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HomeMy WebLinkAboutMiscellaneous - 50 FERNVIEW AVENUE 4/30/2018 (2) 50 Fernview #7 N r SENDER: I also wish to receive the y • Complete items 1 and/or 2 for additional services. m • Complete items 3,and 4a&b. following services (for an extra 4) ` • Print your name and address on the reverse of this form so that we can .>9 41 return this card to you. fee): i m • Attach this form to the front of the mailpiece,or on the back if space 1. El Addressee's Address rn does not permit. + X • Write"Return Receipt Requested"on the mailpiece below the article number. 2 ElRestricted Delivery C " • The Return Receipt will show to whom the article was delivered and the date y c delivered. Consult postmaster for fee. 0 3. Article Addressed to: 4a. Article Number d Z 115 794 533 a .Philip Byrne 4b. Service Type (D 0 24 Jeffrey Road ❑ Registered El Insured N Arlington, INA 02174 � Certified El H W ❑ Express Mail ❑ Return Receipt for p� Merchandise c G13- 1 1 Ma, f Delivery 0 5. nature (AJddresseel 8. Qbe's Address(Only if requested Y ------ ,)ai'd e 1s paid) 6. Signature (Agent) ~ 0 PS Form 3811, December 1991 *U.S.GPO:1993-352,714 -DOMESTIC RETURN RECEIPT UNITED STATES POSTAL SERVICE r Official Business tir. PENALTY FOR PRIVATE USE TO AVOID PAYMENT OF POSTAGE,$300 Print your name, address and ZIP Code here MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108-1904 16171723-3800 Ma Only(800)392-6108,FAX(800)851-8424 5/28/2015 Form of Notice of Casualty Loss to Building Under Mass. Gen, Laws,Ch.139,Sec.313 NORTH ANDOVER BUILDING COMMOSSIONER NORTH ANDOVER TOWN HALL NORTH ANDOVER MA 01845 Re: Insured: CAROLANN LEIBOVITZ&BRIAN S LEIBOVITZ Property Address: 50 FERNVIEW AVE UNIT 6, NORTH ANDOVER, MA 01845 Policy Number: 1157161 Type Loss: Ice Dams Date of Loss: 02/15/2015 Claim Number: 339555 Claim has been made involving loss,damage or destruction of the above captioned property,which may either exceed$1000.00 or cause Massachusetts General Laws,Chapter 143,section 6 to be applicable. If any notice under Massachusetts General Laws,Chapter 139 Section 3B is appropriate,please direct it to the attention of the writer and include a reference to the captioned insured,location, policy number,date of loss and claim or file number. MPIUA Claims Division CMA00021 Date./4 . . ... . . pORTM pf „ro ,°�ti0 of �` TOWN OF NORTH ANDOVER F ... F • PERMIT FOR GAS INSTALLATION •`t ' �9SSACMUSEt h This certifies that . . . . .: . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . at . . . .`... . . . . . . . . . . . . ., North Andover, Mass. Fee. . Lic. No. 1. 5.':. . . . . . . . . . . . . . . . N� . . . . . . . GASINSPECTOR, Check#JUGS"� 693 MASSACHUSETTS UNIFORM APPLICATON FORPFJ 1A r TO DO GAS FITTN (Type or print) Date �d NORTH ANDOVER,MASSACHUSETTS / Building ocations < ® T C� (/�W Permit# Amount$ -� P.r.C/ Owner's Name .� � _ � New❑ Renovation Replacement Plans Submitted ❑ ��, x o U F x F d F aF z z F t�7 w x z OF °' a z o w Cw7 F z H Qd �O„ F w 0 p > w W v W > W ., Q v1 z O z O x, x o x 3 a ° a° > q °a F o SUB -BASEM ENT B A S E M ENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR i 8TH . FLOOR / (Print or type) / Check one: Certificate Installing Company Name ddd El Corp. Address ® Partner. Business Telephone89 11P F m Co, G- G 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 O If you have checked Les,please indicate the type coverage by checking the appropriate box. Liability insurance policy �-- Other type of indemnity Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 0 Agent I hereby certify that all of the details and information I hed(or entered)in above a cation are true and accurate to the best of my knowledge and that all plumbing work installations p rformed under P Is ed for this application will be in compliance with all pertinent provisions of the assachus tts State as Code a t 42 of the General Laws. BY: Signature of Licensed Plumber Or Gas Fitter Title Plumber City/Town Gas Fitter License NiXhber