HomeMy WebLinkAboutMiscellaneous - 518 SALEM STREET 4/30/2018 518 SALEM STREET
210/038.0-0105-0000.0
I
3391-,
Date./.. .. ... .. ....`:...
NORTH TOWN OF NORTH ANDOVER
p PERMIT FOR GAS INSTALLATION
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�9SSACMUSEt
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This certifies that . . . ... . . . . . l . . . . . . . . . . . . .
has permission for gas installation . . . . . . . . . . . . . . . . . . . . .
in the buildings of . . . . .•. . . . . . . . . .II . . . . . . . . . . . . . . . . . . . . . . . . . . .
at . . . . . . .j. . . ... .! l . . . . . . . . . . . . . .. North Andover, Mass.
Fee. . .l. . . Lic. No.. . . . . ... . . . . . . . . . . .
. . .
GAS INSPECTOR
i
i WHITE:Applicant CANARY: Building Dept. PINK:Treasurer
k
MASSACHUSETTS UNIFORM APPL,ICATON FOR PERMIT TO DO G
ype or print) at _ .:; ��� ✓
NORTH ANDOVER, MASSACHUSETTS
IS �a12m c5� ,t
3uildine Locations 5 Pet7ji}t#
'fM
A oust s
Owner's Name ',Ic>f Co,-t a-1 6 Q
Renovation ❑ Replacement Plans Submitted ❑ '
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z WJtr 13 8 ,-� 5E �1 ENT — — — —
u :� SE .M EN 'r
6 'r . FLUOR
? v U . FLOUR ?r
93RD . FLUOR
i'r If FLOU K
6T 11 FL00 K
7T 11 FLUOR
YT 11 F1. 00 R
:'rinf or rypc) Check one: Cenihc;ue Installing Company
am, Andover Md. & Ht4. Co., Inc. Corp. 1t �
duress 20 Agean Dr., Unit-10 ❑ partner.
Methuen. Ma. 01844
9usiness Telephone (978) 685-8383 ❑ Firm/Co.
',amc of Licensed Plumber or Gas Fitter , orae I allose
NSLR.ANCE COVERAGE Check one:
have a current liability Insurance policy or it's substantial equivalent. Yes No'
ou have checked ves,please indicate the type coverage by checking the appropriate box.
piiir; insurance policy Other tvpeofindemnity ❑ Bond
wner's Insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the
lass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
Sienarure of Owner or Owner's Agent Owner ❑ Agent ❑H":
,erebv certify that all of the details and information I have submitted(or entered)in above application,w.;;, and urate to the.
�•. .
ui my knowledge and that all plumbing work and installations performed under Permit Issued for this.:tp'p11#tion will be in
_omoiiance with all pertinent provisions of the Massachusetts State CAS Code and C to 42 of the Generi4 Ws.
�.,. Signature o Licensed Plumber Or Gas Fitter
Title [�Plumber 9983
rvrTUwn as Fitter License Number
l• •ter
Journeyman
!'PR0 EDIOFncF:USEONLY) ❑
Date.
No 4635
4, TOWN OF NORTH ANDOVER
0
F PERMIT FOR PLUMBING
7 SSACMUS�
This certifies that . . . f.�: E.���. .�. . T !�. . . • .�•S . . . . . . . .
has permission to perform . . . . T
plumbing in the buildings of . . . .. . . . . . . . . . . . . . . . . . . . . . . .
at. . . x f . . ..SA North Andover, Mass.
Fee. � Lic. No.. `:7 �'. . S . . . . . . .
PLUMBING INSPECTOR
Check #
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
_--......
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print) -
NORTH ANDOVER,MASSACHUSETTS
Date
Building Location 511 5ckm St V-ezt Owners Name QP- C t d O - Permit#
Amount
Type of Occupancy
New ❑ Renovation Replacement Plans Submitted Yes ---No
FIXTUREScn _
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(Print or type) Check one: Certificate
Installing Company Name ANDOVER PLBG. & HTG. CO., INC. "Corp. 2122
Address 20 AEGEAN DRIVE UNIT 10 Partner..
MFTHIIFN MA- 01844
Business Telephone 978- 685-8383- ❑ Firm/Co.
Name of Licensed Plumber: f F(1Rf;F 1 APQrNF
Insurance Coverage: Indicate the DTe of insurance coverage by checking the appropriate box:
Liability insurance policy 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 a
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 Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts Stat umbing C e Chapter 142 of the General Laws.
