HomeMy WebLinkAboutMiscellaneous - 60 PLEASANT STREET 4/30/2018 / -60 PLEASANT STREET
210/055.0-0015-0000.0
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MORTH
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o? TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
SSACHUSEt
This certifies that . . . . �.� !��. . . . . V `�. �- . . . . . . . . . . . .
has permission for gas installation . . . . ° . . . . . . . . . . . . . . .
in the buildings of . . . . . .K (' 1. !.� ./ . .Z . . . . . . . . . . . . . . . . .
at . . . . �.v . .�'. '!�3 G", ` . . . . . . . . . ., North Andover.�M/aass.
Fee!?. 5.'. . . . . Lic. No. G) . . . . . . ./Gt 6A.,W. 7
GAS INSPECTOR
Check#
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ONCE Puss. .Cate e>,Rtit #
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Building. Lxaiion 6� tQ1�aSe�� ST
Owner's Name
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Tyre of Occupancy )
�1" Svsy New ❑ Renovation O Raplacament Plans Submitted: `fes ❑ No O
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SUB-BSMT.
BASEMENT
1ST.FLOOR
2NO FLOOR
3RD FLOOR
4TH FLOOR
.5TH FLOOR
6TH FLOOR
TTN FLOOR
8TH FLOOR
Installing Company Name ,f tt 7L' /� C Check one: Cei i icate
Address o? 76 Sri) ❑ Corporation,
A/W-tyrn Mff ❑ Partnership .
Business Telephone 9l����34GG ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter D
INSURANCE COVERAGE:
have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes K No O
If you have checked Yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy. ❑ Other type of indemnity O Bond O
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 O Agent O
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 installation performed under the permit issued for this application will be in compliance with all pertinent provisions
of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
By /Type of License:
Title 0 Plumber
�Gasfitter Signature of licensed Plumber or Gas Fitter
Cttyrown Master I`/3G 71
BELOW FOR OFFICE U'-E OFi1.Y
FINAL INSPECTION SKETCHES NO' PROGRESS INSPECTIONS
MERCURY TEST
FEE
FINAL INSPECTION
APPLICATION FOR PERMIT TO VO 1 L1.°E 1.'ITINC+
NAME & TYPF OF BUII_UIM6
LOCATION OF nuiLDIMG
PLUMBER OR GASFITTER
LIC. NO.
PERMIT CnANTITP
DATE I^
qw) wmrrCTOR
=-29!2011 9;09 NI FROM: MTM Insurance MTM Insurance Associates, LLC. TO: 19786839300 PAGE: 002 OF 003
DATE YY
CERTIFICATE OF LIABILITY INSURANCE 3/29/2011)
PRODUCER (978)681-5700' FAX': (978)681-5777 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
MTM Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
575 Chickering Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
North Andover MA 01845 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A:Citizens Insurance CompanyOf 31534
DICK,S TV INC INSURER B;Allmeri.ca Financial Benefit 41840
276 BROAD14AY INSURER C:
,f
INSURER D:
METHUEN MA 01844 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 OFSUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR D'L POLICY EFFECTIVE. POLICY EXPIRATION
LTTYPE OF INSURANCE POLICY NUMBER DA. M ID ATE MMID Y LIMITS
GENERAL LIABILITY EACH'.OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LADAMAGE (RENT �
PREMISES Ea occun-ence) $ 300,000
A CLAIMS MADE ®'OCCUR DBN6530652 10/29/2010 10/29/2011 MED EXP(Any one person) $ 5 000
PERSONAL&ADV INJURY $ 110001000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000
X POLICY PRO LOC
AUTOMOBILE LIABILrrY
COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
B ALL OWNED AUTOS WN6530654 10/29/2010 10/29/2011 BODILY INJURY
X SCHEDULED AUTOS (Perperson) $ 5bb,0.b0
X HIREDAUTOS BODILY INJURY
X NON-OWNED AUTOS (Peraccident) $ 500,000
PROPERTY DAMAGE $ 100,000
(Per accident).
