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HomeMy WebLinkAboutMiscellaneous - 344 APPLETON STREET 4/30/2018Date. / .-. 1 .:.. /...... . •� TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that . z�l� .( . !...�� l has permission for gas installation . ?.. r.`. 1?". X:'.,..:........ . in the buildings of . F a `�.:`�` .............................. at . .. {�. `.' .r �- . % .. ................ . North Andover, Mass. Fee .. u�.' .. Lic. No... f ...'. 6... ........ ....... GAS INSPECTOR Check # /C.' 5 ) _ ( 376 MP 4 SSA I APP CATON FOR PER/N,U T TO DO GAS G `/ or print) .PAItCEI Date 1`1 V M TH AND" Building Locations 137T PPLL� 7o,,uPermit 4 3 7d Amount S L40 Owner's Name S`/11I2U/�/ A1Q Z"L1?. New ❑ Renovation ❑ Replacement Plans Submitted ❑ (Print or type / Check ck one: Certificate Install Company Name � L� `'1%�-� 14112 ra,3 1 -147`6 fD-A-V •,rp. f • Gln Address q1 1 PLj`jpA;7- s ` ❑ Partner. Business Name of Licensed Plumber or Gas Fitter ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑— No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy ❑-r'`r 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 ElAgent❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true anu accurate w 1:1C 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 N.,lassac)1usetts State Gas Code,and Chapter 142 of the General Laws. //_ _,h1//G J/j // By: Title CityiTuwn APPROVED,()FFICr uSc()NLYi '-Signature of Licensed Plumber Or Gas Fitter ❑ Plumber -3 �(/4/,)' [3--r-as Fitter License Numoer �Viaster ❑ Journeyman f. (Print or type / Check ck one: Certificate Install Company Name � L� `'1%�-� 14112 ra,3 1 -147`6 fD-A-V •,rp. f • Gln Address q1 1 PLj`jpA;7- s ` ❑ Partner. Business Name of Licensed Plumber or Gas Fitter ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑— No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy ❑-r'`r 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 ElAgent❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true anu accurate w 1:1C 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 N.,lassac)1usetts State Gas Code,and Chapter 142 of the General Laws. //_ _,h1//G J/j // By: Title CityiTuwn APPROVED,()FFICr uSc()NLYi '-Signature of Licensed Plumber Or Gas Fitter ❑ Plumber -3 �(/4/,)' [3--r-as Fitter License Numoer �Viaster ❑ Journeyman Date... .�5..� .z ... TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION F C 9SSNC'NUSEt SThis certifies that .... !.':.............................. . f-� has permission for gas installation .... f ............. in the buildings of . �.� �h .- :.1.... ......................... . at ........... , North Andover, Mass. Fee.. Lic. No.. �. .. . . _.. � S INSPECTOR Check # A C. 4075 MASSACHUSETTS UNN ORM APPLICATON FOR PERMrr TO DO GAS FITTING (Type or print) L,,,,.Date NORTH ANDOVER, MASSACHUSETTS Building Locations 3 ` ( Permit # Amount $ Owner's Name, New ❑ Renovation 0 Replacement � Plans Submitted ❑ (Print or type)/� ` 1 one: Certificate Installing Company Name rK . I 4 . Pi - (ekt4, � -� 00+`7 Li Corp. Address S �U U u �'� ❑ Partner. Business Telephone (a / _ p Lc7 ©'finn/CO. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 0' No❑ If you have checked M, please indicate the type coverage by checking the appropriate box. 