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Home My WebLink AboutMiscellaneous - 625 GREAT POND ROAD 4/30/2018 � 625 GREAT POND ROAD � � � �� 210/063.=0000.0 �� Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Inspector 1600 Osgood Street North Andover, MA 01845 RE: Insured: Vicente & Donna Lee Rubin Property Address: 625 Great Pond Drive Policy Number: HP2273524 Date/Cause of Loss: 10/29/2012, Hurricane File or Claim Number: 26879-R Claim has been made involving loss, damage or destruction of the above captioned property, GENERAL LAWS,which may either exceed $1,000.00 or cause MASSACHUSETTS , CHAPTER 143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. Ryan Werner On this date, I caused copies of this Notice to be sent to the persons named above at the addresses indicated above by First Class Mail. SigZTMENT and Date ANDERSON ADJU CO., INC. 50 Nashua Road, Suite 303 PO Box 1098 Londonderry, NH 03053 Date. o. . . . . . . . . "oRTM TOWN OF NORTH ANDOVER ° PERMIT FOR PLUMBING This certifies that . . . . . _. ... . . ... . . . . t . .. . . . . . has permission to perform . 1:�'?.? �.t!''. . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . at - . . . . , North Andover, Mass. w n Fee - : .. Lic. No..;.?,,a, . . . . . . . . . . . . . . . . . (� PL WING INSPECTOR Check # `�� 3 7301 MASSACHUSETTS UNIFORM APPLICATION FOR-PERMIT TO DO PLUMBING (Print L�ss. T D to '942'001—2p01— Permit # UVBuildingcati n is ame yA� Type of Occupancy New 0 Renovation 0 Replacement 91,11* Plans, ubmltted: Yes 0 No 0 FIXTURES B.P.-# :SEWER# SEPTIC #f z z � cn Ln } z0 Q z > w z cn I¢— � v f' z = u� uj w Jo w cn to = to !- U w cn N z in Z Of tw- v 1. = = a zo _ Y a p c ° ,� �° IL Ci ce Q o ¢ o Z o o. Q � . � Q o v o z M to D _ to u_ (D ° Q � W m 0 O SUB-BSMT BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR - 7TH FLOOR FLOOR nstalling„Company,Name. Check ong: Certificate �d d ress 0 Corporation - i A�in CA >M N } p to ❑ Partnership tusiness Tele hone_ !ame of Licensed Plumber or Gas Fitter_ Q INSURANCE COVERAGE: - - I have a current liability insurance policy or Its substantial equivalent, which meets the requirements of MGI-Ch. 142- Yes No . 0 If you have checked Yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy P--*-,- Other type of indemnity 0 Bond ❑ OWNER'S 1NSURNACE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 942 of the Mass.General Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent Check one: Owner 0 Agent ❑ ereby certify that all of the details and informatlon 1 have submitted- entered)In above application.are true and accurate to the best of t.knowledge and that all plumbing work and msta.Uat1'o,ns'perfgr ne nd rthe-permit iss for this application will be in compliance with `pertirient p'robislons"of the Massachusetts State Plumbing Code'a 9 t 142 of the eral Laws.... ]3y SI na ure of Licen ed.-lumber Title —�.. City/Town APPROVED(OFFICE I Type of License: aster ❑Journeyman License Number__ L �"'- �-"t.-� .s�"'^.-�'^r..-7..•.--.r'"�..�a�.Jv.-.,-�..7�. yr-�. .,-�.�--'i`- ' --}`.fir-�...-�.-..5f��s d a 4, Date.....0..... �..�7." 1v0 654 ` f ND Tm 0 TOWN OF NORTH ANDOVER qL c - � # PERMIT FOR WIRING ACMUSEt .. x - e This certifies that ......... ... ...... Ct has permission to perform (,,,,_.r �" 441L-- wiring in the buil ing of....... . . ..........a .................................... at.........— ....... .. ... .:.all ,.'fi...... ..... ..,......,North Andover,Mass. Fee....... .... -'//�..... Li c.No. ...a1. ., � .... Z ELECTRICAL INSPECTOR ti 12/20/% 12:00 25.