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HomeMy WebLinkAboutMiscellaneous - 32 FOXHILL ROAD 4/30/2018 �J 32 FOXHILL ROAD �� 210/037.C-0048-0000.0 AdMikk nce �— Safety lnsura Form of Notice of Casualty Loss to Buildin Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall NORTH ANDOVER, MA 01845 NORTH ANDOVER, MA 01845 RE: Insured: WILLIAM-SULLIVAN III and-AMANDA.:SULLIVAN__ Property Address: 32 FOX HILL RD,NORTH ANDOVER, MA Policy Number: HMA 0256504 Claim Number: BOS00034302 Date of Loss: 12/5/2012 Company: Safety Indemnity.Insurance Company Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim number. Allan Leavitt Claim Examiner 12/17/2012 Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3213 Fax: (617) 531-8891 Email: AllanLeavitt@SafetyInsurance.com A DateZ�........................ t ,AORTN, 3 0 TOWN OF NORTH ANDOVER -p PERMIT FOR WIRING �,SSACMus This certifies that ......': t:.:`. " �y��� ' s —, ; ... has permission to perform,.,..,/..,.,V'... ::I �;...... ..-� :....:*:�`......e.... ..:.::.: wiring in the building of.... ............:........................................................... 3 1 11 n r F at:—:�......;/.. ....I ....... 1�.....PiLE�CT�RIC�AL . .North Andover,Mass. Feec?......:...... Lic.No:' :' F�'t y� t /�. ............ .. ..... INSPE R '`eck #,--2-`;L 7 k _ Official Use only Commonwealth of Massachusetts Department of Fire Services Permit No. Occupancy and Fee Checked ? BOAR® OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) APPLICATIOiV FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code MEC). 527 CMR 12.00 (PL EASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 0a 19 9 City or Town of: NORTH ANDOVER To the Inspector of*Wires: By this application the unc ersianed gives notice of his or her intention to perform the electrical work described below. Location (Street epi Number) f Owner or Tenant p� ' �,� Telephone No. Owner's Address QM Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / bolts Overhead ❑ Undgrd ❑ No. of(Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: lyecc) Au'lC 1 tu— Completion of the following table Inay be waived by the lnspector q1 Wires. No. of Recessed Luminaires No.of Ceil.-Susp.(Paddle) Fans No.of Total Transformers (CVA No. of Luminaire Outlets No.of Hot Tubs Generators (CVA Aboven- o.o Emergency Lighting No. of Luminaires Swimming Pool rnd. ❑ rnd. ❑ Battery Units No. of Receptacle Outlets No. of Oil Burners FiRE ALARMS No.of Zones i No. of Switches No. of Gas Burners No.of Detection and Initiatinp, Devices 1 No. of Ranges No.of Air Cond. Tons/ No.of Alerting Devices No, of Waste Disposers Heat Pump Number Tons KW No. of Self-Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Pleating ICW Local[Imunicipal Connection ❑ ®thea No. of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No. of Water KW No. of No.of Data Wiring: Beaters Ballasts Signs 1 No.of DeviLes or Equivalent No. Hydromassage Bathtubs No: of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: ;Ittach additional detail if desired, or cis required by the Inspector q/ Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Stam: inspections to be requested in accordance with MEC 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. CHECK ONE: INSURA CE ❑ BOND ❑ OTHER ❑ (Specify:) /certify,under th in and p carr ties of perjury, thatthein nn a s appticatiora is true and complete. FIRM NA 0 c l bl t4 LiC. NO.: ,10WO—79 Licensee: ✓l i►11r11 " Signatur LIC. NO.: (//'applicable. eN(b " entpt 'irz the license nunr er lute.) Bits. Tel. No. /`Tr-6f9 a3� Address: T1 v Alt. Tel.r MNo.: Pei- c. 147, s. 57-61,security work requires Department of Public Safety "S" License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(check one) ❑ owner El owner's agent. Owner/Agent Signature _ Telephone No. PERMIT TEED $z—Vo r'-- Date. Q C�/ " 4, ,ORT#1 •�tio TOWN OF NORTH ANDOVER ' PERMIT FOR PLUMBING �,SSACNUS� - This certifies that . . . . .. . . -. . . . .":. . .. .. . . . . . . . . . . . . . . . . . . has permission to perform .' . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "a f �: at� . . . v . . . . . . , North Andover, Mass. 3 � Fee'. . . . . .Lic. No.. . . . . . .r';"Vp . . . . . . . . . . . . . . . . . . . . . PL�U�BING INSPECTOR Check # 11 8S 8264 ms's MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO ®O PLUMBING f (Print or Type) ,Mass. Datei() 206 Permit!# �6 Building Location FI) A`I ob.. Owner's Name SO4LI Ull+i Owner Tel# Type of Occupancy__ New ❑ Renovation ❑ Replacement GP-*' Plan Submitted: Yes ❑ No ❑ FIXTURES z rw Z uj H z C7 a W yr � � - w � � ' � CPLA4 � A 0 x t r F 3 .6a ® Q aQw o SUB- SMT BASEMENT Is''FLOOR 2"to FLOOR 3Ru FLOOR 4TH FLOOR Sm FL d;- 6Tn FLOOR OO rn / a. I� I JQCIR L Installing Company Name f Al Check one: Certificate Address �� ,fa�-,, ,"% 65orporation j 'S �' f °` ��' �°#`r�'°�`_ ❑Partnership _ Business Telephone# c El Firm/Co_ ' Name of Licensed Plumber t ==- � y�`a a c INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which mets the requirements of MGL Ch. 142. Yes:eY No ❑ If you have checked yes,please indicate the type coverage by checking the appropriate box. A liability insurance policy ed 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 Mass. General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner L3 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 performed under th t issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbi2a Code and Chapter 142 of th' ral s. By `A Signa a censed 1 Title City/Town Type of License:Master$ a — Joumeynn ❑ APPROVED(OFFICE USE ONLY) License Number a Date TOWN OF NORTH ANDOVER • - PERMI�� FOR GAS INSTALLATION This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . : '-<�^�` ... . . in the buildings of . . . . . . . . . . . . . . . . . . . . . at `-' c !. ,�- �-�! . . . . . . . ., North Andover, Mass. Fe" . Lic. No: /_'. . -!,.,!?.�_. . . . . �F SJNSPECTO�i/ Check# 6.966 _3,0 4` . MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING -- City/Town: MA. Date: _ Permit# Building Location: R ! Owners Name: &v L.L I UA_V0 Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential New: ❑ Alteration: ❑ Renovation:^❑ F�Rplacement: Plans Submitted: Yes❑ No❑ FIXTURES LU t� W ca cc ¢ U) m cos :) W W. WO f� In x ® W W 0 tf9 F- OW W li.l W Q H W O Q F W f� 0 LZi! w Lj z iF = Uy ® W W ® x u. � 0 LL' Z u, _ 0 rn W x Z LU W (A Z F� � J W Z W J O Z C7 � W W W L>D W O Z O F- O EiC LA Z Z Z x — �C LL ttt cv L� x o a O z z W a 0 ga Llc t® � � > }. o SUB BSMT. BASEMENT 15T FLOOR 2Nu FLOOR -i'FLOOR 4 FLOOR _5'FLOOR 6 FLOOR 7 FLOOR $ FLOOR Check One Only Certificate# Installing Company Name: �kLi '- y,. ®rporation ' � IM,Address. /f ,a=�f r� CitylTown:. fs- state: < ' ❑Partnership Business Tel: 14-5 Fax. R ❑FirmfCompany Name of Licensed Plumber/Gas Fitter: -~ 1- ; INSURANCE COVERAGE: 1 have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes D'No❑ 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 ❑ Signature of Owner or Owners Agent Owner [:] Agent By checking this box❑;1 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. By Type of License: L . ["Plumber Title ❑Gas Fitter Sig Licensed Plumber/Gas Fitter [=Master CityTrown []Journeyman License Number: t� APPROVED(OFFICE USE ONLY ❑LP Installer " Location No. CM? Date �ORTM TOWN OF NORTH ANDOVER 0 1.• -_ r Certificate of Occupancy $ �'�S'^•a E Building/Frame Permit Fee $ SACMUS ` Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 13 S O 3 ~—Building InspecIror f '1 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING a. �m MOW '��. ...,.. VAC•' ,�.