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HomeMy WebLinkAboutMiscellaneous - 401 MASSACHUSETTS AVENUE 4/30/2018 401 MASSACHUSETTS AVENUE 210/045.A-0041-0000.0 J � 3 I i A II I I North Andover Board of Assessors Public Access Page 1 of 1 North Andover Board € f Assessors sto"' s ?' roperty Record Card Click Sed To Retzo Parcel ID :210/045.A-0041-0000.0 FY:2014 Community : North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlarge Search for Parous Gf. Search br Sa!es a Summary Residence Detached Structure Condo ir�eEtuserr�a � - Commercial Ct Location: 401 MASSACHUSETTS AVENUE Owner Name: PARKER,JOEL S. PARKER,LAUREN C. Owner Address: 401 MASSACHUSETTS AVENUE City: NORTH ANDOVER State: MA Zip: 01833 Neighborhood:5-5 Land Area: 0.20 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 1246 sgft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 273,900 273,900 Building Value: 117,400 117,400 Land Value: 156,500 156,500 Market Land Value: 156,500 Chapter Land Value: LATEST SALE Sale Price: 314,000 Sale Date: 06/29/2006 Arms Length Sale Code: Y-YES-VALID Grantor: SOMERS,ETHEL Cert Doc: Book: 10264 Page: 0301 http://csc-ma.us/PROPAPP/display.do?linkld=2434620&amp;town=NandoverPubAcc 5/14/2014 Residential Property Record Card PARCEL ID:210/045.A-0041-0000.0 MAP:045.A BLOCK:0041 LOT:0000.0 PARCEL ADDRESSA01 MASSACHUSETTS AVENUE FY:2014 PARCEL INFORMATION Use-Code: 101 Sale Price: 314,000 Book: 10264 Road Type: T Inspect Date: 11/06/2011 Owner: Tax Class: T Sale Date: 06/29/06 Page: 0301 Rd Condition: P Meas Date: 11/06/2011 PARKER,JOEL S. Tot Fin Area: 1246 Sale Type: P Cert/Doc: Traffic: M Entrance: C PARKER, LAUREN C. Tot Land Area: 0.20 Sale Valid: Y Water: Collect Id: RRC Address: Grantor: SOMERS, ETHEL Sewer: Inspect Reas: C 401 MASSACHUSETTS AVENUE NORTH ANDOVER MA 01833 Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LP/o Indust-B/L% / Open Sp-B/L% / I I RESIDENCE INFORMATION LAND INFORMATION i Style: RN Tot Rooms: 6 Main Fn Area: 1246 Attic: NBHD CODE: 5 NBHD CLASS: 5 ZONE: R4 Story Height: 1.00 Bedrooms: 3 Up Fn Area: Bsmt Area: 1246 Seg Type Code Method Sq-Ft Acres Influ-Y/N Value Class v Roof: G Full Baths: 1 Add Fn Area: Fn Bsmt Area: 1 P 101 S 8500 0.200 156,519 Ext Wall: WS Half Baths: Unfin Area: Bsmt Grade: VALUATION INFORMATION Masonry Trim: 18 Ext Bath Fix: 0 Tot Fin Area: 1246 Current Total: 273,900 Bldg: 117,400 Land: 156,500 MktLnd: 156,500 Foundation: CN Bath Qual: T RCNLD: 117383 Prior Total: 273,900 Bldg: 117,400 Land: 156,500 MktLnd: 156,500 Kitch Qual: T Eff Yr Built: 1970 Mkt Adj: Heat Type: FA Ext Kitch: Year Built: 1952 Sound Value: Fuel Type: G Grade: A Cost Bldg: 117,400 Fireplace: 1 Bsmt Gar Cap: Condition: A Aft Str Val 1: Central AC: N Bsmt Gar SF: Pct Complete: Aft Str Va12: Aft Gar SF: 220%Good P/F/E/R: /100//75 Porch Type Porch Area Porch Grade Factor P 190 SKETCH PHOTO 0 Sq,R at; 4, P 9.3140$q 00 FM/11 a3 1246 Sq, 41, �0 sq, 6 1 v 401 MAxa-AcHuSISTTS,AVENUE Parcel ID:210/045.A-0041-0000.0 as of 5/14/14 Page 1 of 1 Date.��: .. . ... . . NORTH 3j pry`, .o ,,'6 TOWN OF NORTH ANDO �o - • PERMIT FOR GAS INS LATION �9SSACNUSES This certifies that . . .,, .,. ./?./?.X1 .1.1'.k . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . Fm'!69 in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . .YQ./. . JVA. .0 f. .A :- . . . . . . . . . North North Andover, Mass. Fee. .2 Y-. .:. . Lic. No../.('P. !. . . . . . . . .' .r��. .. � . . . . GAS INSPECTORvr Check# 53U7 .1 fn —o q o q,- MASSACHUSETTS UNIFORM.APPLICATIQN FOR PERMIT TO DO GASFITTING (Prim or Type) /IV A N bo U C �.. ,Masa. Date �l. Permit# ^r o > ,l Building Location `I 0 1 /�r,rye A S S 1�y 6 Owner's Name U-U t L P&�CPz— Ower Tel# � ? 7 S- r`7 3 Type of Occupancy'9L S )1 6 T)� 1✓ New ❑ Renovation Q.,—Replacement ❑ Plan Submitted: Yes ❑ No M1- FIXTURES W • N a 8M 1•l 0 .0 SUB-SSMT FLOORBASEMENT I OT FLOOR 2 ND FLOOR 4T"FLOOR 5T"FLOOR T"FLOOR Tr FLOOR 8T"FLOOR /►-� .