HomeMy WebLinkAboutMiscellaneous - 633 WAVERLY ROAD 4/30/2018 (2)rl)
NORTH ANDOVER BUILDING DEPARTMENT
1600 Osgood Street
North Andover
Tel: 978-688-9545
Fax: 978-688-9542
B USRVESS FORM F01? TOWN CLERK
DAT& h 3
CAP,
ADDRESS: a, V -e r 0-�� AIJ () W r
.000,
ZONINGDISTRICT: P,4
I
TYPF- OF BUSINESS., E-xecc,,-�i ve-
BUILDING LAYOUT PROVII)ED: YES NO
AVAILABLEE PARKMG SPACP-S:
ZONMC-TBYLAWUSAGE: YES NO
13USINIESS FORM FORTOWN CLERK
2.40 Rome Occupation (1989132) X
An accessory use, conducted -within a dwelling by a resident who. resides in the dwelling as his principal
address, N�hich is clearly 8econdary 'to the use. of the -building for living pluposes. Home occuPatiOns shall
indiide, -b�t not'limited to the following uses; personal services such as famished by an artist or instructor,
but not occupation involved with motor vehicle repairs, beauty parlors, animal kemels, or the conduct of
retail business, or the, manufacturing of goods, NvMch impacts the residential nature of the neighborhood,
4. For use of a dwelling in py residential district or multi-fkmily district for a home occupfition, the
following conditions shall apply:
a. Not more than a total of flm (3) people may be. employed in the home, occupation, one, of
whom shall be the owner of thd h6me Occiipation and residing in said divelling,
b. The use is carried on strictly wiflii� the. princip a] building;
c, There shall be no exterior alterations, accessory buildings, or display which are not custonia-V
with residential buildings; - I
d. Not more than twenty-five (25) percent of the, existing gross floor area of the dwelling upit
so used, not to exceed one thousand (1000) square f4 is devoted to* such use. In
connection -with
such use, there, is to be kept no stock in trade, commodities or pioducts which occup5r space
beyond these limits;
e. There will be, no display of go�ds or x�,ares visible from the street;
f. The building or promises occupied shall not be rendered objectionable or detrimental to the,
residenfial character of the neighborhood due to the exterior appearance, emissioii of odor,
gas, smoke, dust., noise, distur-bance, or in any other way become objectionable or
detrimental to any residential use Mthin the. neighborhood,
g. Any such building shall include no features of design not customai), in buRdings for residential
use.
Signature Date,
Commonwealth of Massachusetts Official Use Only
Department of Fire Services Permit No.
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev. 11/99] (leaveblank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
(PLkA SE PRINT IN INK OR TYPE A LL INFORMA TION) Date: 9/20/05
City or Town of: NORTH ANDOVER To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street & Number) 633 WAVERLY
Owner or Tenant WON PARK Te C1 ie No.
Owner's Address SAME pi? P P
Is this permit in conjunction with a building permit? Yes X No (Check Appropri'a-4te AIOIXVI�
Purpose of Building SINGLE FAMILY DWELLING Utility Authorization No.
Existing Service 200 Amps , 120 240/ volts Overlie X[I Undgrd D No. of Meters
U1
New Service Amps Volts Overhead n) Undgrd F� No. of Meter's
Number of Feeders and Ampacity 40
Location and Nature of Proposed Electrical Work: REWIRE HOUSE GARAGE TO REMAIN THE SAME SUNROOM
TO REMAIN THE SAME
Completion of thefo table may be waived by the Insnector nf Wir,-v
Attach additional detail ij 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 iss . ue 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 XF1 BOND F� OTHER El (Specify:) TE-;Firation —Date)
Estimated Value of Electrical Work: $ 10,000.00 — (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion.
.I . ce?Wfy, under the pains andpenalfies ofpeilury, that the information on this application is true and complete -
FIRM NAME: —STEVEN VINCI ELECTRICAL CONTRACTORS IN LIC. NO.: A17346
Licensee: STEVEN VINCI Signature LIC. NO.:—
(Ifapplicab enter "exempt" in the license number line) '4A -1 —
V Bw.:Tel. No.:- 781601'549.5_
No. of Recessed Fixtures 32
No. Of Cefl.-Susp. (Paddle) Fans
No. of Total
Transformers KVA
No. of Lighting Outlets
No. of Hot Tubs -
Generators KVA
No. of Lighting Fixtures 14
Swimming Pool Above [J� —In -0
P40. 01 Emergency Lighting
grnd. grnd.