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer e i ` \ Office Use Only. T u�JE LIITTIIIIIITtll1E IIfi�LI1L�sEi Permit No. S� tiOt cu an & Fee Checked • Et'. III'1:IIIP.SL1:.Qf II�1IIt ..�"3fP;:I� P c/ 3190 (leave blank) . 80ASO OF "FIRE PREVENTION REGULATIONS X27 C'dR 12:00 23 S APPLICATION FOR PERMIT ,T0 PERFORM ELECTRICAL WORK All work to be performed in accordance with the.Massachusetts Electrical Code, 527 CMA 12:00. (PLEASE PRINT IN INK OR TYPE ALL INFORMATION).: :, Oate Q�X or Town of NORTH ANDWER Te.ihe Inspector of Wires: The ud.ersigned applies for 'a permit"to.perform the electrical work,des ibed:below':. Location ($.tr.eet.& Number) (oa'� �Ceo- l O.veCX• g°' Owner or Tenant Df- 0 Wner-s f-Owner's Address ^ ` • is this permit in conjunc;ion,with a building.permit: Yes :" No° f (Check Apprcariafe 8oxl< Purccse of Suildina � �a•^ �� Uttlidy Authorization No � tin Service Amps � �7t:its.. Overhezd Unag�nd of tNeters Xi sting:g Se . Ne.v Sarvice Amos _J Volts -0veri-ead uncc,,na '. 'No. of Meters Numaer of Feeders.ana Amcacity Lccaticr, ana Nature of Precoskl:Electr cai,:ilcrx 5 ��. ,� i 'No: of Transformers:` Total No: of Lighting Outlets �'" Na t -cs kVA i Abeve— nia. of Lighting r=,xtures,_, 1Sw1mm1ng Pao'' grno. — gree: _ Ganer3iors: :' KV,a ; No: of Emergency Lighting r• No. atRecectac.e Outlets No. at Oil Surners 3arery units *, F Na. of Swrtcn Outlets No. arras Surners At�AMS No.,at;Zones ' Total No. of ^etection ana. l No. of Ranges:.. No. c` Air rJrc:` tons.. g;. e # -Irnnaun �av�ces _ No. of Disoosais Heat Total. Totaf .' „s No f ?u acs Tons K:V' No. cf Scunetng Devices No, of Setf Contained' No. of Dishwashers - ! SoaeeiArea Heanra KVI' Detec,tonrSounaing,Devtces Munrcioai I ^ CvV Lpcat — other hr s .40. of Dryers I'`Hea:;ria ,ev:ces _ Connection No. at No. Of Low Vonage No. of :Vater Heaters KVJ I Signs 3adasis i` +vir:nc No -ivaro Massage Tu'as No of Motors Tatat"-iP is OTHER: INSURANCE COVERAGE: ?ursuant-,a the.reauirements of.'f.tassac usa ;enera Laws, _ s I have a'current Liaotiity insurance ?oucy-;nctuctng..Ccmo:etea Ote'awns.coverage or its:"suostanital eauivatent-`.'ES NO nave sunmi tea valid praaf of same to the:Ottice. YES -NO - nave-nave;checxee YES.. tease inc the type-oi coverage cy checking the aoproonate Cox. INSURANCE - 36tu0: .OTHER _ tP!ease =cecifyj � - .tEXDtrattan Oate1 ESurnatec Value of Eiectncal Work Wcrx -o Start - insaec%on Date ?acuest2c: gn F,nai n S;gnea unser the 2enataes of perjury .. - �Y �'� LIC' �— FiFiVt NAME Signature LIC. NO. -------------- Licensee �/ `� Sus at. No. Actress o� _n ST �' Alt. Tef. Na, , OWNER SURANCcWAIVER: I am aware trial me -;cense- Cas not nave trio insurance coverage or its suostanttat eauryalent: e au�rea n Massachusetts General Laws. and; :hat my signature:9:n :ris aermtt.acoticat,on-waives Ih,s reautremerat. ownerAgent: (.Pease cnecx one) 'aiecnane.No'..: PERMIT FE= S iS;gnature of Owner or Agenu "'= Date.6.� N2 4476 <",0 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACNUS� e This certifies that . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of �/.1. �... . . . . . . . . . . . . . . . . . . . . . . at . .(,. .>'. �A.�A,f /A !:. . . . . . . . . , North Andover, Mass. Fee. .).