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HomeMy WebLinkAboutMiscellaneous - 624 BOXFORD STREET 4/30/2018 (2) 624 BOXFORO STREET 210/105.60023 0000.0 Keenan Construction P O Box 131 Beverly,Ma 01915 Telephone:978-921-6416 keenanconstruction@comcast.net May 12,2016 Jim Hurley Stephan Galinsky 1600 Osgood Street Building#20,Suite 2035 North Andover,Ma 01845 Dear Gentlemen, We are wring your department concerning a plumbing permit.That permit was pulled for 624 Boxford Street.That included two full bathrooms,one kitchen and a half bath on the first floor.With that said,we at Keenan Construction Company,Inc.,have removed the Hinchion Brother Plumbing Company from the above stated address.With several improprieties,this was proper to complete this part of the project. In summation,we have moved on to complete this project.After the rough inspection has been completed,and the above stated company has been paid in full,Keenan Construction Company,Inc.,has hire a new plumbing company.That would be Andrew J Savory Plumbing Company.Andrew will be responsible for the completion of this project.If for any reasons that there may be more information needed,don't hesitate to call.T ank you and have a great day. -- _ Warm regards, i i f een Construction 1 r 'j Keenan Construction P O Box 131 Beverly,Ma 01915 Telephone:978-921-6416 keenanconstruction@comcast.net May 12,2016 Jim Hurley Stephan Galinsky 1600 Osgood Street Building#20,Suite 2035 North Andover,Ma 01845 Dear Gentlemen, We are wring your department concerning a plumbing permit.That permit was pulled for 624 Boxford Street.That included two full bathrooms,one kitchen and a half bath on the first floor.With that said,we at Keenan Construction Company,Inc.,have removed the Hinchion Brother Plumbing Company from the above stated address.With several improprieties,this was proper to complete this part of the project. In summation,we have moved on to complete this project.After the rough inspection has been completed,and the above stated company has been paid in full,Keenan Construction Company,Inc.,has hire a new plumbing company.That would be Andrew J Savory Plumbing Company.Andrew will be responsible for the completion of this project.If for any reasons that there may be more information needed,don't t hesitate to call.T ank you and have a great day. Warm regards, eena Construction Date...IVI(oll 10G06 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING this certifies es that.0 I C kl I cel N� ............................................................................................. .................... has permission to perform ................... ............................. ...... ... ......................... ..... plumbing in the buildings of........ .............................. .....................I.............. ..... at..... ......&6 .4 .. ......... .............. . ......,North Andover,* Mass. Fee.0.........Lic. No. ......................................... PLUMBING INSPECTOR Check# oLfiS-1S MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY _ xZ�Ls..� _ _ MA DATE ® 6 ( PERMIT# d JOBSITE ADDRESS K 1 OWNER'S NAME (r POWNER ADDRESS TEL _ FAX TYPE OR OCCUPANCY TYPE COMMERCIAL© EDUCATIONAL © RESIDENTIAL PRINT CLEARLY NEW: F RENOVATION: REPLACEMENT:© PLANS SUBMITTED: YES NO FIXTURES 7 FLOOR--> BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM I _ DEDICATED GREASE SYSTEM __.J T _! ._.__� �' _.. DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN I J -_--_- ( I I _ I ! __...__I ! .—_---1 ! ----.1 FOOD DISPOSER -_l. I FLOOR/AREA DRAIN ► ___J ____► __ _.___ l f __.___.! _____J .. ._..._C __._._! ..__._I ____.J __..�I I ______{ INTERCEPTOR(INTERIOR) ^_ ( J_�_._ _ .. ' _ ) I I I —_.___i KITCHEN SINK f I ____._! _,__ J LAVATORY I __J _-_ l J _ _I ! l .__I iJ ___..J ROOF DRAIN SHOWER STALL I � ___ I SERVICE/MOP SINK TOILET URINAL I ..._..._..J E __._. -_— ! ..__J .... ! -_------- JE—.J —_2.---j WASHING MACHINE CONNECTION -71 --j J __ _I _.:_.i ..... f .