HomeMy WebLinkAboutMiscellaneous - 326 CHESTNUT STREET 4/30/2018U) m m M. m m X (n m m co C-) 10 0 CD az CO) CDC M , 0, r. 5 CL CO2 CD CD CL cr =r 44C CD CD 0 CD w w a C CD cop) CD O co) CD cp CO) CD z a O 71 CD CD U) w cn :J �j 0 r IV n ;;d 0 cU) C) 0 rD C2 Sm o C-) arc :J M4 CD CL co) c') c') m CL =r CL Erp )t =r CD CD C042 CD -= rP c D CD -4tL :OE aa n7i'D ac:, co O 0 co, Cc, I— EFS-0 C4 c=L CD 0 C CD CD —1 P-% U) w cn :J �j 0 r IV n ;;d 0 cU) C) 0 rD - arc :J M4 )t t .smn ■.■ m m m m _v, y 'O C � 6 d CO2 C7 CD MZ ti CD O 'v CL r F go C C� ca a(O - O CD CL..�. Cr O CD -4 CD .CD O C' CD y CD O y cn C . 6 � v CO) O 1 Z CD O O CS O CD C c -*''o * m -q c N x ao 5.m 1 ti O m O m n N 0 C.n � m =r m CD �omNd O =` =r 0 O C m N m %,!O CS ill 9 O ZS.0 1 O N n _ C rF T LG O Cc, m m H CL w CD N 4` d p� O B Q jJ1 :.� C O W 3 a N g O iV �••� :Em N 111 m � ^: y ? ®, .� f J\ c 3 1 o®: :lam: gr S CD o c� }� CD N m W f1ftb n :1 �s �o -� 2.5" . 1 1% 0 z 0 0 c c� ° °°°r rQ ° ° ° ro z ro ? C" � p l..w w 0' n O r b 1 1 1% 0 z 0 0 c c� fm VZA .T � t, . T/7 P %0 77 v y C � N n 10 O CD n Z N D O 1wa3r. = r-+, O �. � O � O p CCD C = Cr C r—c� m O CD W W (D O N. I � v O z CD 0 o m 0 CD C Z Z m O .ER C n 0-0 C = 2 O � = O s w cn = 5 cD p > m m O m o rt�0c O O N M) — � CD H 'A rt O O rt CL N 0 CD 03 -my o +� N cD 2 V� 0 • ��y n O CQ� ..fir � C W � CD z -io =.- cc �� CD o�N c� 0 O "* � D O N �_ (n c c Q. v, —gym y M N CL n N z co 4 rH ���� *** O o ^ O cn CDCD q n S N o 0) o CL (A V1 co T Z7 T VI T Z7 T n,p T I V1 T 3 O (D p (D (D z O 3 T m D m O fl1 O C y H m A 0 O' 9 G O C m m A n z N m O z j' D1 O C V c W Z N T m O X O' p7 3 O C O C 3 W C p z Z N rm m O (D •06 O O CL 3 O O W D A O m m m D 2 D F=M GENERAL BUILDING NOTES/CHECKLIST- NOT LIMITED TO ITEMS BELOW POST ALL LOT NUMBERS, ADDRESS, AND PERMIT (COPY 0K)..or no inspections INSPECTIONS: (Minimum) Excavation, Footing, Foundation, Frame, Insulation, Final. FOOTINGS: Continuous Full 2x4 Keyway Continuous strip footings for interior columns FOUNDATION: Rebar as required Anchor bolts or -straps Damproofing Foundation drain - pipe/stone/fabric filter/cover and outlet connection. FRAME: Fireblock - over girts/plates between floor joist • Penetrations for plumbing, heat, elec, etc. Walls at stair stringers. Windbrace corners and center bearing partitions. Size ridge to provide full bearing at rafter cuts. Hip and Valley rafters - watch bearing at walls. Ridge & Hip _ Provide proper connections. Cathedral roof rafters provide proper connections and use "Hurricane Clips" tie to plate. Stair stringers - watch cuts and heal support. Joist hangers - fully nailed w/ hanger nails. Sill plates 2-2X6 (1 PT) w/sill seal. Girls - solid brick or steel plate bearing at foundations '/ " air space at sides in foundation pockets. Lateral bracing at ends. Certified calculations. required for Beams/LVL's Trusses. Solid bearing support for Headers/Beams etc. Check headroom clearances - stairways, under beams Attic Access. (min. 22x30 w/3' headroom above). Crawl space access. (min. 18x24). Bath exhaust fans to have metal duct to exterior (not in soffit). Firecode SIR wood frame of "0" clearance fireplaces & stoves Window Schedule or Every Habitable Room Must Have: Natural light equal to 8% of floor area. Y of required glazing shall be openable. Bedrooms required min. 20x24 egress window or door. Vent attic spaces - "proper vent", soffit and required ridge vents. Firecode under stairs if used for storage FIREPLACES: Separate permit required. Inspections at Footing - Smoke Chamber - Finish Smooth parging, clean joints, 8" solid @ combust. DECKS: Lag to house, provide flashing. Rails min. 36 " high, Baluster max space 5" on center. Over 8' above grade, use 6x6 posts w/lateral bracing. Lag all posts and rails. Pier footings down 48", Conc. pad at stair base. FINISH: Handrails returned to wall/newall post. Guardrails required alongside open cellar stairs. Exterior grading. complete. Certificate or occupancy required prior to occupying structure. Temporary Stairs required for inspection. Re -inspection fee - $30.00 (Be Ready). Certificate of occupancy required prior to occupying structure. Date .:'�! .,Y� t/j . . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING CH This certifies that . !!'^� /rr has permission to perform .. ......... �n J ......... . plumbing in the buildings of .. at Nei, Av 1 S ..... .�NorlAndo er, ass. Fee. Lic. No. . j ............... ..... . fO") I' %-� PLUMBING INSPECTOR Check r MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) l • i�r✓lJ� v � ,Mass. Date a I 24 Y Permit # Building L,0=42 ( CTiv 7 Q?r° Owner's Name l� A[-� t �i Owner Te > { ( 04ci co Type of occupancy_2tto / `F'�.