Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 69 MILK STREET 4/30/2018
69 MILK STREET 210/059.0-0039-0000.0 pl �-- 2Y 1'� (2, �,l MA�L P III 1 4 210/038.0-0168-0000.0 96 ABBOTT STREET GILLIS, MI 2101038.0-0190-0000.0 121 ABBOTT STREET SALINI, CHI 210/038.0-0191-0000.0 127 ABBOTT STREET PENNEY, 210/038.0-0192-0000.0 139 ABBOTT STREET QUINN, M 210/038.0-0193-0000.0 151 ABBOTT STREET KRUPKOWSKI, 210/038.0-0194-0000.0 161 ABBOTT STREET ROY, DO 2101038.0-0195-0000.0 171 ABBOTT STREET LOVETT,V 2101038.0-0197-0000.0 197 ABBOTT STREET ROBERTSON 2101038.0-0318-0000.0 353 ABBOTT STREET CONNOLLY 210/038.0-0319-0000.0 345 ABBOTT STREET WONDRASCF 210/065.0-0027-0000.0 20 ABBOTT STREET LARSON, DEI 2101065.0-0029-0000.0 37 ABBOTT STREET UNIEJEWSM 2101065.0-0052-0000.0 61 ABBOTT STREET SARCIA, J 2101065.0-0089-0000.0 49 ABBOTT STREET JAWORSKI, Rt 210/065.0-0090-0000.0 90 ABBOTT STREET FORD, 1 210/065.0-0168-0000.0 25 ABBOTT STREET NICOLAISEI 210/065.0-0205-0000.0 32 ABBOTT STREET IHASANULU 210/065.0-0206-0000.0 44 ABBOTT STREET CLARK, S' 210/065.0-0207-0000.0 56 ABBOTT STREET COGLIAN 210/038.0-0146-0000.0 132 ABBOTT STREET BARBA, . 210/065.0-0284-0000.0 7 ABBY LANE NORTH ANDOVEI 210/065.0-0285-0000.0 15 ABBY LANE HILLARY, 210/065.0-0286-0000.0 21 ABBY LANE D&K SAMENUK 2101065.0-0287-0000.0 27 ABBY LANE KING, CHRI 2101065.0-0288-0000.0 35 ABBY LANE TILTON, E 210/058.0-0019-0000.0 0 ACADEMY ROAD TOWN OF NOR 2101058.0-0020-0000.0 32 ACADEMY ROAD MACLARE 210/058.0-0060-0000.0 0 ACADEMY ROAD NORTH ANDOVER 210/059.0-0001-0000.0 0 ACADEMY ROAD CENTER 210/059.0-0002-0000.0 83 ACADEMY ROAD STEVENS, KATI 210/059.0-0055-0000.0 0 ACADEMY ROAD STEVENS, KAT( 210/095.0-0009-0000.0 56 ACADEMY ROAD KITCO FA 2101096.0-0026-0000.0 0 ACADEMY ROAD STEVENS, Rt? 2101096.0-0033-0000.0 40 ACADEMY OAD STEVE , 2101096.0-0034-0000.0 0 ACADEMY ROAD NORTH PARI 210/096.0-0035-0000.0 114 ACADEMY ROAD EVANS, C. 210/096.0-0036-0000.0 84 ACADEMY ROAD WORDEN, Page 2 Insurance Adjustment Service Inc. 435 King Street - Second Floor Littleton, MA 01460 978-952-6966 - Fax 978-952-2459 Email: iaslittleton n @ etl lus.co P m k � C MAR 2 4 2003 Date: L Board of Health: -" Building Inspector: Fire Department: Re: Insured: ���- Location: Claim Number: ZM ,g , Policy Number:�17,3 Our File Number: Cause of Loss:_ Date of Loss:___��-�G � Dear Sir/Madam: A claim has been made involving loss, damage or destruction of the above captioned property which may either exceed $1,000 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applied. If any notice under Massachusetts General Laws, Chapter 139 Section appropriate, please direct that information tom tion 3B is attention a reference to the captioned insured, location, date of loss and dfile cnumber. Thank you for your cooperation. I Very truly yours, Michael Orlosky Adjuster Ext. 114 Date...........G.. ............ F i NORTH °•,"`°:°1"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUS� This certifies that �^ li .............................. haspermission to perform.. ................... .................................................. j wiring in the building of'.:. ..... .....� ........................................... �' at...................................................................:........... ,North Andover,Mass. Fee r�`�.............. Lic.No.)Z� 1,. ...� : ........ ....... . + ELECTRICALINSP.ECTOR�.� a+ Check # Commonwealth of Massachusetts 0111cial tse 011I` 41 t + _ I Permit No. i, Department of Fire Services Occupancy and Fee Checked r f BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9.051 deme Kink) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to he performed in accordance 11uh the\11assachusetts Hectrical Code(%II:C) ''C�,R 12.00 (PLE.ISE PRI,�T 1,1-/rl'h'OR TYPE.ILL LVyFO .11.LOA) Date: � /City or Town of: /4_1(14\-) i�, &(_ To die h7.ypeciol of l ire,y. By this application the undersigned gives noticeof his or her intention to pert,ornl the electrical work described below. Location (Street& Number) Owner or Tenant ,Z • v t "t Telephone No4 Hv 6, KDIC Owner's Address Is this permit in conjunction with a building per it? Yes No ❑ (Check Appropriate Box) Purpose of Building �f-`..M� 1,,,�� Utilit. Authorization No. Existing Service , Am Volts ( verhead Undgrd ❑ No. of;Meters �L_ New Service Amps / Volts Overhead❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: rccAs ('om lelion u/the fullolbig bible rnov he waived by the Ins)ector lVires No.of Recessed Luminaires No.of Ced.