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HomeMy WebLinkAboutMiscellaneous - 43 GLENWOOD STREET 4/30/2018 43 GLENWOOD STREET 210/006.0-0052-0000.0 I i Date... ............................... koR TOWN OF NORTH ANDOVER 0 �- S PERMIT FOR WIRING This certifies that ............... .......................... ......................................... has permission to perform ......r ......................... wiring in the building of.... ...... h..)mx......................... at...................L/34��e""'rw..4vao......................... .North Andover,Mass. ......... Fee.../...V....4........... Lic.No..N �..;r......... -ea!S ELECTRICAL ?;�� OR Check # 6651 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. Occupancy and Fee Checked 1 l BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/051 (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: City or Town of: M A To the Inspector of Wires: By this application the undersigned gives rW,.tice of his or her intention to perform the electrical work described below. Location(Street& Number) 143 5+ Owner or Tenant Telephone No073-D73-4-397 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) 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 following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA ' No.of Luminaires Swimming Pool Above ❑ In- ❑ o.o Emergency Lighting rnd. rnd. Battery Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No. of Switches No.of Gas Burners No.o Detectuon and Initiating Devices No.of Ranges No.of Air Cond. Total No, of Alerting Devices Tons g No. of Waste Disposers Totals: Tons KW No.o Self-Contained Heat Pump Number Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other /J Connection No. of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No. o Water KW No.of No.o Data Wiring: Heaters Si ns Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: 't'.t AA-, 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: '5--110(o 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 ❑ BOND ❑ OTHER ❑ (Specify:) /certify,under the pains and penalties of perjuryth ` at the information on this application is true and complete. FIRM NAME: 1 LIC. NO.: 4 j Z) Licensee: rJitJ -� Q��� Signature iliil,� ©ffp�i LIC. NO.:r_ (If applicable, enter "exempt"in the icense number line.) Bus.Tel. No.:�o0�������5 Address: Ij LAX ( �000 — )DR Alt.Tel. No.: *Security System Contra or License required for this work; if applicable,enter the license number here: 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 agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ i i O Date..........`Z -.....7... NORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING CHU This certifies that ....../` ........ ...... �T................................ has permission to perform E/... ..�.�.V� wiring in the building of.............r..... 1. !qA..`y........................................ 1 3 ,North Andover,Mass. at.......... .................... � ?.........S .................... hFee .` Lie.No.3.7 6.V........... 1!.- -GG ......... TR ELECICAL INSPECTOR J Check # 3� V "7268 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. '72-lo cP Occupancy and Fee Checked r` 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: ,9 —a& 07 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) f,AIA,., LV e,a4kl 57/ . Owner or Tenant ��/�1'.5•* 1°,U (� ��;g�y Telephone No. 6 s- 5-91- 6611 Owner's Address S 4/'t-r- Is this permit in conjunction with a building permit? Yes [?�- No ❑ (Check Appropriate Box) Purpose of Building 5 T�F,Jc Vj4,A, ,'/)I 1L�X Utility Authorization No.—a a 1 �2 9 L 5 Existing Service (,-,o Amps 1 Ll Volts Overhead Undgrd ❑ No.of Meters 1 New Service 2W Amps /.70 /a?Y6 Volts Overhead Undgrd ❑ No.of Meters f Number of Feeders and Ampacity yo e",-p Location and Nature of Proposed Electrical Work: 2-e „�^ `elf 'C Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires a �' No.of Ceil.-Susp.(Paddle) Fans No.of Tota Transformers KVA No.of Luminaire Outlets �� No.of Hot Tubs ---^ Generators KVA No. of Luminaires Swimming Pool Above 1:1In- F] Battery o Emergency ig mg rnd. rnd. Batter Units 'l No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones o Detection and No.of Switches (� No.of Gas Burners ! No. Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges ,..