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HomeMy WebLinkAboutMiscellaneous - 56 GLENWOOD STREET 4/30/2018 56 GLENWOOD STREET / 210/007_a�9-0000.0 l I I s Date.....7—.2..L/ �?.. NORTH 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING • � �" ter ,SSACMUS� This certifies that ..... / ......................... ,! .............................. has permission to perform ....... c?A......... `:!q/��............................. wiring in the building of......6A.rA��.bRipy at..... ....1 .4 ............................. .North Andover,Mass. Fee... .G ....... Lic.No. ........PIZ .. .1 .. ............. ELECTRICAL INSI� 7 Check # 6 6 �•r�+raai►Berevaurrvaua,�IUT � � � PennitNo. RD / WAOFF'IPBPREVENMRBML4711AMSS27cwnjz� L�PUMWqy 3 Feu ' APPUCA71ONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK To BE PPAPORMED IN AcCORDANCE wrFH THE MAwAcHusm m-EcmxAL.coDz,527 cmit 12:00 (PLEASE PRINT IN INK OR TYPE ALL 1NPORMA7I0N) Da Town of North Andover 'To the Inspector of wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) s-16 Owner or Tenant /�//i'/A.�/ L�J.y✓�i2 Owner's Address .SF�y1/IC Is this permit in conjunction with a building permit Yes No (Check Appropriam Box) Purpose of BuildingL.,4 Utility Authorization No. Existing Service ,/12) Ampri/� !�� olta Ovedwad Underground M No.of Metas New Service Ampex Volta Oveduad Underground 1=3 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work /ZC�A cul i �'�jzQ �,gyyfA Na of Ughdng Oadet Na of Hot Tube No.ofTrartsaostnam ToW Na of Ughtiry Platers Swhmdtts Pool Above Bebw r, KVA UVOW DMA nil KVA No.of Receptsels Oudot Na of OB Burnam No.of Bmergeory[.ishlini Battery Uaiu Na of switch Outlet No.of Osa Bomem Na or Rano Na of Air Con& Tata) FERE ALARMS Teas No.of Zoom No.of Disposals Na of Has Total ToW No,hof De��md Pa. TOM Kw Initiating Devioaa No.of Dishwashem Space Amer HeaWtg iw- No.of Souaft Dedcee No.of gaff Conggh W Dalectioll/Sootaft Devic, No.of Dryee Heating Devioa KW Lard E3 &%WC v Ot No.of Wats Heaton Kw Na of N06 of Connection Sim BNlssls No.Hydro Massage Tuba Na of Mown Total Hp hs�mCove>aga Pumatblrera}imieilydMasd�alGemlLawa ' Ihneaaarmtlalbi,Y)bs�neEt>icysridr;t7Qr of�su6srlirlt�ivalas YES -- Ihnesdsr�dvafdp�dssmeoht7dlort Y!� a)ouh Cfz:oedYEi4,Plet�idcateftetypedarAevgby p om C7 nm,** Wadc4SRR '� 5'41 irapeniortDlRec}tesed Rost �valaed�w* -Wu� cf HRMNAME LimrlreNa Adim . CicaaeNo ���� 01��U' BusaesTaft OW?J 'SMIRANCEWAMR-Iaaa mdatdreEictindaimhm at Tel,No, `fig 973 /5l9 Jdd19my gwont6 moll— mvNd�esd6mgA� �a�� `�o� a �t°��byMsm MGenaitlLaier (Please check one) Owner C3 Agew Telephone No. p]IRMU FEE 2 d � r f Date. yx tORT TOWN OF NORTH ANDOVER- PERMIT FOR PLUMAROG This certifies that . . . . . . . .1114 . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . .h. .� . ..7 4 !fir'. 7. . . . . . . . . . plumbing in the buildings of . c t ;y . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . .. North Andover, Mass. Fee. . Lic. No..ql s. . . . . . . . . , LUIVIBING INSPECTOR Check # 1A 7096 MASSACHUSETTS UNIFORM APPLICATION FOR-PERMIT TO DO PLUMBING (Print or Type) �;yllffi 1%ItNa-)v-cv1 , Mass. Date 20 Permit # d �, Building Location <-6;, G-L-,i?NAjxX)o-_-c Owner's Name_ ?A-1AAJ L, Type of Occupancy_ g It, 4,(, New❑ Renovation 0 Replacement ❑ Plans Submitted: Yes 0 No Gr' i„ FIXTURES S.P, # SEWER # SEPTIC # P , T zz U7) 0 zt Cn � �z _j U), Lr) LU C)� LU Lr) < cl� U D Lr) C)� LU of OJ w cn tr = U w A to( ,U) 71 Ow z z a t,- �=, U z co � to w >- ¢ F- z w . L7 ° X W w O w ¢ to ¢ w n z n �I m o oI = z o owl t� o ¢ � � � 0 m tt' ~ ¢ i a v ¢ J <L ¢ U D S SUB-BSMT o I o BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH.FLOOR ' 7TH FLOOR 8TH FLOOR >talling Company Name �Cl ��+-@_. n Check ong; Certificate dresso _ I Li to-ICA c� ❑ Corporation v t5J c.