www mass govldia �• li'orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricisaw-Plgmbersr. TO BE FILED WITH THE PERbffr VG AUTHORITY. AimbeentIntomation Plmm Print Iftibly Nam(Business/Organization/Individual): i Address; RV City/State/Zip: Are you an employer?Check the appropriate boll:,. Type of project(required): 1•QIamaemployerwlth • employees(Mland/orpart-time).• 7. []New cori truetion 2.Q I am a sole proprietor or partnership and have no employees working for me in g. Remodeling any capacity.[No workers'comp.insurance required.] 9. Demolition 3.01 ant a homeowner doing all work myself.[No workers'comp,insurance required.]' ❑ 4.[]l am a homeowner and will be hiring contractors to conduct all work on my prparty.o I will 10 Q Building addition own that All contractors either have workers'compensation insurance or are sole 11Electrical repairs or additions proprietors with no employees. 12.[3 Plumbing repairs or additions 5.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.❑Roof airs cub-oontractors have employees and have workers'comp.insurance? , 6.G e an a corporation and its officers have exercised their right of exemption per MOL c. 14.Q Other iS2.$1(4),and we have no employees,[No workers'comp.insurance required.] 'Any applicant that checks box N 1 must also fill out the socction below showing their workers'compensation policy information. t homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. yrs that ok*this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-eonmetors have employees,they must provide their workers'comp.policy number. I am an employer than is providing workers'compensation Insurance for v y employees Below is the policy and Job site ir4ormadion. Inslretice Company Name: Policy#or Self-ins.Lie.#: Expiration Date' Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration daft} Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 md/or one-year imprisonpieht,,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.A.Copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby I under th p and p of pe#ury 1hat the information provided above is true and correct Plione E only. Do not write in this area,to be completed by city or town o,ORcial n: Permit/License# orlty(circle one): ealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector son: Phone#• 7697 Date.Y`/37//...... . ,kp RTIC o? �` TOWN OF NORTH ANDOVER • - PERMIT FOR GAS INSTALLATION �,SSACMUSE� M, This certifies that G''v! ../.laU . !.✓!Q%.-. .. . . . . . . . . has permission for gas installation . . . . . . . . in the buildings of . . . .. . . . . at Andover, Mass. Fee. ., Lic. No.. ✓J? . s�. . .. . . . . . . . .. . . . . . . .. . GAS INSPECTOR Check# G . .t r� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING rcay/T.ww'An- Date: .� % r._:., Permit# Building Locatic.. ,�l /?:�. �1.:..�. V ti �� _ Owners Name:, Ct"I Type of Occupan Commercial Educational; Industrial. Institutional Residential New: Iteration enovation: Replacement: Plans Submitted: Yes No FIXTURES LLI W Y U) m 2 O W w v U) Imo— 2 W w W t- O -1 �, w z U) W O a z1-- z O tY W a W p 1- N z z 0 w to W g w O Q a IW. W °' X > W z F' W a = 0 a W 1_ 04 Q W W W z W 2 W W W tY W J > w W z J H ,= O z .a 0 W F IW— W W FW- W BASEMENT 1 FLOOR 2 NuFLOOR 3 FLOOR 4 FLOOR 5"'FLOOR WH FLOOR 7 FLOOR B FLOOR Check One Only Certificate# Installing Company Name: fG ! r ``' '• at p r i on ec o Address:_ j ti-S� City/Town State: �.. .. Partnership ..................._. Z1.P .Code: p Business Tel: Fax:.. FirmlCompany _: . .. ..... Name of Licensed Plumber/Gas Fitter 101-"/— ::: 7,4,C INSURANCE COVERAGE: i have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.542 Yes:,_,:sNo . . 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 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 Owner Agent Signature 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)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 application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. T of License: BY'_ Plumber _..............:.. .......... .. .... Gas Fitter Tiue. Ignature of Licensed Plumber/Gas Fitter . .. . ...:.:...:.....:.:.::.:.:......._.:.......,:.....: :.: Master City/Town Journeyman ,. , .: License Number: APPROVED OFFICE USE ONLY LP Installer f-od:l44 _ 1 Irl ..y Town of Andover Massachusetts (Office Hours 8:00 A.M. to 10:00 AM) Gas & Plumbing Fees Effective March 12,2003 ❑NFW:New Consttuction and Additions ❑ RENOVATION: Plumbing within the existing system ❑ REPLACEI4IENT:Removal and replacement of a fixture to the existing piping "ALL T1:N ANT FIT-UPs ARE CONSIDERED"NEM"' PLUMBING FEES New Domestic Construction—up to 3 Units $100 plus $5 per fixture DNEW Neuf Domestic Construction—4 units or more $200 p,us $S per fixture DNEW Renovation(Domestic) $50 plus $S per fixture DREN Replacement(Domestic) Existing Fixtures ONLY` $f0 plus $2 per fixture DREP Bacicflow Preventer(for boilers) $10 plus $2 per fixture DREP Backflow Preventer for irrigation systems) $25.00 DBAK New Commercial./Industrial $200 ptus $S perfixture CNEW Commercial—Renovation $100 plus $S per fixture CREN Commercial Replacement—Existing Fixtures ONLY $50 plus $5 per fixture CREP Backflow Preventer for boilers $50 O lus $5' er fixture CREP Backflow Preventer (for irrigation systems) $25.00 CBAK Re-inspection Fee $25.00 'INSP GAS FEES New Domestic Construction—up to 3 Units $75 plus $5 pera liance DNEW New Domestic Construction—4 units or more $150 plus $S erappliance DNEW Renovation (Domestic) $50 plus $5 per appliance DREN Replacement(Domestic) Existing A2pliances ONLY $20 plus $Z pera liance DREP Gas Boiler/ imace/ Conversion Burner(Domestic) $50 plus $5 peTa liance DREN New Commercial/Industrial $150 plus $S pera liance CNEW Commercial—Renovation $100 plus $5 pera liance CREN Commercial Replacement—Existing Fixtures ONLY i $50 plus $5 er a2pliance CREP Gas Boiler/Furnace/Conversion Burner(Commercial) $100 plus$5 pera liance CREN MISCELLANEOUS Gas Lo ire Place - $50 plus $5 pera liance DREN Gas Stove/Heater $50 plus $5 pera liance DREN Utility/Bar Sinks $10 plus $2 per fixture DREP Ca ed Sewer Lines $25.00 SCAP. I Re-inspection Fee 1 $25.00 1 INSP These fees are used if the permit is for this work only. If tl:e permit includes other plumbing work, the fee charged will be the I-Lyture fee-which appears under renovation, replacement or new work($2.00 or $5.00) Tie Commonwealth of Massachusetts Department ofIndustrialAccidents _ Office of Investigations, 1 Congress Street,Suite 100 Boston,AIA 02114-2017 www. a ss.gov1dia Workers' Compensation Insurance Affidavits Builders/Contractors/Electricians/Plumbers Ats»licant InformationPlease Print Legibly Naine(Business/Organizatiowludividual):� G� t/`C� /� /►�� Address: - City/State/Zip: Are ,you�em loyer?Check the appropriate box: Type of project(required): LI 1. I am a with employer 4. E] I am a general contractor and I �* have hired the sub-contractors 6. F1 New construction • employees(full and/or part-time). 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling These sub-contractors have g. ❑Demolition ship and have no employees working for me in any capacity. employees and have workers'comp.insurance.t 9 E]Building addition [No workers' comp.insurance 10. Electrical re airs or additions required_] 5. ❑ We are a corporation and its ❑ p 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions right of exemption per MGL 12.❑Roof repairs myself. [No workers' comp. insurance re uired. t c. 152,§1(4),and.we have no q ] employees.[No workers' 13.❑Other comp.-insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for Trey employees, Below is the policy and job site inforinadon. Insurance Company Name: l Policy#or Self- ins.Lic.#: t� s��/�US Expiration Date: 2 1{ Job Site Address- 31 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 MGL c. 152 can lead to the imposition of criminal 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 ORbER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and enallies ofpeilurythat the in ormad.on provided above is true and correct. ---- Si ature: - Phone#: Official use only. Do not write in this area,to be completed by city or town offeciaL City or 'own: Permit/License# Issuing Authority(circle one): 1.'Board of Health 2.Building Department 3.CityfTown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: Af�iSLT .iCIrN �D AS A JO,UFWEYN, _ L�, 1 `` ri rz UES F VEt9CENS�-1`� . f , MARKS B N14 II CO 1, E ' sa rS r 8 "MA, ` X5log, . "ti5iD1/12g �I ' � r i OUMMpN.WEAI,TH OF 14ASS�ICFJl1SE77S , C# M1LR5 AND �AFIT� S � f' "i +GISTfRED A. PLUNIBIN+ � i ISSUES THE A36V tIENSE �It;NIF' Czt D pRI1S�'1�C$&N"G,r�, A� 5T Sid f pf1A�O�94��-�1�� r �`i C$I{Al(�It31 �IVSAL'TH OF'MASSACHl1S' TTS ' ( ¢� i s �iCENSED AS AMASTER �UAAS i SU SrTFIE OUENSE TO e °I ARX MA h1I�ICn - () vi s ST—Is—r �w s r MAS 0410 i Date. ti0 32 °` TOWN OF NOATHLANIDOVER O P 41 • PERMIT FOR GAS INSTALLATION �•`Sy �9SSACMUSE� This certifies that . . has permission'for gas installation . 