Battery Units
No. of Receptacle Outlets 52
No. of Oil Burners
FIRE ALARMS
No. of Zones
No.1of Switches 26
No. of Gas Burners
No. of Detection and 7
Initiating Devices
No. of Alerting Devices
No. of Ranges I
No. of Air Cond. I Total 3
Tons
No. of Waste Disposers
Heat Pump 1-!tbTer
Tgn
No. of Self-G_n�
tained
Totals:
Detection/Alertin Er Devices
No. of Dishwashers
Space/Area Heating KW
Local E] Municipal
Connection 0 Other
No. of Dryers
Heating Appliances KW
Security systems:
No. of Devices or Equivalent
No. of Water KW
Heaters
No. of — — — — NO -_0T_
Data Winn g*
S,
i 3,ns Ballasts
of
NO. Devices ol K�Lu lent
, r
No. Hydromassage Bath 1
u�h :s �p
No. of Motors Total HP
_:,va
Telecommunicati ons Wiring:
—No. of Devices or Eauivalent 10
Attach additional detail ij 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 iss . ue 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 XF1 BOND F� OTHER El (Specify:) TE-;Firation —Date)
Estimated Value of Electrical Work: $ 10,000.00 — (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion.
.I . ce?Wfy, under the pains andpenalfies ofpeilury, that the information on this application is true and complete -
FIRM NAME: —STEVEN VINCI ELECTRICAL CONTRACTORS IN LIC. NO.: A17346
Licensee: STEVEN VINCI Signature LIC. NO.:—
(Ifapplicab enter "exempt" in the license number line) '4A -1 —
V Bw.:Tel. No.:- 781601'549.5_
ok
C)'5
41
a CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Buflding Permit Number 18 (7-13-2005) Date: FebruM 3, 2006
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 633 Waverly Road
MAY BE OCCUPIED AS Rehab — SingLe Egp& Dweffin IN
ACCORDANCE WITH THE PROVISIONS OF TIM -MASSACHUSETTS STATE
BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY -�PPLY.
Certificate Issued to: Wen Park
633.X,,avedy Road
North,Andowr MA 01845
BaUding Inspector
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Location L:�-f
No. 4 Date
Check # S ef
18961
Building Inspectorg
TOWN OF NORTH ANDOVER
J6.
40
Certificate of Occupancy
$
A
C"
Building/Frame Permit Fee
owl
$
Foundation Permit Fee
$
Other Permit Fee
$
TOTAL
$
Check # S ef
18961
Building Inspectorg
Location )P-0,
No. '160 Date
Of 'go Th TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
CH
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check#
I 84L)3 C
Building Inspe(A4
.6 f,;n [oc
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT WA%
RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
99 M
BMDING PERMIT NUMB
DATIE ISSUED: �7-
SIGNATURE:
Building Comniissioner/12E�Wor of Buildings Date
SECTION I- SITE INFORMATION
1.1 PropertyAddress:
1.2 Assessors Map and Parcel Number -
Map Number Parcel Number
1.3 Zoning Information:
1.4 Property Dimestsions:
Zminit District Proposed Use
Lot Area (sl) Frontage (ft)
1.6 BUILDING SETBACKS (ft)
Front Yard
Side YW
Rwr YaTd
ReqWred Pmide
ReqWmd Provi&d
ReqWred Provided
1.7 Water Supply NCOI.C.40. 54)
1.5. Flood Zon, Infounsfin:
zolke Outside Flood Zone 0
1.8 Sewmalp Disposal System
munkipal 0 On Site Disposal System 0
Public 0 Private 0
SECTION 2 - PROPERTY OWNERSEV/AUTHORIZED AGENT
1,11777c; Ui.ctnct: NO
2.1 Owner of Record
&�-
NaiVe- (Print) 1
t Address for Service
Signature
Telephone
2.2 Owner -of Record:
Name Print
Address for Service:
Sistnature
Telephone
SECTION 3 - CONSTRUC770N SERVICES
3.1 Licensed Construction Supmisor:
Not Applicable 0
—:*� ffc, k
Licensed Construction Supervisor:
-:70
License Number
go r L4�1
aa
Address
6q /—',-c>
5P25— -P-44�— 151/_3 91
Expiration Date
Signature
Telephone
3.2 Registered Home Improvement Contractor
Not Applicable 0
. 'T - H - k - Con
Company Name
Registration Number
0 -3
-7 1—)4 -LOG
Address
Expiration Date
Signature
Telephone
SECTION 4 - WORKERS COMPENSATION (XG.L C 152 § 2!
Workers Compensation Insurance affidavit must be completed and submitted
in the denial of the issuance of the building permit.
sianed affidavit Attached Yes ....... o No ....... 0
SECTION 5 Description of Proposed Work (check am appkable
New Construction 0 1 Existing Building 0 � I Repair(s) 0
Accessory Bldg. 0 Demolition 0 1 Other IV
with this application. Failure to provide this affidavit will result
Alterations(s) 0 1 Addition 0
Specify
I �UCTTON 6 - RqTTMATF.D V0NqT2111VT1rnN CnQTC I
item
Estimated Cost (Dollar) to be
Completed by permit applicant
OMCLAL USE ONLY
I
Building
(a) Building Permit Fee
Multiplier
2
Electrical
(b)- Estimated Total Cost of
Construction
3
Plumbing
Building Permit fee (a)z (b)
/0
4 Mechanical (HVAC)
5 Fire Protection
6
Total (1+2+3+4+5)
Z—�
Eh--eck Number
; - - -- -- JL%Y APJ& %-%AffWJUJM JLZU WrmfV
-O—W—N'E'RS CE;T OR CONTRACTOR APPLIES FOR BUELDING PERhHT
1, V6 U71 as Owner/Authorized Agent of subject property
Hereby author'Ze----IJ4a- Al to act on
My beha ' Ji4,all matters relative to rk authorized by this building permit applicaPion.