\ Installing Company Name- ��I� L ✓=`- �V./" Check one: Certificate Address / 0 So UTN MPIN S-]- ❑Corporation DaLETN `/ - Q i 949 ❑Partnership Business Telephone e 7 3� aa3 —/3o;/ ; `Firm/Co. Name of Licensed Plumber or Gas Fitter I I C R y S O -7' INSURANCE COVERAGE: 1 have a current liability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch.142. Yeschecked No ❑ If you have eM,please Indicate the type coverage by checking the appropriate box. A liability insurance policy* Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not ave 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 ❑ Agent ❑ 1 hereby certify that all of the details and information I have submitted(or entered)in above applicatJon aro and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit Issued for this=1 will ante with all )ertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the By Type of License: ` � -Plumber Sign re of Licensed Plum atter Tine O as finer -G-Master License Number City/town •-,Journeyman APPROVED(OFFICE USE ONLY) 1 ' F . :. COMMpf IWE TH.O.MASSACHUSETTS PROFESSIONALDIVISION OF : 'j IN PLUMBERS AND 'G,ASFITTERS LICE,NSE.D JOURNE•'-M'A," GASFITTE ISSUE �THW -E F,TO MICHAEL Bks S�ONeo- 16 NICHOLS `LYNN �•� ; ; 0` 9b2-371a ; 259163 ; ;;13;;;1 •, ,, . . COMMONWEALTH OF MASSACHUSETTS DIVISION OF PROFESSIONAL LICENSLIFE IN PLUMBERS AND GASFITTERS LICENSED AS AN...-L—P—GAS INSTALL !SSUE$.THIS..UCENSE TO HICHAEL A ,BRYSON:,::::SR L6 NICHO.LS `AVEN.U;E .'.;, LYNN M`A:...0902-3718 933 051.070 259162 c Appleby 1a Insurance Agency Inc.. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 152-tolaat St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Beverly, MA 01915 Susan Rabin INSURERS AFFORDING COVERAGE NAIL 0 INSURED Micrael A. Bryson INSURERA: National Orange Insurance CO. 14738 BBA: c/o TTS, Inc. INSURER B: 140 S. Main St. INSURER C: MiNNltoa, MA 01949 INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR D' TYPE Of INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIODATE(MMIDD=N Ira ".0GENERAL LIABILITY TBD 11/01/2008 11/01/2007 EACH OCCURRENCE $ 1 000 A COMMERCIAL GENERAL LIABILITY DAMAGEP. TO RENTED $ SO CLAIMS MADE ®OCCUR MED EXP(Any one person) $ Ij A PERSONAL Q ADV INJURY $ 11"01 GENERAL AGGREGATE $ 290"t GEWL AGGREGATE LMITAPPLfES PER: PRODUCTS-COMP/OP AGG S f, 000 POLICY JET ED LOC AUTOMOBILE LIABILITY COMBINED SINGLE LMR ANY AUTO (Ea accident) _ ALL OWNED AUTOS BODILY INJURY = SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OW NED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO EA ACC S OTHER THAN AUTO ONLY: AGG S EXCESS/UMBRELLALIABILITY EACH OCCURRENCE $ OCCUR D CLAMS MADE AGGREGATE S S DEDUCTIBLE S RETENTION $ $ WORKERS COMPENSATION AND WCSTA 0TH• EMPLOYERS'LIABILITYFR ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT i OFFICER/MEMBER EXCLUDED? If yes describe under E.L.DISEASE-EA EMPLOYE $ SPECIAL PROVISIONS below I E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MNL 10 _DAYS WRITTEN NOTICE TO THE CERT119CATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MNL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. For Inforaatioa Only AUTHORIZED REPRESENTATIVE Marc Slafa /SDOLAN ACORD 25(2001/08) ®ACORD CORPORATION 1988 PDF created with pdfFactory Pro trial version WWW.I)dffaCtory.com Date..�? "',.........�6........... NORTH TOWN OF NORTH ANDOVER p PERMIT FOR WIRING •�,SSACHUS� This certifies that .... ...........l< .. ......... has permission to perform .......... . .. ........... ........,...................................... wiringin the building of .., ...........I............... .......................................... at.........v�..... ....... ---........... ,North Andove/r,Mass. Fee4�....n'.......... Lic.No Jn Ul f, ..!��.. �- ELECTRICAL INSPECMI { I Check # 31� i 67 7 8' Commonwealth of Massachusetts official Use my Department of Fire Services Permit No. � /� Occupancy and Fee Checked 1 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: J�4j L/, 0 1-0 City or Town of: 41,-A h A n t\(->uy r To the Inspector ofWires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Y6 f Cave OwnerorTenant L.6LUre+n gr,/110r Telephone No. 272L7'75-51-13) Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. 