� 4- New a' Renovation ❑ Replacement ❑ Plan Submitted: Yes ❑ No ❑ FIXTURES Installing Company Name_4/ Address Business Telephone Name of Licensed Plumber! INSURANCE COVERAGE: I have a current ilttp insurance policy or its substantial equiv Yes No t] If you have checked mss,, please indicate the type ODvcTagc by checidn A liability insurance Policy ❑ Other type of indeffiiiV 13 OWNER'S INSURANCE WAIVER I am aware that the license'd_ General Laws, and that my signature on this permit application waive -- .� „'-V . �CQ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted and that all plumbing work and installations performed under the permi the Massachusetts State Plumbing Code and Chapter 142 of the Genera By. Signature of Licensed PlutnbeT Title Type of License: Master IM=yman n Cityl7own Lim. Number APPROVED (OFFICE USE ONLY) rate ass. 'my lmowledge I provisions of Fw z z U d z ] z a aao z o F F m Q 3 w 0 a V 1 z Q a .T"3 A a z 3 w O x Q F° SG w 3 1 x o a Cn 3 °� T S BAS ST FLK=• rD FLOOR "aFLOOR C�- ►1 [ �1 U 4TH FLOOR Gra FLOOR 7TH FLOOR I Installing Company Name_4/ Address Business Telephone Name of Licensed Plumber! INSURANCE COVERAGE: I have a current ilttp insurance policy or its substantial equiv Yes No t] If you have checked mss,, please indicate the type ODvcTagc by checidn A liability insurance Policy ❑ Other type of indeffiiiV 13 OWNER'S INSURANCE WAIVER I am aware that the license'd_ General Laws, and that my signature on this permit application waive -- .� „'-V . �CQ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted and that all plumbing work and installations performed under the permi the Massachusetts State Plumbing Code and Chapter 142 of the Genera By. Signature of Licensed PlutnbeT Title Type of License: Master IM=yman n Cityl7own Lim. Number APPROVED (OFFICE USE ONLY) rate ass. 'my lmowledge I provisions of 0 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) !fir✓licey ,Mass. Date 42Q �% Permit # Building ucaticPf t, -r ?2: per's N2me (3RL-1 Z, Ea} Owner Tel# l c-1 q O •- O o `o Type of occupancy_,�eSg �:�f �',',�,4 L New i/ Renovation ❑ Replacement ❑ FIXTURES Plan Submitted: Yes ❑ No 11 w a t7 a R z w Q 3 k o a b w z w d O U w 10 - a a 3 a IMEMMENNOMME No ME-MENEM ... ■MMMM iiiiiiiiiii - -"OMEN .7 IME ■ Plan Submitted: Yes ❑ No 11 Installing Installing Company Name_,P f t /L ai d r J P�2 4 F1 Check one: Certificate o vx✓o� u'Corporation Address1D r / ©Partnership Business Telephone /124-ER� - � l J� ❑ Firm/Co. Name of Licensed Plumber INSURANCE COVERAGE: of MGL Cb. 142. 1 have a current liability instuance policy or its substantial equivalent which meets the regtutemenis Yes �/ No ❑ box. If you have checked �, please indicate the type -verage by checking the appropriate A liability insurance policy o Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER I am aware that the lice.— does not the insiaaaoe coverage required by Chapter 142 of the Mass. General Laws, and that my srgnatu a on this permit aMllca ion waives this requirement• Check one: Owner ❑ Agcut ❑ Signatrne of owner or Owner's Agent cation an _ _ best of I hereby certify that all of the details and information 1 have sabmWed (ors for thired) ins be in compliance with all �epertinent provisions o t and that all plumbing work and installations performed under the permit the MassaeIAISM State plumbm Code and Cbapter 142 of the General ws. By , Signature of Licensed Plumber Tide Type of License: Master pv Jotaneyman ❑ (OFFICE USE O City/Town License Number / ! J U S� APPROVED NLSi7 w a t7 a R z w Q 3 k o a b w z w d O U w 10 - a a 3 a Installing Installing Company Name_,P f t /L ai d r J P�2 4 F1 Check one: Certificate o vx✓o� u'Corporation Address1D r / ©Partnership Business Telephone /124-ER� - � l J� ❑ Firm/Co. Name of Licensed Plumber INSURANCE COVERAGE: of MGL Cb. 142. 1 have a current liability instuance policy or its substantial equivalent which meets the regtutemenis Yes �/ No ❑ box. If you have checked �, please indicate the type -verage by checking the appropriate A liability insurance policy o Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER I am aware that the lice.