Master APPROVED(OFFICE USE ONLY) o Journeyman - . efts i �.airrfljQ�ZWeafl`f j•of Afi=aC� �� ��PQrt?heP&Of�Rt1iL4tTiQI ACCLlIen� t. A, 600 jfr=jjhWMn Street � BQstvrt, MA 02111 r7 workers' A CamPenation WW ="= gvv/� caat Information IBstanee Af {avit Rnflders /ContractorEed riciltus/Pi®bers Please Print Leeibf Na Addresm' City/sta&zix Phone#~ Are yon an emPioyeri Check.the appropriate-bo= ' I Q I,am a employer with Type a,Project 4' Q I a genera!cmt=- tar �PIoY=(full andJm� end I r�i°tJ'�� part-time). have hired the sub-cont� 6• Now cofisbuc6on . am.a.sole proprietor:Ir P--tn, Iistad sh> and hive no em the.l h e°n the attached sheet 3 7. []Remodeling working liar me in sub-com actm� any cap=ity. workers' com ins g' Q Demolition• [No wotfcers 00 p.iasuran 5. [� Wz P• urar=. 9. (] .4i ng] a.cotporation and its ng addition 3•❑ Igin s homeowner doing all work �.i� have exercised their !0.[].Ele��wire or additions MysaI£[No•warl:ms9lt of toceinoon Par MOIL 1!.Q Plumb' ng repaM insurance comp. q � §!(4L snd•we have no or additions �]t• MPZc'Yews.[No work=, 12.r]Raaf'rc*n -A.y a 'ii'mthor 6eohs beet, gip• �w=c:e required.] I�.j].� nmtt eteo 5[1 oittths saation below showing , _ $ Mft="�oe who edbmit this affidavit indj�g they��g� 8 airworkeo oo�MfiM Pei*in{mmnEioa r Coatraatoo that think this bot tenmtat to aah�3tioasi eheeisho end than lois owaids connartots mrist submit a neiu wirm-•the Mme GrtL-cub- afitdavit ind su t r e:an etApfoyer f&a7 P prat2g;wrlr °ad thea w°"ia 'CMez;L-P--U ' on. y kfarrndi.t.L ��eJm'mp�mlmcx B+efasp.s t�..5 Insr �raiioce . urartce CamP�'Name: ' Policy#or Self-ins. Lie. #: - Job SiteAddress; Expiration Bate: Attach a copy of the workers'•co Oih'��teJZip. Failure to se mPe�tiox Poiicy deciarataion Page(showiea oovetage as requiird under Section 25A ofMOL b the policy number and fine to I+► OL C. 152 lead to the imposition' pir�tioa taste}, up 51,500 00 and/or one-year im of dein' Of up m 5250.00 a �o��'as well Es civil penalfies in the farm of a perta}ties of a Investi the violator. Be advised that a copy of this S7Y)P WORK ORDER and a fine gations of the DIA for insurance cov moment may be forwarded to tlm Office of . wage verin:�icn't: I do hereby certify under the pcirts a>sdpeea to Si 'rPe�t�'t�fita`the urfnrmcfion provided obave��e and aonstz Phone#: Dom' iciQl use andy, do at write in this asrq,to he cornptet-Me chy or town. offzcia� City or Town: rity Issuing g AuthD . Perm�t/l:tcoase# (circle one): I. Board of Fieatth L Suiitfiteg De parbuent 3.City/Tofw•u•C.k* 4- Electrical 6 Other Ins pectnr S. PI umbin inspector Contact Per8DtZ: Phone#; intormation a nC! lAstructions Mnsa.ehusetts General Laws chapter I S2 mores all emp;oyers to provide w.oriters' compensation for their empioyees. ' Pursuant to this statuk,an entpfnya is defined as"..:every person in the s-rvice of another under any cmntrad dhire, �^ . express or implied,oral or writtsn." I` An mrrploper is defied as"an individual,partnership,association,corporation or other legal entity,or any two armors of tine foregoing engagad in a joint antmprise,and inclucU"g-the legal reproves of a dec nsad amployer,nrfhe I='ear artnskc-of an individual,partnership,associatic>in or other legal taatity,employing c arployem'Rowmthe owneh;•of a dwelling house having not more than three apa rtrnents and who resides therein, or the occupant of the dwelling house of another who employs persons to do rrn>3i7rteruance,construction orrupair wcirk as such dwtlfinghousr or on the grounds or buil&g sppurt=mt thereto shall not lr•..ca=of such muployment bt deemed to be an amployer." MGL chapter I5§25C(6)aim states fist"every stag a;-foam ficeusing agency shall witbhow the issaaneeor renewal of a license or permit to operate a Women or tt z construct bufkf'mgs in the commonwealth for any applicant who has not produced acceptable evidence-Dir compliance with the. imverage required.