GARAGE LIABILITY AUTO ONLY-EA ACC[DENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR F-1 CLAIMS MADE AGGREGATE $
$
DEDUCTIBLE $
RETENTION $ $
A WORKERS COMPENSATION S. vc STATLY OTH-
ANDEMPLOYERS'LIABILnY YI.N, P
ANY PRO PRIETOWPARTNERIEXECUTIVE❑ E.L.EACH ACCIDENT $ 500,000
OFRCER/MEMBEP.EXCLUDED?
(Mandatory in NH) N6530658 1/1/2011 1/1/2012 E.L.DISEASE-EA EMPLOYE $ 500' 000
If yes,describe under
SPECIAL PROVISIONS below E.L.DISEASE'-POLICY LIMIT $ 500,000
A OTHERProperty Coverage DBN6530652 10/29/2010 '10/29/2011 Bus Personal Prop $576,534
Deductible 1,000
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS.
Certificate holder as listed below
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEDB FORE THE EXPIRATION
L E E EX RATI N
Town of North Andover DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
120 Main St. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
North Andover, MA 01845
' IMPOSE NO OBLIGATION OR LIABILITY OF ANY-KIND UPON THE INSURER,ITS AGENTS OR.
REPRESENTATIVES..
AUTHORIZED REPRESENTATIVE
P MacDonald CPCU, CIC JOfao!/`i
ACORD 25(2009101) O 1988-2009 ACORD CORPORATION. All rights reserved.
INS025(200901) The ACORD name and logo are registered marks of ACORD
r 3/29/2011 9:09 AM FROM: MTM Insurance MTM Insurance Associates, LLC. TO: 19786839300 FAGE:. 003 OF 003
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed'. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATIONIS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized
representative or producer,and the certificate holder, nor does it affirmatively or negatively amend,
extend or alter the coverage afforded by the policies listed thereon.
i
ACORD 25(2009/01)
INS025(200901)
! [7 16 Date. i .... ..�.
NORTIy
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TOWN OF NORTH ANDOVER
• - PERMIT FOR GAS INSTALLATION
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This certifies that . . . �Ak.w.'y. �.. . . . . . .- U Al�L�1.�. . . . . . . .
has permission for gas installation . . . .Bo ., . . . . . . . . . . . . . . .
in the buildings of . . . do. M . . . . . . . . . . . . . . . . . . .
atj.�1�. . . . ( � .! . . . -'. . . ., North Andover, Mass.
Fel,3b.-.00' . Lic. No...1-2.3.c).(o . . . . .
GAS INSPECTOR
Check# S L
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING
City/Town: /JQ' MA. Date: —�/ Permit#
r Building Location:// Owners Name: VA
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Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential
New: [ Alteration: ❑ Renovation: ❑ Replacement: [ Plans Submitted: Yes❑ No
FIXTURES
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'SUB BSMT.
BASEMENT
15T FLOOR
2 ND FLOOR
3 FLOOR
4 FLOOR
5TH FLOOR
6 FLOOR
VH FLOOR
8 FLOOR
tt � Check One Only Certificate#
Installing Company Name: 'TlC---3/-T-r PL-13 Wt tAj G
_ ,�( ❑Corporation
Address: 57z (11 1 rte► City/Town:CJ 'MWWS-,Q-1j-Q;tate: ✓ A
�
/ ��� a�a9 � El Partnership
Business Tel: ��0 Fax: 6A w ki-Prm/Company
Name of Licensed Plumber/Gas Fitter: ►J t s
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 below.
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
Massachusetts General Laws,and that my signature on this permit application waives this requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this box❑;I 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 Plumbin a and Ch pt 142 of the General Laws.
