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HomeMy WebLinkAboutMiscellaneous - 43 ELMWOOD STREET 4/30/2018 43 ELMWOOD STREET 210/003.0-0009-0000.0 09980 Date . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that . . . . (�!�!1. ?�-. . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . plumbing in the buildings ofl. "al'J . . . . . . . . . . . . . . . . . . . at . . .L�!`n.�- GY.. . . . . . . . ,North Andover, Mass. � ��77tt N Fee . Lic.No. .1.11 . . . . . . . . . . . . . . . . . . . . . . . . 4bw PLUMBING INSPECTOR Check# MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY; (� �"' i�(aiC MA DATE�� /JIPERMIT# _ -._._ ___-_. JOBSITE ADDRESS OWNER'S NAMES, /11 .1rh7 • OWNER ADDRESS ___ __ __( TEL! ;FAX r-_,_____--_._-___.l _ _____.___ �.___._-_._._._........i TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL �_ RESIDENTIAO( PRINT +'� CLEARLY NEW: 1-4 RENOVATION:;_ REPLACEMENT/ PLANS SUBMITTED: YESE.1 FIXTURES-1 FLOOR BSM 1 2 3 4 5-1-6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM - - DEDICATED GAS/OIL/SAND SYSTEM -- _ ...... DEDICATED DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM I - DISHWASHER I _ - DRINKING FOUNTAIN FOOD DISPOSER -- -i "- - i ,_- _. FLOOR/AREA DRAIN - INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN --- - -- SHOWER STALL SERVICE/MOP SINK TOILET i URINAL _ - ,___ .. �:_ _ { WASHING MACHINE CONNECTION WATER HEATER ALL TYPES -- WATER PIPING OTHER - 1 I i I INSURANCE COVERAGE: -17 I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO [,i IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY %( OTHER TYPE OF INDEMNITY I- BOND I 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: OWNER it' AGENT L SIGNATURE OF OWNER OR AGENT 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 RM=q( e with all Pe 'n nt p ovision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME(_MICHAEL HOUSE - -- - i LICENSE#17173--1 NA RE MK'.--, JP CORPORATION %{# 3377C �}PARTNERSHIP� (#?- LLC COMPANY NAME j MERRIMACK VALLEY CORPORATION I ADDRESS 1 15 AEGEAN DRIVE,UNIT#3 CITY I METHUEN I STATE MA ZIP 01844 TEL I -- --�- — L �._._ `978-689-0224 FAX i 978-689-2206 CELL!978-815-4523, ;EMAIL 1 LLITTLE@MVALLEYCORP.COM ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES I ,Y f I The C-Omwomveaft of Manachmetts DePwent of Iii A Once ofIRv0d9ado s 600 WaskhVion,SwW Boston,Masi 02111 Workers' Com "'"'"'• govMa Pensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbe A licant Information rs Print 'b Name(&w.Won/lr hVidW). �/yf Address: Ci"tate/Zip: Phony#: � r Are on an employer. 1. I am anemployer Check the ropriate box: v —�� 4. 0 I am a project(required): employees(full and/or pert time)s � and I 6.0 New c ce 2•❑ I am a sole proprietor or have hired the sub-conttacxors ship and have no listed on the attached sheet• 7.0 Reeling working for me m any capacity. These have opacity. 8.I J Demo [No workersemployees and have workers' htron required] comp.instnance cOmP•ince. 9.G Building addition 3. (i I am a5.0 We area homeowner doing all or additions corporation and its work officers have WMised their 10.0 Electrical nryself o w repair's Insurance required]t cel' d�� ce perm MGL 11.0 Plumbing repairs or additions §l( �and vie hoe no 12.G Roof employees.[no workers' �P•insurance requireq 13.�Other �AaY aPPaat ehecl�boot#1 am:t .tea ceedc thft a>t atw oat me section below,6onro�thea t 'Zzoorc:rn� mis baa mast a are ae work am thedj* a bice oam the sab•ooatraeaars have mast oabeet sy°R! g me acme of the a new a sorb. 1 an an aWkyer that is e0 �rorloera► n®her whdi er or rot those eath�es haveemployees u mformatio>t: �0n =M for my�yef.Below is the poft MUM site Insurance Company Name: Policy#or Self-ins.Lic.