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HomeMy WebLinkAboutMiscellaneous - 42 ROYAL CREST DRIVE 4/30/2018 (2) 1 43 ROYAL CREST DRIVE Complaint Detail Report Printed On:Fri May 06,2011 Complaint#: CT-2011-000047 Status: In discovery GIS#: Violator: AIMCO-DBA-ROYAL CREST v qa*RT04 y Address: 43 ROYAL CREST DRIVE Map: Address: 4582 SOUTH ULSTER STREE Date Recvd.: Apr-27-2011 Time Recvd.: 11:22 AM Block: Denver,CO 80327-2662 Q Category: Housing/Mold/Asbestos Lot: Type: Residential GeoTMS Module: lBoard of Health District: Trade: 4a_ b••r,o�''` Recorded B Ma Ippolito Zonin S By: DPpg' tructure: E Description Complaint: Received handwritten Building Department Complaint for Investigation Report from Mary Ippolito in Building-Caller was Sharon Doges,43 Royal Crest Drive, Unit 9: 1.Mold and asbestos on carpeting from water damage during the winter. 2.Small children 5&10 years old living in apt. Mrs.Dones was told by Royal Crest that carpeting will not be replaced. Please setup an inspection.--p.d. Comments: Inspector Assigned to Complaint: Michele Grant Contacts I Contact Type Date Time Name Phone Best Time To Reach Recorded By Response Tenant Apr-27-2011 11:22 Sharon Dones (978)873-4527 Q Mary Ippolito Follow-Up by Health AM Inspector Actions Taken GeoTMS Module Status Date Time Response Type Action Taken Comments Board of Health REFERRAL Roil Dk�_Ia 4 GeoTMS®2011 Des Lauriers Municipal Solutions, Inc. Page 1 of 1 ............. OF ORT TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING CHU This certifies that . �' has permission to perform 0......................................................... .......................................��.j......... ...S. wiring in the building of ()........................................................................ —0. at ............ ......... ......... N rth Andover,Mass. Fee... ............Lic. No@O.K ............ ELECTRICAL INSPECTOR Check 3 3 LO, f qqgg�� 1 a►�manuieal k 4//lueeuchubnfaFd 0 �6kkll Ilse Only �] Permit No, I � �A�dNitJHRl1f A�JbrR�Iarviomb -- Occupancy and fee Checked BOARD OF FIRE PREVENTION REGULATIONS [ltcv. 1/07,1 (leave Blank) APPLICATiON FOR PERMIT TO PERFORMELECTRICAL WORD All work to be pertorined in accordance:with the Massachusctis 1,'.1wrical C'odo(MEC),527 CMR 12.00 (PLEASE PRINT IAUNIC OR TYPE ALL INI'l.)RMATION) Date: Catty or Town of: P0'l' 1, 6L,,, -y _ 7'ra the Inspeclor of Wires: Sy this application the undersigned gives notice of his or her intention to perform the electrical jwork 1described bel w. Location(Street&Number) Owner or Tenant k't Kob --,__ -- ' elephone No. Owner's Address 50-_ 1t�1 G\tS-"C 'DrY&..._W07a� `f is this permit In conjunction with a building permit? Yes No (Check Appropriate Dox) Purpose of Building .?Wi4 N Ul(yl –__ _ Utility Authoriaat.inn No. Existing Service Amps / Volts Overhead❑ l)ndgrd❑ No.of Meters _ New Service Amps /-- --Volts , Overhead Undgrd No.of Meters Number of feeders and Ampneity _ Location and Nature of Proposed Electrical Worlc: �yZ-�,� Wt��•- � Cn► �r �81�" :'crn�, C __To P,t? 1 aca >` 1�a.�" .. a:y�i 1?r,�a.Ss_l'4,� IL C:'om�letiorr o'1lre �rlio,nin !n'hle mnry Ge waived G the lrrs ecidr orll'ir•es.LISrQt No.of Recessed Luminaires No.of Ccil.-Sus (Paddle)plans o•cl Total P ( Transformers I';VA, No.of Luminaire Outleke No.of Hot Tubs Gencrntors ICVA Above �Tn� o.of Emergency eg rng No.of Luminaires Swimming Pool rnd. Q incl. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.o Initiating ng D an Devices 'I otal No.of Ranges No.of Air Cond. Tons No.of Alerting Devices Heat Pump I.Number. 