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HomeMy WebLinkAboutMiscellaneous - 51 MAYFLOWER DRIVE 4/30/2018 y THENJCRIICIIK ®VIII h7AIIIi GROUP@ July 30, 2015 FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B Building Commissioner, or Inspector of Buildings c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 Board of Health or Board of Selectmen c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 Fire Department or Arson Squad c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 RE: Our File No.: P1598286 Insured: OLD SALEM VILLAGE OF NORTH Address: 51 MAYFLOWER DR, NORTH ANDOVER, MA Policy No.: R0639620A Loss Date: 02/25/2015 Loss Type: Building or Other Structure Damage A 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, Ch. 143, Sec. 6 to be applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct it to my attention and include a reference to the captioned insured, location, policy number, loss date 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 the claim will be paid in our customary manner. Sincerely, Linda E. Babineau Property Claim Examiner 1-800-688-1825 x1253 NORFOLK&DEDHAM MUTUAL FIRE INSURANCE CO. 222 Ames Street,P.O.Box 9109,Dedham,MA 02027-9109 DORCHESTER MUTUAL INSURANCE CO. Telephone:(800)688-1825 FITCHBURG MUTUAL INSURANCE CO. i elo Fax:(781)329-1818 945 Date... .............. ........ TOWN OF NORTH ANDOVER PERMIT FOR WIRING SACMUSEt This certifies that ........ ... ...... .........JZ��.. ............ has permission to perform ....... '. ......... a ��•fly,.,,. // ................... wiring in the building of......./.l...t.. .. :..^....' ...........................:.................. .v Z Z / 5/{ at.... .......... .... _...................... .../°?. . /. ,North Andover,Mass. C Fee..... .>...... Lic.No.., .!• ............ . .. .... ELECTRICAL INSPECTOR V l Check # /� Gontmvnw eatth of Massachusetts Ot)icial Use Only Department of Fire Services Permit No, y t BOARD OF FERE PREVENTION REGULATIONS Occupancy and Fee Checked _ Rev. 1/07j leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL ��s All work to be performed in accordance with the Massachusetts Electrical Code(MEC).520 WORK (PLEASE 1)R11VT IN INK OR TYPE ALL INFORMATION) Date: 'City or Town of: NORTH ANDOVER --�—�U Bthis application the undersigned gives notice of his or her intention to perform heth To e 'e electrical wor dtescribed below. Location(Street& Number) �o Z �� ()caner or Tenant a i---u .+-- C. Owner's AddressTelephone No. is this permit in conjunction with a building�ermit? �,� Purpose of Building r ZZ tNo ❑ (Check Appropriate Box) Existin Service �� A Utility Authorization No, g` ��/ zY0 volts --- 216 Overhead ❑ Undgrd C��No•of Meters New-----SeC•vtCe Amps _/ _Volts Overhead❑ Undgrd ❑ No.of Meters d Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ----- � Com letion.1,1h- OIIDN in table ma•be K•a e h the!ns eetor o '4l'ire No.of Recessed Luminaires No.of Cell,-Soap.(Peddie)Fans 0.0 ota No.of Luminaire Outlets No.of Hot Tubs Transformers KVA Generators KVA Swimming Poo[ No.Of Luminaires ove ❑ n_ o.o mergency Lighting rad. rnd. � Bette Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.o etechon an No.of Rangeslnitiatin Devices No.of Air Cond. ota No.of Waste Disposers eat ump um er T ns No.of Alerting Devices Totals: ° ° - ontaine No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW Local❑ unicipa No.of pryers Heating Appliances Connection El other t o.o ater KW curtty,ystems: )!eaters KW � o.o No.of Devices or E uivalent °'° Data Wiring: Signs Ballasts No.of Devices or E uivalent No. Hydromassage Bathtubs No.of MotorsTotal HP a ecomjnunecattons (ring: OTHER: No.of Devices or E uivalent Estimated Value of E leetrical Work: A!tach additional detail if desired, or as required by the hispector of Wire., Work toStart- /,t Inspections to be requesteclhinnaccordan auired ccordance MEC policy.) lNSURA.NCE COVERAGE: Unless waived by the owner,no C Rule 10, and upon completion. the licensee provides proof of}lability insurance including Permit for the performance of electrical work may issue unless undersigned certifies that such coverage is in force,and has`exhibit d proof of same tpleted operation" o pere ormit uyu ngtotfice. valent. The CHECK ONE: INSURANCE OND I cern ❑ OTHER ❑ (Specify:) fY, ander the pains and penalties r�f prrlury.that the infornsatioK on FIRM NAME; this application is trot and complete./f Licensee: LIC. NO.: y 3-S IJl(1pphcuhle. en -r .. Signature e.rrnyrt DRi t/re license numherline.) �` _ _L�IjC•yyN-O.: Address: 5 z Bus.Tel.No.: _�� Per M.G.L c. 147,s. S -h 1, security work requires Departm of Public Safety"S" License: e Alt."rel. No.: OWNER'S INSURANCE WAIVER: f am aware that the [_icen.ee docs nui have the liability insurance coverage normal( Lic. No. required by law. By my signature below, I hereby waive this requirement. f am the(check one) owner OwnerlAgent K Y Signatureowner's ag ent. "" Telephone No. PERMIT FEE: $ 97, ��/ � A r M Datej.