` ilb1 siness Telephone_ '17S 6 aN ❑ Partnership me of Licensed Plumber or Gas Fitter S49Yn-e. ❑ Firm/Co. VSURANCE COVERAGE: have a current liability insurance policy or-its substantial equivalent, which meets the requirements of MGL Ch. 142. Yes ❑ No . , you have checked ves, please indicate the type of coverage by checking the appropriate box. T liability insurance policy ❑ Other type of indemnity 0 Bond ❑ -WNER'S INSURNACE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 42 of e Mass. Gen al Laws, and that my signature on this permit application waives this requirement. fig ure of O finer or Owne s Agent Check one: Owner ❑ Agent reby certify that all of the details and information I have submitted (or entered)In above application are true and accurate to the best of knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with )ertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General La By Titlt Signature OHLicensed Plumber City/'T'own i APPROVED(OFFICEUSEONLY) Type of License: ter ❑Journeyman License Number. 2j Ba State Gas 1y Y A NiSource Company May 22, 2006 Landry Brian Account Number: 3963520052 56 Glenwood St North Andover, MA 01845 Dear Landry Brian: This follow-up letter is to inform you that your gas H/H W/H located at 56 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. Left lock after 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# CAdsupdatedle�VO'ston Street P.O. Box 869 Lawrence, MA 01841-2312 978-687-1105 Fax: 978-688-1870 22106 Date. . lU . ... .. �r r,OFTM 1 �Oya 3 O1NN OF NORTH ANDOVER • - PERMIT FOR GAS INSTALLATION • o i �9SSAcmus This certifies that . . . . ��! �. . `. . . . . .� . . . . . . . . . . . . ... . . . . . has permission for gas installation . . . . . . . . . . . . . . . . . . . . . . . in the buildings of . . /.k- S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . North Andover, Mass. Fee. ll1 X, . . . Lic. No.`?!.'. .` . . . . . .. . . . . .-Sn ..... . . . . . . r GAS INSPECT04 Check# Yl C h1ASSAC:I 1-16ETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING ( , r]i (Print or Type) IV" /r O 7V /JW'30✓1-1LMass. Date-9 1• ©Ca 20 Permit t�� Building location 4�(o &i-e ry/w". Owner's Name lgro'g&I Type of Occupancy New Renovation❑ Replacement[] Plans Submitted: Yes ❑ No p� I I i it LU 0 m Z L0 mw O a O w l— LIU U) z ~ w ¢ • ; cc O � p .� w u�= O L 1=L CSL > o n0. w SUB-BSMT BASEMENT lel 1ST FLOOR 2ND FLOOR 3RD FLOOR. t 4TH FLOOR STH FLOOR 6TH FLOOR TTH FLOOR. 8TH FLOOR ns tailing Company Name (2,/l f�� 14, Irl Check one: Certificate address—NI n sA, ❑ Corporation AW+'hhl-cr'L "0/ i siness Telephone -0-1i g©y -5a cjs", I] Partnership darn p Firm/Co.of Licensed Plumber. Fitter S'/�yi1 ,.�, 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. A liability Insurance policy ❑ Other type of indemnity ❑ Bond OWNER'S INSURNACE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass_Cneral Laws, and that my signature on this permit application walves this requirement cam/ Check one: a re 6f Owner orwnei's Agen Owner ❑ Agent ; hereby certify that all of the details and Information I have submitted for entered)In above appilcation are true and accurate to the best of my knovAedge and that all plumbing work and Installations performed under the permitlssued for this appilcation will be in compliance with all pertinent provisions of the Massachusetts state Gas Code and Chapter 142 of the Ceneral Laws. Type of License: yy ` BY ❑Plumber S gnatYre of L tensed Plumber or Gas Fitter Title p G as fi tte r Cityrrown �p,tdlaster License Number APPROVED(OFFICE USE ONLY) I p Journeyman Date.... '... S- 4. + t NORTH 1 ?°•`:r`` "�,� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING 4 i • CHUSE� This certifies that .w v �D has permission to perform S�'�1//C E����n .....................j. .................. ................... wiring in the building of fs !¢�....!^�f.khfl.y........................ �f . ....................44.70�� . .North Andover,Mass. Fee. �' Lic.No,ad . fit ............. .........lf ....... i LECTRICAL INSPECTOR Check # � �3?' 673 :) Commonwealth of Massachusetts l"crinit \10, 735� 'S Department of Fire Services Occuraw anti Fce ClicAcd BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9 oil APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORT' �11 tt)rk to lie rcrtiinled III Iccol.