'funs 1C�V ., o.o'Self-C:ontaane No.of Waste Disposers Totals: "'""' Detection/Alerting Devices No.of i)ishwashers Space/Area heating IOWLocal _unicipal M Other _ Connection No.of Dryers Heating Appliahces KW T SccuritNo.of Devi es or E guivolent No.of Water, No.of a.b' Data Wiring: Heaters signs Ballasts No.of Devices or Equivalent Nn.H dramassage 13ai:htubs No,of Motors 'Total HP c etommltutcations matt : y No,of Devices or Et uivAcnt OTHER: Allach additional r/r••'Itril it de.vhtd,or as required by the Inspector of YC Ices, Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: i; I Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for t.hc performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed 613erat:ion"coverage or its substantial equivalent. The undersigned ecrtifics that such coverage is in forec,and has exhibited pmol"ofsame to the permit issuing office. CRECIC ONE: INSURANCE O BONE) E] OTHER ❑ (Specify:) I certify,udder the,pubts and penalties of perju?y,that they information on thisapplication is true and complete FiRM NAME: Newpon Eloctric LiC.NO.: A20803 Licensee: David McMullen Signature.� JAC.NO.: 1160813 (Ifappliaable,enter "exenyx in the flcansc number lime.) Rus. Rus.'Tel,No„401-293_0527 Address: 200.,i! h oint,Ave. Portsmouth„Rf_02871. ..-__ - _ - _ Alt.Tel.No.:_617-908.4193 '"Per M.G.L.c. 147,s.57-61,security work requires i5epartment of public Safety"S”License: Laic,No. OWNER'$INSURANCE WAIVER: i am aware that the Licensee does not have the liability insurance coverage normally required.by law. By mysignature below,I hereby waive this requirement., (fain the.(check ane x owner owner's agent, Owner/.Agent Signature — Telephone No, / ,/ G.��"�-r Cis /� �� � �l �' - � -�s Date..-?. w�.`.�.............. �Nowriy� ?°,•"`;;';..���m TOWN OF NORTH ANDOVER o PERMIT FOR WIRING CHUS� This certifies that ..::..... .. �,.,, .of.. .L`lll. ..................... has permission to perform . .�!....Y wine in the building of.. , ..,............... ............................................................................. `1 1_%North Andover Mass. Fee......12� .........Lic. No?��..��.........!....M................. Check# . . . ....1........ ... ELE RIC AL INSPECTOR r. ���j h Commonwealth of Massachusetts official Use onry— Department of Flre Services Permit No, C'(U BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Pee Checked (Rev. 11/99] 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 A L4 INFO TION City or Town of: �IOr Date: By this application the urtdersi n N ©`1r1��(' To the Ins ect S ed gives notice o is or er mtentton to perform the electrical work described below, Location(Street& Number) &0—\A t Owner or Tenant �4t�►-ca —�"��L�� CirG�a r� "�` 3� r�(' d] ' y Is Nv i_i, Owner's Address kl.CY�� Telephone No, 77� G�� 7a Off, Is this permit in conjunction with a buildingpby O)a4 ' t 11 I Purpose of Building permit. Yes ❑ No 1Jv e�, (Check Appropriate Box) Existing Ser vice Utility Authorization No. Amps N p Volts Overhead❑ Undgrd❑ No. of Meters '— �u Amps / Volts Overhead Number of Feeders and Ampacity 0 Undgrd ❑ No.of Meters Location and Nature of Proposed Electrical Work; p G` hl N1\S\V� 1 1N �� lel I 1 N t�.Lll 1 1� 5 (LnJc� _ L VPS�;U �� lesion o 'the ` ollowin table ma be waived b the Ins ector o Wires. No,of Lighting Outlets No.of Recessed Fixtures No,of Cell.-Stssp•(Paddle)Fans 0.0 KVA Transformers No.of Hot'Pubs Generators KVA No,of Lighting FixturesSwimming Pool rn ve ❑ n- ❑ o.o mergency g ng No.of Receptacle Outlets rnd. Butte Units i No.of 031 Burners No.of Switches FIRE�ALARMS No,of Zones No.of Gas Bursters 0- 0 ori an No,of Ranges otal Initiatin Devices No,of Air Cond'cu ump um er No,of Alerting Devices No,of Waste Disposers Tons ons Totals: o•o e - onta e No, of Dishwashers Detection/AlerlinnDevices Space/Area Heating KW ❑ UMCIP No,of Dryers Heating Appliances Local orxnection d Other 0.0 ater KW ecur - 111,111111111211111111:heaters KW o.o No.of Devices or E ulvalent o.o Data Wiring: Si ns Ballasts No. f Devices or E uivalent No,Hydromassage Bathtubs No.of Motors a ecommun cat ons r ng: Total HP h1Nr¢ni?' OTHER: 6 G�2cTr1CSe r No. of Device or E uivalent INSURANCE COVERAGE; Unless, Attach additional detail lf'derlred or �Q�MpSTduired by the Inspector � s waived b} the owner, no permit for the performance of electricaI work may issue unless the licensee provides proof of liability insurance including`bompleted 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 Par BOND ❑ OTHER [] (Specify;) Estimated Value Of Electrical Wor Work to Starr, .