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 Mass. General Laws, and that my signature on this permit application waives this requirement. of Owner or Owner's Check one: 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 MassachuseVs Statp Gas Code and Chester 142 a General Laws. Nj/� City/Town (OFFICE USE ONLY) Signature of Lidensed Plumber Or Gas Fitter [ ' Plumber 3.16 . ❑ Gas Fitter License Number 0—Master [:]Journeyman �3RD. FLOOR r0 R (Print or type)/� ` 1 one: Certificate Installing Company Name rK . I 4 . Pi - (ekt4, � -� 00+`7 Li Corp. Address S �U U u �'� ❑ Partner. Business Telephone (a / _ p Lc7 ©'finn/CO. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 0' No❑ If you have checked M, please indicate the type coverage by checking the appropriate box. 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 Mass. General Laws, and that my signature on this permit application waives this requirement. of Owner or Owner's Check one: 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 MassachuseVs Statp Gas Code and Chester 142 a General Laws. Nj/� City/Town (OFFICE USE ONLY) Signature of Lidensed Plumber Or Gas Fitter [ ' Plumber 3.16 . ❑ Gas Fitter License Number 0—Master [:]Journeyman o:tt:,• :se only The Commonwealth of Massachusetts ' Permit b.VU C/ Department of Public Safety o Occupancy S Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 3/90 (teave blank) APPLICATION FOR PERM IT.TO,. PERFORM , ELECTRICAL_ WORK NI work to be performed In accordance with the Maraachusetu Electrical Code; 527 CMR 12:00 (PLEASE. PRINT -IN.. INK OR .TYPE ALL INFORMATION) Date City 6' Toon of xly,'/asli l/�%ie - p To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Numberff) 3 7 ZJe&e_A7i_1 SG - Owner or Tenant 17111e c1' - Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No [Doo' (Check Appropriate Box) Purpose of Building �lCli�t �y .f_Vs�W' - Utility Authorization NO. Existing Service Amps / Volts 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 .�,g2 L3,1 (�ox,- !v /s� e .Sy,/ No. of Lighting Outlets No. of Hot Tubs al No. of Transformers TKVA1 No. of Lighting Fixtures Swimming pool grad. ❑ grnd. ❑ Generators KVA No.•of Receptacle Out -lets No. of Oil Burners Battef Emergency Lighting No. of Switch Outlets` ` No. of Gas Burners FIRE ALARMS ` No. of Zones No. of Detection and Initiating Devices ''i. No. of Sonding Devices NDeec Sol( Contained Detection/Sounding Dentes Local Municipal f'-Nother ❑ Connection �•. z;.Total No. of `Ranges No. of Air Cond�, tons No. of Disposals' Heat Total Total;- No. of Pumpsonsu T KW No. of Dishwashers Space/Area Heating KW S p g No. of Dryers Heating Devices KW No. of Water Heaters KW No, of NO. or Si ns Ballasts Low Voltage Wirin Ur 1 eir f P_r f No. Hydro Massage Tubs No. of Motors Total HP Atolf5 S 6, Y.S. OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liabilit Insurance Policy including Completed Operations Coverage oVSNO substantial equivalent. YES g NO [] I have submitted valid proof of same to this office. YES ❑ If you have checked YES, please indicate the type of cover a by checking the appropriate box. INSURANCE OND OTHER (Please Specify) 5 - o � Estimated Value of Electrical Work S /e r,d (Expiration Date) Work to Start 120v_ Inspection Date Requested: Rough Final Signed under the penalties of perjury: FIRM NAME Licensee ryG�fi/� �O 3' Signature LIC. N0. f/3�l C �� Bus. Tel. No. �',�//D �P'�G� t►0S/2 Address Alt. Tel., ifo. fi✓3/!� �% OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its su - stantial eq4valent as required by Massachusetts General Laws, and that my signature on this permit applicati aiv s this tart ent. Owner Agent (Please check one) PIP Telephone No. ,f%e ifp 6ZM� PERMIT FEE -S �-� gnature ofer or gent S'�✓yf - 4 _� ' `` ' ' _ -- ' ' �'�'�-_��,-__� - '- . � � -� ` _' ' ' �� �_,'�,' --=�_ ` '- - '�� '-`-.