(.1mice�Nllll the r. 527(AIR 12.1M I'L E.INE PRL%T 1A 1A K OR TYPE-I L L IA FOR.1 1.1 Tlo,V) Date: 05 Ch or Town of: 1,1_f%100j1q jO I I�, )NC'!+)'r To Ihe hl' '11,jL�10j-ol 1f`i!-e S.. By 111IS qj)11L�Itioll the undersi'lled ZlIves "olice ot'his or licr 111tclitioll to J?erf,`)1-111 the Jectrical %<ork deArihed hvilm. Location (street & Number) Owner or Tenant R I N L WD Ll Tclephoaae No. Owner's Address Is this permit in conjunction with a building permit? Yes Y No (Check Appropriate Box) Purpose of Building — Utility ,authorization No. Existing Service Allips Volts Overhead 0 UndgrdE] NO. of Meters New Service Amps Volts Overhead El Undgrd No. of Meters Number of Feeders and Ampacity Location and Nature of Prop sed Electrical Nor No.of Recessed Luminaires No.Of Ced.-Susp.(Paddle)Fans No.of TOW Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Liminaires In- o.o mergency Lighting Swimming Pool ,above b,-od. i r;,d iBatfixy [:llits No.of Receptacle Outlets No. of Oil Burners PRE ALARMS No. of Zones No.of Switches No.of Gas Burners :No.of Detection and No.Of Ranges No.of,lir Cond. Total Initiating Devices No.of Alerting Devices No.of Waste Disposers Heat Pum Number 1, Tons P JK W. No.of Self-Contains Totals: .1 Detection/.k lerting Devices .No.of Dishwashers Space/Area "eating KW 'Local __1 Vluuicipal F1 Other L_ 0 Connection ,qr ea ti ,appliancesn I K W g No. of Drvers HeatingKW vstems: 0.ofNo.' ,No.Of Water NO.of Of bevices or Equivalent Heaters KW No.Of Data Ballasts Data Wiring: .s Ballasts No.of Devices or Equivalent No. "ydromass,, N o of"Joto rsT tll HP ige Bathtubs No, of Motors Total H P (elteommuilcitions Wring: OTHER: No.Of'Devices or EtL!!LiN.alent q7Y 37V F.,.tirnatvd VJuc ot ri'al Work: "":F'(,J, . )*.,.tl.�',Ilill'L.i; F)A:Clr� t k�hen I,CtjUII_Cd b', fIIUni6V1Jl p(,,liCN,.) \`Ivorkto�tart: G 0.6 In:pectiun;to bu requested in .tt:ci,rtlance with \IEC Rule i0• and upon completion. INSL RANCE 0A OM;E: 1. olc,s waned by the ott,11ur. no PCI-111it f,Ur the 1"CIAL)IIIIaIlLc of IJULNILA ��ork inai'AIC didl, !ht: liccliset: h:IS hihitcd proof iA "111;11' rc, 111C I'lAllj _J 9.: CtIlsve'. ------ Address: ;(XLII'iry f()I-[I-J." I.'[Pplic,1111C J% liCL11_',C 11t1jill�' I,. I IM N IFR'S INSt!41A.`•(.'.E 'W\IvEf4* I tile I L,.lL1ircd ti�, law. Ry �hyil)AIl-;WC,_' Q 11, rmt�11, thi: (Jleck cnc) Owner/Agent 0 ITT il-X-- Date�. NORT#j Of TOWN OF NORTH ANDOVER 0 �. � IF • PERMIT FOR GAS INSTALLATION CHUS Ett This certifies that . . . . . . . . . . . . . . . . .. has permission for gas installation . . . . . j . . . . . . . . . . . . . . . . . in the buildings of . . . -(-/: . /. . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . ... . . . . . . . .. North Andover, Mass. Fee... . ... . . . . Lic. No.. . . . . . . . . . . . . . ... . . . ,GAS INSPECTOR Check# 4451 I i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Building Location -6j%-A/Q Owners Name Permit# Amount Type of Occupancy le„ -�-t,� ./ New Renovation Replacement 1:1 Plans Submitted Yes No ❑ FIXTURES E~ U a z Ad w H> 1-0 a A A x x x a, � � *4 H S�H4VIC BAS VENT BE FLOM �II HDCit 3R11 HDM 4TH HIM SII-I H" 61H HDOR 7IH)"TOOK SIH HAOM (Print or type) Check one: Certificate Installing Company e f p' r l9�"� d —Ij ❑ Corp. Address 66 ^� S^ 1 1:1 Partner. Business Telephone Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity El ❑ 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 Owne Agent I hereby certify that all of the details and info ation I have bmitted(o entered)in ab e ap lication are true and accurate to the best of my knowledge and that all plumbing w rk and inst ations pe e n r P t ed for this application will be in compliance with all pertinent provisions of the ass et mb' g de d ter 142 of the General Laws. BY igna ure OT LICen um e Title Type of Pluybing Lice e �v City/Town icense INUMDer Master Journeyman ❑ APPROVED(OFFICE USE ONLY Date/ ...... NORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING 3 CHU This certifies that ../-.....