`- Additionally,MGL chapter 152,§25C(7)states"Neither tic commonwealth nor any of its-palitical saibtlivisions shat} anter MW ray contract for the periornranea of public woiie• Until•accepole e:'videncx of=npiiaac a with the insurance requazme rds.of fhis chapter have bean pr=Maftd to.tho mc3ty =tirng authority." .Appiicartia Please:fill out the workers'.compensation•affrdavh c:omplenntely,by checki Date. .C . . �'.".o"T:��o TOWN OF NORTH ANDOVER PERMIT FOR RCUMBING ,SSACNUS� ` This certifies that . . . . r" !-. ?. . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . .4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . !+. ,h *. . . ., . . . . . at . . .(-.c_. . . F.r.`./?h. t r. .-. . . . . . . . . . . . . . North Andover, Mass. r Fee. Lic. . . . . . . . . ��: . . .�::!-��.. . . . . . . PLUMBING INSPECTOR Check # o 821x0 9 0 U 2 Date. .�..� 14,o TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACMUS� 4 1 E . . 4"rt r d This certifies that . . . � r . . . . . . .. . . . . . . . . . . . . . . . . . . . .ti has permission to perform . . . �). �.ktrr4 SL-r. . R' :(►.1� �T. . . . . . . _ x. . . .(. . .14 rs(4 plumbing in the buildings of . . '�� �. . e. . . . . . . . . . . at y w.4u . . . . . . . . . ., North Ando er, Mass - . Fee��. .3. Do. .Lie. No..9333 . . . . . . . t'Q -.� . . i _ PLUMBING INSPECTOR Check !f � fi �(�i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING IV t � / City/Town: ,MA. Date• 0 C Pe1mit# Building Location:,6-666(V r Alie— Owners Name klL�� OY.�h Type of Occupancy: Commercial❑ Educational❑ Industrial❑ Institutional❑ Residential Q� New:❑ Alteration:❑ Renovation:❑ Replacement:V Plans Submitted: Yes❑ No❑ FIXTURES DEDICATED SYSTEMS LU z OC Z Z Y O � W Z } V W C9 z cc AA11�. Z a. W Z Z_ Vf Z Q CaC CA Z N I? W QaA 1N2 I` W_ . N C 0 1- , K 5 m N W F > cc I X z an Q 61 LL � = J Q 3 f' J D Q h Q W w O 0 W W4A LU �_ LU LU LU LIC LIG O W W V H = LL C) V Z Q Q 0. Z Z ~ ~ = 0 H W Q Q m m o c © x Y O = � a L>C Q Q c� Q Lr tr Q g 3 LIC � �, r_ 5 SUB BSMT. BASEMENT 1 FLOOR 2ND FLOOR 3RD FLOOR e FLOOR -i'—FLOOR e FLOOR 7TH FLOOR 8 FLOOR G Check One Only Certificate# Installing Company Name: T [9-e rporation Address•kzCity/Town: State: ❑Partnership Business Tel e Fax: ❑Firm/Company Name of Licensed Plumber: 1W.6 bai� �,�a M M INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes V,146❑ If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy R<- 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 ❑ Agent ❑ 1 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 Chat ha ter 142 of the General La By Type of License: Title ElPlumber S attire of License umber City/Town D�laster APPROVED(OFFICE USE ONLY) ❑Journeyman License Number: r j I I f� f' MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date ©/r Building Location � ,���d? F�✓ Owners Name S��jQ��� Perini # p a d o _ Type of Occupancy 14Z�d Amount New Renovation Replacement �� Plans Submitted Yes ❑ No ❑ FIXTURES x � H > � w � Ln V Z a w o° U ..a t� A � x H L7 A Q � oa &SEVEN' ISl:FLDLit . I T- M FLOOR 3M FLOCR ll A 1 - 1 4EM KJOCR 5M FLlOCY2 GIH FIS I T ( _ 719 RfM SIH MOM (Print or type) /r Installing Company Name Check one: Certificate �l f �— ❑ Corp. Address ❑ Partner. ® ?s' Business Telepho e p 0—f m/Co. �- Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 13—.� -Other type of indemnity ❑ Bond ❑ 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 ❑ Agent I hereby certify that all of the details and i rmation I have s mitted(or ent4d, ove pplication are true and accurate to the best of my knowledge and that all plumbi g work and installatio s perfo edw Issued for this application will be in compliance with all pertinent provisions o e Massachusetts ate robinChapter 142 of the General Laws. By. rgn re of Ocensec, um er Title Type of Plumbing License City/Town ense AUDI= APPROVED(OFFICE USE ONLY Master rM Journeyman .fr The Commonwealth of Massachusetts k1 f 1 Department of Industrial Accidents t � ! Office of Investigations 600 Ar hin�on Street Boston, MA 02111 wu�rv_rnassgov/din " Workers' Compensation sen-ante Affidavit. Builders/Contractorsmieatricianstpinm A� licant Information hers Please Print Le—gbi NaE' a(Business/Dwization/Individual): Address: City/State/Zip: Phone#. . Are you an employer?Check the appropriate bo7nd L❑ I rim a employer with 4. ❑ Ienera,contractor and I Type of protect(required):' PIoY (full and/orpar— t- )etum .