— does not the insiaaaoe coverage required by Chapter 142 of the Mass. General Laws, and that my srgnatu a on this permit aMllca ion waives this requirement• Check one: Owner ❑ Agcut ❑ Signatrne of owner or Owner's Agent cation an _ _ best of I hereby certify that all of the details and information 1 have sabmWed (ors for thired) ins be in compliance with all �epertinent provisions o t and that all plumbing work and installations performed under the permit the MassaeIAISM State plumbm Code and Cbapter 142 of the General ws. By , Signature of Licensed Plumber Tide Type of License: Master pv Jotaneyman ❑ (OFFICE USE O City/Town License Number / ! J U S� APPROVED NLSi7 �vu xriabsacuusetrs P ieetncat gone Amendments 527 CMR 12.00 § Rule 8: in accordance -with theprovisions of M.G.L. C. 143, § 3L, the Permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed oil the prescribed form Atter a permit application has been accepted by an Inspector of Wires appointed pursuant to M. aL c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L, G. 143, § 3L. Permits shall_be limited as to the time Of ongoing construction activity, and maybe deemed-by_the Inspector-of_Wires abandoned-and•fi validifhe—. or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be. terminated upon the written request of either the owner or the installing entity stated on the permit application. d The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job;growth and long-term economic recovery and the Permit Extension Act fiuthers this purpose by establishing an automatic four-year extension to certain•permits'and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008.and extending'through August 15, 2012. > 2ule 8—Permit/Date Closed: "2- * Note: Reapply for new permit t / 151< ❑ Permit Extension Act — PermM)ate Closed: I 02 k11 Of NORT►, A F A ,SSACNU TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....... /'%� le X�....... �.e. r G..�' ...................:.......... has permission to perform K! :`........ Z.- ��°'' ',' 2 �4 ....................................................... wiring in the building of ..%�t .v!.!'I........ .......................... at ..4 ... C..fl,Psif/v.�.......Srr........ ,North Ando er, Mas Fee ... . ' ....... Lic. No.? % C�(' �. / LECTRICALINSPE R Check # / z Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. ! G / O Z^ Occupancy and Fee Checked [Rev. 11071 eave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (PEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 5� it City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. tl ocation (Street & Number) 36'AG (_ (TE5- TK)6_r ' Owner or Tenant lowner's Address Is this permit in con,' ction with a build! g permit? Yes El Purpose of Building�517t:/JC No ❑ (Check Appropriate Box) Utility Authorization No. Existing Service 900 Amps a!V / Volts Overhead Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity No. of Meters No. of Meters Location and Nature of Proposed Electrical Work �5 ,L� p�172aC�t1� Completion of the -following table may be waived by d* Inspector of Wires. M No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans r o ota Transformers A No. of Luminaire Outlets 3 No. of Hot Tubs Generators KVA No. of Luminaires Swimming poolove n-' rnd o.oEmergency Lighting &ttea Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of SwitchesNo. of Gas Burners o• o etection an Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers eat p Totals: um r __...................................._..._......................... ons o. oSelf-Contained Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW p g Local ❑ Municipal❑Other Cyostnnection No. of Dryers Heating Appliances KW Security Devices or Equivalent No. of Water KW Heaters o. o o. o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP TelNa of Devices or E uim ent OTHER: f Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value o Electrical Work' „i 06) (When required by municipal policy.) Work to Start: '910 1(t Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE CC VERAGE: 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: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: LIC. NO.: Licensee: rntj9 V E LE*gC it Signature LIC. NO.: 7J�: (If applicable enter "exempt" m the lice,n�ss'e number line.) Bus. Tel. No. . Address: �'U j30K_ 0 K (� to 9kubxi-�- c ( Alt. Tel. No.: *Per M.G.L 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 weer [I owner's agent. Owner/Agent SignatureTelephone No. Q% PERMIT FEE. 