� _ � '_ ,' `- -_ - ' - -.' -- .` ' _ =�.�.�=.� r^-___` - - -- '�`^=�----' `/�- -- -_� � -����z- ��` r'��' _ '--� ' - -- - --'-�����'--�'���.____ __`-�`,r'�'.. /����____� ` ' '_---� - _' - -__-___'.__--_'_ _ ' - _- - -- - - ' ____------_-__--_� - _ ' - ----'---_� --� . - ' -' '' ' - - _- �-_ __ _. - - - -'_'. - ' �� -'' - ' - Date ...... f........ (.................. 206 NORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING r '7 This certifies ..... .` ... = ' . has permission to perform wiring in the building of .......:.:> 1:r......l?::. .............................. �''� at.. --3'/..t/ ... }�'. � :(ZLf??....... ................. . North Andover, Mass. �` i Feer�...°�..-' ......... Lic. No /.;� ............................. {fes% ELECTRICAL INSPECTOR 1.4 25-00 PAID WRITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File 50362 OWesting ouse Electric Corporation CAVE I T r'IIINIIN ,, 1:0 • 121113- 4725 WESTINGHOUSE SECURITY SYSTEMS 545 E. JOHN CARPENTER FWY. SUITE 1000, IRVING, TEXAS 75062 1-800-654.6770 TEL. 214-830-6100 FAX: 214-830-6098 SKU 0 1 Price I Total Notes: ^ Subtotal E9uTmenl_.. ...................... . D — H� I . ..... ......... �l SMOS_ T ........... .......... .... +G ��V SUBTOTAL Mpn4pmg a ' Maintenance Services (Sched M Or P),,....... }) Own/Close RePon (Business Only) ............. Test: In OUI Subtotal Seneca ............ ......................... Operator .. _ __._...__..___—.._.. Other Tay.............. ............... Upsale: Service[-] Install (] Permit Fee (i1 repuired)........._....................- Other ❑ Total Due METHOD OF PAYMENT TO SALES REPRESENTATIVE TOTAL AMOUNT COLLECTED AID # Today's Date_ r(b /_Q�c�� Residential Branch # _���� City❑S�OYI Account # ._ 11 vb v Sched. Date_, / tq /_1J_ Commercial J Installer # House I.D. # Sched. Time -1-:3-00m 1 Story U S.C. # 1 Lit.v Name =^ }T Fi`CSZ Alarm Permit #, Install Date I / 2 Story ')l!" Exterior Doors b Square Footage Customer Name (last) _LL r (first)_ (m.i.)_Telephone (�ti ) _ o - f� I) Authorization Date Call Waiting? Yes N J Business Name (if Commercial) _Do You? Ren J OwLease J 1 Equipment Address A (4Q A Cross Street ►L opP,fl' C_ City _A Slate j*Zip i�gL�Subdivision -_Map Location SYSTEM INFORMATION •PNTlRE.SYSTEM CONFIGURATION Hardwire ❑ Wheless ❑combi-t— Package Type A Q B C O D 0 Other C3New CLEARLY MUST BE INDICATED ZONE I.D./ LOCATION/DESCRIPTION Install 13 Prawns f3PanetType Takeover ❑ Service Request 0 Reassignment ❑ Previous AID 0 Package Price Old Contract ❑ New Contract Panel Phone Number Same Other ❑ (_) cTFI'1 System Move ❑ (check below) Same Branch ❑ From Branch ❑ Panel Multiple Phone Lines 13 13 Phone Number I) • ANY ALTERATIONS FROM THE BASIC PACKAGE SHOULD BE LISTED HERE SKU 0 1 Price I Total Notes: ^ Subtotal E9uTmenl_.. ...................... . D — H� I . ..... ......... �l SMOS_ T ........... .......... .... +G ��V SUBTOTAL Mpn4pmg a ' Maintenance Services (Sched M Or P),,....... }) Own/Close RePon (Business Only) ............. Test: In OUI Subtotal Seneca ............ ......................... Operator .. _ __._...__..___—.._.. Other Tay.............. ............... Upsale: Service[-] Install (] Permit Fee (i1 repuired)........._....................- Other ❑ Total Due METHOD OF PAYMENT TO SALES REPRESENTATIVE TOTAL AMOUNT COLLECTED $ • 1° Cash __,,�•C Check # J Financing Option D.L. # 'J Money Order # S.S.N.