ii�giiue Date
SECTION7b OWNEAI&TAORIZED AGENT DECLARATTON I
1, \-4 1 1 Z L/ Vt 11-1 ri-,- As Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are time and accurate, to the best of my knowledge'
and belief
U-ilYoa-19
i, � r i awAnd1t
0
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLQnR TINIDERS I Yr 3RD
SPAN
DUVIENSIONS OF SELLS
DINIENSIONS OF POSTS
DIrVIENSIONS OF G110ERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHRANEY
IS BUILDING ON SOLID OR FELLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
I
f
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or . landowner from compliance with any applicable or requirements.
6 Mae* � **********APPLICANT FILLS OUT THIS SECTIO
APPLICANT -20-a, A/0 ' e—r, PHONEjZj,—J?3d-9/3?
LOCATION: Assessor's Map Number PARCEL
SUBDIVISION LOT (a)
STREET,�33 Ad
ST. NUMBER
RECOMMENDATIONS OF TOWN
ADMINISTRATOR
OFFICIAL USE ON
TE REJECTED ------------
( C)
TOWN PLANNER
DATE APPR—ov-E-D-----------
DATE REilEmpn --------------
EN
FOOD INSPECTOR -HEALTH
DATE APPR-OVE-D------------
DATE REJECTED
SEPTIC INSPECTOR -HEALTH
DATE APPRov-E-o------------
DATE REJECTED
PUBLIC WORKS - SEWER/WATER
DRIVEWAY PERMIT
cloc
"M 1 MR I
RECEIVED BY BUILDING
RevbWMIM
Ilse Commonwealth ofMassachusetts
Q Department of Industrial Accidents
Office of Investigations
Boston, MA 02111
600 Washington Street
www.massgov1d1a
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print LeLyibly
Name (Business/Organization/Individual):
Address: (2-2- Pb
I
City/State/Zip: G,,,k e Phone#:
Are you an employer? Check the appropriate box:
1. 0 1 am a employer with 4. 1 am a general contractor and I
employe6 (fiill and/or part-time).* have hired the sub-contractoTs
2. 0 1 am a sole proprietor or partner- listed on the attached sheet t
ship and have no employees
working for me in any capacity.
[No workers' comp. insurance
required.]
3. 1 am a homeowner doing all work
myself [No workers' cornp.
insurance required.] f
These sub -contractors have
workers' comp. insurance.
We are a corporation and its
officers have exercised their
right of exemption per MGL
C. 152, § 1(4), and we have no
employees. [No workers,
corm. insurance required.]
Type of project (required):
6. E] New construction
7. [E Remodeling
8. El Demolition
9. F] Building addition
10 -El Electrical repairs or additions
I I - M Plumbing repairs or additions
12 -El Roof repairs
13. [-] Other
t-ly GFFII�MIL LIM UU2L ft I MU51 aiso nu out ine sectlOn below Showing their Workers, compensation policy information:
Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a n4;w affidavit indicating suck
tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers, conip. policy information.
I am an employer that is providing workers.9 compensation insurancefor my employees. Below is the polity andjob site
information.
Insurance Company Name:
Policy # or Self -ins. Lic. #: Expirat . ion Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under 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-yeafimpnsonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of 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.
I do hereby certify under the pains andpenalties of.PeriurY that the information Provided above is true and correct
Signature:
Phone #:
Official use only. Do not write in this area, to be completed by city or town officid
City or Town:
Issuing Authority (circle one):
1 -Board of Health 2. Building Department
6. Other
Contact Person:
Permit/License #
3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
Phone M
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 11 ... every person in the service of another under any contract of hire,
express or implied, oral oT written."
,an individual, partnership, association, corporation 6r other legal entity, or any two or more
An employer is defined as Joy , e
of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased emp er or th
y he
receiver or trustee of ah individual, partnership, association or other legal entity, employing emplo ees However t
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."
chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall
Additionally, MGL I mpliance with the sur ce
enter into any contract for the performance of public work unti acceptable evidence of co in an
requirements of this chapter have been presented to the contracting authority."
Applicants compensation affidavit completely, by checking the boxes that apply to your situation and, if
Please fill out the workers' n with th ir
necessary, supply sub-contractor(S) name(s), address(es) a d phone number(s) along e certificate(s) of
ance. Limited Liability Companies (LLQ or Limited Liability Partnerships (LLP) with no employees other than the
insur ensation insurance. If an LLC or LLP does have
members or partners, are not required to carry workers' comp mitted to the Department of Industrial
employees, a policy is required. Be advised that this affidavit may be sub affidavit should
Accidents for confirmation of insurance coverage. Also be sure to sip and date the affidavit. The
ed to the city or town that the application for the permit or license is being requested, not the Department of
be return in a workers'
industrial Accidents. Should you have any questions regarding the law or if you are required to obta
compensation policy, please call the Department at the number listed below. Self-in=ed companies should enter their
self-insurance! license number on the
City or Town Officials
to
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bot in
the event the Office of Investigations has to contact you regarding the applicant
of the affidavit for You to fill Out in cense nurnber which will be used as a reference number. In addition, an applicant
Please be sure to fill- in the permit/li nly sub t one affidavit indicating current
that must submit multiple permit/license applications in any given year, need o n1i
"Job Site Address" the applicant should write "all locations in _(city or
policy information (if necessary) and under
town)." A copy of the affidavit flat has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affi . davit is on file for future permits or licenses. A new 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 bum 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,
pleas- e do not hesitate to give us a call.