� , Z) (When required by municipal policy,) (1-xptrahon Date) ' rInspections to be requested in accordance with MEC Rule 10,and upon completion. I certify, under the pains FIRM NAME: Nmid penalties oIPerjury,that the Information on this application is true and complete. em CG Licensee: LIC.NO,:, 03 (If applicable enter "azempt"in the lice se number line,) Signator c Address: D LIC. NO,: (�d Por mt! d `�`1 Bus.Tel.No. V OWNER'S INSURAN E WAIVER: I am aware that the Licensee does not have the liabili required by law. By my Signature below,I hereby waive this requirement, I am the Alt.Tel,No,• - 3 Owner/ gent (check one insurance coverage normally Signature owner owners a ent. Telephone No._W____- PERMITFELE: $ 3a So 4 (25- G� ,/ `��� O� ✓ �-��' �v y � ,� �/ � � � � • 4 � b � 1 � � l� r Department of,Illd"strial Aecidlems Office o fblvestigatioixs 1 COITPM'Street,Sti to 100 py BostOn, MA 02114-2017 wwMr,Inass,gov/dia Workers' Compensation Insurance Affidavit. Builders/Contractors/Electricians/Plumbers AIDDliCant Tnfa irinnlat;o>a lease'rint Ee iibl afT1e(t3usiness/f)rgani7,ation/Individual): 11:11 11,10 Address: i'f'i � {,D to L A� �T7 City/State/dip: rwmv Phone#: �AS ` F2,D ou an employer?Check the appropriate box: am a employer with 4. Ll I az>d a.general contractor acid I TYPe of project(required): employees(full and/or part-time .* have hired the sub-cotktra.ct r 6, New construction } o.s1.an a'sole proprietor or partner- listed on the attached sheet. 7. j]Remodeling slip and have no employees These sub-contractors have S. warlcit�g, for me in any capacity. Cmployees and have workers' D Demolition ns [.No workers' comp, insurance comp. insurmce.t 9• �Building addition woe 3.© required.] 5. We are a.corporation and its 10 Electrical repairs or additions 1 am a homeowner doing all worlr of>leers have exercised their myself, [No workers' cornp, right of exemption per MGL Plumbing repairs or additions insurance required.]t c. 152, §1(4),and we have no 12•El Roof repairs employees. [No workers' 13.0 Other ' cornp, insurance required.] *Any applicant that checks box ff 1 must also fill out the section below slyowing their workers'compensation policy information. 1'Homeowners who submit this affidavit indicating they are doing all wurk and then hire outside cghtractors must submit a new affidavit indicating such, fM01Y M that Sub-c this box i have a ernpcct ee additional sheet showing the name of the subcontractors and state whether or.not those entities have employees. tithe sub-contrpctors have employee,they nsuat provide their workers'comp,policy number. I am ail employer that ispro viding r►torker's'cotrtpensatiorf insrrrarrce for my etraplovees, Below is the policy andjob site xnfornmation. Insurance Cvm.pany Name; Policy#or Self--ins.Lic.#: i Expiration Date: 0/ Job Site Address:��3Vc�I �y, "—" Oity/Skate/?ip: Vte- fill 0I9''�►.a Attach n copy of the workers,coMpensAtiorl policy declaration page(showing the policy number and expiration date), Failure to secure coverage as requirCd under Section 25A of MGL e. 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 forwarder!to the Office of Investigations of i'he.DIA;for insurance coverage verification, t cin fr.er�G cerci t,trader tlr ar.rr nd erxalties o 'Jer irr t that fire in ornration pro„ided aGove is true and correct, Si nature: _ — — Date: Q Phone#: — Of�cial use only.. Do not Y write . rn dais area,to be cont lefed b &- 17 y ty or town official. City or Town: Permit/License# Issuing Authority(circle one)! 1,OtherBoard of lfiealth z.Building Department 3.City/Town Clerk 4,Electrical Inspector 5. Plumbing Inspector 6, Other P Contact Person: Phone#� `;,.e�COMMONWEALTH ©F�M�kS.