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HomeMy WebLinkAboutMiscellaneous - 38 Water StreetOf Ky�N 9 o ;a`6ty 0 4 4SSAee+us� Town of North Andover Machine Shop Village Neighborhood Conservation District Commission 1600 Osgood Street Nordi Andover, MA 01845 For EXCLUSION From Certificate to Alter Certain alterations are excluded from review by the Machine Shop Village Neighborhood Conservation District Commission in accordance with the Bylaw. Applicants for exempt projects must fill out the form below and submit to the Commission. Chairperson (contact info below). Date: 11 t4� 1 t 2— Contact Wnmp Ar AAA -- Project Project Exclusion From Review Requested For. 0 i. Interior. Alterations ❑ 2. Storm windows and doors, scree_ n windows and doors. ❑ 3. Removal, replacement or installation of gutters and downspouts. ® 4. Removal, replacement or installation of window and door shutters. ❑ 5. Accessory buildings of less than 100 square feet of floor area. ❑ 6. Removal of substitute siding. ❑ 7. Alterations not visible from a public way - 8. Ordinary ay.8.Ordinary maintenance and repair of architectural features that thatch the existing conditions including materials, design and dimensions. ❑ 9. Replacement of existing substitute doors, substitute siding or substitute windows with new materials that are substantially similar to the existing condition. ❑ 10. Replacement of original fabric windows or doors with substitute windows or doors that maintain the architectural integrity with respect to form, fit and function of the original windows or doors. ® 11. Reconstruction, substantially similar in exterior design, of a building, damaged or destroyed by fire, storm or other disaster, provided such reconstruction is begun within one year thereafter. MSV NCDC Page 4 Cuaent Chau-: laz Fe-.ssy, 77 Etm Street, tzettafennessvC�vahoo com 978-68&2915 .1;_1 f lCRry Town of North Andover Machine Shop -"age Neighborhood Conservation District Co saCHus t� 1600 Osgood Street North Andover, A11A 01845 mmission kation For EXCLUSION From Certificate to Air,.r For Items 9,10 or 11, provide the following documentation: Photos/drawings of existing doors, windows or siding, as applicable DescriptionlCatalog Cuts of proposed materials to be used for doors, windows or siding Plan and elevation of reconstruction for Item 11 Determination: This project is determined to be CA exempt ® not exempt from review by the Maclaine Shop Village Neighborhood Conservation District Commission. Projects that are not e_empt must complete the Application for Certificate to Alter, available, from the Building Department and be reviewed by the Commission. Determination made byr Lizetta M. Fennessy Signature Chairperson Neighborhood Conservation District Commission. 7/26/12 Dar MSV NCDC Page 2 Current (hair Liz F°ennessy, 77 Elnt Street, lizettafennessv@yahoo com 413-688-2915 SETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) / - NORTH ANDOVER, . Maas. Date o tf , Al 19 Building Permit # LocationOwne Namer,s b t , I ,'J,r,,,/, New O Renovation O Replacement Plans Submitted: Yes d No El Instaning Company Name P(-,6-,, Address 4 0 S p a v --<1e- l) �- . _ Business Tefephone 11 — `t I d G Name of Licensed Plumber or Das Fitter 0, vc,� Check one: Corp. d Partnership O Firm/Co INSURANCE COVERAGE:i Check one I have a current liability Insurance policy or its substantia) equivalent. ' Yes O No O It you have checked ,yes, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy M' Other type of Indemnity O Bond 0 CertNicate 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: %natute of Owner or Owner's Agent owner O Agent O 1 hereby certify that atl of the details and Information I have submitted (or entered) In above appllcatlon are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit Ise for lhls application -)MI be In compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the wt. BY- T of Ucense: TRIO Plumber na urs o naewuanroraser . Gasniter r Master License Number —*',P.2 `o CltyRo'n D Joumeyman A11110NE0 (OFFICE USE ONLY) rrrrMR ENO Aw RIM wwwrwrwwrrrrrMR tl�7 rrrrMMMMNN EMIR wwwwMIwwrrrw Room ' . ' . MNMNM1 MMNMMMM1MMMr5, M rrwrrrr■ . rrrrrrrr�rr�arwwwrwr�rrrrwrrr■ " rrrrrrrrrrwrwwwrwwrrrrrrmoon ::: r�tiirrrwrrr�r�rwrrwrrwrrrrrrrrwr■ ■rrwrwrrrw�rwMrwrrrrrrrrr■ .. 