Type of License:
By (lumber
Title
El Gas Fitter Signature of L ensed Plumber/Gas Fitter
master
City/Town ❑Journeyman License Number: 2 3
APPROVED OFFICE USE ONLY ❑LP Installer
l
-60 PLEASANT STREET 055.0-0015
Complaint Detail Report
Printed On:Fri Apr 07,'-2 06
Complaint#: CT-2006-000032 Status: In discovery GIS#: 2982 Vol KLISIEWICZ,TADEUSZ K
paRrp Address: -60 PLEASANT STREET Map: 055.0 Address: 60-62 Pleasant Street
?�y,,ta +` yoo� Date Recvd.: Apr-06-2006 Time Recvd.: ^ 02:35 PM Block: 0015 NORTH ANDOVER,MA 018
a Category: Zoning Violation Lot: Type:. Residential--•--__.
GeoTMS Module: Board of Health District: Trade:
�,SACNU�E� Recorded By: Pamela DelleChiaie Zoning: Structure:
Description
Complaint: Received an anonymous complaint from a resident of Wiley Court complaining about residents at a house on the corner of Pleasant and Water Street who are
keeping at least"3 roosters/chickens. The exact number of the house was not known/given,but guessing it is 70-72 Pleasant Street(THIS NEEDS TO BE
CONFIRMED VIA A SURVEY OF SURROUNDING PROPERTIES TO BE SURE). Caller also concerned about outdoor domesticated fowl contracting"Avian
Bird Flu"from wildlife.
Confirmed with Public Health Nurse that the Avian Bird Flu is not a threat in this capacity. Therefore,there are no health code violations. There are,however
zoning violations if indeed a person or persons are keeping chickens:
Zoning Bylaw-Section 4.122-Residence 4 District
6.b.On any lot of at least three(3)acres,the keeping of a total of not more than three(3)of any kind or assortment of animals or birds in addition to the household
pets of a family living on such lot,and for each additional acre of lot size to five(5)acres,the keeping of one additional animal or bird;but not the keeping of any
animals,birds or pets of persons not resident on such lot.
Please have the Building Inspector follow-up and investigate possible violations. Thank you.
--Pfd
xc:
Gerry Brown,Inspector of Buildings
Brian Leathe,Building Inspector
ich Glennon,Zoning Department _
Comments' 4/7/06-I observed chickens in yard at approximately 2:45 p.m.On Friday,4/7/06-pfd
Callers
Date Time Name Phone Best Time To Reach Recorded By Response
Apr-06-2006 2:35 PM Anonymous Pamela DelleChiaie Forwarded to Building Inspector
Actions Taken i
GeoTMS Module Status Date Time Response Type Action Taken Comments
Board of Health REFERRAL Apr-07-2006 2:45 PM Follow-up b(y/Health 4/7/06-1 observed chickens in the yard at
Assistant approx.2:45 p.m. There appears to be a
chicken coop area as well.--pfd
GeoTMS®2006 Des Lauriers Municipal Solutions, Inc. Page 1 of 1
North Andover Board of Assessors Public Access Page 1 of 1
1 w
Parcel ID: 210/055.0-0015-0000.0 Community: North Andover
SKETCH PHOTO
Click on Sketch to Enlarge Click on Photo to Enlarfe
60-62 PLEASANT STREET 1
LN_
Location: 60 PLEASANT STREET
r N Z
Owner Name: KLISIEWIC , TADEUSZ K
EWA B KLISIEWICZ
Owner Address: 60 PLEASANT STREET
City: NORTH ANDOVER State: MA ZIP: 01845
Neighborhood: 5 - 5 Land Area: 0.26 acres
Use Code: 104 - TWO-FAM-RES Total Finished Area: 2540 sqft
i
ASSESSMENTS CURRENT YEAR PREVIOUS YEAR
Total Value: 400,400 376,500
Building Value: 239,200 227,200
Land Value: 161,200 149,300
Market Land Value: 161,200
Chapter Land Value:
LATEST SALE
Sale Price: 136,000 Sale Date: 03/07/1991
Arms Length Sale Code: L-NO- Grantor: LAWRENCE SAVINGS
REPOCESSN BK
Cert Doc: Book: 03226 Page: 0236
http://csc-ma.us/NandoverPubAcc/j sp/Home.j sp?Page=3&Linkld=804610 4/7/2006