By: ZSignature Ium0er
Type of Plumbing License
Title
City/Town License nm er Master Journeyman El
APPROVED(OFFICE USE ONLY
Location
5-(s-
Nod Date
NORTH '7 1444rx—,-�—
TOWN OF NORTH ANDOVER
3?0�,,`•O •,SOL
• OA Certificate of Occupancy $
Building/Frame Permit Fee $ r
�'�b'••°'�t�'
GMUFoundation Permit Fee $
SJASt
Other Permit Fee $
*, Sewer Connection Fee $
T Water Connection Fee $
TOTAL $
Building Inspector
12686`1113119.18 e0'N 1
11 Div. Public Works
Location
No:
Date ll�
,.ORT1y TOWN OF NORTH ANDOVER
O? • • OA
F p Certificate of Occupancy $
Building/Frame Permit Fee $ �
Foundation Permit Fee $
SscwuS
Other Permit Fee $
t Sewer Connection Fee $
Water Connection Fee $
TOTAL $
Building Inspector
07/15/98 09:18 90.00 PAID
Div. Public Works
I
I E' MIT NO. APPLICATION FOR PERMIT TO I3UILI)********NORTII ANDOVER, MA
M\P NO. o 3 . 0 1.otmo. _ ll b 2. RECORD OF OWNERS111P DATE BOOK PAGE
V
LOhC SUB DIN'. LOT NO. r
1.0( (1If)N 1 (1 s" +- Pllltl(7dE(>f 1)1111UIN<;
OWNER'S NAME U ✓ NO.OF S TORIES \`GSIzF
OWNER'S ADDRESS BASEMENT C)R SLAB C"`
ST ND
.AR(TItIEC-I'SNAME SIZE OFFIOOR IILIIIERS J I 2 3
BI III DE R'S NAME l V C SI.AN
v
DISI ANCE lO NEAREST BUILDING 1 DIMENSIONS OF SII.I.S ?
DIS TANCE I RCXN STREET' DIMENSIONSOT-I'C 161 S G AJ(—Z
DIS I ANCE FROM I.OT LINES-SIDES j,71 REAR D J, 3 DIMENSIONS OF GIRDERS ��J
AREA OF LOT A L A1L FRONTAGE �7`OJ I IEIGI If OF FOUNDATION / TI IICKNESS 1
IS t3UII_DING NEW �9 lJ SIZEOF 1:0(Yl INC ) X
21 /
IS BUILDING ADDITION t /\ MATERIAL OF CHIMNEY
IS BUILDING ALTERATION CJ S IS BUIIDING ON SCA.ID OR F11 LED LAND L
Wit 1.BUILDING CONFORM TO REQIIIREMENI S Or CODE Cy S IS 81111.DING C(NJNECI E1) IO-OWN WA'1 ER
HOARD OF APPEALS ACTION, IF ANY L IS BUILDING CONNECT ED TO TOWN SEWER A
I v IS BUILDING CONNECT ED TO NAI URAI.GAS LINE
INS T(!('7IONS 3. PROPFIVIY INFORAIA110N I.ANDCOS]'
ES 1. BI IXi. COST
PAGE 1 FII.I.CX ff SECA IONS 1-3 ES f. til DG. COST PER So. FT. "--1
ESI. BLDG. COS I PER R(XXA
ELECTRIC METERS MUST BE CNJ OUTSIDE OF BUII DING SE191C PERNII 1 NO.
AFIAC11EDGARAGES MUST C(NJFORM'TOSTATEFIRE REGUI.AT-INJS a. APPROVED DY:
PLANS MUST BE FII.ED AND APPROVED BY BUIIJ TNG INSPECTOR I III.DING 1 � 'TOR
DA I E FILED l l OWNERS 1 Et.#)Z L �� 1
C(NJIR.IEI.# /—, -3
)J
SI(iNA fl IRF OF OWNER c Ni Al TI 1 NN217Ji1)AGENT COM'R.I.IC# V 0 —3 vCI �
E1:1: ITI.C.M
I'IiRhiIT GRANfEI)
��19
r10RT
F N
fTown of over
* Z _ dover, Mass., 19
LAKE 1
'9 COCHICHEWICK iY'�•
E D
S E BOARD OF HEALTH
PERMIT T Food/Kitchen
Septic System
BUILDING INSPECTOR
THISCERTIFIES THAT...............................�.............. alo-C)................................................................ Foundation
has permission to�re�f-.... - ........ . :........... buildings on ...........moi . . ..........., .�- �"�-............ .... - Rough
to be occupied as.....................................:.... 1'S.�1.o.. ................. - ..................................... 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
Final
PERMIT EXPIRES IN 6 MONTHS
UNLESS CONSTRUCTION SELECTRICAL INSPECTOR
T Rough
.... . . . .. ...... . .. . .
