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HomeMy WebLinkAboutMiscellaneous - 361 WAVERLY ROAD 4/30/2018n N O w O � � � Q G 7c�� m O o v -� '� MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108-1904 16171723-3800 Ma Only (800)392-6108, FAX (8001851-8424 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec.3B NORTH ANDOVER BUILDING COMMOSSIONER NORTH ANDOVER TOWN HALL NORTH ANDOVER MA 01845 Re: Insured: MARGUERITE J. SARSON Property Address: 361 WAVERLY ROAD, NORTH ANDOVER, MA 01845 Policy Number: 1298145 Type Loss: Ice Dams Date of Loss: 02/11/2015 Claim Number: 330078 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1000.00 or cause Massachusetts General Laws, Chapter 143, section 6 to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 313 is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. MPIUA Claims Division CMA00021 2/13/2015 -IN-2 - 4 3 6 1 4-� I - c9 -c- Date.& '40 40 TOWN OF NORTH ANDOVER 0 PERMIT FOR PLUMBING SACHUS e- - . 1. . :4 This c i'tifies that,� has permission to perform ..................... . ................... plumbing in the buildings of ...... ........ at ................................ I ...... North. Andover, Mass. " �"l e:111? Fee. / ...... Lic. No .......... . e ....... WHITE: Applicant CANARY: Building Dept. PINK: Treasurer A MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Pri t or Type) �N -2 Mass. Date Permit # Building Location3 i K,6- Owner's Name N _N1 New ❑ Renovation ❑ Replacement N FIXTURES Type of Residential Plans Submitted: Yes ❑ No ❑ Installing Company Name Heritage Htg, &Plg. Co. Inc. Address 35 Pleasant Street Stoneham, Ma 02180 Business Telephone 781-A 3 8- 7 7 76 Name of Licensed Plumber Gordon Switzer Check one: Certificate C$ Corporation 714 F-1 Partnership 1-1 Firm/Co. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes N No ❑ If you have checked Ye, please indicate the type coverage by checking the appropriate box. A liability insurance policy M 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: 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Ch ter 142 of the Gen ral La s. By _ 12411 Signature of-CiceTised Plumber Title Type of License: Master jg Journeyman City/Town_ APPROVED (OFFICE USE ONLY) License Number 8 3 2 2 s N= N m o Y z . w Y ¢ _j i4 N r a U a h �n z 7 C7 � n o z o a e O W _ z_ y .• a r.. U� +J I1 J 0 a 0 'r, •. L) U Z fr o 7 N W Q da` Q W ,� p a W Z Cr it K' J LL x W z Q= 3 3 o z i 3 a¢~ a '� W o x w xx a N h z o o° N= z w o c� x �I o •ri a 3 1- Y J W N O J 3: = F N LL a'.] Z a: a] O 3 v SUB—BSMT. BASEMENT 1ST FLOOR W 2ND FLOOR N A 3RD FLOOR D T 4TH FLOOR I T 5TH FLOOR Ri I I I I I S 6TH FLOOR E 7TH FLOOR C 9 Ffl aTHFLOOR T D Installing Company Name Heritage Htg, &Plg. Co. Inc. Address 35 Pleasant Street Stoneham, Ma 02180 Business Telephone 781-A 3 8- 7 7 76 Name of Licensed Plumber Gordon Switzer Check one: Certificate C$ Corporation 714 F-1 Partnership 1-1 Firm/Co. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes N No ❑ If you have checked Ye, please indicate the type coverage by checking the appropriate box. A liability insurance policy M 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: 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Ch ter 142 of the Gen ral La s. By _ 12411 Signature of-CiceTised Plumber Title Type of License: Master jg Journeyman City/Town_ APPROVED (OFFICE USE ONLY) License Number 8 3 2 2 I1 J z O w N D w U LL LL O O LL 3 O J w m N z'. O F- U W CL N z N N w K� O. ail N z O U w d N z 2 J Q LL w w O z U z m a J a O a O r r 2 a w a S O LL z O_ r a U J a a Q m U - 0 O W a F- og otl w X Q z a w m i D J Q a w r z Q m c� r i a W a 0) w r Q G I ,r 4 f Date.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... . T&W.. ( ..... has permission to perform wiring in the building of ......... .............................................. at ............... ....... North Andover, Mass. P..... ..... ... !:2 T iC. No.��11* ....... ...... ..... Fee.91 ............... ..... ................ . CAL NS LE I Ll 2012 Massachusetts Electrical Code Amendments 527 CMR12.00 § Rule 8: in accordance -with the provisions of M.G.L. c. 143, §. 