The Department's address, telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
office of Investigations
600 Washington Street
Boston, MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax # 617-727-7749
Revised 5-26-05 www.mass.gov/dia
North Andover Building Department
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of IVIGL c 40 S 54, a condition of Building Permit
Number is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by IVIGL
c 11, S 150 A.
The debris will be disposed of in:
(Location of Facility)
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
A
J.H.K.CONSTRUCTION
01)
RSF: 2,592
Building 633 Waverly Road
Floor: 3
Contractor: Jae Ho Kim
Date 105/07/2005
HARD COSTS:
COSTA
COST -2
Construction
Allowance
$124,100
$23,000
by owner
SUBTOTALI
$154,100
SOFT COSTS:
Plumbing & Electric
Architect
BP fee
0
0
$33,050
0
0
by owner
by owner
SUBTOTALI
01
$33,0501
PROJECT TOTAL:
1 $124.100
1 $56,0501
$180,150
Assumptions & Qualifications:
*Budget based upon revisions discussed at 05/07/2005
*See detail estimate for additional notes
*All appliances by Owner
*BP Building Permit
C 0 ST 0 M E R \11�e,7�AT E
IBILDER DATE
NONA052005
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SELTSER & GOLDSTEIN Fax:9789214575 Oct 18 2005 12:37 P.01
SELTSER & GOLDSTEIN
PUBLIC ADJUSTERSf INC.
FACSIMILE TRANSMITTAL COVER §HEET
Tuesday, October 18, 2005
TO: Mike McGuire, Building Inspector of North Andover
RE: Insured: Won Park
Location of Loss: 633 Waverly Road
North Andover, MA 01845
Date of Loss: November 26, 2004
Type of Loss: Fire
FAX* [1] 978-688-9542
Dear Mr, McGuire:
#OF PAGES: 2
Due to the severity of damages and the fact that all interior walls, ceilings and floors
needed to be completely demolished, as a result, all electrical, plumbing, framing,
insulation needs to be brought up to Mass Building Code Section 34043 New Building
Systems.
/sas
That is how other building inspectors have cited the Mass Building Code.
Should you have any questions, I can be reached at 978-921-6333, Thank you.
Very truly yours,
Af-G-arY M. Goldstein
900 CUMMINGS CENTER, SUITE 309-U - BEVERLY, MA 01915-6169
OPPICE: (M -F/8:30-4:30), (978) 921-9481 '? FAX: (978) 921-457,5 * 24 HR. ANSWERING SERVICE: (978) 921-2926
SELTSER & GOLDSTEIN Fax:97892145?5 Oct 18 2005 12:37 P.02
Tuesday, October 18, 2005
RE: Won Park
Page 2 of 2
SELTSER & GOLDSTEIN
PUBLIC AI)JUSTERS, INC.
CONFIDENTIALITY NOTICE
The documents accompanying this FAX transmission contain information from the Public
Adjusting Firm of Seltser & Goldstein, Inc., which may be confidential or privileged, The
information is intended for the use of the individual or entity named above, If you are not
the Intended recipient, be aware that any disclosure, dissemination or use of the
information here contained is prohibited. IF YOU HAVE RECEIVED THIS
TRANSMISSION IN ERROR, PLEASE IMMEDIATELY NOTIFY US -AT 978-921-9481 SO
THAT WE MAY ARRANGE FOR THE RETRIEVAL OF THIS TRANSMISSION AT NO
COST TO YOU.
900 CUMMINGS CENTER, SUITE 309 -LJ 1, BEVERLY, MA 01915-6169
OFFICF! W -F/830-04)), (978) 921-9481 - PAX: (978) 9214575 - 24 HR. ANSWERING SERVICE: (978) 921-2926
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SELTSER & GOLDSTEIN
jr I PU . BLIcADjUSTERS, INC.
U I
Wednesday, November 02, 2005
Won Park
633 Waverly Road
North Andover, MA 01845
RE: Won Park
Loss Location: 633 Waverly Road
North Andover, VA 01845
Date of Loss: December 23, 2004
Type of Loss: Burst Pipe
Claim No.: 192 FR 1_51_5958 E
Sent via e-mail
Dear Mr. & Mrs. Park:
Pursuant to the above -captioned loss matter, enclosed please find the following self-
explanatory documentation for your review:
1) Code upgrade claim as prepared by Michael F. Foley, Technical Code
Consultant
2) Letter dated November 1, 2005, from Kristen Dong, regarding the code upgrades
request
Kindly review the above aforementioned and contact me directly to discuss same.