't ✓r MASSACHUSETTS WORKERS' COMPENSATION ASSIGNED RISK POOL APPLICATION FOR WORKERS' COMPENSATION INSURANCE MAIL TO: The Workers' Compensation Rating & Inspection Bureau of Massachusetts P.O. Box 55005 Boston, MA 02205 (617) 439-9030 IMPORTANT: Forassistance completing this application, refer to the Pool Procedures for New Applications under Residual Market on the Bureau's website, www.wcribma.org. A separate application must be filed for each legal entity. This application must be typed or printed in ink and submitted in duplicate to the Bureau. Under no circumstance will coverage be assigned if: payment or required deposit does not accompany the application; the declination requirements are not met; there is a record of coverage in force for the entity making application; the applicant is in default of premium for pr or workers' compensation coverage; or, the applicant has an audit or inspection from a pdorworkers' compensation policy that remains incomplete due to the applicant's failure to cooperate with the prior insurer. The earliest possible date coverage can be bound is at 12:01 A.M. the day after the application and required deposit are received in the office of the Bureau. The undersigned employer has failed to obtain workers' compensation and employers' liability insurance in the voluntary market and hereby applies for such insurance in the Massachusetts Assigned Risk Pool and expressly represents that such insurance is sought in good faith. I. GENERAL INFORM TION NAME OF EMPLOYER (Na a t^he sole 2. B1 4 , general partners) ortrustee(s) along with the trade name (If pending, attach a copy of the IRS application.) Requested _ Effective Date: me ousiness.) ❑PENDING PRINCIPAL MA LOCATION Number Street City State Zip Phone 5. TOTAL NUMBER OF MA LOCATIONS 6.. Q a C �?� e , a `� Qy�-l� 1 ADDITIONALMA LOCATION Number Street City r State Zip Phone (If is more than one additional MA location, attach a list of addressesandphone numbers. Fully complete Section VI for each location.) �therestreet 7. r DNumber Street LOCATION OF RECO;Sole City State Zip Phone 8. LEGAL STATUS Proprietor ❑ Partnership ❑ Corporation ❑ Trust ❑ Limited Partnership ❑ LLC ❑ LLP ❑ Other (explain) II. ELIGIBILITY REQUIREMENTS To be eligible to obtain assigned risk coverage: • The employer's application for voluntary Massachusetts workers' compensation coverage must have been rejected by two (2) carriers licensed to write workers compensation in Massachusetts; • The employer must not be in default of premium for Massachusetts workers' compensation insurance; • The employer must have complied with all laws, orders, rules and regulations in force and effect relating to the welfare, health and safety of employees; and, • The employer must not have an audit or inspection on a prior workers' compensation policy that remains incomplete due to the employer's failure to cooperate with the insurer. 1. List the names, representatives, date(s) of discussion, and phone numbers of two insurance companies licensed to write workers' compensation in Massachusetts who have refused to write voluntary coverage for this risk in the past sixty days. Each representative named must be an employee who has authority to bind coverage for the insurance company. A failure to reach such a representative cannot be construed as a refusal to write coverage. q,N? ME OF tTJSURrtihIGE,COMPANY'. 0 FUI C AIAAdE�OF..-.REPRESEPtTAT[Vt=" �� DECLINATION DltTfJ, PkiOAfE Z NOTE: If coverage was recently terminated or expired in either the voluntary or assigned risk market, you must attach a copy of the cancellation or nonrenewal notice. The reason for cancellation or nonrenewal must be indicated. If the coverage was in the voluntary market within the past sixty days, the cancellation or nonrenewal will serve as one of the two required declinations. Generally, coverage must be replaced in the voluntary market if voluntary coverage was cancelled or non -renewed at the employer's request. 2. Have you received any offers of voluntary coverage? ❑ YES [ ]-<O If YES, attach the offer for coverage, including all multi -line, deductible, or retrospective rating terms. 3. Is there any unpaid workers' compensation premium due from you or any other commonly owned enterprise? ❑ YES [' NO If YES, provide the entity name, balance and policy number(s). If the premium is being disputed, attach an explanation for Bureau consideration. If an arrangement for payment has been made, attach a copy of the signed agreement. -,� 4. Does the employer have any outstanding audits or inspections on a prior workers' compensation policy? E][ YES NO If YES, provide the name of the carrier and the policy number. If the employer has scheduled an audit, provide the name and telephone number of a contact at the carrier. PheniN JRUtUat FIRE INSURANCE COMPANY HOME OFFICE • ]ACKMAN BUILDING • 42 PLEASANT ST • P.O. BOX 900 • CONCORD, N.H. 03302.0900 TELEPHONE 603 225.2773 COMMON POLICY DECLARATIONS NEW --DIRECT BILLED - INSURED POLICY NO. CPP0718472 NAMED INSURED: MARK LEACH DBA RACEWAY ELECTRICAL SERVICES MAILING ADDRESS: PO BOX 612 HUDSON, NH 03051 POLICY PERIOD: From 11/03/09 to 11/03/10 at 12:01 A.M. Standard Time at your mailing address shown above. BUSINESS DESCRIPTION: INDIVIDUALS IN RETURN FOR THE PAYMENT OF THE:PREMIUM, AND SUBJECTTO ALL THE TERMS OF THIS POLICY, WE AGREE WITH,YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A.PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO�ADJUSTMENT". PREMIUM COMMERCIAL GENERAL LIABILITY COVERAGE PART $ 572.00 TOTAL $ 572.00 Premium 6 shown is payable: $ 572.