-Susp.(Paddle) Fans No.TransTidal Trsformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- , o. u Emergency ig ulg No.of Luminaires Swimming Pool rnd. ❑ rnd. ❑ _Battu Units -- _ --_—_No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones No. of Switches ' No.of Gas Burners No. Detection and In J Initiatin Devices Total No. of Ranges No.of Air Cond. i No.of Alerting Devices _fl y Tons Heat Pump Number Tons KW No.of Self-Contained f No. of Waste Disposers Totals: _ . _ .......... IDetectiun/Alertin Devices No. of Dishwashers Space/Area Heating KW Local❑ tilunicipa) E] Other l Connection_______ No.of Dryers Heating Appliances KW Security S stems:* No.of Devices or Equivalent No. of Water KW No.of No.of Data Wiring: Heaters signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: IIIucA puled iurtol drl�+il iJ�drsired, or us rcquired hr rhe ln•s/;t'elvl'uJ II'i�'e':;I Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start:--L lit 6 _ Inspections to be requested in accordance with ',IEC Rule 10, and upon completion. i INSURANCE C ER GE: 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• " undersiuned certifies that such co ' lge is iii force, and has cXhibitcd proof of same to the permit issuin'.z office. CHECK ONE: INSURANCE S4 BOND ❑ 01-1IEIZ ❑ (Specily:) .11 I c'erli/jt,.under the pains and peniait' �/'perjr�rp, thin the in%urmulion on this application A rrrre wid contlVele. FIRM NAME: fir. 'J, LIC. I`IO.: 9�j Licensee: . _ �.c.r .•ff Signature LIC. :N0.: rol;lic•uLle. ter "r.reuii;r"inthCTokio i ntunbO,tle.j Bus. Tel. No.:_ 71 dFiJ t6/7J�i Address: -F r 'r �t Aft.Tel. No.:_ _.I *Security System Contractor License required for this work; if applicable,enter the license number here: _I OWNER'S INSURANCE WAIVER: I and aware that the Licensee c/0trs 1701 hover the liability insurance coverage normally � required by law. By Illy signature below, I hereby waive this requirement. I ani the(check one)❑ owner ❑ ownet''s ,*gent. Owner/Agent dp :signature . Tcicphone No. PF(;;�/17 4:'F, .4 f 1 Commonwealth of Massachusetts :L f 4/ t. Department of Fire Services Occupanc\ and Fee Checked i BOARD OF FIRE PREVENTION REGULATIONSL Rev. 9 05 •' "'��/ I IiilbC(1,111) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Ak'A01'k to he performed in accOrdance%pith the\lassachusCttS HCCt•ic.11 Code(\11:C). -'_-C\IR 1'-.()0 4)LE:ISE PRL\T LN LN OR TYPE.ILL INFO 1,11.( lO,�� Date: 0 / Cih- or Town of: f''��-ro � �•&I"i&(1 Tu lhe 1)7.S•I?er10r• 4,/ lav this applic;I6011 the Undel-Sidled�IbCS 110t11'l'Ot hlti 01'hl'r Intention to pert'( the CICCh'll'ttl work described below. Location(Street& Number) C ) Owner or Tenant ` c. p•. E'±"' ) 1 t� Telephone No t c� Owner's Address Is this permit in conjunction with a building per it? Yes No ❑ (Check Appropriate Box) Purpose of Building rr e,.�,; C, .� I '- Utility Authorization No. Existing Service `' 4� :gym U/ r��,-L Volts ( verhead ®/ 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: , r r j _..' C, 0C ('one:Iclion o/llhc' 'allot irrt�(able curt he Ivan Cd by the Inspector of II'ir" No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets y No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool ;%bove ❑ In ❑ ; o.o mergency lg in 3rnd. end. Battery Units No.of Receptacle Outlets No.of Oil erners �� - _ ._N -.