Service
B DING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove Rough
Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector.
Burner
Street No.
Smoke Det.
ay 7
Location
No. Date
40RTol TOWN OF NORTH ANDOVER
3? oL
F 9
a
.Certificate of Occupancy $
CNusEt� Building/Frame Permit Fee $ S
Foundation Permit Fee $
Other Permit Fee $
f TOTAL $ `
I
r
Check #
r
1
r
a1263
Building Inspector
z
i
1
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TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
`" htr: .�5� :s' ��Ql•�Iflll��I$�Q ,,.
BUILDING PERMIT NUMBER: DATE ISSUED: _ D
i
t
SIGNATURE:
Building Commissioner/I for of Buildings Date
SECTION 1-SITE INFORMATION '
1.1 Property Address: 1.2 Assessors Map and Parcel Number:
Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Areas Frontage ft
1.6 BUILDING SETBACKS .ft
Front Yard Side Yard Rear Yard
Required Provide Reqaired Provided Required Provided
C
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Infomution: 1.8 Sewerage Disposal System:
Public 0 Private 0 Zone Outside Flood Zaae 0 Municipal 0 On Site Disposal System C
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT n
2.1 Owner of Record (l�
Name(Print) Address for Service
0
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:. C
2
R
Signature
Telephone
SECTION 3-CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor: Not Applicable 0
o Ao060f � Z �
Licensed Construction Supervisor: ` C
f 6 S_ �� G It<L f /1 �Yj� Z jt.tr� License Number
T
Address ter—• [ I'"fi
Expiration Date
.Signature Telephone r
3.2 Registered Home Improvement Contractor Not Applicable ❑
Company Name J1rrn
f
.n/ `� Registration Number r
Y' I �t L��„r— t�
Address
Date n�
Signature Tele hone Expiration `+,
i
is
G
tthe
ON 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) `
Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
[inial of the issuance of the buildin nmit.
ffidavit Attached Yes........0 No.......0
' SECTION 5 Description of Proposed Work check all applicable)
i New Construction 0 Existing Building Repair(s) 0 Mterations(s) ,RC" Addition —0-
Accessory
Accessory Bldg. ❑ Demolition 0 Other ❑ Specify
Brief Description of Proposed Work:
� j
v �� y
ij
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item _ Estimated Cost(Dollar)to be
Completed by permit applicant
1. Building (a) Building Permit Fee
dc--) Multiplier
2 Electrical (b) Estimated Total Cost of >
Construction (d C1
rHereb
Plumbing Building Permit fee(a)x tel
hanical HVAC
Protection E
1+2+3+4+5 Check Number
N 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
i
r .
as Owner/Authorized Agent of subject property
horize to act on
in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
I, ,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
70
Print Name
Signature of Owner/Agent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB 4-
SIZE OF FLOOR TRVMERS 1ST2 No3
SPAN
DIMENSIONS OF SILLS
MIENSIONS OF POSTS
DMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHMVINEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUELDING CONNECTED TO NATURAL GAS LINE
_ 4
: Page of
Wood
Free Estimates 105 Haverhill Street
Fully Insured Methuen, MA 01844
THOMPSON'S ROOFING (978) 691-1355
Shingles — Slate—Rubber Roof
Single Ply — Copper Work
PROPOSAL SUBMITTED TO PHONE DATE
Joe Cataldoi - v1
STREET JOB NAME q
i
518 Salem Street
CITY,STATE AND ZIP CODE JOB LOCATION
North Andover MA 01845
AItHITECT DATE OF PLANS JOB PHONE
We hereby submit specifications and estimates for:
Remo-" and re race 411• tri.4 boards o-n both sides' of house ( 1x2 )
Break off any tabs .that ase ltaft.inq°
"l ist-A'll Aluminum drip-edge around roof line
Apply ice and water shield 3f t". u"p` 1 laaing edges
Reshingle with a 25 year '3tK5bSKl1VWe
Install new flanges around soil pipes
Cutinia new ridge vewft,•
Remove all work related debris
25 year warranty on material
10 year guarantee on labor
Construction lic, #060112
Improvement #128612
Option : If you decide to have a 254year Architect shingle i.t wi_11
cost you $480.00 more ( four hundred and eighty dollars) "0 Y
C 3propoa hereby to furnish material and labor—complete in accordance with above specifications,for the sum of:
Three thousand six haddedd ------------ 3 . 600 . 00
dollars($ ).