`00 ` at 'Inception. Forms applicable to all Coverage Parts: IL 00 17(11-85), COMMON POLICY CONDITIONS � c COUNTERSIGNED 140 J, 109BY e'-- -� ` (Date) (Authorized Representative) AGENCY: 2154 ROLAND L. MAHEU INSURANCE 172 UNION AVENUE P 0 BOX 6248 LAKEPORT, NH 03246 (603)524-0753 IL 00 19 11 85 Copyright, Insurance Services Office, Inc., 1983, 1984 Prepared on 11/12/09 INSURED "COPY 1 goat 9t0� 5 t 20�� pN��°t`ry yo ca GO < des e�5� 0 ik y of t ora\ L1 �8.6�� rged,°ma`tme wn`es ` erse ote5s p02 cra jo?e ens at d \s tc t PC or M o��,s suce P o°t \`e Geneue\Oaaoet t 44. `ONis� 0°St actress�e �O cetec for °{ �s`�°ase nafi�afie oaaPio ire ?.,,te9e'eeP yrs en f\ aON tt y° O"ec` Pppt,� Ubtecetsonat e�so"• • °Rere�� rseastt',s �p otre�\ eda`J� `t Cr` afiera ed t° a as to N�, ao a s,90� P°st.NpR�1� PetS°O. �p1t��✓''� .................. Date .... ( ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING -,- j --,I .......................................................... This certifies that .... I ....... has permission to perforin ..( .... , ........... ....... +1 ............. ... .... .... .. . ........................................... wiring in the building of ......................... ....................................................................... ...... at ................... —..70 ....... N rth Andover, Mass. ...... ..... ..... . . ............. . ...... ........ . Fee..p ................ULic. No.1... .i— * ........... .....'.. '...'*................... ..... 'Aro�YELECTRICALINSPECTOR Check# t" - 13363 (5 I 01-zol�- H�- prim Form Y �inmorecaetsd�i o� Il{aysaehusel Official Use"" Only Permit No. 3. (p S eLJeParirnant o��ire Jeruices Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Jgcv.1/o7j (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK No. of Cell.-Susp. (Paddle) Fans All work W be pedonned in 4cccordance with the Massachusetts Electrical Code (MEC),5 7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: G fill 15 - No. of Luminaire Outlets /19cc Z City City or Town of: Aw* 44ZWtW To the Inspector oo W Wires: Generators KVA By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 32,6 7Wy7— 51— 1Owner Above hi- Swimming Pool d ❑ d. ❑ Owneror Tenant Telephone No. No. of Receptacle Outlets Owner's Address FIRE ALARMS Is this permit in conjunction with a building permit? Yes ❑ No Q (Check Appropriate Box) No. of Switches Purpose of Building Utility Authorization No. No. of Detection and Initiating Devices Existing Service Amps I Volts Overhead ❑ Undgrd ❑ No. of Meters .� New Service Amps ! Volts Overhead ❑ Undgrd ❑ No. of Meters No. of Waste Disposers Number of Feeders and Ampacity— Number Tons Location and Nature of Proposed Electrical Work: 2 Ha 4-65&2 57X00 41 vrt6+e5 3 ylP efj�2b Comnletion ofthe fallowinv table mov be waived Iry the Insnector of fres- No. of Dishwashers No. of Recessed Luminaires % No. of Cell.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets /19cc Z No. of Hot Tubs Generators KVA No. of Luminaires e wiser Above hi- Swimming Pool d ❑ d. ❑ o. o mergency ng Bane Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS Na of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Coad. Toilo Tons of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number Tons KW No. of Self -Contained 3 etection/Ale Devices No. of Dishwashers Space/Area Heng KW Local []Municipal Connection Other Connection No. of Dryers Heating Appliances KW Systems-* Security No of DeSyvices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Ruing: No. of Devices or Equivalent No.'Hydromassage Bathtubs No. of motors Total HP Telecommunications Wirinngg No. of Devices or anraient OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections tb •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 blas exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER Ll (Specify:) I certify, under the pains and penalties of perjury, that the inforhtation on t ' plic on is true and complete FIRM NAME: DAVID ELECTRICAL CONTRACTING LLC LIC. NO.: Licensee: DAVID HAGGAR Signature �-- Lic. No.: 14963 (Ifapplicable, enter "exempt" in the license num V t Bus. Tel. No: 978-582-6262 Address: 87 BELMONT ST, NORTH ANDOVER, MA 01845 Alt. Tel. No.: 978-375-5734 *Per M.G.L. 