*.................................................................................. has permission to perform ---!• -r1-- =��' ;.�j -�'' ' wiring in the building of '/............................................. • at......�... --< t J--� ..... - ' - .... .. ............................................................... .North Andover,Mass. rrzl Fee.YQ............ Lic.No. ELECTRICAL INSPECTOR Check # 4 8 i 3 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit /F__ 4&3 BOARD OF FIRE PREVENTION REGULATIONS [ Occ pane and Fee Checked leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), MR 12.00 (PLEASE PRINT IN INK OR E AL INF P-MATION) Date: City or Town of: To the Inspectol of Cres: By this application the undersigned gives i e of his or er i tent' to perform the electrical work described below. Location(Street&N ber) Owner or Tenant / Telephone No. 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: Installation of Security system Q)'L Completion qf the ollowin 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 ❑ In- Elo.o Emergency Lighting rnd. rnd. Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners o.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices No.of Waste Disposers . Heat Pump Number Tons KW No.of Self-Contained Totals: 1 Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local E] Municipal ❑ Other Systems:No.of Dryers Heating Appliances KW Security stem of es or Equivalent No.of WaterKit No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total IIP Telecommunications Wiring: No.of Devices or Equivalent 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 ❑ BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electric 1 Work: '303,- — (When required by municipal policy.) actric Work to Start: 1Q VY Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify, under the sins and penalties of perjury, that the information on this application is true and complete. FIRM NAME: ADI Sac=ity Ser_�Aires 12 LIC.NO.: 1 r J(` Licensee: John S. Bassett Signature LIC.NO.: 1533C (If applicable, enter"exempt"in the license number line) Bus.Tel.No.: 603 594 592$ Address: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Lic, see 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'sa ent. Owner/Agent I ] Signature Telephone No. PERMIT FEE: $ Date.. ................................ tkORTM TOWN OF NORTH ANDOVER PERMIT FOR WIRING A US Thiscertifies that ....................... ............... ............................................... has permission to perform.,,,.,--1d . ...................................... wiring in the building of.. ......... ........ ............................................... at... ...... ..... ............. .North Andover,Mass. Fee ............. Lic.No.............. ............... . ........................... �—ELEcnicAL INSPECTOR Check # 4740 THE COMMOATWEALMOFMMSSACHUSETTS /F Office Use only DEPARTNIEWOFPUBIICSAFEIY Permit No. BOARDOFFIREPREVEMONREGUIE1770NS527O RI200 Occupancy&Fees Checked APPLUCATTONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Spector of Wires The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) � ' � Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: YesNo (Check Appropriate Box) Purpose of Building Utility Authorization No. _ Existing Service Amps ;/ Volts Overhead Underground No.of Meters New Service Amps / Volts Overhead M Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 7^r 7; 777� No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures I Swimming Pool Above Below Generators KVA / round ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices ( ' No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER• t htstna=Covaage Rusla�tothete ofMassa�a>seitsGa alLaws TbaveaomutliabkhrnuancePbhcyinchxkgComplEtCovtWorilsstabsUldegoivAq YES 0 NO lbaveabrmlodvalidploofofsa=todbeoffiora YES If you havecircledYES,pleaseirxhc*drtypeofcowrageby ch0djT&TP0bo u f INSURANCE Bolam OII�R (PleaseSpecafy) �r� ( (�.