* ed the sub-eomsadors 6 ❑New construction 2.❑ I am.a.sole proprietor.or partner- lthe attached sheet 3 7. ❑Remodeling ship and have no employees }�...contractors have working forme in any capacity,. ' comp.insurance. g' Q Demolition [No workers'comp, iBsurance 5. ❑ a corporation and its 9 Q Building addition required.] ohave exercised their 1Q•Q Electrical repairs 3.❑ I arrr a homeownerdoingailworkriexemption per MDL l I. oradditions myself[No"workers,co ❑ Plumbing repairs or additions insurance required.]t 1(4),'and we have no 12.[] Roof repairs employees. [No workers' comp. irtsurancerequired.] t3.QOther 'Any appiicartt that checks r t must also tett out the section below showing their workers'oompensetio,,peiicy information t Homeowners who submit this at�davit indicting they are wing an work and there him ourside con ;Ccntracton;that check this box musretraohtd an additiaas]sheet show' mon must subtntt a new affidavit indicatin such. 1 aFir as the name of the sub-carnractors and their work=, �:�. cen p.,.o.•...information. employer thai is protr'"errg:workers'conpensatrori irrsuraneefor mJ'employees Below it thep o inforntatfort: hcy and job site . Insurance Company Name: " Policy#or Self-ins.Lie.#: . Expiration Date: • Sob Site Address: - City/Swal ip. Attach a copy of the workers' compensation policy deCiaration page(showing the policy number and a 1=aiiure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminaalirate penalties 0°dat?ea fine up to$1,500.,00 and/or one-year imprisonment,as well Ms civil penalties in the form of a STOP WORK p es of i Of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of a fine investigations of the DIA for insurance coverage verification. I do hereby cmq*under the pains and penalties of perjury that the ormadon provided-above in f is true and rowed Si Date: Phone#: ozriciat use only Do not write in Utes areq re be completed b YY or townofficiaL City or Town: # Issuing Authority(circle one): Permit/License I.Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector S. PlumbingIns 6.Otber Inspector Contact Person: Phone#: Information a. nd Instructions fi} Massachusetts General Laws chapter 152 requires all emp 3oyers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, - express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the'fomping engaged in a joint enterprise,and includir-ag the legal representatives of a deceased employer,or the receiver ortrustee,-of an individual,partnership,associatioin or other legal entity,employing employe-s. *However the owner.of a dwelling house having not more than three apastinen s and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant:thereto shall not because of such employment be dee►ned to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shad withhold the issuance or renewal of license or permit to operate a business or to construct baiklings in the commonwealth for any applicant who has not produced acceptable evidence.of compliance with the insurance'coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the perfiormffiicc of public work- until-acceptable evidence of compliancx with fl.w insurericc requirements of this chapter have been presented to the coriisact'tng authority." Applicants Please fill out the workers'compmwdon.affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(m),and phone number(s)along with their certificate(s)of insusamce. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are,not required°to-carry workers'coirnp=s:ation insurance. If-an LLC or LLP does have empioyees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage., Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the.application for the permit or license is being requested,not,the Department of Industrial Accidents. Should you have any.questions regarding the law or if you are required to obtain a workers' r ` compensation policy,pleasecali the Depmtnent at the muruber,listed below, Self insured aniesshouldenterther nterth self-inswance-lieense number on the'appropriate line. City or Town Offic" Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in darn event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which%-M be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicaiing-current poiicy'inforination(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of-the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for fi>tme permits or licenses. A new affidavit must be filled out each year.When a home owner or citizen is obtaining a license: or permit not related to any business or commercial venture (i.e. a clog license or permit to bum leaves etc.)said persons is NOT required to complete this affidsviL The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of IvMassachusem Department of Industrial Accidanis Office of Lnvestfigstions 600 Washington Street Boston, MA 02111 TeL # 617-727-4900 ext 406 or 1-8-77-MASSAFE Revised 5-26-05 Fax 4 61 7-727-774 www.mass.gov/dia AddressJ5'D _ Title of File Page of Date f=ile Open: Date file closed: Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes action Document/ document/ Num. Action Department Board of Appeals — Board R Health — Planniing Board — Conservation Commission — Building Department Town of North Andover NORTF OFFICE OF 3?og "" ,"'6 L COMMUNITY DEVELOPMENT AND SERVICES - p 146 Main Street + 0 `• WILLIAM J.SCOTT North Andover,Massachusetts 01845 �,"SSAcNus�`�y Director LETTER OF COMPLIANCE CASE # 55 DATE: January 31, 1997 TO OWNER OF RECORD PROPERTY LOCATION Philip Byrne 50 Fernview Ave. 24 Jeffrey Road North Andover, MA Arlington, MA 02174 01845 A Health Department ORDER LETTER dated January 16, 1997 was issued to you as owner of record of the property listed above citing violations of the State Sanitary Code, 105 CMR 410.000, Minimum Standards of Fitness for Human Habitation. A re-inspection of the property on January 31,1997 indicated that all violations noted on the order have been corrected. A copy of this letter is being sent to the person(s) who made the complaint. If the complainant has any questions or comments concerning this determination of compliance, the Board of Health must be contacted within ten (10) days of the receipt of this letter. Sincerely, usan Y. For Health Inspector BOARD OF APPEALS 688-9541 BULL.DING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 NORTH ANDOVER HEALTH DEPARTMENT 120 Main Street • North Andover, MA 01845 Telephone (508) 682-6483, Ext. 32 Housing Inspection Report COMPLAINT # COMPLAINANT P, ADDRESS OF PREMISES -SO /4- ,1�� .,; e-1, 4-tz- / OCCUPANT �a►�, OWNER ;ir;•..P l ` , / `�oZ1> OWNER'S ADDRESS `� F DATE OF INSPECTION HOUR ROOMS/VIOLATION: C P-5- � . `�16, � zaa ry a t�l1�rK�h✓ -� �i ,7 921 x 1:;)7- -e' 21 INSPECTOR Form MR-1 Action Press 885.7000 - � F. �i`.i I .__. .. ,it'V�,�i.ala ll,l 0521 P. c31 I ,)iVEW; I-I „Ii 4C:J,'1, 61 ATI,ATITIC 4-N ''lll>> �11.it,t� ;,,11, 1,'�r ,,Ul; Ui�J'1 it-,illli�'LuIJ, I:ti +l/ 1 I) }.('l rl t. , ;V 1{f 'stxLJ 18 i ♦ . f 1 r f Itl;"'SW:E t I I I I i 1 I ' I 1 ' r I *0A) Li,) �'� i1.1'.l 1, L►'l. ti' 1'i.:,,.:� , l'.',I r..:_.l". i +, � 1''•�t::+. ; li.:iT��J l�i'i'I I.�i V{U.(.CL Ui -L+S� <21 II Z 115 794 533 Receipt for Certified Mail No Insurance Coverage Provided T� Do not use for International Mail POSTAL (See Reverse) Sent to Phil i 12 B)zrnp Street and No. 24 P.O.,State and ZIP Code Postage $ 2. 52 Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt Showing 0) to Whom&Date Delivered r ,C Return Receipt Showing to Whom, Date,and Addressee's Address TOTAL Postage C &Fees 0 Postmark or Date E sent 1/16/97 0 U. rn M. STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). m 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address m leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier (no extra charge). IC 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return M address of the article, date, detach and retain the receipt, and mail the article. 