3L, the permit application form to provide notice ofinstallation ofwiring sh all be uniform throughoutthe Commonwealth, and applications shall be filed' on the prescribed form. After a permit application has been accepted by an Inspector of Wires ap' pointed pursuant to U 01 o. 166, § 32, an K electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification ' ofcompletion ofthe work as required in UCT.L. c. 143, § 3L. 9 Permits shalLbelimited as to thetime, ofongoing construction activity, and maybodeemed-by-theJuspector-of-W-ires abandoned-andirrvalid-iflie— or she has determined that the authorized work has not commenced or kas not progressed during the preceding 12 -month period. Upon written application, an extension oftime for completion ofwork shall be permitted foz refisonable cause. A permit shall be terminated upon the written request ofeither the owner or the installing entity stated ontliqliermit application. n The Permit Extension Act was created by Section 173 ofChaMt r240oftheActs of`2010 andextendedbyS ections.74 and 75 of'Chapter 23 8 of theActs of2012. The purpose ofthis actis toprornotojobigrowth and long-term economic recovery and the Permit Extension Actfiarthers this purpose by establishing an automatic four-year extension to certain -permits -and licenses concemingthe.use or development ofreal property. With limited exceptions, theAct automatically extends, forfouryears beyond its otherwise applicable expiration date, anypeiinitor approvalthatwas "in effect or existence' during the qu"arifying period begirming on August 15, 2008.atid extendingthrough August 15, 2012. )i&ule 8 — Permit(Date Closed: Note: Reapply for new permit-< 0 Permit Extension Act —Per::j:j; at "Closed:_ yv Commonwealth of Mamackuaetta Official Use Only cc�� Permit No. 2eFartment o/ Dire Serviced Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 C 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFO TIl N) Date: / Z -%' City or Town of: No rA Y4 YI d (l To the Inspector of Wires: By this application the undersigne gives notice of his or her intention t perform the electr�ca work described below. Location Street & Number pl Owner or Tenant Owner's Address Is this permit in conjunct' n withJa building permit? Yes ❑ Purpose of Buildinge� Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Electrical Telephone No. No ❑ (Cbeck Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ No. of Meters No. of Meters I ICompletion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- EJo. rnd. rnd. o mergency Lighting Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of InDetection and Initiatin Devices No. of Ranges g No. of Air Cond. Total Tons No. of Alerting Devices Heat Pump Number Tons KW No. of Self -Contained No. of Waste Dis osers p Totals: .................. Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances Kms, Sec Na f D vices or Eq uivalent No. of WaterKms, No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: S (When required by municipal policy.) Work to Start: CO rAInspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVE GE: 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 o rage is in force, and has exhibited proof of ame to the[permit i uin office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:)(t,{ /�/ Ch�% I certify, under the pains enaides of perjury 1hat the i7formation on this pplication is true and complete c FIRM NAME: ©%Z G (� LIC. NO.: r ,5 % Licensee: Signature LIC. NO.: (If applicable, enter " xempt" 'n the license n tuber I'n )A01" 6 /5 VL Bus. Tel. No.: 9 Address: s Alt. Tel. No.: $S 7 *Per M.G.L. c 47, s. 57-61, security work requires Department of Public Safety "S"license: Lic. No. 2,53 V 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) NORTH ANDOVER Mass. Date 1/8 19 97 Permit # 3406 s Building Location 361 Waverly Rd. Owner's Name Lawrence Sarson r Type of Occupancy Residential h Pi New ❑ Renovation ❑ Replacement C Plans Submitted: Yes ❑ No ❑ FIXTURES Installing Company Name Heritage Htg. &P1g. Co. Inc. Address_ 3S Pleasant- Street Stoneham. Ma 02180 Business Telephone 617-438-7776 Name of Licensed Plumber Gordon Switzer Check one: IX Corporation ❑ Partnership ❑ Firm/Co. Certificate 714 INSURANCE COVERAGE: I have acun reliability insour❑ance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes If you have checked rtes, please indicate the type coverage by checking the appropriate box. A liability Insurance policy M 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: 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 the permit issued for this application will be in compliance with all . pertinent provisions of the Massachusetts State Plumbing Code and Chapter 1_ of the General Laws. By Title Signature of Licensed Plumber City/Town Type of License: Master [X Journeyman E]APPROVED OFFICE S ONL License Number 8322 z y y N o Z ►- y 0 W N O 'Z Q ¢ = N Z — O Z Z Z LU a N W W y F. y W Y H ~ Q Uj W N N W :Z H K ++ . U Q Z W O m O W N d W y Q +: ~ Q y Z Z (!!