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 ❑ owner's agent. Own tura nt PERMIT FEE: $ -j Signature Telephone No. The Commonwealth of Massachusetts Department of Industrial Accidents Qjfke of Investigations ' 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass gov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Le:ribly Business/Organization Name: DAVID ELECTRICAL CONTRACTING LLC Address: 87 BELMONT ST City/State/Zip: NORTH ANDOVER, MA 01845 Phone 9: 978-682-6262 Are you an employer? Check the appropriate bog: 1. ❑ I am a employer with 8 employees (full and/ or part-time).* 2. ❑ 1 am a sole proprietor or partnership and have no employees working for me in any capacity.- [No apacity.[No workers' comp. insurance required] 3. ❑ We are a corporation and its officers have exercised their right of exemption per c. 152, §1(4), and we have no employees. [No workers' comp. insurance required]** 4. ❑ We are a non-profit organization, staffed by volunteers, with no employees. [No workers' comp. insurance req.] Business Type (required): 5. ❑ Retail 6. ❑ RestaurantBar/Eating Establishment 7. ❑ Office and/or Sales (incl. real estate, auto, etc.) 8. E] Non-profit 9. ❑ Entertainment I0.❑ Manufacturing 11.0 Health Care 12.❑ Other ELECTRICAL CONTACTING *Any applicant that checks box #1 must also fill out the section below showing their workers compensation policy information. **If the corporate officers have exempted themselves, but the corporation has other employees, a workers' compensation policy is required and such an organization should check box #1. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy information. Insurance Company Name: FEDERATED MUTUAL INSURANCE CO Insurer's Address: PO BOX328 City/State/Zip: OWATONNA, MN. 55060 Policy # or Self -ins. Lic. # 9353694 Expiration Date: MARCH 1, 2015 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 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 ofthe DIA for jn�urance coverage verification. I do hereby certify, undpenalties of perjury that the information provided above is true and correct- Signature: orrectSi ature: / Date: Phone #:�-- tjfickd use only. Do not_tw ite in this area, to be completed by city or town offwial. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3.,Cityfrown Clerk 4. Licensing Board 5. Selectmen's Office 6. Other Contact Person: Phone #• www.mass.govidia 0 Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 RE: Insured: Property Address: Policy Number: Date/Cause of Loss: File or Claim Number: John & Evelyn Tobin 335 Chestnut Street NX4931 2/1/2011, Damage Caused by Ice 25318-R Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL 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 or file number. Ryan Werner On this date, I caused copies of this Notice to be sent to the persons named above at the addresses indicated above by First Class Mail. , and Date ANDERSON ADJTMENT CO., INC. 50 Nashua R,6ad, Suite 303 PO Box 1098 Londonderry, NH 03053 *PCL V2.25.8* TOWN OF NORTH ANDOVER PARCEL LISTING 04/19/17 PAGE 2 PARCEL ID: 2018 210/098.C-0070-0000.0 (Page 2) **** VALUE HISTORY # 1995 LAST UPDATED 11/22/1995 Select Srce CS - COST Land Value 74200 State Use Cd 101 - SNGL-FAM-RES Final Value 182700 Bldg Value 108500 Markt Ld Val 74200 **** VALUE_HISTORY # 1996 LAST UPDATED 06/26/1996 Select Srce CS - COST Land Value 74200 State Use Cd 101 - SNGL-FAM-RES Final Value 182700 Bldg Value 108500 Markt Ld Val 74200 **** VALUE HISTORY # 1997 LAST UPDATED 03/10/1997 Select Srce CS - COST Land Value 74200 State Use Cd 101 - SNGL-FAM-RES Final Value 182700 Bldg Value 108500 Markt Ld Val 74200 **** VALUE HISTORY # 1998 LAST UPDATED 03/19/1998 Select Srce CS - COST Land Value 98600 State Use Cd 101 - SNGL-FAM-RES Final Value 216700 Bldg Value 118100 Markt Ld Val 98600 **** VALUE HISTORY # 1999 LAST UPDATED 03/11/1999 Select Srce CS - COST Land Value 98600 State Use Cd 101 - SNGL-FAM-RES Final Value 216700 Bldg Value 118100 Markt Ld Val 98600 **** VALUE HISTORY # 2000 LAST UPDATED 03/24/2000 Select Szce CS - COST Land Value 98600 State Use Cd 101 - SNGL-FAM-RES Final Value 216700 Bldg Value 118100 Markt Ld Val 98600 **** VALUE HISTORY # 2001 LAST UPDATED 02/09/2001 Select Srce