As always, thank you in advance for your anticipated cooperation.
/sas
Enclosures
Very truly yours,
*_ ;�- , . a= -
Gary M. Goldstein
900 CUMMINGS CENTER, SUITE 309—U ck BEVERLY, MA 01915-6169
OFFICE; (M -F/8;30-4:30), (978) 921-9481 0 FAX: (978) 921-4575 a 24 HR. ANSWERING SERVICE: (978) 921-2926
MICHAEL Fi FOLEY
I THURSTON STREET
'S-IOMERNILLE, MA 02145
.-..(,617)17764813
TE,f,'FAI�,r'AL-C-ODE-'C.ON,SITLTANT
October 24, 2005
Gary Goldstein
Seltser.h. Goldstein -P.ublic Aigugers
911CUMminp Center, -Suite 309-V
�Beverjy'.Mi 11.1 s
�Re: Insured: Won -Park
433 Wamit Road, North Andover
'Claim #* *192 FR L51598 E
4 MYR L5,M129 T
Dca!%Mr..Go)dstejn
V he 4' gverlv
Please actept this-=.purt*1xi -response jo -vour-regaesl le YWm I -cl Jun of 633 W
and
renovation of the fire.damage and burst pipe -loss to this.property. NN%ere opportunity to -visit the
j)rkuertv pre -reconstruction -was not �urovided,.I-am.-providiikv,.this. rekagnse based uponthe
inffinm�iim Immded and themte xir& rznducted.
Ulic-h&ormation iubaditted andthe-dgim-nioml -indicate
losses. Tte-Flivi. loss appears -to becaused: by-fim ou-Noveinlier 26, 2004 and -the 2d loss -by a burst
-pipe ph -December.239.1-094,
Yourofficthai jsrnyidtd mpiesaf Jh6-Ims rqjiort-..r4.11-afiqg `(O-Mlk Vf --the CW'ffis- n prepand
1ky -HenU'radlin! and Kristen -Dong. Included were coqt additions ky XH.K'Coustruction, Pilleri
ftl =Wag -1, Heafiq,- S teven, K V_=Ci Ekctr1W- Contradorwil Structural - Rep art b y Golden
DCAPS.
I TrNiewed All -the Warmation,provided affid tompiled The Code Up -Grade as one esfimate..A
91te-111sit onOct6ber.2�, 2005 revealed fittle evidence of damages sustained-by."both-losses.'The
rVz',)nFftWtl011'Of this APee himilY MA&I'licAe iF wdi'malong, The wifth-fra-ming, electric -al and
0 envelopt wAh jlew window, 3, sliding
doors -and Ifinged doors is complete, -exteflor sidingis-in.process. Roof sYwgies am on site but no
.w. a r1c. , h = - prog re s sedi n re nz o -.in g - the'2 . 143 le —. 0 f - ei i s t i r. g -2, tab asp 1. : - 111 A. ft i We.
Tberontrartnr. and de-qi,gn rangultant wi%h.ta inchide.os.part of th.e tf,L-. replapp.mg,"t nf
thle-c-cater beam. and the-ift3tullilficaf MrWindow Anddoor headerk A tq
and -multiple doorand -Window -headers -ot traditional, dimensional -lumber Mive�beeninstJlled.Fhe
Araign-commitapt dr-texmined INA the PARting-bram wos undenUffid. ondIaMe-d-to dignbute five. and
Aead1wadvand.thertrure Wulf ina stuttbNellection. Thextports*-.pravided do-notpro*vide sallitient
'information to -dispute these'rindings.
0 -
T.-c-Phidiblav"CO a—tz acto.--indicated,
tw..the.b wm.waskInc miw.whe alk Compliant
athr C
7and'r-eqtCired-to-be-r!eplaced- All-4Dfihe-roughplumbing-including-waste -and supply has-been
..replaced, Tbe, demes -to be installed and -work to be
Performed. Whert the projed is in the tough instaliftithn MageN, theitems4enoted in the-codevp-
grade -report wM be �required forfinal: acceptance bythelocal Inspectors.
+31ic gumArmils mid handrails for the deck and PaBo, wAkway are.not -code compliant and
-100 be required -to'be replaced pfior to -ompancy. Ile heiglit -of tbe -guards are requires) to be a
md ab na m, a f 3 UP a n d tqp a b Ic- 4 ff -,,ft st and i ; ig a - I atcr 2"11 o a d - a f 2 0 0 1 b s:pc r -s q un re foo t I - h ave inc 1 ud c d
these ws pan of Ahe code mip-grade cost, Ihey may not "Mme.-imstained dasnage due lo, fifterims but
*here NW
w is occurding.lb-61ijeld' jL9pectpr mav inilml th. I
1 41 -1 _they
The 03timOted-Vaklesprovided in.-thisreparl are bawd,armna the site -A-Gif and the
infomation supplied -and -am.addifisinal -wst incurre.dby the home-owmerbeyond Ihe property loss
values.congide +red Jn Even, Attempt.has beemmade-mot to
duplicate or Indudc T.-Jue-that has been congidered andpro�idcd in other'loss reports and
iinprovements*-that were not applicabie -w -the Oligi!)AHOSSM
I
'51--jetural
S-10,432.69
:':El kxbical
S SM1400
S4 '164.82.