�...:....Z.......:..v. f NORTH �?;�_tt`• 0 TOWN OF NORTH ANDOVER « p PERMIT FOR WIRING Y $A US This certifies that .......f..'. 'f �( / ..............................`.............. .............................. has permission to perform ...... ................... ✓ .. ".......�f` .` .5...-e-...... wiring in the building of..... �. !..1.:..:."....�............. ..................... at �' 2..? 3: !`'��.�//'�`w i;North Andover,Mass. d� Fee�a�:.... Lic.No.A,2`2.73 ............... .. .. . . . ..... .. ... �. ....... ELECTRICAL INSPE R Check # ����� 9175 Commonwealth of Massachusetts Official Use only 5MUTM; Permit No. fl Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/071 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: /..2- -?J - a 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) 2 Owner or Tenant OC "y C Telephone No. Owner's Address < e�2x Is this permit in conjunction with a building permit. YesNo ❑ (Check Appropriate Box) Purpose of Building `Al 4 ,�� /� Utility Authorization No. /1E<ri ",;�5lolr Existing Service Amps / Vo s Overhead ❑ Undgrd❑ No.of Meters New Service 2 6 �Amps /zc'/ Z yG Volts Overhead❑ Undgrd�No.of Meters r Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: /i✓,tet. 41 Completion of the ollowin 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.of Emergency Lighting rnd. rnd. Battery Units ` No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I 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 Tons g No.of Waste Disposers Heat Pum Number Tons K.W. No.of Self-Contained TotalsDetection/Alerting Devices ! No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of KW 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 OTHER: a Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 1Z (When required by municipal policy.) Work to Start: /z 2/ —G 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: INSURANCEOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: /,, LIC.NO.: 91 y 3 3 Licensee: r, ZI Signature Lg�IC..�NO.: 3 (If apph 1ble,en r "exempt n the license number line.) Bus.Te'.No.:4x--7— Address: Alt.Tel. No.: *Per M.G.L c. 147,s. 57-61,security work requires De�partmeOof Public Safety"S" License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does no 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 0.0 Signature Telephone No. PERMIT FEE. r .a i C ti i Date./��• :/.,�!�.`,? . . . . .. . FORTH pf ,.to ,°.1ti0 o? p� TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION SSACMUSEt This certifies that . . . . P.*.e' .� �,!. . f�. . ,/'t�?inky. . . . .Z. has permission for gas installation . . . . . . . . . . . . . in the buildings of . ..�I-iy/X . . . . . . . . . . . . . . . . . . . . . . . . . . . . at !. r. . . . . . . . . . . . . .. North Andover, Mass. Fee. .7G.. Lic. No.. . . . . . . .e'-i —C.", .- -- . . . . . . GAS INSPECTOP- Check# 7014 s.-°• s,� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFIT TING (Print or Type) Mass. Date l=_20 �?O/ Permit# O t y J`ss,�h ,,�sca Building Location Owner's Name Telephone 41 Type of Occupancy Ae,5 New M Renovation Replacement Plans Submitted: Yes E] Nor—] Y F 0 0 Lod d V m r- E _ ` N 04.0 m 2 � 2 o > � 1 y l0 = �. 0 G > w. ted, V _ y d > d C R .Q = O O O O N t = O = u_ � � oC7 � v � �' oCL1-' O SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 7 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name EnergyUSA Propane,Inc. Check one: Certificate Address 100 Myles Standish Blvd.,Suite 101 X❑ Corporation 132 C Taunton,MA 02780 Partnership Business Telephone (800)822-1300 X8055 Mike Smith Cell(508)922-7891 Firm/Co. Name of Licensed Plumber or Gasfitter William Kent Corson(800)822-1300 X8051 Cell(508)294-6660 INSURANCE COVERAGE: EnergyUSA Propane,Inc. has a current liability insurance policy or its substantial equivalent,which meets the requirements of MGL Ch.142. Yes XD No ri If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ElOthertype 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: 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Code and Chapter 142 of the General Laws. l Type of License: BY Plumber - � Title X❑Gasfitter Signature of Licensed Plumber or Gasfitter City/Town ElMaster APPROVED.