- Tons g No.of Waste Disposers Heat Pum Number Tons KW No.of elf-Contained 3 Totals Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local E] Municippi ElOther Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW _ No.of No.of ata Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring. 3 �� No.of Devices or Equivalent 1 OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. �- Estimated Value of Electrical Work:0LI 5 e'0 • c-'o (When required by municipal policy.) Work to Start: 1b,A,2 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 ❑ BOND ❑ OTHER 2-(Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME:. DAM j (i�R4'3 I;-(r-c+r-, (-- LIC. NO.:3 7 1 (,ofl Licensee: i� �� ;S i Signature if'G ��----1 LIC. N0.:37)(Q (If applicable, enter exempt"in the license number line.) ^Cy Bus.Tel. NoRW-�9� -7*71/� Address: Jot-* Sa- j�A se-olu-C./✓ AJ, U 17 -11 Alt.Tel.No.: *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, I hereby waive this requirement. I am the(check one) owner ❑ owner's agent. Owner/Agent I PERMIT FEE. $ Signature Telephone No4�(a3� 5•e/I-C�fu� a 'i► 1 .� ,�o s��-��-�7 ��,� ��n� �`� � ���� 7 P,� ��.� � � a � �� � �� A 0 �� Date Z-/� .. 47.. . . ,aORTIy pf �.ap ,°,ti0 , TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION i oda _ a f ACsm This certifies that . .�.. . . . . . . . . has permission for gas installation . . . . . . . . . . . . . . . . . . . . . in the buildings of �. - �-! . . . . . . . . . . . . . . . . . . . . . . . . . at .y ".F.` � , . . North Andover, Mass. Fee���.�. Lic. No..3Q. . . .". . . . . . . p GAS INSPE O Check# �� 5989 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date _ NORTH ANDOVER,/MASSACHUSETTS 1,12 y 1 Building Locations C� Permit rt� Amount$ Owner's Name New Renovation Replacement u p � Plans Submitted Z pe�, V1 F W vO� g z w (7F Z C z d W H F SUB-BASEMENT A G9 V a > A F O 8 A S E M ENT 1ST. FLOOR 2ND. FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) Name -� C k one: Certificate Installing Company M. Corp. Address } Partner. usiness 1 a ep one Firm/Co. Name of Licensed Plumber or Gas Fitter d- INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes If you have checked es please indicate the type coverage by checking the appropriate box. No Liability insurance policy '110 Other type of indemnity ED Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the y Mass.General Laws,and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent Check one: OwnerEDAgent 0 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 apd installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Cha ter 142 of the General Laws. G By: Signature of Licensed Plumber Or Gas Fitter Title ® Plumber City/Town [3Gas Fitter (cense u�46 Master APPROVED(OFFICE USE ONLY) Journeyman Date �:�� �. ,0RTM TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SACMUSE� a J r This certifies that . . . c'.-.,_ . . . . . . . . . . 1' .1 . . . . . . has permission to perform .—,-It � 70_"-.... . . . . . . . . . . . . . . . . . . plumbing in the buildings of . �:�` &-4 . . . . . . . . . . . . . . . . . . c . at . . .7. . : . : . . . . . . . . . . . . . ..1 : . . . . . . , North Andover, Mass. Fee.7/.. . . . .Lic. PLUMBING INSPECTOR Check # C://c 1 7381 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH AN//D//OVER,,MASSACHUSETTS Building Location Date Owners Name Permit# ;7-3 e of Occu an Amount j e� New Renovation Replacement Plans Submitted Yes No FIXTURES �Bsva R4SRWW ! / za HDM mRaR 4MHfm SIEIINIOQt '"�' 6Ifi IIDIIt 7IS RaR SII I+IOQt (Print type) Installinin sel'41 g Company NameAn�= � Check one: Certificate Corp. Address /� 11 9 Partner. 1W 97 Business Telephone Firm/Co. Name ofLicensed Plumber. ��— Insurance Coverage: Indicat®type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity 0 Bond ❑ Insurance Waiver. I,the undersigned,have been made aware that the licensee of this application does not have any one of the above threeinsurance Signature Owner Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations compliance with all pertinent provisions of the Massachusetts Stateg ode and under erchap 142 forthis thGeneral application will w . be in By: rgna o ice " FOUR/ Title Type ofP1 mg License City/Town 0 APPROVED(OFFICE USE ONLY rcense um IF Master Journeyman ❑ L'em),)BayStateGas A NiSource Company May 22,2006 Licciardelo Sarah Account Number: 3293520036 43 Glenwood St North Andover, MA 01845 Dear Licciardelo Sarah: This follow-up letter is to inform you that your gas H/H located at 43 Glenwood St has been tagged due to a violation of state safety regulations. It is unsafe to use until the following condition has been corrected. Shut off due to flood 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# CAdsupdatedletters\236 05/22/06 55 Marston Street P.O. Box 869 Lawrence, MA 01841-2312 978-687-1105 Fax: 978-688-1875 Date J,. f TOWN OF NORTH ANDOVER ° PERMIT FOR PLUMBING SSACMUS� This certifies that . . . !�. .�: . :. . 1-7.1. . . . . .. . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i Plumbing in the buildings of . .�.�. �.�.�.�. .�. (6. . . . . . . . . . . . . at . . . . . . .rte.(. .c.t. .c. . . . . . . . . . . .. North Andover, Mass. Fee. Lic. No.T./?.) . . . . . . . . , . .y-., �. . . . . . . PLUMBING INSECTOR Check !