3. If you want a return receipt,write the certified mail number and your name and address on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed 0 . ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. �C�p 4. If you want delivery restricted to the addressee, or to an authorized agent of the addressee, M endorse RESTRICTED DELIVERY on the front of the article. 0 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If LL return receipt is requested, check the applicable blocks in item 1 of Form 3811. Cl) 6. Save this receipt and present it if you make inquiry. 105603-93-B-021e Town of North Andover f NORT/y , OFFICE OF 3�°.t"` 400L COMMUNITY DEVELOPMENT AND SERVICES p 146 Main Street +, ,; ► North Andover,Massachusetts 01845 �,'`��;;to'.P`�e* WILLIAM J. SCOTT95'74 NUS�� Director NORTH ANDOVER BOARD OF HEALTH ORDER Issued under the provisions of the State Sanitary Code, Chapter II, Minimum Standards of Fitness for Human Habitation, 105 CMR 410.000. Date: January 16, 1997 To Owner of Record: Property Location: Philip Byrne 50 Fernview Ave. 24 Jeffrey Road North Andover, MA Arlington, MA 02174 01845 An authorized inspection was made of your property at the above address by North Andover Health Department personnel on January 16, 1997. This inspection revealed violations of certain regulations of the State Sanitary Code, Chapter II, as listed on the attached Violation Form. You are hereby ORDERED to correct these violations within the time allotted on the enclosed form. Failure to comply within the allotted time period may result in a criminal complaint against you in the Lawrence District Court and may result in an assessment of a fine. You have the right to request a hearing before the Board of Health if you feel this order should be modified or withdrawn. A request for said hearing must be made in writing and received by the Health Department within seven (7) days from the receipt of this order. At said hearing you will be given an opportunity to be heard and to present witness and documentary evidence as to why this order should be modified or withdrawn. All affected parties will be informed of the date, time and place of the hearing and of their right to inspect and copy all records concerning the matter to be heard. You may be represented by an attorney. You also have the right to inspect and obtain copies of all relevant records concerning the matter to be heard. Susan Ford Health Inspector BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 i VIOLATIONS TO BE CORRECTED NO LATER THAN TEN (10) DAYS FROM RECEIPT OF THIS ORDER LETTER: VIOLATION REGULATION REINSPECTION 1) Sliding glass door with broken lock. 410.480 Every means of entry shall be fitted with operating locking device ■ Fix Lock 1) Ants entering apartment. Observed dead 410.550 and living ants in the rug and around the doors. The apartment must be maintained free of any insect infestation. ■ A certified Pest Control Operator must be contracted to assess, identify and eliminate the source of the problem. A certified PCO can only apply pesticides. It is unlawful for anyone uncertified to apply pesticides except in a dwelling of less than three apartments. The Board of Health must receive a copy of the report before a certificate of compliance can be given NORTH ANDOVER HEALTH DEPARTMENT 120 Main Street • North Andover, MA 01845 Telephone (508) 682-6483, Ext. 32 Housing Inspection Report COMPLAINT# COMPLAINANT �2i in�]i tka k' ADDRESS OF PREMISES S n d4 / OCCUPANT OWNER a �vr,..� f7 - `-1,3 v 1 ?RD OWNER'S ADDRESS DATE OF INSPECTION 7 HOUR ROOMS/VIOLATION: no Z' �lb, � aa J i e 4 rlP �Nj�A c Cil � l n V a - a r✓- lea 1 a ad/ x 42,45e, INSPECTOR Form#HIR-1 Actlon Press 885.7000 s '•.':1t I ; i I , II' � :[•V:NttkA:t:.f:`A'Ai. :;.};;r'�'<fff3? 't •`. #r#}•':::: ••`.:••`.; •.I .i. 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