9(.o% 1-1 Cf 1,/ Existing Service Amps 120 / yc�Volts Overhead D-' Undgrd❑ No.of Meters New Service Zog Amps M /J t{C') Volts Overhead Eg"" Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: S e,r u,C.e up !4 rake Completion of the following table ma be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell: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- ZnBaottery .o mergency ig ting nd. d. Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection an Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting g Devices No.of Waste Disposers Heat Pump .umber ,ons ..................... No.oSelf-Contained Totals: Detection/Alertm* Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW ecurrtySystems:* No.of Devices or Equivalent i No.o Water KW No.o o.o Data Wiring: Heaters Signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Waring: i No.of Devices or E uivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: CXR (When required by municipal policy.) Work to Start: J ui)r o(o In pections 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 cove a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ff BOND ❑ OTHER ❑ (Specify:) ' I certify,under thepains andpenalties of perjury,that the information on this application is true and complete FIRM NAME: LIC.NO.: Licensee: Signature LIC.NO.: 10017- (Ifapplicable,enter "exempt"in the licens number line.) Bus.Tel.No.• Address: /yl NK6. Jr ,y1 Ut61 1 Alt.Tel.No.: *Security System Contractor License required for ihis work;if applicable,enter the license number here: 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. Owner/Agent , Signature Telephone No. PERMIT FEE. $ r C r t Li a 0 6 pgvz-� t f .! O qi J Date. .�.1. .`. .� . No 4. 7 35 TOWN OF NORTH ANDOVER F PERMIT FOR PLUMBING SSACHUS� ��/��//,/G; ./ This certifies that . . . . ., . . . '. . . . . . . . . . . . . . . . . . . has permission to perform . . . . T. . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . ?.°. . . . . . . . . .'. . . . . . . . . . . . . . . . . . . . at . .fes'= ,��'�/� X/ f . . . . . . . . . . . .. North Andover, Mass. I Fee. . . . . . . .Lic. No.. !. . . . . . . . . . . . . . . . . . . . . . . . . . . .". . '-1 . . . . . PLUMBING INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) �atZ Ly ZZLP00,-R , Mass. Oated� a c 1 19 errnft # �✓b Building Location_yv! �SS• Owner' ame ,_°�'�K S a D'-t �T pe of Occupancy New ❑ Renovation ❑ Replacement Plans Submitted: Yes ❑ No ❑ B •P.m SEWER# FIXTURES SEPTIC# z z � — N = Y < 1— vl y N O = j J ,+r W T4 W Y J N � U < O Q W v O Z N Q 2 Q ~ _ N a..i JJ x i z o _ z a J N W N N u W y Y Q 0 � X u = iL 0 m Q: H W } Q ~ N Z D 4 N C7 a 0 CL W w 3 o Q 3 y J ? Q Q t- C x U. ? — � ' < J J Q 2 CC eL Q 0 < 0 J 3 = N Y. C7 3 Q < sue—BSMT. BASEMENT 1ST FLOOR 2N0 FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH-FLOOR 7TH FLOOR STH FLOOR Installing.Company Name)lopl--ly,91" 4" Check one: Certificate m Address P/V ❑ Corporation 0,MP 6 VCA Cy s s 0 ,Partnership Business Telephone G?g V')S— Firm/Co. Name of Licensed Plumber S�%VO W - INSURANCE COVERAGE: I have a currerlt liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked res, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy ff Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the In 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'sggent Owner ElAgent ❑ 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 gode and Chapter 142 of the General Laws. BY Title Signalure of Licensed PI ber City/Town Type of License: Master,' �i Journeyman ❑ APPROVEp OFFIC USE ONLY) License Number 6 3497 Date:./. .. ..... . . ........ NORTH TOWN OF NORTH ANDOVER F,t pyo��ao ,e,ti Cp PERMIT FOR GAS INSTALLATION �9SSACNUSEt This certifies that . . . !/. . . .! . .. .. . .. . . . . .. . . . . .. . . . . . . . . . . . . . . . . has permission for gas installation . . !. .. . . . . . . . . . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. North Andover, Mass. Fee. . .''