�A>rHUS �. ,ISSUES THE FOLLOWING �1��fNSE 'AS .A-� . R'1+1;ESTERf D MASTER ELE,C,TR I C I AN N_EWFIRT,`ELECTRIC CORPORAT I-1>N1Tlvj 9 AVIb 'A MC11J - BURS ST— No ` , 1;0WELt r MA 01852 4076 `. 11103 s CQ MONWEaLTH`(?F Mini CHIS EL1 TR 1 C.1 ANS <5511ES. THE :MLL6Wt G L1 CENSE A ;i Eia' JOURI�EYMAt ELtCTRd`C..IA�f appy} A MCMULLEN `'' F\ Y T: I IRL1. ST ! ..1�i'1 n 2$71 p##ITSMOUTH i AC�� NEWP013 OP ID: LS .--' CERTIFICATE OF LIABILITY INSURANCE ER THIS DATE(MMvodrrrr) THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLO 0910$12014 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICTHIS IES BELdV11, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IN8URER(S), AUTHORIZED I REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED Subject the terms and conditions of.the policy,certain policies may require an endorsement- A statement on this certificate does not confer rights a th certiflcate holder In Ileu of such endorsements, r 1 t to PrtotKJCER e DF Dwyer Agency T D,F, D 38 Bellevue Avenue wyer Insurance Agency Newport,RI 02$40 P E -___- 401-846-9629 A/C No 401.846.9629 Daniel F.Dwyer III Ate ;did(rdfd aL4— _ wyer oom INSURE AFFORDING COVERAGE AO— —^~ INSURED^ NeWPOrt rUCtiOn ElectrlC COnstT INSURER A:Foremost NAIC it Corp INSURER B:Scottsdale Insurance company _ 200 High Point Ave,Suite 135 INSURER C:Beacon Mutual Insurance " 41297 Portsmouth, RI 02871 INSURER0: _....._._............. ..._-__.._. INSURER E: COVERAGES CERTIFICATE NUMBER; IMURER F THIS 13 TO CERTIFY THAT TWE POLICIES OF INSURANCE LISTED BELOW HAVE.BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD REVISION NUMBER: 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. TYPE OF INSURANCE ...................._..___.__. ___--_•_ GENERAL LIABILITY POLICY NUMBER - -- LIMITS A X COMMERCIAL GENERAL LIABILITY SCP006046448EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE Xf occuR 12/30/2013 12/30/2014 —' 2299[12fli ., $ 300,00 MED EXP An one arson $ 10,00 PERSONAL 8 ADV INJURY $ 1,000,00 GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PRO- LOC PRODUCTS•COMP/OP AGG S 2,000,00 AUTOMOBILE LABILITY S A ANYAUTO O B N O SINGLE LI IT AL SCP005046448 E accl on __ 1,000,00 AUTOS OWNED X SCHEDULED 12130/2013 12/30/2014 BODILY INJURY(Per person ; AUTOS ) HIRED AUTOS X NON-OWNED BODILY INJURY(Per accident) $ AUTOS PR PERTY D GE UM9M.'LLA LIAR E X OCCUR $ •--.^ B X EXCESS LIAR CLAIMS-MADE BSOO19598EACH OCCURRENCE S D ETE 1213012013 12/30/2014 AGGREGATE WOWERS COMPENSATION 61000100 AND EMPLOYER$'LABILITY $ C ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WC STATU- OTH. OFFICER/MEMBER EXCLUDED? 68861 $-,_,._•_,� (MAndatoryInNW) N/A 01/1812014 01/18/2015 E.L.EACH ACCIDENT It yes describe under $ 600,00 DE CR PTI N OF PERATIONS below E.L.DISEASE-EA EMPLOYEE 3 600,00 A Empl Prac Liab 8CP00504644812/30/2012!30/2014 E.L.DISEASE-POLICY LIMIT s 600,00 13 --- —"- 60,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VENCLES (Attsoh ACORD 101,Addltlorm1 Remarks Schedule,It more spaoe Is required) CERTIFICATE HOLDER CANCELLA ON SHOULD THE EX IRATIIONHDATE VTHEREOF, NOTICE I WILL CBE CDELIVERED RIN Insured's Copy ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Daniel F. Dwyer III ACORD 26(2010/06) The ACORD name and logo are registered marks of CORD D CORPORATION.. All rights reserved. 0365 NORTH + TOWN OF NORTH ANDOVER PERMIT FOR WIRING T.0 Thiscertifies that ... ............................................................................. has permission to perform .....A .......... ....... ........ wiring in t building of.... building 1-�.............. at..,- . ............�?.........* North Andover,Mass. t67)?......... .. . .. .................. ..... ... Fee.l?