/ 6{' 63 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS O l Date ' 6 `0 6 Building Location y,� �ioo�/ �Z Permit# 6 Amount Owner New Renovation Replacements Plans Submitted Yes No FIXTURES StJBB9VIC I�v>ovr IST.RIM 2M FL" 3M FIOOR 4IH FLOOR 5M FIOOR 67H FLOOR M FIAM SIH FLOOR (Print or type) /J Check one: Certificate Installing Company Name, a?,,T•� .D�U/l7�vY��' � 1 qll f' D Corp. Address O n- 13ax �7/ 7 � '/ /� Partner. a. 0 7 2 Business Telephone e;k/r7 /"X S ❑ Firm/Co. Name of Licensed Plumber: /y7iG�OZ�� rT 454 Insurance Coveraee: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ® Bond D Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner D Agent I hereby certify that all of the details and information I have submitted( entered)in abo application are true and accurate to the best of my knowledge and that all plumbing work and installations p rmed unde P it Issued for this application will be in compliance with all pertinent provisions of the Massachusetts Plum in a Chapter 142 of the General Laws. By: Signature oT Etcenseaum er Title Type of Plumbing License a I?City/Town icense um er Master Journeyman D APPROVED(OFFICE USE ONLY Date. �.,1�.f. ... .. ,10R TM OF 3j p TOWN OF NORTH ANDOVER Y �.,I. ' D ' PERMIT FOR GAS INSTALLATION �,SSAC MUSES This certifies that . ' . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . u . . . . . . . . . . . . . . . . . . . . . in the buildings of . /L . . . . . . . . . . . . . . . . . . . . . at . . .t H. -< �. . [ , North Andover, Mass. r GAS INSPECTC Check# 5569 MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FYITNG (Type or print) Date L�i 7 b NORTH ANDOVER,MASSACHUSETTS Building Locations �?� 9�G✓�.!//Oo� S Permit# J p Owner's Name Amount$ � �' New❑ Renovation Replacement I�,' Plans Submitted ❑ r ! F a a O a W x a a N GF oo F-4 w o w --t SUB -BASEM ENT B A S E M ENT 1ST . FLOOR a 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . F L O O R (Print or type) Check one: Certificate Installing Company Name Corp. Address partner. Busmess Te ep one G o _� �/O /y 13 Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 13 No 13 If you have checked Les,please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity Bond 13 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 I hereby certify that all of the details and information I have submitted(or tered)' above application are true and accurate to the best of my knowledge and that all plumbing work and installations pe ed u r Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts Sta a�Cd d Chapter 142 of the General Laws. By. Signature of Licensed Plumber Or Gas Fitter Title Plumber / 44 City/Town Gas Fitter License Numoer -® Master APPROVED(OFFICE USE ONLY) Journeyman BUTTERWORTH & O'TOOLE, INC. P.O.BOX 8294 SALEM,MA 01971-8294 ADJUSTERS/APPRAISERS FOR INSURANCE COMPANIES ONLY TELEPHONE(978)741-5731 FAX(978)740-9109 December 11, 2006 FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B DEC 2 2 2006 TOWN OF TH ANDOVER TO: Building Commissioner or Board of -ART ENT' Inspector of Buildings Board of Selectmen City/Town Hall City/Town Hall ADDRESSES North Andover/MA North Andover/MA RE: Insured: Sarah Licciardel Address : 43 Glenwood Street North Andover, MA 01845 Policy No. : F0102370 Loss of : File or Claim No. : 060-1668 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1, 000 . 00 or cause mass. Gen. Laws, Chapter 143, Section 5 to be applicable.. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. If no reply is received from your office within ten days, we will assume you have no liens of any type against this property and we will recommend to the insuring company that this claim is paid. Paul A. Dionne Adjuster Member of National Association of Independent Insurance Adjusters BUTTERWORTH & O'TOOLE, INC. P.O.BOX 8294 SALEM,MA 01971-8294 ADJUSTERS/APPRAISERS FOR INSURANCE COMPANIES ONLY TELEPHONE(978)741-5731 FAX(978)740-9109 December 11, 2006 FORM OF NOTICE OF CASUALTY LOSS TO BUILDING RECEIV Q UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B DEC 2 2 X006 T0: Building Commissioner or Board of Health o ��HEALTH DEPARTMENT ANDOVER Inspector of Buildings Board of Selectmen City/Town Hall City/Town Hall ADDRESSES North Andover/MA North Andover/MA RE: Insured: Sarah Licciardel Address : 43 Glenwood Street North Andover, MA 01845 Policy No. : F0102370 Loss of : File or Claim No. : 060-1668 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1, 000 . 00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. If no reply is received from your office within ten days, we will assume you have no liens of any type against this property and we will recommend to the insuring company that this claim is paid. Paul A. Dionne Adjuster Member of National Association of Independent Insurance Adjusters