#: Job Site Address• Expiration Date: /3 �_ Attach a copyof the workers'corn �/ rp' compensation pobeY declaration page(sh the h number and Failure to secure coverage as °� P° expiration(date up to S 1,500.00 and/or one y ung Mona of MGL 152 can lead to the imposition of criminal $250.00 a 'isonment as well as civil Penalties is the form of a STOP WORK 01�E�d a fine fine�Y against violator.Be advised that a copy of this statement maybe forwarded to the Office of DIA for y a verification. I do herb}, Investigations of the Si e: P�Ju►3' the info • n p above is true and correct �` .Plate/Dare: Print Name; LD Phone#: �lClal use only Do not H,rke At this area to be CO ''©•��t d b3' 1'or town o,,�icial City or Town: Issuing Authoritycense#: 1.Board of Hea (�one): 6.Other 2' lig Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbin g Inspector Contact person: Phone#• O • COMMONWEALTH OF MASSACHUSETTS ; We PLUMBERS AND GASFITURS. LICENSED AS A MASTERPLUMBER ISSUES THE ABOVE LICENSE T0: ml'CHAEL . H HOUSE m 63 MARS LN E$EEMEE . TWP ME 04414-6132 -" � X17"3 05/01/14 1 �, 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with theprovisions of M.G.L.c.143,§•3L,the permit application form to provide notice of installation of wiring shall be uniforin throughout the Commonwealth,and applications shallbe filed- bn the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.01 o.166,§32,as electrical permit shall be issued to the person,firm or corporation stated on the permit application.Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall_be limited as to the time of ongoing construction.activity,and may be.deemed-by-the Inspector-of_W.ires abandoned-and-invaliddf he—. or she has determined that the authorized world has not commenced or has not progressed during the preceding 12 month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on thq permit application. The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job,growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certairrpermits-and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends for four years beyond its otherwise applicable expiration dateE anY permit or approval thdt as 'in effect or existence'during the qualifying period beginning on August 15,2608-and extending through August 15,2012. Oe 8—PermiVDate Closed:�1, lZ�` ***N eapply for new per Permit Extension Act-Permit/Date Closed: II S n. Date....7'.2 GI_OGj NORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING CHUSE� This certifies thatL .......... �n.� E �-�=` .. ........... ,�........�°� / ............ ................ ....... haslpermission to perform ...l.�l� L3..zriti�S wiping in the building of....... .................................................... — t...�{'?.... L,! ..la��o, .....s .............�11 th Adover,Mass. ` Fee..2 d ... Lic.No.... . * �.n SLECTRICALINSPECTO0 Check # 9 9 9 n Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. rf� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M C),5 7 CMR 12.00 (PLEASE PRINT IN INK OR TYP A INFORMATION) Date:STI' I "I / City or Town of: � To the Inspector of Wires: By this application the undersigned gives notice of his or her intent' n to perform the electrical work described below. Location(Street&Nuer) Owner or TenantPTelephone No. Owner's Address ED c.C60;�EKE Is this permit in conjunction with a building permit? Yes ❑ 04 (Check Appropriate Box) Ivi Purpose of Building 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: () Completion of the ollowing table may be 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 [I In- ❑ o.o Emergency Lighting rnd. rnd. Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No. --Detection and Initiating Devices No.of Ranges No.of Air Cond. Total NDevices (� o.of Alerting g No.of Waste Disposers Heat Pump FNumber Tons KW No.of Self-Contained Totals: Detection/Alerting Devices ' No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent Heaters No.of Water KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or E uivalent OTHER: 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 q BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value qf Ele rical Work: (When required by municipal policy.) Work to Start: [flInspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,undegth'e insand enalties,of perjury that the information on this application is true and complete. FIRM NA E (� LI NO.:�L- (�.(E Licensee: 1 Signature W�,4 LICII (If applicab enter " emp "in th license nu r line.) Bus.Tel.No. Address: � ''�� l , '`�!