� Lic.No. ............. .... ���x*.......... ELECTRICAL INSP CTOR Check # • Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. ` =7 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked a [Rev. 11/991 (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: 10-13-2011 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. Location(Street&Number) 50 Royal Crest Drive Building# 7 3 Owner or Tenant Royal Crest Estates Telephone No. Owner's Address 50 Royal Crest Drive Is this permit in conjunction with a building permit? Yes No X (Check Appropriate Box) Purpose of Building Apartment Buildings 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: Upgrade Emergency Lighting Completion o the foll ing table maybe waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ In- E] o.of Emergency Lighting 6 rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices ns No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: I I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances K-W Security Systems: No.of Devices or Equivalent No.of Water KNV No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent r No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent ' OTHER: i Attach additional detail if desired,or as required by the Inspector of Wires. 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 has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE x BOND ❑ OTHER ❑ (Specify:) 3-21-12 (Expiration Date) Estimated Value of Electrical Work: Work to Start: 10-17-11 Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the Pains andpenalties ofperjury,that the information on this application is true ait' mplete. FIRM NAME: Stilian Electric,Inc 108 Tenney St.Georgetown,MA 018 LIC.NO.: A11067 Licensee: Karl Gonsiorowski Signature LTC.NO.: E31598 (If applicable,enter"exempt"in the license number line) Bus.Tel.No.: 978-352-9994 Address: 108 Tenney Street Georgetown,MA 01833 Alt.Tel.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. Owner/Agent Signature Telephone No. [PERMIT FEE. $125.00 f�� � ����'�i�� l r Y 7594 .. ....... HORTM TOWN OF NORTH ANDOVER FO P / - PERMIT FOR GAS INSTALLATION SS�CHUSE This certifies that,l!h'. �.�t.7. . . . . c . . � ! has permission for gas installation in the buildings of" dam L, .� � #7 -1- at North Andover, Mass. FeL411 . . . Lic_. No.. 31(-?q�.. . . . . . . . . . . . . . . . . . . . . .. [ GAS INSPECTOR Check# jj/�_ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town: ,#4/GbyE� MA.L Date: 1-19-A01/ Permit# Building Location: ✓ U 1 L a�/iii( Cwt► Owners Name: Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential ❑ New: ❑ Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes❑ No❑ FIXTURES U) m W H Y = IM 2 Ir 0O W W U U) Fy- O = W W z H Q Z O W z W W O f' N ¢ N w w w m 0 Q a I- o � w X co V z m W O Q W _ LL W w z 9 x w l- w o U W Z O J ~ H O Z J U' LL N W W W W z W �- N J Q Q m w O z 0 > z H V o o LL 0 0 = _ � O a �� H > > > � O SUB BSMT. BASEMENT 1 FLOOR 2 NuFLOOR 3 FLOOR 4 FLOOR 5 Tr FLOOR 6TH FLOOR 7 FLOOR 8 FLOOR Installing Company Name: Check One Only Certificate# ljy" �d�J�I- /�9lcr'/� ��r ❑Corporation , Address: 1.5Z 6K01f�J� City/Town:d�Cl��(Jf 'y State: 4i� ❑ Partnership Business Tel: 7.zI eJrV-!'ZW Fax: 7dl z57q ;�,5ey ❑ Firm/Company Name of Licensed Plumber/Gas Fitter: J ir,.� icG INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes❑ No❑ If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy-0 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 Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner El Agent El By checking this box❑;I hereby certify that all of the details and information I have submitted(or entered)regarding this 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 provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Type of License: By ❑Plumber Title El El Fitter El Master Signature of Licensed umber/Gas Fitter Cityrrown ❑Journeyman License Number: P&O 7 APPROVED OFFICE USE ONLY ❑LP Installer 10RYh O• gLCD 6'S.