(OFFICE USE ONLY) Journeyman License Number 3707 BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. APPLICATION FOR PERMIT TO DO GASFITTING NAME &TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED DATE 20 GASINSPECTOR Date NORTH TOWN OF NORTH ANDOVER o� 4, o40 PERMIT FOR PLUMBING ,SSACMUS� .� This certifies that . . .fir. �i' r h !. . . . . . . . . . . . . . . . . . . . . . . . has permission to perform plumbing in the buildings of . . . ` . . . . . . . . . . . . . at . . .T/. .,,/..)//"v 4/-r.-,' North Andover, Mass. Fee.6 f'. Lic. No..:/.0�.���. . . . . . .�� . :!-U� . . . . . . . . . . PLUMBING INSPECTOR Check # 82 + 7 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) �] N U.,jr Mass. Date q_ i I- 200j _Permit# ('.Z (' Building Location �`� � �Y��ow�r QCT Owner's Name blaC,pp Sdc.r► U' t b1/q,( Owner Tel# Type of Occupancy 15'k n& rC-4e New Renovation ❑ Replacement -❑ Plan Submitted: Yes ❑ No ❑ FIXTURES Z a Z > V) w a"i x H z o z Z A in w v h 2 rn F U W x w a gz a z 3 X U zp a Q w Q k1 z A raL ��1 z " ° w x w H H w A a x F ¢ Q A w WX a x 3 = o z w 3 � as o z Q H Q .H ¢ a °x �' ¢ ¢ C) ¢ ° ° a ¢ °o ¢ H S a w V) o A �a 3 x t~ w [7 a A 3 x w 1 o SUB-BSMT BASEMENT 1"FLOOR I 2"D FLOOR p 3&D FLOOR t 4T"FLOOR 5T"FLOOR 0 FLOOR 7T"FLOOR TM FLOOR Installing Company Name fels, A SLl Check one: Certificate Address 0 �Z�c V Y ❑Corporation ❑Partnership Business Telephone#_ 7 j 37 1�3 ❑Firm/Co. Name of Licensed Plumber INSURANCE COVERAGE: I have a current I' ility insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. Yes t� No ❑ If you have checked}_es,please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws,and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted(or en red)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit i's for thi application will be in compliance with all, pertinent provisions of the Massachusetts.State Plumbing Code and Chapter 142 of the General s. By Signature of 1,denseflPlumber Title / Type of License:Master C3'/ Journeyman ❑ P own APRj PPROVED(OFFICE USE ONLY) License Number Date. �� /. ? G.`?.... .. ,4pRTM / 41 TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION SACMUSE h This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . .e k'. . . . . . . . . . . in the buildings of . . 1�.�� . . . . .�*. fir. 1.��! . . . . . . . . at . . . . . . . . . . . . .. North Andover, Mass. Fee., p'�. . . . Lic. No.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR Check# -7 % Q 69 GUo MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) �A n i Mass. Date _rr- 20©O Permit# Building Location Owner's Name bt o Owner Tel# L Type of Occupancy-25 L 4L New Renovation ❑ Replacement ❑ P Plan Submitted: Yes ❑ No ❑ FIXTURES � � w Cn LO P4 U U w * . z2 m N ¢ o o °o N J z ¢ w J Q Z N �'� 0 > w F U .a w a ti It M z o z of t 0 0 2 � A Cd7 a UU P4 > Q a H 0 SUB-BSMT BASEMENT A 1sT FLOOR I I 2"D FLOOR 3RD FLOOR 4T"FLOOR 5T"FLOOR 6T"FLOOR 7T"FLOOR 8T"FLOOR Installing Company Namee; / -91 P` Check one: Certificate Address ro U( ❑ Corporation 41 t t ❑Partnership Business Telephone#_ /0 `j7 '��Y ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE: I have a current i ity insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. Yes No ❑ If you have checked yts,pleaseindicate the type coverage by checking the appropriate box. A liability insurance policy e/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 11 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 the permit issued for this application will be in compliance with all ertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General La s. By Type of License: Plumber Signat re o Licensed Plumber or Gas Fitter Title •-Gas fitter "��ff� yWlaster License Number 110 / i City/Town •-Journeyman APPROVED(OFFICE USE ONLY) I f Key-Lime, Inc. 10 Hepatica Drive North Andover,MA 01845 978-683-3163 r July 22, 2009 North Andover Building Department 1600 Osgood Street North Andover, MA 01845 Re: Lot 22 Dear Department Staff: Enclosed is a copy of the as built foundation plan for Lot 22 (51 Mayflower Drive) Old Salem Village. Please let me know if you have any questions regarding the plan. Yours truly, Benjamin C. Osgoo Treasurer i