__.._`. w-- WATER HEATER ALL TYPES WATER PIPING OTHERI -._J —I LL- ..._ I I INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES T<N0 I IF YOU CHECKED YES,PLEASE INDICATE THE YPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY DI BOND El- OWNER'S 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 0 AGENT SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best my!nowledge and that all plumbing work and installations performed under the permit issued for this application will be in co nce with I Pectin t pr sio f the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME 1c- [..1 i n .,(0✓i I LICENSE# �3 SIGNATU IMPTU"',JP® CORPORATION # PARTNERSHIP# LLIC COMPANY NAME h _Iv _(� ; ADDRESS 14 J1 CITY L�o STATE [ ZIP 11 TEL OQ FAX I CELL _...7 . �Z EMAIL wl8 _ _ .._ _ 1_cv._... _ ..__ I i ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Q c Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: PERMIT# PLAN REVIEW NOTES _ r I % The Commonwealth of Massachusetts Department of IndustriqlAccidiks Office of Investigations 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information b Please Print Legi Jly Name(Business/Organization/Individual): 1 A Address: WV,VQ- ' C,illi-.e,— �,V C_ City/State/Zip: O 116 0hone#: 87- 17 Are you an employer?Check the appropriate box: Type of project(required): 1.n I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction 2.eployces(full and/or part-time).* have hired the sub-contractors lm a sole proprietor or partner- listed on the attached sheet. E]Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for mein any capacity. workers'comp.insurance. g ❑gg addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.E]Electrical repairs or additions 3.El am a homeowner doing all work right of exemption per MGL I L ]Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' 13.0Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. 51 / cS Policy#or Self-ins.Lie.#: ��V`"�J ,y— Expiration DatNo,/IA, ep , ^ (� Job Site Address:(52 7 �'C�G '� V `fy—� City/State/Zip: U' o/�� /'T cXc �-- � Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one=year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine o£up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA.for insurance coverage verification. Ido hereby certi and lie sins and en ZY s of perjury that the information provided ahoy is tr a and correct. - Si afore: < Date: UD �� 1 ` Phone# Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.PIumbing Inspector 6.Other - - - Contact Person: Phone#: Information and Instructions ' Massachusetts General Laws chapter 152 requires all employers 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 foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments 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 deemed to be an employer." MGL'chapter 152,§25C(6)also states that"every state or,local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings 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 performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe 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' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials f ' 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 the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number.Ju addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(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 future permits or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or'-permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. 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 Com oufflalthofMossachusetts f Dopadment of Industrial Accidents Office of Investigations 600 Washington Street Boston,Il4A.021.It Tel.,#61.7-727-4900 ext 406 or 1-877:MASSAFE Revised 5-26-05 Fax 617727.7749 WW=ss.govfdia I� COMMONWEALTH OF MASSACHIISTTS BOARD OF r f f PLUMBERS>AND GASF I S�TERS" i ISSUES. .THE FOLLOWhNG LICENSE; ICENSEO ASA MASTER PLUMBER X1;1 CHAEL S HI NCH I ON 19 WIN' CE AVE PfABO'UYMA 01960-607' r*rsrm�.