� � 0� 6`• . g i°OG . NORTH ANDOVER BUILDING DEPARTMENT °R=eo cy 1600 Osgood Street �SacHus�•c . . North Andover Tel: 978-688-9545 Fax: 978-688-9542 .BUSINESSFO"F'OR TOWNCLERK DATE: ADDRESS:_ 2©s-� � 4 c t ZONINNGDISTRIOT: TYPE OF BUSINESS: BUILDING LAYOUT PROVIDED: YES A.vAILAPLE PARING SPACES: ZONING BYLAW USAGE:_ YES z AUILDING INSPECTOR SIGNATURE BUSINESS FORM FORTOWN CLERK 2.40 Home Occupation(1989132) An accessory use conducted within a dwelling by a resident who resides in the dwelling as his principal address, which is clearly secondary to the use-of the building.for living purposes. Home occupations shall `include,"but not'Tunited to the following uses; personal services such as f imished by an artist or instructor, but not occupation involved with motor vehicle repairs, beauty parlors, animal kennels, or the conduct of retail business,or the manufacturing of goods,which impacts the residential nature of the neighborhood. 4. For use of a dwelling in any residential district or multi family district for a home occupation, the following conditions shall apply. a. Not more than a total of three (3) people may be employed in the home occupation, one of whom shall be the owner of thd home occupation and residing in said dirvelling, b. The use is carried on strictly within the principal building; c. There shall be no exterior alterations, accessory buildings, or display which are not customw with residential buildings; - d. Not more than twenty-five (25) percent of the existing gross floor area of:the dwelling unit. so used, not to exceed one thousand (1000) square feet, is devoted to'such use. In connection with such use, there is to be kept no stock in trade, commodities or products which occupy space beyond these limits; C. There will be no display of goods or wares visible from the street; f. The building or premises occupied shall not be rendered objectionable or detrimental to the residential character of the neighborhood due to the exterior appearance, emission of odor, gas, smoke, dust, noise, disturbance, or in any other way become objectionable or detrimental to any residential use within the neighborhood; g. Any such building shall include no features of design_not customary in buildings for residential use. Signature Date r TOWN OF NORTH ANDOVER of "°erN b.; ��• r..y, oL ° 1A Building Department 1600 Osgood Street cw 1`u Building 2- Suite 2-36 Building Dept io 4.0''E�`y gcHus North Andover MA 01845 Tel: (978) 688-9545 Fax (978) 688-9542 COMPLAINT FOR INVESTIGATION DATE: �/ TEL #: �75 -�Sa7 NAME OF COMPLAINTANT: • �J�✓ ADDRESS,.,-... COMPLAINT TYPE: Electrical: Plumbing: Gas: Building: Property Owner: Address: Other: Signed:N " Complaint Form-Revised 6.2007 43 ROYAL CREST DRIVE Com laintDetail Report Printed 0n:Wed Jul27,2011 Complaint#: CT-2011-000047 Status: Closed GIS#: Violator: AIMCO-DBA-ROYAL CREST a '4047req Address: 43 ROYAL CREST DRIVE"--' Map: Address: 4582 SOUTH ULSTER STREE ,yap � Date Recvd.: Apr-27-2011 Time Recvd.: 11:22 AM Block: Denver,CO 80327-2662 o Category: Housing/Mold/Asbestos Lot: Type: Residential GeoTMS Module: Board of Health District: . Trade: Recorded By: Mary Ippolito Zoning: Structure: Description: Complaint' Received handwritten Building Department Complaint for Investigation Report from Mary Ippolito in Building-Caller was Sharon Dones,43 Royal Crest Drive, Unit 9: 1.Mold and asbestos on carpeting from water damage during the winter. 2.Small children 5&10 years old living in apt. Mrs.Dones was told by Royal Crest that carpeting will not be replaced. Please setup an inspection.--p.d. Comments: Inspector Assigned to Complaint: Michele Grant Contacts Contact Type Date Time Name Phone Best Time To Reach Recorded By Response Tenant Apr-27-2011 11:22 Sharon Dones (978)873-4527 Q Mary Ippolito Follow-Up by Health AM Inspector Actions Taken GeoTMS Module Status Date Time Response Type Action Taken Comments Board of Health REFERRAL May-09-2011 11:10 AM Follow-Up by Health 5/9/11-Ms.Grant left a Inspector message on voicemail. She then spoke to Sharon. She is withdrawing her complaint. She said she is all set. GeoTMS®2011 Des Lauriers Municipal Solutions, Inc. Page 1 of 1 NORTH ANDOVER HEALTH DEPARTMENT 27 Charles Street • North Andover, MA 01845 Tel. 978 688-9540 • Fax: 978 688-9542 email: healthdept@townofnorthandover.com Complaint Investigation/Inspection Report OWNER ADDRESS DATE Rev.6/04 INSPECTOR NORTH ANDOVER HEALTH DEPARTMENT 27 Charles Street • North Andover, MA 01845 Tel. 978 688-9540 • Fax: 978 688-9542 email: healthdept@townofnorthandover.com Complaint Investigation/Inspection Report OWNER ADDRESS DATE I Rev.6/04 INSPECTOR i Inspection.Form Use for Field Training and Audit Inspections Agency Name, Address, Phone } SSC 105 CMR 410.000: Chapter 11, Minimum Standards of Fitness for Human Habitation Date Time #Occupants #Children<6 Years Address Unit# C.ity/Town Occupant Name Phone# Owner Name Phone# Owner Address City/Town Zip Code #Dwelling/Rooming Units in Dwelling #Stories Floor Level of Unit #Sleeping Rooms #Habitable Rooms(.400) Inspector Title If violations are observed and checked,describe them fully on Page 3. Area or . Type of Violation Possible Code /if Responsible Party Element Use blank boxes for ones not listed Section(s) Violation Observed Owner Occupant Exterior,Yard Locks 480 &Porch Posting, ID,Exit signs/emergency lights 481,483,484 Handrails,steps,doors windows,roof 500,501,503 Rubbish—storage and collection 600,601 Maintenance of Area 602 Common Light,windows 253,254,501 Areas&Entry Egress. 450,451,452 Handrails s03 Interior Halls Floors,walls ceilings 500 &Stairs Hallways, railings,stairs 503 Light,windows 253,254,501 Bedroom 1 Location(circle): Front Rear Middle Left Middle Right Floor Level of Unit Ventilation 280 Ceiling height 401,402 Windows,screen 501,551 Bedroom 2 Location(circle): Front Rear Middle Left Middle Right Floor Level of Unit Ventilation 280 Ceiling height 401,402 Windows,screen sol,551 Bathroom Toilet,sink,shower,tub,door 150 Smooth,impervious surfaces iso Lights,outlets,ventilations 251,280 Floors/walls 504 Kitchen Sink,stove,oven;good repair,impervious and smooth, 100 space refrig Pagel of_ 40 ,a Area or Type of Violation Possible Code /if Responsible Party Element Use blank boxes for ones not listed Section(s) Violation Observed Owner Occupant i Lights,outlets,ventilation,windows,screens 251,280,501,551 Kitchen,cont. Ceiling height 401,402 Floor 504 Living room Lights,outlets,ventilation 250,280 and Dining Ceiling height 401,402 Room Windows/screens 501,551 Basement Maintenance 500 Watertight 500 Lighting 253 Water Source(circle): Public Private Must be potable 180 Quantity, pressure - 180 Responsible for paying MGL ch 186 s 22,metering 354 Hot Water Fuel Type(circle): Natural Gas Oil Electric Other Temp.: Of Location taken: Quantity, pressure, 110 F min, 130 max 190 Venting 202 Heating Type(circle): Forced Hot Water Forced Hot Air Steam Electric No portable units 200 "Habitable room and every room with toilet,shower,tub" 201 • 68 F7 am to 11 pm,64 F 11:01 pm to 6:59 am, except 6/15-9/15 • 78 F max in heating season/measure 5 feet wall,5 feet floor Venting,metering 202,354,355 Electrical Type(circle): 110 220 Amp: Amperage,temporary wiring, metering 250,255,256,354 Drainage, Type(circle): Public Private Plumbing Sanitary drainage required and maintained 300,351 Smoke&CO Required&operational 482 Detectors Pests Free of pests(rodents,skunks, cockroaches,insects) 550 Structural maintenance and elimination of harborage 550 Asbestos or 353,502 Lead Paint Curtailment 620 Access 810 Other Page 2 of A Referral: ❑ Electric ❑ Fire ❑ Plumbing ❑ Building ❑ Other This inspection report is signed and certified under the pains and penalties of perjury. Inspector Signature Occupant or Occupant's Representative Signature Reinspection Date Time "The information presented above is only a summary of the law. Before you decide to withhold your rent or take any other legal action,it is advisable that you consult an attorney. If you cannot afford to consult an attorney,you should contact the nearest Legal Services Offices is which is(Name),(Address),and(Phone). Written description of any violation(s)checked above Include Area or Element,code citation and a description of the condition(s)that constitute the violation. You may include remedies that would be an acceptable means of achieving compliance with 105 CMR 410.000. NOTE: *indicates that this housing inspection has revealed conditions which may.endanger or materially impair the health, safety, and well-being of any person(s)occupying the premises Area/Element,Code Citation and Description of Violation . Acceptable Remedies Page 3 of_ y e. l � c 410.990: continued THE FOLLOWING IS A BRIEF SUIMMARY OF SObfE OF THE,LEGAL REMEDIES TENANTS MAY USE IN ORDERTO GET HOUSING CODE VIOLATIONS CORRECTED. 