� Lic. No.. .SP.l`? . . . . . . . . RLUMBING INSPECTOR Check # 7 WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS �� Rv l/(� LP (J DateBuilding Location Z NamePermit# v/ Type of Occupancy Amount New Renovation Replacement 13 Plans Submitted Yes r-1 No FIXTURES w x a z �' F x a -< �F- a F F a z 0 E" SLRBM B�4IVIIVI' Y IR FILM M HDM 3MROCIR HOCR 5IH FLOCK 6EEIREXR 71H ILIXR SIH MUR (Print or type) Check one: Certificate Installing Company Name �'1 �j �4 Corp. Address /U�O/3��A� %/ Partner. Business Telephone (p$ 2 o p 9� Fin:n/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Er 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 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 is application will be in compliance with all pertinent provisions of the Massachusetts State bing C a a 'of the General Laws. By Signatureo icens um er Y Type of Plumbing License Title WW 7 S 4 City/Town -cense NumDer Master11 Journeyman ❑ APPROVED(OFFICE USE ONLY N° 21 23 Date ........ NORTH TOWN OF NORTH ANDOVER OL ° p PERMIT FOR WIRING ,SSACHU Thiscertifies that ....:. :.. ��;, .•r -? ............................................................. has permission to perform .. ` -� --- �-� ..................,.e..<�:J:: wiring in the building of... :..:. .................................................. at. .. ��....... ...... ... ' ...`. ...... ,North Andover,Mass. Fee. .. ... Lic.No G!l�l. ............... . -±';4..........-4.. a.:.. ......... ELECTRICAL INSPECTOR 97 WHITE: Applicant CANARY: Building Dept. PINK:Treasurer THECI0MMONWEALTHOFMASS4CHU.SETTS Office Use only DEPARTALEA 'OFPUBLICSAFETY Permit No. g!a"3 BOARD OFMEPREYEMONREGU ATIOAS527CMR12:00 Occupancy&Fees Checked VAPUCATTONFOR PST TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 ' (PLEASE PRINT M INK OR TYPE ALL INFORMATION) Dat_Q 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) G 6T-1 ( PC)A)l RL) Owner or Tenant P19U L cieC� Owner's AddressL Is this permit in conjunction with a building permit: Yes L(J No ® (Check Appropriate Box) Purpose of Building e7�; IL,W CC Utility Authorization No. Existing Service Amps / Volts Overhead O Underground Q No.of Meters New Service Amps / Volts Overhead ED Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 6-0// E I FTI + 77607075/77 No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA and 171 ground No.of Receptacle Outlets 12, No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets !� a 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.otVater Heaters KW _ No.of No.of Si Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER hstraroeCotier�e Ptast�atYY�thetegtmarteisd�C�aaiLaws Ihx,ea=atlia7ityhnxanoePobym&jcbrgC a Co►csagcrtssksontWaWiva YES ® NO I haw stfn gtedvalidpmofofsa elo&0)1m YES M NO a If}uhmdrdodYESpkmmdc&&tpecfcmbydednttx �� M. Boren ❑- _ OTI-lER 0 reaw ) Z3 Valuecf�l Wu$ WodctoStwt Dade Fmal C h>s� W� L �Nu�A>rtrME Pdtalaes ofpa�tay C'v CSC 7V C Lio� . J OF y Sigr� 5 / _ BtlsitmTel.Na d ZS y Al Tel Na OWNER'S MJRANCEWAIVER,I amwA=#AtfieLJ=wdbm not the mstmcea orkssbutaleivalatast4aedbyNtCinaa1Larm and@�atmysglr�6taemthisp� icxtwanesilns ttx�r��[ � (Please check one) Owner ® AgentED Telephone No. PERMIT FEE S ..r.�, ,-'..*...�S4i.�r''f"" '.�Wr+'�.-`-��.ur.:�"Y,"'' """ .. .--r-w'--•.. �:�,.`,'_,.,�•`�+-,� r..--'..�...-..,ri�w�`y.�� p Date... J� . ... . 1960 CF ,ORr e TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION44 A tSSACMUSE - -. This certifies that . . � . . . . . . � . IC . has permission for gas installation A . . . . . . in the buildings f . ,L . . . . . at Fee j Lic. No.q L/7,.