Payment to be made as follows:
All material is guaranteed to be as specified.All work to be completed in a workmanlike manner
according to standard practices.Any alteration or deviation from above specifications involving Authorize/
extra costs will be executed only upon written orders,and will become an extra charge over and Signature 1
above the estimate.All agreements contingent upon strikes,accidents or delays beyond our
control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully Note:This proposal may be
covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within days.
- C
Acceptance of Vropozal —The above prices,specifications and
conditions are satisfactory and are hereby accepted.You are authorized to do the �(^
Signature ��K' r *•�
work as specified.Payment will be made as outlined above.
Date of Acceptance: Si nature /
9
CERTIFICATE OF LIABILITY INSURANCE
DATE 04.23.01 (MM/DD/YY)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS
PELHAM INSURANCE SERVICES INC UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER
122 BRIDGE STREET THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PELHAM NH 03076- I N S U R E R S A F F O R D I N G C O V E R A G E
INSURER A: Liberty Mutual
INSURED INSURER B: The Maryland
Thomas Doyle DBA INSURER C:
Thompsons Construction & Roofi
8 West St. INSURER D:
Salem NH 03079
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL
THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS
GENERAL LIABILITY
B [x] COMMERCIAL GENERAL LIABILITY SCP 34865353 04.17.01 04[x] .15.02 FIRE DACH AMAGE `(Any one fire) 81 300,00
� � [ ] CLAIMS MADE OCCUR MED EXP (Any one person) $ 10,000
PERSONAL & ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000
( ]POLICY [ ]PROJECT [ ]LOC PRODUCTS - COMP/OP AGG $2,000,000
AUTOMOBILE LIABILITY
] ANY AUTO COMBINED SINGLE LIMIT
(
( ] ALL OWNED AUTOS (Each accident) $
[ ] SCHEDULED AUTOS BODILY INJURY
[ ] HIRED AUTOS (PereIson) $
C ] NON-OWNED AUTOS t p
[ j PROPEPer RTYiDAAMAGE $
(Per accident) $
GARAGE LIABILITY
[ ] ANY AUTO AUTO ONLY - EA ACCIDENT $
[ ] OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
( ] OCCUR [ ] CLAIMS MADE AGGREGATE $
[ ] DEDUCTIBLE $
[ ] RETENTION $ $
$
AWORKER'S COMPENSATION AND [X] WC STATUTORY [ ) OTHER
EMPLOYER'S LIABILITY WC2-31S-314995-019 04.21.01 04.21.02 E.L. EACH ACCIDENT $ 100,000
E.L. DISEASE-EA EMPLOYEE $ 100,000
E.L. DISEASE-POLICY LIMIT $ 500,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Job: Roofing Job at 6 MIDDLESEX ST. NO. CHELMSFORD, MA
CERTIFICATE HOLDER [ ]ADDITIONAL INSURED• INSURED U ED LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
FRANK DEAMICIS THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR
6 MIDDLESEX ST. TO TO TTHHELLEFT.DAYS BUTWFAILUREEN NTTOICE TO Do SO TSHALLRIMPOSETENO OBLIGATION
NO. CHELMSFORD, OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
MA 01863 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
k) 'z e'�
(7/97)
Page 1 of 2
�ORTIy
E
Town of 4. Andover
0
No.
OEM4a /
dover, Mass., ..30
7� ORATED p5
S H �
BOARD OF HEALTH
Food/Kitchen
Septic System
. PERMIT T D .
C'/Q BUILDING INSPECTOR
THISCERTIFIES THAT.......... .............................................................................................................................................. Foundation
has permission to erect.... . .. ........... buildings on ......,�...�.8.......S. 1.1.W.........S.. ....... Rough
t0 be OCCUpI@d as .................................................... Chimney
: . ........ .r.........1 A.Y R....
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. `rye 3 9 p /d c;L57
. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
PERMIT EXPIRES IN 6 MONTHS Final
UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR
Rough
Service
..I.. ........................................................................
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove RoughFina,
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.