1. Rent lWithholding(General Lams Chapter 239 Section SA), If Code i rolafions Are,Vof Being Con ected l-ou ruay be entitled to koid back.i our'reni pmniext. Pon can do thus t,'itbaai being er4cfed r`' A. You can prove that your dwelling unit or common areas contain violations which are serious enou-Ji to endanger or materially impair your health or safety and that your landlord)stew an-bout,The Violations before you were behind in your rent B. You did not cause the violations and they can be repaired while you continue to live in the building. C. You are prepared to pay any portion ofthe rent into court if a jud_s a orders you to pay for it (for this it is best to put the rent money aside in a safe place.) 2. Repair and Deduct(General Lams Chapter 111 Section 127L). This law sometimes allows you to use your rent money to make the repairs yourself. If your local code enforcement gmncy ce7ifier that there are code violations which endanger ormaterially impair your health.safety orwell-being and your landlord has received writtennotice of the t6olations,you maybe able to use this remedy.If the owner fails to begirt necessary repairs(or enter into a written contract to have them made)within five days after notice or to complete repairs within 14 days ager notice you can use up to four months'rent in any year to make the repairs. 3. Retaliatory Rent Increases or Eviction Prohibited(General Law's Chapter SSG,Section 18 and Chapter 2.39 Section 2A). I7re aumca-mm-not increase ti,our rent or evict you in retaliation for making a complaint to your local code enforcementagency about code violations.If the owner raises your rent or tries to ev iet within sixmonths afteryou have made the complaint Ire or she vyill have to show a good reason for the increase or eviction which is um'elated to your complaint. You may be able to sue the landlord for damages if he or she tries this. 4. Rent.Receivership(General Laws Chapter 111 Sections 127C-H). The occupants andior the board of health may petition the District or Superior Court to allow rent to be paid into court rather than to the owner. The court may then appoint a"receiver"who may spend as much of the rent mouev as is needed to correct the Violation.The receiver is not subjectto a spending limitation of fourmonths'rent 5. Search ofWananty .ofHabitability. You may beentitled to sue your landlord to have all or sone of your rent returned if your dwelling unit does net meet mirtimu m standards of habitability. 6. Unfair and Deceptive Practices(General Laws Chapter 93A) Renvng an apartment with code violations is a.Violation of the comsumer protection act and regulations for which you may sue an owner. THE INFORIMATION PRESENTED ABOVE IS ONLY A SU\QVIARY OF THE LAW.BEFORE YOUDECIDE TO ln4TPHHOLD YOUR REIT OR TARE AA`Y LEGAL ACTION.1T IS ADT'ISABLE TIiaTYOU CONSULT AN ATTORNEY.YOU SHOULD CONTACT THE NEAREST LEGAL SERVIC$S OFFICE lIrMCH IS: (NAME) (TELEPHONE NUMBER) (ADDRESS) Page 4 of TOWN OF NORTH ANDOVER NORTH q O �t�eo OL O M Building Department 1600 Osgood Street Building 2- Suite 2-36 Building Dept "SSgCHU5 `C North Andover MA 01845 Tel: (978) 688-9545 Fax (978) 688-9542 COMPLAINT FOR INVESTIGATION DATE: � � R TEL #: 9W f73 NAME OF COMPLAINTANT: �� ���� �)`'lt/e ADDRESS.: COMPLAINT TYPE: Electrical: Plumbing: Gas: Building: Property Owner: Address: Other: Signed: Complaint Form-Revised 6.2007