(� 3h Expialion D& WolktoStatt C{ ' h�specrionDa� R Es1ur>a>edValwofElec"WoIk$ ' ��J a � Final SignedunderTr of ERMNAME Cc-, Li0cmNo. 0 Signat. LioewNo ���/�s- BusirmTel.No. 1 Alt Tel No. � 3 -r:,•"=.A5— OWNER'SINSURANCEWAIVER;IamawarethattheLioewdoesnothavedleinsut =comngeoritswbstanhalegtrivalentasIeqtliudbyMwsadmettsGeneralLaws and dialmysigr mondmpermitapplicationwaivesdtisIegtlnmte<II. (Please check one) Owner Agent od Telephone No. PERMIT FEE Igna ure or_ wner or Agent The Commonwealth of Massachusetts G, b Department of Industrial Accidents Office of investigations w~ Boston, Mass. 02919 Workers'Compensation Insurance Affi-davit Name Please Print Name: Location: City Phone # f —1 I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for nny employees working on this job. Company name: Address City Phone# Insurance.Co. Policy# Company name: Address City: Phone# _ Insurance Co. Policy# Failure to secure coverage as required.under Section 25A or MGL 152 can lead to the imposition of criminal penalties of.a fine up to$1,5oo.00 and/or one years'imprisonmentas YmU_as_civil.penaltiesinlhelorm-f-a-STOP.W-ORK ORD.ERind_a.fine_af_($11lo.DA)-aAay.agaWztms, I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. /do hereby certify under Me pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone.# i' Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing Building Dept E]Check I immediate response is required I] Licensing Boafd E] Selectman's Ofcc Contact person: Phone#: E] Health Departmen Other Date.�.�:.?S. .r o'<".O RT:��o TOWN OF NORTH ANDOVER ° p PERMIT FOR PLUMBING 40 ,SSACHUS� This certifies that . . . . . ...��`. . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform �/G.'/';a.� ?H. . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of .41'4. . . . . . . . . . . . . . z at . . !1. . �. . . . . . . . . . . . . North Andover, Mass. Fee Lic. No.. ./. 0. .U . . . . . . . . . . . . . . . ' PLUMBING INSPECTOR Check # 3 573 '1 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) �' f NORTH ANDOVER,MASSACHUSETTS Date 3 Building Location .Sp o Owners Name Permit#�/ Amount Type of Occupancy r� New Ica Renovation ® Replacement ® Plans Submitted Yes NO FIXTURES 1z CA cc w a � >4z H � H a S{B-BWK BAS EVENT I ISE FifM 2M ILOCR �FIOCl2 4II3 RfM 5MFIM 6MROR 7IH FIOIR SIH FI m (Print,or type) Check one: Certificate Installing Company Name 13 Corp. Address r S S^ Partner. Business Telephone Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: r Liability insurance policy 11 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 O Agent I hereby certify that all of the details and informatio have sub itted(or e d)in above on are true and accurate to the best of my knowledge and that all plumbing work d install a' ns perform e rmi for this application will be in compliance with all pertinent provisions of the M sach State um ' g C e , d to 142 of the General Laws. By: 3ignanue o icenfr er Type of Plumbnse Title City/Townv icense N11m er Master Journeyman APPROVED(OFFICE USE ONLY Location No. �`� Date NORTh TOWN OF NORTH ANDOVER O'tt�•o .•',�•p a Certificate of Occupancy $ s�CMusEt� Building/Frame Permit Fee $ 350 Foundation Permit Fee $ Other Permit Fee $ + TOTAL $ 3 �_ Check # `� 6 6 51 Building Inspector it TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING """MGM M��q BUILDING PERMIT NUMBER. / DATE ISSUED: rO x l /0?- SIGNATURE: Building Commissi2EEIREeor of Buildings Date SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Num Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: /�Ir/sti �Asf�Pr;M� Zoning District 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 0 Municipal 0 On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No I'll 2.1 Owner of Record 4t�4_(, Name(Print) Address for Service Si re Telephone 2.2 Owner of Record: vr+ N2me Print Address for Service: I11 Siglwture Telephone SECTION 3-CONSTRUCTION SERVICES 9 3.1 Licensed Construction Supervisor:.a�— Not Applicable ❑ �-o,(1_.