CS - COST Land Value 122900 State Use Cd 101 - SNGL-FAM-RES Final Value 281100 Bldg Value 158200 Markt Ld Val 122900 **** VALUE HISTORY # 2002 LAST UPDATED 06/13/2002 Select Srce CS - COST Land Value 134100 State Use Cd 101 - SNGL-FAM-RES Final Value 306500 Bldg Value 172400 Markt Ld Val 134100 **** VALUE HISTORY # 2003 LAST UPDATED 02/13/2003 Select Srce CS - COST Land Value 154100 State Use Cd 101 - SNGL-FAM-RES Final Value 326500 Bldg Value 172400 Markt Ld Val 154100 **** VALUE HISTORY # 2004 LAST UPDATED Select Srce CS - COST Land Value 172100 State Use Cd 101 - SNGL-FAM-RES Final Value 382100 Bldg Value 210000 Markt Ld Val 172100 **** VALUE HISTORY # 2005 LAST UPDATED Select Srce CS - COST Land Value 180600 State Use Cd 101 - SNGL-FAM-RES Final Value 397500 Bldg Value 216900 Markt Ld Val 180600 **** VALUE HISTORY # 2006 LAST UPDATED : Select Srce CS - COST Land Value 195200 State Use Cd 101 - SNGL-FAM-RES *PCL V2.25.8* TOWN OF NORTH ANDOVER PARCEL LISTING 04/19/17 PAGE 3 PARCEL ID: 2018 210/098.0-0070-0000.0 (Page 3) Final Value 426100 Bldg Value 230900 Markt Ld Val 195200 **** VALUE HISTORY # 2007 LAST UPDATED Select Srce CS - COST Land Value 221300 State Use Cd 101 - SNGL-FAM-RES Final Value 448000 Bldg Value 226700 Markt Ld Val 221300 **** VALUE HISTORY # 2008 LAST UPDATED Select Srce CS - COST Land Value 200000 State Use Cd 101 - SNGL-FAM-RES Final Value 418300 Bldg Value 218300 Markt Ld Val 200000 **** VALUE HISTORY # 2009 LAST UPDATED Select Srce CS - COST Land Value 200000 State Use Cd 101 - SNGL-FAM-RES Final Value 418300 Bldg Value 218300 Markt Ld Val 200000 **** VALUE HISTORY # 2011 LAST UPDATED Select Srce CS - COST Land Value 202000 State Use Cd 101 - SNGL-FAM-RES Final Value 383900 Bldg Value 181900 Markt Ld Val 202000 **** VALUE HISTORY # 2012 LAST UPDATED Select Srce CS - COST Land Value 202000 State Use Cd 101 - SNGL-FAM-RES Final Value 425300 Bldg Value 223300 Markt Ld Val 202000 **** VALUE HISTORY # 2013 LAST UPDATED Select Srce CS - COST Land Value 198100 State Use Cd 101 - SNGL-FAM-RES Final Value 423800 Bldg Value 225700 Markt Ld Val 198100 **** VALUE HISTORY # 2014 LAST UPDATED Select Srce CS - COST Land Value 188400 State Use Cd 101 - SNGL-FAM-RES Final Value 414100 Bldg Value 225700 Markt Ld Val 188400 **** VALUE HISTORY # 2015 LAST UPDATED Select Srce CS - COST Land Value 198100 State Use Cd 101 - SNGL-FAM-RES Final Value 423800 Bldg Value 225700 Markt Ld Val 198100 **** VALUE HISTORY # 2016 LAST UPDATED Select Srce CS - COST Land Value 205300 State Use Cd 101 - SNGL-FAM-RES Final Value 449300 Bldg Value 244000 Markt Ld Val 205300 **** VALUE HISTORY # 2017 LAST UPDATED Select Srce CS - COST Land Value 206600 State Use Cd 101 - SNGL-FAM-RES Final Value 453700 Bldg Value 247100 Markt Ld Val 206600 **** LAND # 1 LAST UPDATED 11/06/1997 Land Type P - PRIMARY Acres .66 Zone R3 - 25,000 SF State Use Cd 101 - SNGL-FAM-RES Nbad Code 6 Base Rate 4.9 Value Method S - SQUARE-FOOT Nbad Class 6 Base Value 206563 Square Feet 28697 Land Value 206563 *PCL V2.25.8* TOWN OF NORTH ANDOVER PARCEL LISTING LAST 04/19/17 PAGE 4 PARCEL ID: 2018 210/098.C-0070-0000.0 (Page 4) Type 2 - MAJOR ADDITION Amount 31900 Memo FY 98 5 TO 6 Permit Desc FULL SHED DOMMER **** LAND INFLUENCE # 1/ 1 Inf Adj Pct 100 **** RESIDENCE # 1 LAST UPDATED 07/09/2012 State Use Cd 101 - SNGL-FAM-RES Main Fn Area 1428 Overall Grad G - GOOD Occupancy 1 Unfnshd Area 867 Year Built 1968 Bldg Style CP - CAPE -COD Attic Y - YES Eff Yr Built 1974 Story Height 1.75 Bsmt Area 1156 Att Gar Cap 2 Roof Type G - GABLE Total Rooms 6 Att Gar Sqft 484 Roofing AS - ASPHALT-SHNG Num Bedrooms 2 Tot Fin Area 1428 Ext Wall Typ FB - FRAME-CLAPBD Full Baths 2 Fun Pct Good 100 Foundation CN - CONCRETE Half Baths 1 Ecn Pct Good 100 Heat Type HW - HOT-WATER Bath Quality T - TYPICAL RCN 316845 Fuel Type O - OIL Kitchen Qual T - TYPICAL RCNLD 247139 Fireplaces 2 Int Condtion A - AVERAGE Cost Bldg 247100 Stacks 2 Ext Condtion A - AVERAGE Rmain Pct Gd 78 Central A C N - NO Overall Cond A - AVERAGE Userchar 2 1977 Sketch U*.75{2)/FM(1)/B(0)[R23U20]:SR26U2R20U24L46D26,FM(1)[L8U18]:U22SL16D17R16U17,G[1)[L27U19]:L16U22SU5L22D22R2 2U17,0(1)[L34U30]:L38U27SR9U4L9D4,0[1)[R26U321:R28U26SL5USR5D8, Memo 2nd floor under const rough plumbing and elec 10-11 26 **** BUILDING PERMIT # 1 LAST UPDATED 03/17/2010 Permit Nbr 2010544 Permit Type 2 - MAJOR ADDITION Amount 31900 Permit Date 03/10/2010 Permit Desc FULL SHED DOMMER *PCL V2.25.8* TOWN OF NORTH ANDOVER PARCEL LISTING 04/19/17 PAGE 5 PARCEL ID: 2018 210/098.C-0070-0000.0 (Page 5) **** BUILDING