. . . :. . Lic. No.. . . . . '... . . . . . . . . . . . . .". : . . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) 7 _ Mass. Date r` 19 Permit # Building Location��� ��/r S' V e: Owner's ame L 50PP90 J"M rRS ypa of Occupancy New ❑ Renovation p Replacement ( Plans Submitted: Yes❑ No ❑ N ¢ N W N Y 2 ¢ N W W ¢ 0 U m S n O N. J ¢ h- Q )- = = 0 1" o u a ¢ ¢ 0 w 0 a c of ►- ¢ N C7 U W N Q ¢ 0 a > W N ¢ V) W = ¢ ¢ W ¢ W W d W J C7 H W W U C7 }. J F- 2 h- I- } N O = O ul 0 tA 2 = Q W Q C m = d W > ¢ W O =. Q < Q O O W O tl ►- ¢ 3 0 0 a > a a 1— 0 BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR _ I r 4TH FLOOR { STH FLOOR 'I 6TH FLOOR 7TH FLOOR BTHFLOOR ,,// Installing Company Name /'/0'r'0'<W'0gV t�G «�1� Check one: Certificate Address �'9 1MA11-1V/4,' X-Wl-f ❑ Corporation /�D© I/F,Q /eL/�ss 1911k1" �. Partnership Business Telephone 7*)8 V7-5- 35,2,9' fl Firm/Co. Name of Licensed Plumber or,Gas Fitter INSURANCE COVERAGE: I have a current 4abiiity insurance policy or its substantial equivalent which meets the requirements of MGL Ch. ?42. Yes lI(1 • No LJ If you have checked Yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy �K 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 Owners Agent Owner❑ Agent [I 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 Gas Code and Chapter 142 of the General Laws. B Type of License: Plumber Sign r Title Gasfitter e o Licensed Plu r or Gas Fitter Master License Number City/Town LJ Journeyman APPR VE1 (OFFICE USE ONLY) 3 3 7 '1 Date.//-./ ': G...... NpRTM TOWN OF NORTH ANDOVER o? p� PERMIT FOR GAS INSTALLATION t ,SSACH USEt This certifies that . . . .�. . Sf l-¢�Z' .t.� .1� �. . . . . . . has permission for gas installation . . . �!�.`! . . . . . . . . . . in the buildings of . 5 C�A?r'-A .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . Y.0.1. .,!nl? . . . . . . . . . . , North Andover, Mass. r (� Fee. .1? ' . . Lic. No.. (.? . . P .T,;f .. . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DOG FITTING I ' (Print or Type) j�f /Vv /�p( Ft , Mass. Date �/' - o���� P it # 3 Building Location_- AliF Own me I oml- _([lS/Drp ei- is /10 Type of Occupancy rPS/ New ❑ Renovation ❑ Replacement/� Plans Submitted: Yes[] No ❑ w y a . Y WN N N U Z U) X m a °C �" x N t- C7 J N W F- U m ~ S .4 x 0 Uar t- a � z ? O �- w N H ¢ O a m w a 'u t-- ;; a a W W v1 J x Q i a cc a CC w r' W ~ i to a Y a W J 6 C ~ W yW„ W O > U.0 t- U J � W � m z o x a o 1y x a 'i o tl n n 3 c d y n a F- O SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR a 4TH FLOOR STH FLOOR r JI- 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name BAY STATE GAS COMPANY Check one: Certificate # Address 55 MARSTON STREET SCJ Corporation 1862 LAWRENCE, MA 01840 ❑ Partnership Business Telephone .687-1105 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Francis X. Corkery INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes K No El If you have checked Yes, please Indicate the type coverage by checking the appropriate box. 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner❑ Agent ❑ 1 hereby certify that all of the details and information I have submitted(or entered)in abo plication are true and acc ui Ate to the best of my knowledge and that all plumbing work and installations performed under the permit Issu f r this application will n mpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene S. i Type of license: Title Plumber Signature of Licensed Plumber or Gas Gasliitter Q'ty/Town Master License Number 8697 O FIC SE ONLY Journeyman BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE N0. APPLICATION FOR PERMIT TO DO GASFITTING s NAME TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED DATE .