1 in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . at . - !.�� . ��. ., North..Andover, Mass. FeLic. Nohw . . . . a � ^�' !'?x�- . . . . . . . . . . . GAS vNI LITOR Check#: //f 3 7064 Uµ:. (t: �S MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASF1TTING - (Print or Type) ZM /62(; ?p Permit# /G� Mass. Qate Building Location Owner's Name 5'qg'4 ti / l� A Type of Occupancy New ❑ Renovation ❑ Replacement 'E Plans Submitted Yes ❑ No ❑ m cn w vi Yc Z CC rn rn U a: f— cc W Cn w it O U m F- = U) . Z O w Q M Cc Z D O Z w Q m 0 L— W w 0 � a � W Q Lu ¢ = Z rn O > W Cl)LU Cc of w Z U w r4 w Q m LLI L— p L— = to C7 I.-- Z J H Z W W 0 > LL. U J L I Q W > M W j Z Q .M Q m 0 0 W E O W F' L= = O 0. = u. M 3 o 0 v a: > o a O SUB-BSMT. BASEMENT 1 ST FLOOR 2ND FLOOR 3RD FLOOR ' 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Com//pony Name ase✓ r� Check one: Certificate ClD� fi-�!�® Address 2 C3 Corporation ❑ Partnership Bdeiness Telephone r N irm/co. Name of Licensed Plumber or Gas Fitter I,, i5 ` INSURANCE COVERAGE: 1 have a curre Lability insurance policy or its substantial equivalent which meets the requirements of.MGL Ch 142. Yes No ❑ If you have checked yes, please indicate the type of coverage bychecking the appropriate box. A liability insurance policy ZYeiOther type of indemnity ❑ Bond ❑ OWNERS 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: Owner ❑ Agent ❑ Signature of Owner or Owner's 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 the permit sued for this application will be in compliance with.all pertinent provisions of the Massachusetts State Lu bing Code an pte 42 of the General Laws. By Type of License Title ❑ Plumber ❑ Gdsfitter Signature of Licensed Plumber or Gas Fitter aster J j�� Cit gown ❑ Journeyman License Number 1 e anvcn r =lrc i Ica n.0 OwN"OF NORTH ANDOVER Z 00 PERMIT FOR PLUMBING This certifies that . . . . . . . . . . . . . . . . . . . . . . . . has permission-to perform . . . . . I. . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . t . . . . . . . . . . . . . . . . . . . . . . at. .3.1 .lq . . . . . . . . . . .I North Andover, Mass. Fee. Lic. No. . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check # 6718 'h1spection of Plumbing MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Printor Typel J Mass. Date ol _ Building Location w� Permit # Owners Nameseak IrKe- � Type of Occupancy New ❑ Renovation p Replacement Plans Submitted: Yes O No O FIXTURE Z Y V) W .. H ►h' 07 W W t6 4 .. f' VY i M .Y- C N_ y 14 s SUB- H � C . SMT, BASEM FNT iST,:FCgOq 2ND`FLOOR - 4TH,FLooR STH'FLopR 6THFLOOR TTH FLOOR aTHFL00R Installing Company Name- Xr; ice• Address U ibc Check one: Certificate Y-\ Corporation Business Telephone. -78\ - p Partnership Name of Licensed PlumberO Flrm/Co.a INSURANCE COVERAGE: I have a current ilabilly Insurance policy or its Substantial equivalent which meets the requirements of Yes No r MGL.Ch. 1'42., ,If You have checked y", please indicate the type 4 b.coyote e checking. the appropriate box. A liability Insurance policy WAIVEROther type of indemnity p Bond O Chapter 142 OWNER'S fNSt1RANCE : 1 am aware that the licensee of the Mass. General Laws, and does_ no � the insurance Coverage required by that my signature on this permit application waives this requirement.Check one:ent nature o no,or . net's.A ant Owner C A . . o O I hereby certify that all Of the details and information 1 have submitted for enter d)in above application are true and accurate to the best o}my knowledge and that ell plumbing work and installations perfiirmed under the permit issued for tic application will be m compliance with of pertinentprovisions Of the'Massachusetts State Plimbiny Code and Chapter 10 of the General Laws. By Title �pnalure o icense um Cit /Town Type of Ucense urneyman(]+ AovE�i• E� E --�_ license Number n BELOW FOR OFFICE USE ONLY fl- NK.4.:IN�PEl11.0�1� aKE` T` fall ►RODlogs 100FICT^ IONS NO. I APPLICATION Eos rtwMn TO 00 rcuMeiNo UNDERGROUND ROUGH COMPLETE ROUGH` . FINA6INSPROMON #, 0 P1MIT QIUNTIED_._; 1 . RAZE PLUMSlkd INSPECTOR