� � Alt.Tel.No.: �- OWNER'S INSURANCE WAIVER: 1-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 gent. Owner/Agent O Signature Telephone No. PERMIT FEE: $ Date.. � . ���.... . . NpRTH o; TOWN OF NORTH AN ER h A ' PERMIT FOR GAS INSTALLATION a i UCHUS This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . has permission for gas inst-al� . . ,...... . . . . . . . . . . . . . . . . . . . . . in the buildings ,. . . . . . . . . . . . . . . . . . . . . 41,3 at . . . . . . North Andover, Mass. Fee . .- . Lic. NoV4201 .(-4- /f . . . . . . . . . . . GAS I P -OR D (! vv Check# -.2710 6851 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING CitylTownr�a1.� W � 1;61Jl- �i� Date: , Permit# Building Locatio „7 /�11 /J,.. / . Owners Name _.., v. . Type of Occupancy: Commercial Educational Industrial Institutional Residential= New:! Alteration:i., Renovation£ Replacement i Plans Submitted:. Yes; No u _ w FIXTURES W w U D w 0 _ U) to vi m _ 0 O Lu U to H w cn g w w O Z IX Q O O W D w O Q O z � rn w W w w m OO. Q CL a X IX > N V W W W Z g = N O W O = v a > U w Z O 'J I- H O Z -jou- U' w Z FWw- W W = Z w >- W 0 � Q Q m w O Q z O ~ ~ w UC�7 = x O a. oC W > > O SUB BSMT. BASEMENT --i'FLOOR 2 Nu FLOOR 3 FLOOR 4 FLOOR FLOOR FLOOR 7 FLOOR -i'FLOOR -- _ Check One Only Certificate# Installing Company Name: .1 ;.. .. __..__ . ..... ... _; �. Coro �'9 Corporation J iAddress City/Town(/�Nt7/ ,_- -,- :.:.State r� Partnership Business Tel: %f Fax ..r. . :1 " y Firm/Company , Name of Licensed Plumber/Gas Fitter.`. w ';1;�f2 'YG INSURANCE COVERAGE: 1.V I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yet/.N, "Nc, If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. 11 A liability insurance policy Other type of indemnity?ry N 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 Owner `', Agent Signature of Owner or Owner's Agent By checking this box(];I hereby certify that all of the details and information 1 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 C e and Chapter 142 of the General Laws. Type of License: ` i Plumber Title wy ;Gas Fitter g Sig ture o i ensed Plu ber/Gas Fitter Master CiJourneyman A , ,. .: , LP Installer Number APPROVED OFFICE USE ONLY jai FINAL INSPECTION BELOW FOR OFFICE USE ONLY PROGRESS INSPECTION(S) FEE: $ PERMIT# APPLICATION FOR PERMIT TO DO GAS FITTING NAME&TYPE OF BUILDING LOCATION OF BUILDING SKETCH PLUMBER,GASFITTER LP INSTALLER LICENSE NUMBER: PERMIT GRANTED E] DATE: GAS FITTING 1NS'PECTIOR Date. ORT" TOWN TOWN OF N RT ANDOVER PERMIT F PLUMBING i si a +_ SA US This certifies that . . .'. . . . . . . . . . . . . . . . . . . . . . fas permission to perform . .E—� . . . . . . . . : . . . : :. . . . . . . . . . . . . : . . plumbing in �h buildings of . . . . . . . . at. . �' . . . . . . . . . . . . . . . .--r~-. . . . . . . . . . ., North-Andover, Mass. os 0 U CTOR ry PLUM�NG�NSPIE Check # C7` 7161 (/ 8140 \ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING rX, City/Town: MA. Date: Permit# Building Location: Y,� �G� `a'�� Owners Name: Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential% New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Pians Submitted: Yes ❑ No FIXTURES z z rn O Y U Z W a W z H Y a U) Q Q N Z Z co Z Om N W a W N ~ W 4 rn Y m a x p LL a N a W 0 Q W N .W J Z lX a = W W W Y = = a 0 N f- V Z a CL Y Zt– a Q m ° a O f— > 0 = o Q a a a SUB BSMT. BASEMENT / 1 FLOOR 2 FLOOR 3 RD FLOOR 4TH FLOOR FLOOR FLOOR : Trff— FLOOR --4-8 FLOOR Check One Only Certificate# Installing Comp ny Name: e' o�� ty leCorporation Address: � # City/Town: State:hil ❑ p O Partnership Business Tel: /2g 6 0-QFax: ❑ Firm/Company Name of Licensed Plumber: Y'- Te-j 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 Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:1 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 Owner ❑ Agent ❑ Signature of Owner or Owner's Agent 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. By Type of License: .'�Title �._ SPI ber Signature of Lice sed PI er aster / 9 /� �TAPPROVEDCity/Town ❑Journeyman License Number: OFFICE USE ONLY 11NAL INSPECTION BELOW FOR OFFICE USE ONLY PROGRESS INSPECTION(S) FEE; S PERMIT k I I 'APPLICATION FOR PERMIT 1'0 DO PLUMBING i NAM1'X TYPE OF BUILDING I i LOCATION OF BUILDING i SKETCH PLUMBER LICENSE• NUMBER'. 1 PERMIT GRANTED❑ DATE I i i I PLUMBING 1NSPEC"IIOR i s Date,�-� /7d6...... ............................ NORTH TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING SACHUS &,etc Thiscertifies that ........................... . . ...... .................................................. has permission to perform'--- '-' ...... wiring in the building of..... ........................................ ............North Andover,Mass. at....q—?..........C ............................................. Fee?!�/Q......... L i c.N o �L....................... ....... ELECTRICAL INSPECTOR Check # 6654 Commonwealth of Massachusetts Official Use Only PDe artment of Fire ServicesPermit No. 61,5-4 Occupancy and Fee Checked 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: ,5'-18-eL City or Town of: N, A� 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) '-3j,M'W't,c,D Owner r Tenant rp.£c?'S ac4 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box) Purpose of Building 'Q 4k,� G Utility Authorization No. Existing Service I oy Amps I2tr Volts Overhead O❑ 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: Completion of the following table maybe waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans o.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- El o.o Emergency Lighting rnd. rnd. Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones R s o Detection and No.of Switches No.of Gas Burners No. Initiating Devices No.of Ranges No. of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pum Number Tons KW No.of Self-Contained Totals Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Mun'cipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water KW No.o 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 A OTHER: ,.} Attach additional detail if desired, or as required by the Inspector of Wires. ' Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE K" BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: j,tdr„t 1~�� C tF"yRAJ._ C),E-C. C.P. l AjC_ LIC. NO.: Licensee: '?L4&7,7- M AG t R LIC. NO.: Fj1Zs14 (If applicable, enter "exempt"in the license number line.) Bus.Tel. No.:c)l Address: -IM l,0 W Lkj, N P)� dt Ss/ Alt.Tel. No.:` ')8'•3?s?Y 19 *Security System Contractor License required for this 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, 1 hereby waive this requirement. I am the(check one)❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ �SZv s Ba 1y y S t a teGas A NiSource Company May 24,2006 Anderson Paul Account Number: 3177240076 43 Elmwood St North Andover, MA Ol 845 Dear Anderson Paul: This follow-up letter is to inform you that your gas H/H located at 43 Elmwood St has been tagged due to a violation of state safety regulations. It is unsafe to use until the following condition has been corrected. Flood boiler under water,disconected and pluged The Masachusetts code pertaining to the installation of gas appliances and gas piping, established under Chapter 737 Acts of 1960,requires that the condition be remedied. If you have questions or would like to discuss this issue, please call 978-687-1105 and ask for the Service supervisor. Please disregard this notice if the condition has been corrected. Sincerely, Service or Meter Department Bay State Gas Company CRR: CRR# Q\asupdatedletters\236 05/24/06 55 Marston Street P.O. Box 869 Lawrence, MA 01841-2312 978-687-1105 Far,: 978-688-1875 Date .' . TOWN OF NORTH ANDOVER ° p PERMIT FOR PLUMBING ,SSACMUS� This certifies that . . . . . . . . . . . . . . -' ;�. . . has permission to perform u . . � plumbing in the buildings of(.—I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . - . : .-::�. . . . . ., North Andover, Mass. l � , Fe../--6.