`^ O a Q f/r J Z Q 6 O _a. 6 Q tr C O LL A f• U H > F' h' O S d G > 07 F J Z O O W Z Z `t FW- 0 LL 0 S W 'Y '. 3 Y J m N O O J 3= H N W O O d 3 O m O ra 33 rd rd 33 rd r�i SUB-BSMT. BASEMENT 1 IST FLOOR 2140 FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR - 7TH FLOOR STH FLOOR Installing Company Name Heritage Htg. &P1g. Co. Inc. Address_ 3S Pleasant- Street Stoneham. Ma 02180 Business Telephone 617-438-7776 Name of Licensed Plumber Gordon Switzer Check one: IX Corporation ❑ Partnership ❑ Firm/Co. Certificate 714 INSURANCE COVERAGE: I have acun reliability insour❑ance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes If you have checked rtes, please indicate the type coverage by checking the appropriate box. A liability Insurance policy M 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: 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 the permit issued for this application will be in compliance with all . pertinent provisions of the Massachusetts State Plumbing Code and Chapter 1_ of the General Laws. By Title Signature of Licensed Plumber City/Town Type of License: Master [X Journeyman E]APPROVED OFFICE S ONL License Number 8322 J z O W N W V LL LL O a O LL O J W, to O Z m i J a O O O r r O a z a a O LL z O h - V J W d LU CL Date. H-3 3�66 T 0 1, TOWN OF NORTH ANDOVER 0. '0 0. PERMIT FOR PLUMBING SACHU H 1-/ This certifies that ................ has permission to perform .... U� ........................... plumbing in the buildings of ... Iql/ .................. at . . '? ('. / . . V C. 1.4.4 y .. 0.� .... * ** . , North Andover, Mass. . 1.:;D - - Fee. Lic. No..? . ....... * 1--pl—P ......... � LUMBING INSPECTOR 01/13/97 12:07 27.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Lo&,ation2 No. _9 Date TOWN OF NORTH ANDOVER 0. Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # z 13, 0 Building Inspe TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVAT5 OR DEMOLISH A ONE OR TWO FAMILY DWELLING M _ ....... ,. . .... -:.... „ .. Wb BUILDING PERMIT NUMBER: DATE ISSUED: Cv SIGNATURE: Muilding CommissioneLqEgWorAFBuildings Date 6. --z',C) SECTION 1 -SITE INFORMATION 1.1 Property Address: 361 Wd ViERL Y 1.2 Assessors Map and Parcel Number: 6 it Map Numbei Parcel Number ,,PP 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. t§ 34) 1.5. Flood Zane Information: Public ❑ Private ❑ Zone Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record ,q,M% o_F_ k) Tim Name (Print) Address for Service Signature Telephone 2.2 -Owner of Record: ,Mame Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor ht//D CAST 1 c-6,JE 4EGz + S.DG, Not Applicable ❑ 16 Company Name U—I T ) S 77 d6l, Registration Number U ss ell -z ?> Expiration Date Si nature Telephone 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 all a Ucable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: �S7r�IP -f- )e-6OR- SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to beOFCIALUSE Completed b ermit a licant V 1. Building Q U (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 p Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, as Owner/Authorized Agent of subject property Hereby authorize I?A V / P % � 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,D AV IT CAS TR / /SfZ 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 S ± �-=-s Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS iST2 ND3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 7O 1�--i I I R;", x w A a C� v aGv o O w E a 0 cn � U GO � z a O w 0C O CG C U m C X. O u w z p' p CG cdW C w O w u U °�° p C4 u v cn co C w O '_ U X. .1 p 1:4 m w Q ►.. W o cn p,o o c� o CO c c Q C2 ` C H _O C y... O V V •dam Q. 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