( C 1 l Licensed Construction Supervisor: (3(10 ©S 9_3 License Number i Address / 7�1 Expiration Dae gnatu Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Compatly Name Registration Number r Address r v Expiration Date Signature Telephone Y t 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.......❑ No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ TAddition ❑ Accessory Bldg. ❑ Demolition ❑ Other Specify — ' Brief Description of Proposed Work: �IAI SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be C#FFIG` USE t)NLY , Completed by permit applicnitl g (a) Building I. Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(e)X(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5) eA> . O 0 Check Number SECTION 7a OWNER AUTHOMATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FO�R.B�UII.DING PERMIT Clry \ as Owner/Authorized Agent of subject property Hereby authorize to act on My b in m s r tive tow uilding permit application. ature of(honer Date— SECTION at 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 knowledger and belief Print Name Signature of Owner/A ent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TRvIBERS iST 2 ND 3 RD SPAN DMIENSIONS OF SILLS DM ENSIONS 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 _ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 `''��M Sy•'' Workers'Compensation Insurance Affidavit Name Please Print Name: fps Location: 4- 1 S City A0 114(1Ptl 14 O / v I `' Phone # 7� r I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity am an employer providing workers'compensation for my employees working on this job. Company name: Zk s Y-,-1 C!, t 1 Address city., �ci �..,�-. Phone#: Insurance.Co. Do!L-4- Poli. # 3 oa 3 Y*7`l Company name. , Address Citic:, Phone#.- Insurance Co. Policy# Failure to secure coverage as required:under Section 25A or MGL 152 can teal to the' and/or one years'imprisonment.as _c�vit vi n id crirnnal pertalhes -aji ne a to$1 m I .pienaRies�o3f�fim����?S?P]II�QRK9RDERand_a 1ne�€�S}DQW)��Yme. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DLA,for coverage verification. I do hereby cefily un the penalties ofPeJLNY that the irrfi Mk-ftrr provbWd above is true and correct. Signature ¢ -Elate,,/� /� Z Print name ��--,-6 J phone-# / 2k Official use only do not write in this area to be completed by city or town offidar City or Town Ina- E]Chedc QChedc yimmediate Brei ng Dopt response is required a Licensing Boam Contact person: Phone# Q Selectman's off, tD Health Depaitm, Q Other NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in properly licensed solid waste disposal facility as defined by MGL Chapter 111, S 150 A. The debris will be disposed of in: , (Location of Facility) i Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector t � ✓�ie �om=»eanueallfi of . ��iraur*'�r�se�s BOARD OF BUILDING REGULATIONS v License: CONSTRUCTION SUPERVISOR Number. CS 060963 Birthdate: 04/30/1963 Expires:04/30/2005 Tr.no: 11654 Restricted: 00 LEONARD B GETTY 363 NO MAIN ST (,.Ew.•. �i ANDOVER, MA 01810 Administrator 1 � DESIGN BUILT CONSTRUCTION LEONARD B. GETTY 93 Main Street Olde Andover Village South Mall Building Andover, MA 01810 (978) 470-4943 Fax (798) 470-2968 andoverbasement.com Revised August 13, 2003 Brian& Jamie Landry 56 Glenwood Road North Andover, Ma 01845 Dear Brian&Jamie; Thank you for the opportunity to provide a price quote for basement conversion we discussed. Following is an itemized list of the work required to complete this job, along with a price quote for the total job. Framing: Frame interior walls with 2x4 wood studs 16"on center for Play area, Game room area, 1/2 Bath /laundry room, Storage closet, and Mechanical room. Reframe new stairway 2x12 stringers and plywood treads and risers. Close up existing basement door and stairs. Build new closet in master bedroom. Remove old bulkhead frame new entrance way with steel door and plywood stairs. Windows: Install 3-new foundation windows w/screens and grills. Insulation: Install insulation R-13 faced in exterior walls. Blue board: Install 1/2"blue board w/skim coat of plaster. Ceiling: Plaster w/sand finish. Trim: Install interior solid doors primed white W/2 1/2"Colonial casing primed white. Stairway: Install plywood treads and risers. Railings: Install red oak railings with white balsters on one side of stairs a in living room on 1'floor. 