S690-.00
Yuel
$1-150.00
Phunbing
S998.00
320,43.
5.69
oiler Read M% S2,441:57
Profit 10% S2,427.93
Totai CodeUp'Grade sw-jrms
'-4Jkv qumliOns Or concerns "ith the idurmadon prmided, please contact ine,
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11/01,�005 16:23 6034747228 PREMIER INSURANCE PAGE 01
A
The Fftmltx
A'TraMm CxnporV
One Chestnut Place
10 Chesinut Strcct, Suite 300
Worcester Ma. 01608-2898
WWw.RfeMier1nS,Com
1-800-245-0063
Seltser & Goldstein Public Adjusters, Inc.
900 Cummings Center Suite 309-U
Beverly, MA 0 1915
Dear Mr. Gary Goldstein;
Kathleen H. Devericks, CPCU
Manager
Clalin Department
Kriglen Dung
P.O. Box 1237
Seabrook, NH 03874
Phone/Fax 603-474-7229
November 1, 2005
I have received and reviewed your most recent correspondence in regards to the code up
grades that have been presented for Mr. Won Park. The report submitted by Michael
Foley was not based on a pre -construction analysis and I have noted several items that
would not be related to the losses. As previously requested we need a letter from the
to,Am building inspector of North Andover stating any code upgrades that were necessary
due to the actual losses, as well as proof of payment, cancelled checks, from the insured
for the upgrades related to the losses, please refer back to the letter sent by Manny
Carvalho. The town building inspectors saw the loss pre -construction and would have
advised Mr. Park what was necessary.
Based on the damages of these losses, the only possible code upgrades that would be
considered appear to be electrical and the smoke detectors.
Once the appropriate documentation is received we will review.
Sincerely,
�o a
Kristen ong
PrOPertY ClSiMS Adjuster
I
Locationv/3-3
Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
CHU
Check #
19 Pij 6
Foundation Permit Fee $
Other Permit Fee
TOTAL
s
$
—Building Inspectf
Locationa,3--3 RQ,
No. 61 Date
TOWN OF NORTH ANDOVER
Other Permit Fee
TOTAL
Check # 9gfq
19006
d
a
g Inspectcu
Certificate Occupancy
of $
CHU
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee
TOTAL
Check # 9gfq
19006
d
a
g Inspectcu
REGNANTE, STERIO & OSBORNE LLP
Town of North Andover
Late Invoice
03/03/2006 21585-36866
Invoice Amount Amount Paid
48.00 48.00
9288
03/03/06
WLS51 13LNI TUTTLE PRINTING A ENGRAVING 800-IM"M PRINTED IN U.SA.
GeraldA. Brown
Inspector of Buildings
Regnante, Sterio & Osborne LLP
Edgewater Office Park
401 Edgewater Place, Suite 630
Attention: Seth FL Hochbamn
Wakefield, Massachusetts 01880-6210
Re: 63 3 Waverly Road
Mr. Hochbawn:
TOWN OF NORTH ANDOVIER
OFFICE OF
BUILDING DEPARTMENT
400 Osgood Street
North Andover, Massachusetts 0 1845
Telephone (978) 688-9545
Fax (978) 688-9542
February 27, 2006
Pursuant to You request letter of February 16, 2006 for all copies of Building Department documents for
property at 633 Waverly Road. Please consider this as a billing invoice for the amount of $48.00 for 56 pages and
amount of hours to Produce the requested documents. A check for $48.00 should be made out to the Town of
North Andover and sent to 400 Osgood Street North Andover. If you have any questions please let me know.
Sincerely,
Gerald A. Brown,
Inspector of Buildings
BOARD 0jAPPJ--,A1,S 689-9541 CONSERVATION 688-9530 HEALTH 698-9540 PLANNING 688-9535
vkORTII
TOWN OF NORTH ANDOVER
.0,10 ,,, -
0
OFFICE OF
BUILDING DEPARTMENT
400 Osgood Street
North Andover, Massachusetts 0 1845
GeraIdA. Brown
Inspector of Buildings
Regnante, Sterio & Osborne LLP
Edgewater Office Park
401 Edgewater Place, Suite 630
Attention: Seth H. Hochbaum
Wakefield, Massachusetts 01880-6210
Re: 633 Waverly Road
Mr. Hochbaum:
Telephone (978) 688-9545
Fax (978) 688-9542
Pursuant to you request letter of February 16, 2006 for all copies of Building Department documents for
property at 633 Waverly Road. Please consider this as a billing invoice for the amount of $48.00 for 56 pages and
amount of hours to produce the requested documents. A check for $48.00 should be made out to the Town of
North Andover and sent to 400 Osgood Street North Andover. If you have any questions please let me know.