>. . .Lic. No.?3i0. . . yc,!. . . . . . . . . . . . PLUMBINff 1SPECTOR Check A/L - 6969 6 z IFS. 4`df Ci L -1 I 'K 1r;fiNr �ve 4; IVIJ j fa ks' t�;f C", y r,,ova KAI LJ X Cn ,C5 eff. X 3- 0 < X X J D_ X E-- o 0 W X W CC X QL 0 0 FJ S FA T� EASEMENT S T FLOOR 2ND FLOOR 3 RD FLOOR 4TH FLOOR 0 STH FLOrR is Tit FLOOR f CLIMATE DESIGN HEATING and AIR CONDITIONING, LLC Installing Company Name 5 South Summer Street Check one: Lertificate Address Bradford,MA 01835 978-372-9999(phone) 0 0 &'Corporation 978-372-0882(fax) Partnership Business Telephone Lic. Plumber: Name of Licensed Plumber IRSIURANCE COVERAGE: I have a current liability Insurance policy or its substantial eclut-valent which mets flue requirements of MGL Ch. 142. Yes I F�ft No D It You have checked yes. please Indicate th--type coverage by checking the appropritte box A liability Insurance policy 'W/ Other type of Indemnity 0 13ond D OWNER'S M'SURANCE WAIVER: I arae aware that the licensee does riot have the Insurance coverage required by Ctlapter 142 of the Mass. General Laws. and that my signature on this Ps-rrnft application Waives this require'Ment. - Check one: Owner El Agent .1 hereby celt&y that&JI Of the dr-tails and information 11ham subacitied for antered)in above RPP[iczbGn ara true znd accurate to me est of 1-ny knawledge end that all plumbing work and installafions doniied under the parmit is"Od for this apphtion VAII be in complimce with all Portin.ent prmisiotis Of Uw MaslaChusetts-State Plumbi, Cod© I d to I f the General Lees. umb Code W sender t n F, cxansed )um er C4 'I r t,vf ro�-qn We of Licence:44aslor _burfie.man Lic;eRs,1 Number c'5 Date. . ... .��?. . . NOFTPI TOWN OF NORTH ANDOVER fi a PERMIT FOR GAS INSTALLATION a io • s • Z 9SSACNUSE� z This certifies that . . ",P"4 . . . . has permission for gas installation .. .. .Q. - �E. . . . . in the buildings of . . .. .-N :� /. . . . . . . . . . . . . . . . . . . Ic 1 at _....... . . . . . . ., North Andover, Mass. Feelv °�. . . . Lic. No.,�.?/0. . . . . . . pi . . . . . . . . GAS INSPE0,fjA ti Check# 5578 �L� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) _ t;<L� d4l�yr,' Mass. Date -v2 3. e Permit # Building Location d - �vov� s/ Owner's Name Type of Occupancy_�i�i/_- G�<,ris New ❑ Renovation ❑ �. Replacement Plans Submitted: Yes❑ No o fn (n W N Y Z ¢ v) Nfn U ¢ F- N ¢ 0 MOM to = F- W j N. W O U m S v ¢ a } z Z a ¢ Z o •u Q ¢ ¢ a D a W Q m (n }- W W O! d C Q N C7 W < = Z 2 N o > W U W N W Q ¢ F G F- S W W Of W 2 Q = Q ¢ C] ¢ W W U H ¢ W W O > LL F- J }. W = Q W } N > N m Z O - O y S Q W S W Z. Q ¢ < 't O O W 0 w }' O c7 2 LL 7 O d iJ U Y p a 1— O SUB—asMT. BASEMENT 1ST FLOOR 2ND FLOOR I 3RD FLOOR I 4TH FLOOR I STH FLOOR 6TH FLOOR 7TH FLOOR CLIMATE DESIGN HEATING and AIR CONDITIONING,LLC Check one: Certificate Installing 5 South Summer Street y^•� Address Bradford,MA 01835 ''Corporation 978-372-9999(phone) — _ Partnership 978-372-0882 (fax) Business Telephone Lic. Plumber: Firm/Co.. Name of Licensed.Plumber or Gas Fitter INSURANCE COVERAGE: I have a current liability insurance policy or Ks substantial equivalent which meets the requirements of MGL Ch. 142. Yes WrNo ❑ If ybu have c ecked Vis, please Indicate the type coverage by checking the appropriate box. A liability insurance policy�7 Other type of indemnity❑ Bond Q: OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coveragerequired by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner❑ Agent ❑ Signature of Owner or Owner's 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 th;n7aure t issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 eneral Laws. By. T of License: Plumber ofL.icen P umber or asFtter Tiile Gasfitter �/W �Master nse Number Gty/Town journeyman APP�(OFFICEUSF ONLY) Date "ORTN TOWN OF NORTH ANDOVER 0 Siam. p PERMIT FOR PLUMBING 7� y. . . . . . . . . . . . . . . . . . This certifies that has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings 'of .. . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . . . North Andover, Mass. Fee. . . .Lic. No ... . . . . . . . . . . . . Y- U M. B-I-N G INSPECTOR Check # 6979 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS / r' � ) Date (-0 Building Location 7 �nl6L./CSC' Owners Name Permit# 7 y Amount Type of Occupancy New Renovation Replacement 1 Plans Submitted Yes ❑ No ❑ FIXTURES d H Z z w con F U zas a z AMM >kSEVvr 1 t isr Hfm ?11.1 FL OR FLOOR 4IH MOOR 5IH FLOOR 6IH HIM 7IH FLOOR SIH FLOOR (Print or type) l Check one: Certificate 'l L Installing Company Name/u/Lso", kj-..f Lng, gm1 kt ❑ Corp. Address 69-) -a ke ST Partner. . mess e ep one � Q --d( ' �Firm/Co. Name of Licensed Plumber: S u. A t,—), cA('jY1 Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy L, Other type of indemnity ❑ Bond ❑ Insur e Waiv : I,the