�.. a�''a"� w�z�.,�'*�� �y BUILDING PERMIT NUMBER. �. DATE ISSUED: c , 4 -16 — 6 C SIGNATURE: ,&Iding Commissioner/I for of Buildings Date SECTION 1-91-YE INFORMATION I 0 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: \� Zoning District Proposed Use Lot Area(so Frontage 00 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Rea Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Q� 2.1 Owner of Record i Name(Print) Address or Service: Sign iture Telephone l 2.2 Owner of Record: Name Print Address for Service: O Signature Telephone SECTION 3-CONSTRUCTION SERVICES 00 3.1 Liaised Construction Supervisor: Not Applicable ❑ i Licensed Construction Supervisor: O License Number Address wn Expiration Date Signature Telephone r 1 3.2 Registered Home Improvement Contractor Not Applicable ❑ Lr. . Co-m-p9ny Name '22�\ CV` Registration Number M Address rM l C 9- - tG Expiration Date ^ Signature Telephone G SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check au applicable) - New Construction ❑ Existing Building ❑ Repair(s) Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: f 4 • SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be � nOFFICALUSI+.EINIC.Y Completed b permit a licants _ _ 'a w 1. Building .� (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT . a 1, as Owner/Authorized Agent of subject property Hereby authorize to act on +� My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED —AGENT DECLARATION I, y� �'�'t_t 7 �,.� as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name 1 ' ems- Sr ature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TMERS 1ST2ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CFUMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Mario Castricone, Prop. Tel, 682-4266 -71 �''�� CASTRICONE ROOFING & -SIDING CO. �. 31 Court SL, No. Andover, Mass. 01845 M 61 CIO X_yg�-' EWAA The Commonwealth of Massac,�use is --~ , — Department of Industria"c,idents �C Office cf lnvesticatians Boston, Mass. 01,1111 Worker,;' Compensation Insurarce.4ifdavlt Name F!ecse = int Loc=ticnf% �Sa (—� I am a homeowner performing all work myse!f. L� j I am a sole proprietor and have no one wcrikino in any capacir/ u i CI am an emcicyer providirg workers' compensation for my employees working on this job. C � Comcanv name:( S C l CU Y \ s 1 c Address Cihi �C) Phcne Insurance Ca Cts Pclic•i 1 Comcanv name: Address City Phone T Insurance Co Police T Failure to secure coverage as recuired under Sec;:en 25A or v1GL 152 can lead to the impcs;6cn cr cnmir.al penalties of a rine uo to s1.SCO.Co ancicr one years'imprisonment as ,veil as c:vii penalties in the form cr a STCF'n/CRK ORCE=and a:ine cf(s1 CO.CO) a Cay against me. I understand that a cop/ci this statement may'ce iormarcea to the Cfce of Invesucaticns cf:he GIA-For coverage verincaticn. I co Hereby ger try urdar the gains and penalties of- fury that;he information provided accve is:rue and ccmc` r" Signature r/L!?! t� Cell Gc�2� Gate - Print name W C Z CCSA I _Phone#0,D - A ocic:ai use aniy do net write in.this area to de completed by c:-,y cr:c%vn c .ciai C;ty or Town Permit/Ucens:rc Building Cept ❑check,f immediate response is required ❑ L/canslne Ceard C Se!ec;rnan's GIWC� C ntac:persa2 Fhcre r health Departrrerlr Other i �ile Poomneavw�ea/f�o���aoaaC/inaelta HOME.•IMPROVEMENT CONTRACTOR ( Registration' 103317 Type - DBA Expiration 07/07/00 G d P CASTRICONE.ROOFING & SIDING C Mario T. .Castricone t D""ll,7f' 6�eS13Wourt-St. ADMINISTRATOR N. Andover MA 01845 r tAORTFI Town of Andover 0% No. dover, Mass.,, COCHICHEWIC 0""ATED C S BOARD OF HEALTH Food/Kitchen Septic System LOGO 1 BUILDING INSPECTOR THIS CERTIFIES THAT...... �77 ... .... ............A................................................. B PERMIT T D . ....... I Foundation 0 ......�­* ...... has permission to erect A 1 ..... ........... buidings n ....... ....... .....................I.................................... Rough to be occupied as.... . ......................................................................... Chimney provided that the person accept! his permit shall in eve form to the terms of the application on file in Final v I t this office, and to the provisio7nthe Codes and By-Law , lating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST J/eaA4,,,. Rough ................................................................................................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.