�;6, S0S/01/16 298700 it Date..... ..tom:d..lam'...... E NORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSAcmUS Et This certifies that ... ............... ........... has permission to perform ......r:55:�...1.14-4 % ...... wiring in the building of ....... 11�1 at...6x.94. ... ..... ................. .North Andover,Mass. Fee Lic. ........ ...... ... ......... k c 'I ELECTRICAL INOicrm V Check # Cal.- 6771� Commonwealth taPlfRass��1#users Official Use Only DII�ea,tment of Fire Services i'et mlt No. E3QAf�D OF FIRE PREVENTION REGULATIONS Occupancy incl pee Cliec)ted / APPR,f�ATi�1fV �Q;F� PERMIT [rceti�. t V)9) .""'�".•�,-- \/ leave All v:orlt tobe perronned in accanla„ce!with the%la ��l�r t � �.�R1(",�� w (PLEASEPIUNT)7VINI�OR TYPF,,11.1INFURAr 1TIpNj WORK 7CMR 1200 0t^y 0#'ToWD OF: Date, ay this aPP"cation the undersi �cd "'=f- u--•61)� tJ FP guts l�ottce of or ilei .; Iu 1lae lrr�p/_�tu l ocatlon(Street&Niiinlier) "cation c Perforin the elect,'00 ees ai work described below, Qwater or'Feitant Owner's Address --„�__4 rel Phone Na^ Is tills Permit lu con)riiietlon with a bulidfnfi Pe.tinit? yQs Purpose ofFRntldln // /� f No � -�,�� g-- f --_Sj1 ' T (Check APlaroptlate Box) -� �:tt#st#tag Service '-------�-----__- Utility ,t,aatboriz�tloaa No, ---- Amps . Volt's CD,'encead�•''-� Amps ED #ii,dgrd N"mbea•of Feeder )ins d """'—�--'---Faits No.of Meteas An*pAclE)' f�Yel'liead(� tJndgrcl """'.” Lacti"01t NO-of Meters �^ Nafur ofPra used r��-__ - - P �jec/#�rdcal Worlo i4'o.of Reecssed Fixtures No. . C�nr tletrolr o the ollolvin table trrav be rvaineAGy t/ae!ns ectot o l�aars "".,--.------ No.of Ceii.�,Sus . ot Na^of tt#� Ot#rlets ---- p (Paddlip)rang o.�"_ 'ITT No.Of Not Tubs Tratis>Fa)nters NO rC4ei'AtOrS KV(SVLighting Fixtures A �------- A Swit oa c n it- o.o amea'gencv No.of Iteceptaele outlet r»d• [iatrea LJaaits 8Iiig - ---- No.tifoil R+urners No.of Slvitches FIRE Aa.ARMS No.of Zo!csi �� e 5 11ruerS 0 elect an No.of Ranges 0. ---" NO.of Ali-Conti, Mal lnitlAil an Devices r No.of Waste Disposers Beat unlli Nltiulier Ttis No.of Alerting Devices - ---- - ons 0. of Se nnEnlne No.ofl?ishwasiaoTotalsri's -- (1 _ 'DetecttonlAlertlit Space,,Area,#--_Ae,ntlog I�W Devices :too of on,ers Local D MutaieipA Ilea U119 A.pptinatces Connection Q Other 0.0 rater leu- ecur ty yat'ems. i-icaters RW o•of""� — 1 0.o No.of Devices of-F "ivalcpt Ballasts Data Wiring: No, liydroniassnge Bathtubs T' ----- --_ No.of pevices nr F Vo.of!l9otors Tow lip P "#valent ._...'__'--^..�,^.....,..�..-._.__.__�._...._____-.�__..� TNlecottits'atia�t'icu-"7F;rtx�'✓wing: �TIIFR: —------ No,of Devices or i tiii•alent INSURANCE CQVFR rut;/i nddirinn r/dcrnil rl dran'ed.n,ns r nq,dred hW+ke litspecror of:f'irrs. AGE: Unless 1vajYCcl by rt,e o,aner,no per nit for the performance ofelcct'ical worts may issue unless tine licensee provides Proof of liability insurance i1,�lud ng•'completed operation"coverage or its substanttal equivalent. The undersigtted certifies that such coven is it Force,and),,as oxhibired proof ol•.sante to the permit issuing ofFce. CHECK ONE: INS('RANCE BOND Q OTHER (] (Specify:) _6 (Exbolt Dat FSt1 t' i �f I trlcal {d (Wliea: squired bymuliicipal policy.) �I&fl /1 �J l:t•,spectionslApbe egncsted tr.acarn'dancc with MEC Rule 10,and upon completion, W tog ld_G--- rrntler rite , Petialties of pesiurl:,that for inforntnrinr n dais application is b ue and cosnpletc+. das p 1 1C.NO.: F11t,M NAMR: Si�aature LiC.NO.: Licensee: = F Bills,Tel No. (flaAAhcabte. ter ere,r "to rite :censr n�ruber lb, � ��c Ali.Tel.Na.: -- Address: IR F12; 1 am anare that the !_s�ensee rloe,'iron have the liabtln�,insurance coverage normally OWNE>= S IN UR11N .E A waive this revatrcnierl. i all,The(check 0110 [i owner owner's a+eat. ,•equirect by lftu,'. Lay my stgatiafiute�t lqw^l hF;F PERMIT FEE. $ "___� OwtterlAgci►t ,je,Iglione No. - -- ---~- Sigtratarc •-"--------