unders' ned,have been made aware that the licensee of this application does not have any one of the above thr re 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 in lat ns p formed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massa sett tat lumbi Coe Chapter 142 of the General Laws. By: igna o cense um er Type of Plumbing License Title l�L 1 S 3-)-c-) 7`/"� City/Town LlCense Numoer Master Journeyman ❑ APPROVED(OFFICE USE ONLY rr vv Location No. Date i NORTH TOWN OF NORTH ANDOVER i Certificate of Occupancy $ Eta' Building/Frame Permit Fee $ 17/SsACMUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # " 15678 � Building Ins e�tor TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING 89. :» � � � �� � �' � � �` •gam � �m �� BU ILDING PERNUT NUMBER: SUED M / DATE IS , X SIGNATURE: 'Praoow- BuildingCommissioner/Inspector of Buildings Date Z SECTION 1-SITE INFORMATION 0 1.1 Property Address/: 1.2 Assessors Map and Parcel Number: Ooo� 11,3z ZPK W OL' Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Diaric­t Proposed Use 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. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑. Private ❑ Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHENAUTHORIZED AGENT M 2.1 Owner of Record (� 106ud AkdeYsopl y3 zzt wood JT, Name(Print) Address for Service Signature Telephone 2.2 Owner of Record: 4 Name Print Address for Service: O z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ 41AItIC (J Licensed Construction Supervisor: O / 3701 O /ot License Number Address '� Ae" j- Expiration Date !/ Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 /�'�liieC fQ/Nl4I-b a Company Name m /a �l/-exS(q5�o,K *W Registration Number r Address r aLc- 7y � e 0—��o Expiration Date ^� [ Signature Telephone G) 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. Si ned affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Workcbeckall applicable) New Construction ❑ Existing Building %— Repair(s) ❑ Alterations(s) S— Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify e Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be UFF`ICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee 0 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) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize ;' t to act on My behalf,in all matters relative to work authorized by this building permit application. �hlC,-c_ oaCc� Signature of Owner Date SECTION 7bOWNER/AUTHORIZED AGENT DECLARATION I, 1�ykt Ct�-c— 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 Lb 0 Print Name Signature of Owner/A ent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TI1vIBERS 1 2 3RD 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 TO" . of Andover 0 L_ o dover, Mass., CC,':.AEWICK DRATED PS S H BOARD OF HEALTH PE.. D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.. ............... .................. ........... Foundation has permission to erect....................................... buildings on �..�.�....... .......... . ............... . ......�� Rough to be occupied as.. Chimney provided that the person accepting permit shall in eiery respect co to the terms of the application on file in Final this office, and to the provisions of Codes and By-Laws relating to Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTIONS ELECTRICAL INSPECTOR Rough .../.(......................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — De Not Remove Final No Lathing or Dry Wall To Be Dom FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. e BOARD OF BUILDING REGULATfON$ 1 :License: CONSTRUCTION'SUPERVISOR +4..� € I Number:"SCS,. 