PERMIT # 2 LAST UPDATED : 11/12/2014 Permit Nbr 2015403 Permit Type 3 - MAJOR REMODELING Amount 22000 Permit Date 10/28/2014 Permit Desc FINISH 2ND LEVEL **** BUILDING PERMIT Q 3 LAST UPDATED : 10/05/2015 Permit Nbr 2016341 Permit Type 6 - MINOR REMODELING Amount 8360 Permit Date 09/16/2015 Permit Desc R/R ROOF a m 2 O O o U N � v rr au 0 as m c a W W D Z F U) W U Q) W n Q J W U L 1 O O 0 O 0 H O J O O Y U O J m A O O O Q O O 0 0 0 0 ti O O U 06 Q> P O N b JI LU U 1 U 00 f6 00 N O N U 00 N N O II U a v O O coM p N U YY 22 O{ 0 0 00 0 0 0 W-, O (Y 0 Z- O W O> N LL 00 Z o N Zn 0-0 O O 00 o c e m J_J Jm M N O O o NCV §, _ o mmm_(� d QC� Y(UO E-°Ewc —'0 a O Mfit' d N E 7 N C O 'p a m a U W E U C O D O O J J 3 N z Z N U U)o (o Z U .' � 0 W M D Q JCD 000 0 U O or — mink LU O ra m ro s h W 0 m LL Z m}F- : ,,o CL �a� pZo OW QmmLU ,. 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CLC, �o�ti.. ° eno _ W� CD0 w n_W p N N N N c m (U U «� 3 U O 0' 00 r M y s 4t + in inU)U) Oft=din �jj to M 0 O = Ao Up a cm 00 ° u O co NN C) m a � �O �H o LnLr) UC�2 Zin U) U = a ai vi as 6 m Q ai @ ai (U O p m �— m O N O co LO Lo o mQ O N UUu� ° C C U D C O v }� N O X ammaa)a (AN UI �HHH c�u1U E ai �iq Q Ei7 U -O m i �.. �• N Em E zQ r yu)� CO Ul c U) U �' O O "" "' N QmLLm a2tn000 `u,° O N N O00 O LL "�O CJ rn rn U Q `° o w Z O a LL Q N N c0 NL— a LL N N Q �Q ami a) as Q m c<C m� 4EO LL r Q c mai •= o 0 (� p LL LL SiL }` -o�U o m mo o Z — u0 2�QZ� LU C9Ua a v m Q v 00 -2 O LO LL ao LU Z k m LL UULL e�LLL m m Q o E io •• °o ° f° � Q W fA @ mC°1�w 00 °teammmt U U QQ W W vY EEO v Z W H w p N 7 c6 vC C6 = -iC Ul Ul "' O Q �z� O HmLL2WmYW mm¢ a a Y� �Z- W Q OOU N (D (J) H U�0LL U =ONz 00 O ooM z N ) N F- C m ° CLC = U N fA S l4 C c c OOQQ ) o� N c cu s E)ac 2Lii C) Y N mv)�w2ii CIL *PCL V2.25.8* TOWN OF NORTH ANDOVER PARCEL LISTING PARCEL ID: 2018 210/098.C-0070-0000.0 (Page 1) **** PARCEL LAST UPDATED : 10/01/2012 Active Y - YES Sale Price Sale Page 410000 State Use Cd 101 - SNGL-FAM-RES Sale Date Grantor 05/16/2006 Own Acct Num M_ 231899_935746 Sale Type P - LAND-&-BLDGS Assoc Par 2 L7A Sale Book Owner Name 1 10183 Par Add No 1 326 Sale Page Owner Name 2 133 Par Add St 1 CHESTNUT STREET Grantor DEFUSCO, PAULINE Owner Name 1 GALIZIO, KEVIN A. Verif Source Userlist 1 D - DEED Owner Name 2 GALIZIO, JAYNE A. Sale Valid 453700 Y - YES -VALID Owner Addr 1 326 CHESTNUT STREET Adj Sale Pr 316845 2013 Owner City NORTH ANDOVER Visit Date 247139 10/24/2011 MA MA Measure Date 206563 10/24/2011 Owner Zip 01845 Entrance C - COMPLETE -INS Tot Lnd Area .66 Info Source 0 - OWNER -SPOUSE Tax Class T - TAXABLE Collector ID 453700 RRC Res Exempt Y - YES Inspect Reas C - RECOLLECTION Road Type T - TWO-WAY Reinspection N - NO Road Condtn P - PAVED Data Chg Typ CS - COST OT - OTHER Traffic M - MEDIUM Data Chg Dte 193100 07/09/2012 Memo 0098C 00070 00000 **** PAR SALES # 1 LAST UPDATED : 03/17/2010 Sale Link ID 0 129253 Sale Page 133 Sale Price Pct Com Bld 410000 Grantor DEFUSCO, PAULINE Sale Date 0 05/16/2006 Verif Source D - DEED Sale Type P - LAND-&-BLDGS Owner Name 1 GALIZIO, KEVIN A. Sale Valid Y - YES -VALID Owner Name 2 GALIZIO, JAYNE A. Sale Book Userchar 3 10183 Owner Addr 1 326 CHESTNUT STREET **** VALUATION 1980 Userlist 1 LAST UPDATED 12/02/1990 Cost Total 453700 Sel Bldg Val 247100 RCN 316845 Select Srce CS - COST RCNLD 247139 Final Value 453700 Cost Land 206563 Land Value 206600 Cost Date 11/01/2016 Bldg Value 247100 Comp Est 326500 Pri Totl Val 453700 Select Value 453700 Pri Land Val 206600 Sel Land Val 206563 Pri Bldg Val 247100 **** VALUE HISTORY # 1992 LAST UPDATED 12/01/1992 Select Srce CS - COST Land Value 82600 Final Value 193100 Bldg Value 110500 **** VALUE HISTORY # 1993 LAST UPDATED 11/12/1993 Select Srce CS - COST Land Value 74200 Final Value 184700 Bldg Value 110500 **** VALUE HISTORY # 1994 LAST UPDATED 07/25/1994 Select Srce CS - COST Land Value 74200 Final Value 184700 Bldg Value 110500 04/19/17 PAGE 1 Pct Expt Bld 0 Pct Res Bld 100 Pct Ops Bld 0 Pct Com Bld 0 Pct Ind Bld 0 Pct Expt Lnd 0 Pct Res Lnd 100 Pct Ops Lnd 0 Pct Com Lnd 0 Pct Ind Lnd 0 Userchar 1 6 Tot Fin Area 1428 USERCHAR 2 210 Userchar 3 935737.798009231 Userchar 4 231898.989181974 OLD—EFF—YEAR 1980 Userlist 1 R3 - 25,000 SF Usernum 1 28749.6 Owner City NORTH ANDOVER Owner State MA Owner Zip 01845 State Use Cd 101 - SNGL-FAM-RES Pct Chng Tot 100 Pct Chng Bld 100 Pct Chng Lnd 100 Markt Ld Val 206600 Cost Bldg 247100 Det Struc Val 0 Markt Ld Val 82600 State Use Cd 101 - SNGL-FAM-RES Markt Ld Val 74200 State Use Cd 101 - SNGL-FAM-RES Markt Ld Val 74200