____________ J Visa Expiration 'J Mastercard Authorization Date J Amex 'J Discover -T MO m YR m -F -i-T IST TT T- I TT- I Comments METHOD OF PAYMENT TO SALES TECHNICIAN TOTAL AMOUNT COLLECTED $ 'J Cash Check # J Financing Option D.L. # ---ST. 'J Money Order # S.S.N. J Visa Expiration J Mastercard Authorization Date _ J Amex 'J Discover MO m YRFE Comments SIGNATURES I HAVE READ AND AGREE TO THE TERMS ON THE REVERSE SIDE OF THIS SCHEDULE. Westinghouse Electric Corp.. Security Systems Dept. AUTHORIZED REPRESENTATIVE Custoom�err((s))y Date j ���._P--mss.,_, _ --------------- �--------� ��� I Note: If billing address Is different from Alarm Location, put on Schedule B. CP (41941 (SEE REVERSE SIDE) • NEW ENGLAND CLAIMS SERVICE, INC. Incorporated 1985 ❑ Reply To Reply To P.O. Box 345 131 Dodge Street, Suite 6 Mansfield, MA 02048;ap Beverly, MA 01915 NDER TEL. {508} 337-8058 ",; USTERS TEL. {978) 927-3000 flillRS FAX {978) 927-3002 r f 1? FAX {978) 927-3002 wrandall@newenRlandclaims.com FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B To: Building Inspector N. Andover, MA RE: Insured: Mark Schwalm & Sara Weiss Property Address: 344 Appleton St, N. Andover, MA Cause of Loss/Date: Ice Dam 2/16/15 File/Claim No.: BOS53798 Claims 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, police number, date of loss and claim or file number. Section 3B. No insurer shall pay any claims (1) covering the loss, damage or destruction to a building or other structure, amounting to one thousand dollars or more, or (2) covering any loss, damage or destruction of any amount, which causes the condition of a building or other structure to render section six of chapter one hundred and forty-three applicable, without having at least ten days previously given written notice to the building commissioner or inspector of buildings appointed pursuant to the state building code, to the fire department or arson squad of the city of town and to the board of health or board of selectmen of the city or town in which the same is located. If at any time prior to payment the said city or town notifies the insurerby certified mail of its intent to initiate proceedings designed to perfect a lien pursuant to section three A, or to section nine of chapter one hundred and forty-three, or section one hundred and twenty-seven B of chapter one hundred and eleven, the said payment shall not be made while the said proceedings are pending; provided, however, that said proceedings are initiated within thirty days of receipt of such notification. Any lien perfected pursuant to section three A, or to section nine of chapter one hundred and forty- three or section one hundred and twenty seven B of chapter one hundred and eleven, shall extend to and may be enforced by the city or town against any casualty insurance policy or policies covering any loss, damage or destruction pursuant to. which the proceeds to perfect the lien were initiated. No insurer shall be liable to any insured owner, mortgagee, assignee, city or town, or other interested party for amounts disbursed to a city or town under the provisions of this section, or for amounts not disbursed to a city or town under the provisions of this section. 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. Very truly yours, . s ?Jo eph Lantieri Adjuster 732-330-4295 cell Location f?;/-•�-'�r` 4�f'% No. S " - Date AORTh TOWN OF NORTH ANDOVER OL 9 Certificate of Occupancy $ "•, a` n MUSE< Building/Frame Permit Fee $7 © d Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 24675 Building Inspector