� . . . . . . . . . .. . . . . . . . . . . . . . . �// GAS INSPECTOR WHITE:APNic � A4TY f3uilding Dept. PINK:Treasurer GOLD:File MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING I (Print or Type) NORTH ANDOVER Mass. Date — 113uilding Location ��245� jF)5 Permit # Owners Name 0& Y ., New -7 Renovation D Replacement Plans Submitted D 9 FIXTU—RES G1 . �++ � V `a m to tW- '� ¢ o o ' o z r W 4 W w W 0 a cc y N c� 07 w z v `� Y 0 w 4 0: 0 c t- W as O FLU W- 2 !r 2 W Lu 0 0 ? U_ fW. V j C1 EU G Oa O r s = Q tu y .0 W O `t G d Q O O w 5 O W F- x O O = W a 0 ..c I o y ca a t— o SU$—aSTMT. BASEMENT 1ST FLOOR 2MD FLOOR 3811 FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR TTI{ FLOOR 8TH FLOOR (Print or Type) Check one: Certificate Installing Compan am 0 Corp. Address 0_ r Partner. Business Telephone: Name of Licensed Plumber or Gas Fitter Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q 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 coverages. Signature of owner/agent of property Owner ❑ Agent F7 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 worst and instAiLations performed under*Permit issaed for this application Will_be in oomplianoa with ali patiaent provisions of the Massachusetts Slate Cas Code:nd Chapter 142 of the General Laws. By TYPE LICENSE: Plumber Title Gaufber Signature of Licensed Plumber or Gasfitter City/Town: Master Journeyman APPROVED (OFFICE USE ONLY) ic6nse Number ..• If� . . . 7�� Date............ .. i NORTH Ottt�ae .e,M TOWN OF NORTH ANDOVER PERMIT FOR WIRING �,SSACHUSEt - - This certifies that ° ~' 4..��fI Q has permission to perform ...... ........ K bt u' wiring in the building of......../(�.- at �,....... �.Pa ctL /............. ,North Andover,Mass. Fee.........:........... Lic.No.............. ..........................:..................:...:.......:..... c ELECTRICAL INSPECTOR p� p C F WRITE: Applicant CANARY: Building Dept. PINK:Treasurer �' I ` _ Office Use Only- 01 nly - 1 )� u efto Permit No. v- _- u�>: C,l�mmnnw>:ttl� of �tt�� (S. +1eparttnent of Public tufetu Occupancy& Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date (X* or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned 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: Yes ❑ No l (Check Appropriate Box) Purpose of Building S� �• Utility Authorization No. Existing Service '2--O- Amps -V--rJJ Z Volts Overhead ❑ Undgrnd No. of Meters New Service Amps C Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity e C-V\Co r Location and Nature of Proposed Electrical Work S No. of Transformers Total No. of Lighting Outlets No. of Hot Tubs KVA Above In- No. of Lighting Fixtures I Swimming Pool grnd. ❑ grnd. ❑ I Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Air Cond. Total No. of Detection and No. of Ranges tons Initiating Devices --FN..of Heat Total Total No. of DisposalsPumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices I Municipal No. of Dryers I Heating Devices KW Local ❑ Connection ❑Other No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES _ NO I have submitted valid proof of same to the Office. YES = NO :: If you have checked YES, please indicate the type of coverage by checking the appropriate box. f _' Y C INSURANCE BOND -- OTHER = (Please Specify) �-� (Expiration Date) Estimated Value of Electrical Work S r7 d Work to Start Inspection Date Requested: Ro Final Signed under the P allies of perj / FIRM NAME G v ^ LIC. NO. Licensee Signature LIC. NO. p� Bus. Tel. No. Address O2aAlt. Tel. No. �a OWNER'S INSURANCE WAIVER: I am aware that the Lic see does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent CJnt (Please check one) C Telephone No. PERMIT FEE $ (Signature of Owner or Agent) s•55o5