BOARD OF APPEALS 688-9541
CONSERVATION 688-9530
Sincerely,
Gerald A. Brown,
Inspector of Buildings
HE,U,'fH 688-9540
PLANNING 688-9535
Date.
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
+Zia—
Nz�� r
...........
This certifies that ... ..............................
Ff -
has permission to perform ...............
plumbing in the buildings of ..........................
at'.
....... North Andover, Mass.
F e e 'L*i c* lNo'. 4 ...............
�A - �-x' I
PLUa(?'dG INSPECTOR
Check # 04
66U7
'." 1�
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS Date
Building Location633 0Q1VJr) 1,/ Owners Name 0A (PL r Permit #
Amount C?
Type of Occupancy
New Renovation Replacement 1:1 Plans Submitted Yes No
11
FIXTURES
(Print or type) Ch k Certificate
Installing Company Name? I' 4�1 L P�Ur-b I'VC) P-JzT
Address Q003 Partner.
W& OP15
Tu—sin—es=e ephone 2 el� / Fiffn/Co.
7
Name of Licensed Plumber . Ta (�' I L-; zvle-r I
Insurance Coverage: Indicate the type of insurance �overage by checking the appropriate box:
Liability insurance policy Other type of indemnity 11 Bond
Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature — Own er 11 Agent 0
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 State Plumbing Code and Chapter 142 of the General Laws.
By: S-ig-Marure Of Licensea FIUMDer I - /-) A X
Title Type of Plumbing License
13 /
City/Town Meense INUMDer Master Journeyman
APPROVED (OFFICE USE ONLY EY
.6090
Date ..... . ? .. - . eA,5—
.. . ..........
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
/ --Y-
This certifies that ...... &-—z . ..............
has permission to perform ..............
wiring in the building of ...... IU! -!'4 . . ... 6-�'-'-A ..... ................................
z'-Sj 2zj
at ........................................
-e� ................ . North Andover, Mass.
Fee/90
................. Lic. No. .......
E�EcrRICAL INSPEq�OR
Check # 2 �r
V t, d6
I
I
91
Commonwealth of Massachuseffs
Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
Official Use Only
Permit No. 6, () �o
Occupancy and Fee Checked /�Fef,
[Rev- 11/991 (leaveblank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
(PLEA SE PRINT IN INK OR TYPE ALL INFORMA TION) Date: 9/20/05
City or Town of: NORTH ANDOVER To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street & Number) 633 WAVERLY
Owner or Tenant WON PARK Telephone No.
Owner's Address SAME
Is this permit in conjunction with a building permit?
Purpose of Building SINGLE FAMILY DWELLING
Existing Service 200 Amps 120 240/
New Service Amps Volts
Number of Feeders and Ampacity 40
Yes X No 0 (Check Appropriate Box)
Utility Authorization No.
Volts Overhe X[:] Undgrd 0 No. of Meters
R71.
Overhead n� Undgrd No. of Meters
Location and Nature of Proposed Electrical Work: REWIRE HOUSE GARAGE TO REMAIN THE SAME SUNROOM
TO REMAIN THE SAME
Cnmn7&tinn nf thp fnllnwina tnhlp mnv hp wffivod hu tho Imcnortnr nf Wir—
No. of Recessed Fixtures 32
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 14
Swimming Pool Above Ei In-
grnd. grnd.
of Emergency Lighting
Battery Units
No. of Receptacle Outlets 52
No. of Oil Burners
FIRE ALARM
No. of Zones
No. of Switches 26
No. of Gas Burners
of Detection and 7
Initiating Devices
No. of Ranges I
No. of Air Cond. I Total 3
Tons
No. of Alerting Devices
No. of Waste Disposers I
Heat Pump
Totals:
mber
I Ny .. ...............
I Tons
I .... ... ............
I.NW
No. of Self -Contained
Detection/Alerting Devices
No. of Dishwashers I
Space/Area Heating KW
Local E] Municip�l Fj Other
Connection
No. of Dryers I
Heating Appliances KW
Security Systems:
No. of Devices or Equivalent
No. of Water KW
Heaters
No. of No. of
Signs Ballasts
Data Winn *
No. of Jevices_or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
Telecommunications Wiring: 10
No. of Devices or Equivalent
OTHER:
A aacn aaamonat aetau y aesirea, or as required by the Inspector oJ 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 X[] BOND E] OTHEREI (Specify:)
Estimated Value of Electrical Work: $ 10,000.00 (When required by municipal policy.) (Expiration Date)
Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion.
I certify, under the pains andpenalties ofperjury, that the information on this application is true and complete
FIRM NAME: STEVEN VINCI ELECTRICAL CONTRACTORS INC. LIC. NO.: A17346
Licensee: STEVEN VINCI — Signature LIC. NO.:
(If applicabTe, enter "exempt" in the license number line) Bus.Tel. No.: 781609.5195,,
10, -Too, �'vz� � U V,.", ,
TO 2563
'40RT"
0
0
Date... C::�� 5' ). ...
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that . . . . .. ......Iq ........
has permission for nstallati n .. ..... ..
in the buildi gs of .