1 DESIGN.B UIL T CONS TR UC TION Heating: Install new zone of baseboard heat to existing boiler. Plumbing: Bathroom: Install hot and cold water lines. Install 2"P.V.0 drainpipe for 36"vanity sink. Install 4"drain in basement floor for toilet outlet. Laundry room: Install hot and cold water lines for washing machine. Install 2"P.V.0 drainpipe. Install 4" dryer vent vented outside. Allowances: 36"vanity $300.00 18" sink $55.00 Faucet $35.00 Toilet $180.00 Counter top $200.00 2 ---DESIGN BUILT CONSTRUCTI-ON August 13, 2003 Brian& Jamie Landry 56 Glenwood Road North Andover, Ma 01845 Dear Brian& Jamie; Following is a schedule of payment amounts for the basement job. Payment Due Balance Due Total Job Cost $35,000 Down payment: $7,000 $28,000 Frame completed: $5,000 $23,000 Windows installed: $2,000 $21,000 Rough heating: $5,000 $16,000 Rough electrical: $4,000 $12,000 Plastering completed: $6,000 $6,000 Finish work completed: $5,000 $1,000 Punch list completed: $1,000 $0. Painting: Not included. Flooring: Not included. The Specification Sheet will control when disputes arise, unless written agreement has been made. Please do not expect the Contractor to be accountable for verbal discussions made without the proper written verifications. Buyers will make timely decisions when asked to make choices of product and color. These choices are important in delivery schedules established in the Specification agreement. Delays in these choices will extend the overall time of completion. Any items not identified in the Specification Sheet are cost plus 25%. Date: Contractor: Client: 4 DESIGN B UIL T CONS / Electrical: Playroom area: Install 6 recessed lights on a 3-way switch. Install plug outlets every 6'to8, at floor level. Install one (1)phone box and one (1) cable box at floor level Game room area: Install 8 recessed lights on a 3-way switch. Install plug outlets every 6'to8, at floor level. Install one (1)phone box and one(1) cable box at floor level. %2 Bath/Laundry room: Install ceiling light-fan combination on a single pole switch. Install GFI outlet @ counter top height. Install wall light over vanity on a single pole switch. Install plug outlets every 6'to8, at floor level. Walk-in closet: Install 1-over head light on a single pole switch. Mechanical room: Install 1-over head light on a single pole switch. Install plug outlet at floor level for service work. Install fresh air system. 3 DESIGN BUILT / Dotes or Questions 5 1 U W 11 vt v � A. u�%AL% . Iftwo JL .,... 6� $ . �( q =�= dover, Mass., T O L ACI� COCMIC i %SDRATED P?G,`�� H 4 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......... N.........�a!V�~ ..................y............................................................................ Foundation has permission to erect......r1**QA.A...... buildings on .. rN.frir.rr• •....... Rough P ...6'0.4P ....... to be occupied as......��.�.... � , 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 In pection, Alteration and Construction of Buildings in the Town of North Andover. P7/ ? SSW PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough N............................!T!�................................. Service BUILDING INSPECTOR Final Occupancy Permit Required t0 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. mp pu p Play area 10 10 i FExisfingairs to be remove. KAi � I 7 3 Install freash air system Ln 0 Storage room Install new stair w y S riser to platform 3 riser to floor. Dow UP i I 1/2 Bath Laundry room VL 69 O Walk-in lecrtica c/o et rel Brain & Jamie Landry Date 8/28M 56 Glenwood Road North Andover, MA. Scale 1/4"=1'-0" i I (978) 689-8630 I I Design Built Construction Corp. 93 Main Street Olde Andover Village South Mall Building Andover, Ma 01810 Phone (978) 470-4943 Fax(978)470-2968 www.andoverbasement.com