0000000000MUNrw rrrrrrrr■ ..mom NOrrNOMMIN MWOMMrrrrrrrwr .. ■rrrrrr�rrwrrrr�rrrrrrrrmoon Instaning Company Name P(-,6-,, Address 4 0 S p a v --<1e- l) �- . _ Business Tefephone 11 — `t I d G Name of Licensed Plumber or Das Fitter 0, vc,� Check one: Corp. d Partnership O Firm/Co INSURANCE COVERAGE:i Check one I have a current liability Insurance policy or its substantia) equivalent. ' Yes O No O It you have checked ,yes, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy M' Other type of Indemnity O Bond 0 CertNicate 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: %natute of Owner or Owner's Agent owner O Agent O 1 hereby certify that atl of the details and Information I have submitted (or entered) In above appllcatlon are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit Ise for lhls application -)MI be In compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the wt. BY- T of Ucense: TRIO Plumber na urs o naewuanroraser . Gasniter r Master License Number —*',P.2 `o CltyRo'n D Joumeyman A11110NE0 (OFFICE USE ONLY) u 10 m w m o -1 y p r M m , C > C Y P 4 m m d c� D N O y > �+ N � b O O Im rm- O O 0 O m. m -i o f m E: y p r M , C C v P Co m O r_ z O y > �+ m 00 • O O rm- O O 0 O m. m -i o f � � z r - c t f m r M O _ M , � v O r_ z O y > �+ m 00 • O O rm- O O 0 O � m -i o C � z r - c p O ' N _O z i o t O m M M , v r_ > ar -1 O rm- O O 0 O m -i = O O m R � i c O N o m O O , Q > N z r � m •z .: ;y�uJ.•r':•.alailv AdCERTIFICATEOINSURANC1,27 DATE (MM/DD/YY) ,.. kQ �,4 .".."'S'vh-'e^ w`�:".......:T .t1,rtJaa�cnmwr� .«.R,;..•.: (L�i. < , ,' , t�C. yaks}c ;.+� " r�S k i � �O �� J PR ICER ,THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS James P. Hainsworth..,,Ine A enc NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, Y EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW 150 Main St.<, , __....._ .. _- _. North Andover, Ma., 01845 COMPANIES AFFORDING COVERAGE COMPANY A CODE SUB -CODE LETTER Mu to al Fire Ins. Co. - ;w,.��. a.Vy �,rr.`.t.,e.e�,.St W„+��mv��tiva�:r:-`.&; «�'�..k;E`. '.C' � ^d�xt R'b •'`��'.u^"U*'�'+'+y'. V K wiw l�F"a' e : �'W M P,ba°'},fit-.. �.;`';s� #�x.-� x"'�"4`i:-. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION'OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION. . LTR (MM/DD/YY) DATE (MM/DD/YY) 3 ALL LIMITS IN THOUSANDS GENERAL LIABILITY �._.m Q Q A GENERAL AGGREGATE $ — XS ] COMMERCIAL GENERAL LIABILITY ' SMP20-203022 4-19-91 4`19-�92 pgODUCTS-COMP/OPS AGGREGATE $ 25 i...._.._.I_..._....; _.,......_.................._ ..... ;CLAIMS MAD I OCCUR.! PERSONAL & ADVERTISING INJURY: $ OWNER'S & CONTRACTOR'S PROT i 1 d .. . ........... .. .. ... V - ----- DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS 4S i Plyrmbing Contractor V` ",\ I (� yr CERTIFICATE HOLDER ' f Town of Wilmington Wilmington, MA. Atten: Plumbing Inspector ACORD 25-S (3/88) -ANCELLATION a. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPREUNTATIVE I /I ©ACORD CORPORATION 19881 EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ _ AUTOMOBILE LIABILITY MEDICAL EXPENSE (Any one person). $ --CO Ml� MONWEALTH OF MASSACHUSETTS ANY AUTO i*" 1 r $ _ . ALL OWNED AUTOS ' }}.� rrX LUMBI ANC TT6tS _._...----- SCHEDULED AUTOS �.- GASFi 4` . ' �v} ' { 8 Z. xi $ HIRED AUTOS y • # • S THI q°, ” ,, • ISSUE NSE ......... I NON -OWNED AUTOS TO S,Y.��ry ��1 r $...... i I GARAGE LIABILITY '; �y y .. ..., 44 S PAP UR •� L' _. . . EXCESS LIABILITY LAWRENLE MA B1g43-3I)32`„'S EACH AGGREGATE OCCURRENCE, `OTHER THAN UMBRELLA FORM ' ...._ .� ?L LENSED�4 AS A 'JOU RAIEYMAN $ WORKER'S COMPENSATION 22694� (i5 PLUM [83�__.. I�IJ92 -._.. oqr _ i AND • ' • • • _--- (EACH ACCIDENT) ' EMPLOYERS' LIABILITY i - --- —(DISEASE—POLICY I $ LIMIT) (DISEASE -EACH EMPLOYEE OTHER i 1 d .. . ........... .. .. ... V - ----- DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS 4S i Plyrmbing Contractor V` ",\ I (� yr CERTIFICATE HOLDER ' f Town of Wilmington Wilmington, MA. Atten: Plumbing Inspector ACORD 25-S (3/88) -ANCELLATION a. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPREUNTATIVE I /I ©ACORD CORPORATION 19881 Date. ! f NORTM 9 TOyW(%{N,O .,,NORTH. ANDOVER F�O� -A ^i�4 �if;MIT FOR GAS INSTALLATION x z r 9SSACHUSE� This certifies that .... ee .44.J, '1':0 has permission for gas installation in the buildings of ...IJ. J' at ?aJ'.y . North Andover, -Mass. Fee... '''- Lic. No:�2-6 . ..... f GAS INSPECTOR WHITE: Applicant ! CANARY: Building Dept. PINK: Treasurer GOLD: File