. .. .............
at .......,North Andover, Mass.
Fee 0 .... Lic. No.. ..........................
� 1* GASINSPECTOR
(('SH5h: Applicant CANA Y: Building Dept. PINK: Treasurer GOLD: File
Cjj\\ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING1.
(Print or Type) 0
M a s s. D a t e 5-01�jc 19 Permit #
P Building Location co 3 Owner's Name P-0 tj
Type of Occupanc Y�Lz C- C=
New Renovation 0 Replacement Plans Submitted: Yeso No
d
Z CC
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W Uj 0
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01
(Do T -S I
BASEMENT
I ST FLOOR
2ND FLOOR
3RD FLOOR
4TIA FLOOR
STH FLOOR
6TH FLOOR
8TH FLOOR
7TH FLOOR
Installing Company Name___AEERjfAS Check one:,. Certificate
Address 9 -i, Ti Corporation.
- 1:1 0 B
Tnnsfir-lrl MA niqsi L-1 Partnership
BuslnessTelephone 9Q8-887-- '153 El Firm/Co.
Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE:
I have a cur,ent liability Insurance policy or Its substantial equivalent which meets tile requirements of MGL CI -L 142.
Yes W No 0
If you have checked yes, please Indicate the type coverage by checking the appropriate box.
A liability insurance policy :0 Other type ef Indemnity 0 Bond
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 tj-,at my signature o this permit application waives this requirement.
Check one:
Owner -E] Agent 0
Signature of Owner or Owner's 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 perfoim8d under the pnrmit issued for this application will be in com Iliancee withn
" 's "' 'o ')e
peitinent provisions of the Massachusetts State Gas Code and Chapter 142 of the e r Aaw S.
C
nl r or
lumber gpinatuce of Ocense Plum 6 or (las itt r
Title Gasfitter
Master License Number Lf
QtylTowrl Journeyman
APhXA1ED—TC—)FFFCX USE FDHEVV—
6
v-e3A\j��YZLY S: -I.
f-�' IQ) \/ IE n__ / " vi.
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Date. ....... .
2571 /-<�- �� -
Of 40RTN TOWN OF NORTH ANDOVER
"to 6
N
PERMIT FOR GAS INSTALLATIO
�"U
This certifies that ... ..........
has permission for gas installation ... /Pa 1�1 -// ...........
in the buildings of . . e�_. 0. C). �
..........................
at ..6 Npxth Andover Mass.
. . ?. -' . . �? ,-. 1. 1. L
Fee. 1.1i Lic. No.. . .......
INSPECTOR
WHITE: Applicant CANARY: Building Dept. INK: Trea3urer GOLD: File
MAbbAkAl U,--ot: I I b U(W- UhM At-t-LIL;A I IUN'FOR PER MIT TO DU GASFITTING
(Print or Type)
PA.. Mass., batej!� Permit #
Bul Iding Location I-A-44-�Ve Owners Name 6-0'0 g2�
Type of Occupancy—'&L$-J�
New Renovation E] Replacement [j Plans Submitted: Yes[] No
Installing Company Name BAY STATE GAS COMPANY
Address 55 MARSTON STREET
LAWRENCE, MA 01840
Business Telephone 508-683-1105
Name of Licensed Plumber or Gas Fitter Francis X. Corkery
Check one:
)D Corporation
El Partnership
0 Firm/Co.
Certificate #
I AA?
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 -
Yes K No 0
If you have checked yes. please Indicate the type coverage by checking the appropriate box.
� A liability Insurance policy K I Other type of Indemnity El Bond D
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:
I Owner or Owner's Agent Owner -0 Agent 0
I hereby certify that all of the details and information I have submitted (or entered) in abg>0 lication are true te to the best of my
knowledge and that all plumbing work and Installations performed under the permit Issu P is app, liance with all
pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the ' ne r -th
T, e of Ucense:
Title Plumber nature of Licensed PI
Gasfitter
Citijo.wn, Master Ucense Number 8697
Journeyman
AP U�TICF S�FONLY��
SEEN,
MEN
MENEM
NO
IS
Installing Company Name BAY STATE GAS COMPANY
Address 55 MARSTON STREET
LAWRENCE, MA 01840
Business Telephone 508-683-1105
Name of Licensed Plumber or Gas Fitter Francis X. Corkery
Check one:
)D Corporation
El Partnership
0 Firm/Co.
Certificate #
I AA?
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 -
Yes K No 0
If you have checked yes. please Indicate the type coverage by checking the appropriate box.
� A liability Insurance policy K I Other type of Indemnity El Bond D
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:
I Owner or Owner's Agent Owner -0 Agent 0
I hereby certify that all of the details and information I have submitted (or entered) in abg>0 lication are true te to the best of my
knowledge and that all plumbing work and Installations performed under the permit Issu P is app, liance with all
pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the ' ne r -th
T, e of Ucense:
Title Plumber nature of Licensed PI
Gasfitter
Citijo.wn, Master Ucense Number 8697
Journeyman
AP U�TICF S�FONLY��