043801 + , B!rthdate 4':11/19%1952 Bxpires 11/1g/2003 Tr.no: 7849 x Restrict ed 00 MARC W,RINALDO , 12KENSINGTON:AVE METHUEN, MA U1844 "' Administrator Board of Building Regulations and-Standards HOME IM p ROVEMENT CONTRACTOR Reg�strat�n�-101177 a-xp!4;abon k5/2004 ` type individual MARC RINALDO .b t t Marc Rinaldo y w` 12 Kensington Ave4! - Methuen,MA 01844 Administrator i Location?a No. C DateZ— NORTH TOWN OF NORTH ANDOVER 3 0IL ♦ i a Certificate of Occupancy $ cHUS Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # _ 5 ", O "-Building Inspector Ix TOWN OF NORTH ANDOVER Y BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING TIns:SecfEo>a:,foir{?ff>i w Use`OaI BUILDING PERMIT NUMBER: DATE ISSUED. rn a X SIGNATURE: C � Building Commissioner/I for of Buildings Date SECTION I-SITE INFORMATION z 1.1 Property Address: 1.2 Assessors Map and Parcel Number: O 80 CAT,106t7J Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposad Use Lot Area(so Frontage(ft) 1.6 BUTLDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5" Flood Zone Inforaution: 1.8 Sewerage Disposal System: Public 0 Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record I�met" Namet(Print) Address for Service Signature Telephone t 2.2 Owner of Record: Name Print Address for Service: O rn Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ WeLUkM Licensed Construction Supervisor: `J O 90. ,% ,e_ b r � 1� S License Number address r� � D - /,)V,4�, O 2 2-6 Expiration Date signature T Telephone .2 Registered Home Improvement Contractor Not Applicable ❑ v 1-4/1) OWYC77 ompany Name 10 1 b rn Registration Number r S16 &cv)(x "4 a)�jS r ddress 1 12g102 /A JAR 29-P, Expiratio rifDate ^ mature Tele hone 1d,/ 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.......0 No.......0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s)—6—r rations(s) 0 Addition er Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: Sc�I ,Q SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be ,yk i� pSE ONLY Completed bypermit plicant „fit, ,F 1. Building (a) Building Permit Fee Multiplier 2 Electrical �-rD (b) Estimated Total Cost of rjOb Construction 3 Plumbin Building Permit fee(a)x (b) 4 Mechanical(HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) SOb Check Number SECTION 7a OWNER AUTHORIZAT O TO BE COMPLETED WHEN . OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 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 I, tel'_I h, as Owner/Authorized Agent of subject property Herebv declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name 6 lob Z Si ature of wner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS 1 2 3 SPAN DIMENSIONS OF SILLS DIIv1ENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CFE[MNEY IS BUILDING ON SOLID OR FILLED LAND L'S BUILDING CONNECTED TO NATURAL,GAS LINE 36� 4y FORM U - LOT RELEASE FORM L o 4APe INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLIC#NT FILLS OUT THIS SECTION*********************** APPLICANT _ PHONEq3Q YI'71 f6 6 4 LOCATION: Assessor's Map Number 04, PARCEL SUBDIVISIONp LOT(S) STREET ST. NUMBER ************************************OFFICIAL USE ONLY*********************************** RECQJMEN)VAT094 OF TOWN AGENTS: A IO A INISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS F INSPEC OR- ALTH DATE APPROVED �7 DATE REJECTED SE TIC INSPECTOR-HEALTH DATE APPROVED G n ( DATE REJECTED COMMENTS PUBLIC WORKS-SEWERMIATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm SF-SSORS: 1 4 5A, LOT 16 10 ELEVATIONS SHOWN HEREON REFER TO AN ASSUMED DA TUM. PROPER T Y LINES SHOWN HEREON ARE A PFROXIMA IF ONL Y, NO BOUNDARY SURVEY HAS BEEN PERFORMED. TR ENCES.- BOOK 10483, PAGE 533 so V BOOK 154, PLAN 27 3 r 1e X +/ -P 1 7 .......... "AL, V .......... ------- 1. 6PA. PFV 10 4. k. 2 PROPOSED PROPOSED HIGHBUSH BLUEBEM 'Y. GRAVEL DRIVE HFA 4 DISCON77NUE MOWNG 102 x 3,v AREA TOR EVEGE TATE NA TM L L Y 'IX A PPROXIMA IF AREA PRE WOUSL Y RESTORED 1.Y.`` \/`drJ l re 02. 486 --t- SK. M/77GA TION AREA 2.•1) 206 -1- S.F. OF 25' NO-DISTURBANCE ZONE AL 7FRA 77ON Town o 4 over No. F- 0 over, Mass., C OCHICHEMCK RATED F\' BOARD OF HEALTH Food/Kitchen PERMIT T Septic System THIS CERTIFIES THAT...... ......xj-0�0..-e........................................................................................................... BUILDING INSPECTOR r Foundation has permission to erect..�9ZY.x......0.............. buildings on ....... 6 .......................... ..... ...................................r............... Rough to be occupied as.......... . 0 0*4.,''-e 1900 / I 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHSFinal UNLESS CONSTRUCTIPN AIR!TS ELECTRICAL INSPECTOR Rough 110r/ ....... .....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 Street No. SEE REVERSE SIDE Smoke Det.