„ 19 GASINSPECTOR Location 41 I A s No. 3 Date U 3 ,.ORT1y TOWN OF NORTH ANDOVER L }ya •;j Certificate of Occupancy $ �ss�creo MusE<� Building/Frame Permit Fee $ 5 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # /0a '+ 6 Z 6 ,-, Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING sT � BUILDING PERMIT NUMBER: SIGNATURE: Building Commissioner/In ctor of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 1/ ( -MA gS-r4 ,A ) /j,) -)w 1, i Map Number Parcel Number �/ `�' 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(so 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.40.1 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ �® SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Name(Print) Address for Service: SCJ Signature Telephone 2.2 Owner of Record: Name Print Address for Service: z M Signature Tele hone SECTION 3-CONSTRUCTION SERVICES 3. tcensed C��onns�structio Supero' or: Not Applicable ❑ Licensed�onstntction Supervisor. ��/J _1� 3 it � License Number 7ignddress�. I& � �� l OCve� lf L1 gl6 Expir —Dajteature Telephone 3.2Agistered Horne Improvemtot Contractor � Not Applicable ❑ C(' � frJ Q 1 Company Name I Registration Number Adress �l \<I L/" Expiration Date \ Telephone l 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.......0 SECTION 5 Description of Proposed Work(check all applicable) New Construction ❑ Existing Building ❑ Repair(s) 0 Alterations(s) 0 Addition 0 Accessory Bldg. ❑ Demolition 0 Other ❑ Specify Brief Description of�Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be ' OFF C.IAL.USE QNLY, Completed by permit applicant 1. Building - (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of ^ � '1 ` Construction V 7 3 Plumbing Building Permit fee(a) X (b) 4 Mechanical HVAC C 5 Fire Protection V 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 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 1, 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 Nam Si nature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS Is 2 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHININEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Tel, 682-4266 CASTRI[ONE ROOFING & SIDING CO. 31 Court St, No. Andover, Mus. 01845 / 20,63 ��Aae �� '�z � NORTIy ED o of �_...Y.w. ..� A. No. qq 3 dover, Mass., 3' ADRATED S H E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT............kt.49.0V a 00 61........... m r« r r Foundation m s �-� has permission to erect...... ......,.., buildin s on 1 A & ....... Rough to be occupied as..... ..Q�. 00.. ..................���. ��►t... ............................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. W-; P* ' 1 $ � �m- PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ........... ............ .......................................................4............................ 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 At Street No. SEE REVERSE SIDE Smoke Det. 2`ae CommonwWah of 9ilasrachruetts i Department of f ind=riaf,qccidents �;.. QT= of Investigations 600 Washington Street Boston, 9KA 02111 Workers' Compensation Insurance Affidavit APPLICANT LNFORMATION please PRINT Le_aibly . Name• ai�� ('����h�� - Location: � ��� City' _i' r�Q' Telephone#: 2- 711 ❑I am a homeowner performing all work myself. ❑ I am sole proprietor and have no one working in my capacity ❑I am an emper providing workers' co pensation for my employees working on this job Company Name. C� Address: t City: / Telephone#: Insurance Company: Policy#: W C I o? I kF ❑I am(circle one) sole proprietor,general contractor or homeowner and have hired the contractors listed below who have the following workers' compensation policies: Company Name: Address: City: Telephone#: Insurance Company: Policy#: Company Name: Address: City: Telephone#: insurance Company: Policy#: Attach additional sheet if necessary Failure to secure coverage as required under Section 25A of MGL 15B can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that,a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certf fy under the ins and penalties of perjury that the information above is true and correct 22 Signature: "A Date: Print Name: /1I 0ti'l o e"'S ( COW-0-- Phone;V Z L aC-a—2 J 6 Official Use ONLY-Do not write in this area ❑Building Department City or Town: Permit/License#: o Licensing Board o Selectmen's Office M Health Department M Check if Immediate response is required o Other