___-- `_:,_. . - .. ,1 IRE ALARMS IYo. of Zone.. No.of Switches No.of Cas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total Tons i;No.of Alerting Devices No. of Waste Disposers Heat Pump Number Tons KW ,No.of Self-Contained �� Totals: Detection/Alertin Devices No. of Dishwashers Space/Area Heating KW LLocal❑ ''"ol"cipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* • No.of devices or Equivalent No. of Water No.of No.of Heaters KW Data Wiring: Si Ballasts igNo.of Devices or Equivalent _ No. Hydromassage Bathtubs No. of Motors Total HP f elecommunications Wiring: No.of Devices or Equivalent OTHER: [[ h .. t I Iltrr4h r,!clr(irrrru!Jr;�lil r/,!rsrr-cd, r;r'yrs err/treed h} rile h,.l,c.(,;r•,; II;,, Estimated Valuc of Electrical Work: Oklien required by municipal policy.) ork to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE C'(. 'ERr CE: Unless waived by the owner. no permit for the perlornuulce ufclectrical work may issue unless, the licensee provides proofof liability insurance including'%onlplcted operation"coveraLc or its substantial ccluiv,llcnt. Hh' !ndCr'i!:ncd certifier that ticll coir a,e ir, in li)rce, ;incl has c:,hihitccl proof of:,axle to the permit i:,�>uin^ office. ! 'I11'_CX ONE: INS( R.VX0 BOND �] I)f flliR ❑ t tipccily:l / c'+li/j, wider.Nse pa.;n.c;rear/pr;tulrir's /'pq%urt•, .';luf 1be hi 'rwation,;ra;his:rPh�lcrrt/nn i:v�rr.r, rr. (I r u•rrple�e. 1."RIVINAtiIE: icensee: ere 7�. ' :ii lultule ,s' - l' !� _ �•_—L--�'• . :r — 3us. Tel. o1/0'I.L1 ddress: 1It. Tel. No..::�.- �� ----- ��// tiecurity System Contactor License required for this work; if applicable. enter the license number here: OkVNER'S INSURANCE LVAIVER: I {1111:iw,ire that the Licensee do( not hr.rnr the liability insul'ance cover.t e ncrnl;llly lc(luired by law. By illy below, I hereby waive this reyuircntult. I and the(check one)❑ owner ❑ oWnc:r•:' ;I"'ent. Owner,'Agent �- i;;rlatuee �_�Cy;ltt;etc :•)._ ��1d t f I T i i January 18, 2007 Dear Mr. Murphy, Please be advised that I am relinquishing any responsibility for the Electrical work and permit taken out for 69 Milk Street on February 11, 2006. The owner is Peter Tomsaz and the project was for an addition over a garage. If you have any further questions please call me at 978-265-6863. Regards, James Barrett � � t T I COMMONWEALTH OF MASSACHUSETT 0 OF NS REGISTERED MASTERRTELECTRICIAN ISSUES THIS LICENSE TO J R BARRETT ELECTRIC LLC JAMES R BARRETT - 11 MUNROE. ST HAS/E.RHI.LL MA 0;1.830-6840 . 17246 A 07/31,'/ 999293 s •. 4 NOMaE—A--- DRIVER'S LICENSE Q ,dk141M1 S'43594992 DATE OF BIRTH CLASS REST HEIGOHT. M k y TM 06-15-1964 0 ; EXPIRES e w H0615-2008 r�` 4 IBARRETT IAM' R 11 MILE ST HAVERHILL,MA os taia6 0783M840 I 1/18/2007 10:36 AM FROM: Journeay Journeay Insurance Agency, Inc. TO: 1-918-688-9542 PAGE: 002 OF 002 • ACORDm. CERTIFICATE OF LIABILITY INSURANCE DATA DIYYYY) 1 PRODUCER Phone: 978-34"761 8761 Fmc: 878 346.8620 THIS CERTIFICATE M ISSUED AS A MATTER OF INFORMATION JOURNEAY INSURANCE AGENCY INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 8 WEST MAIN STREET HOLDER. THS CERTIFICATE DOES NOT AMEND, EXTEND OR MERRIMAC MA 01860 INSURERS AFFORDING COVERAGE NAIL p INSURED INSURER A: NafkmW Grange Mutual Insurance CO 14788 J R BARRETT ELECTRIC,LLC. INSURER 8: Natlorral Grange Mutual Irmnnee Co 14788 CIO JIM BARRETT INSURER C: 11 MUNROE STREET HAVERHILL MA D1830 INSURER D: 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 OP SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NTH AOOINSPTWE OF INSURANCE POLICY NUMBER POLICY EPaEenrE POLICY EXPIRATION LIMAS DATE Mbuoanr CEN LIABILITY DATE 12/05105 12105106 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DANAOE TORENTEO PREMSES Ea amurence $ 300,000 CLAIMS MADE 7 OCCUR MED.EXP(Arty one person) $ 10,000 A PERSONAL&ADV INJURY $ 1,000 000 T__ GENERAL AGGREGATE $ 2,000,HXIO GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG. $ 2,090,000 POLICY JECr LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Es accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per W ddert) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR 7 CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WCB25169 11/26105 11/26/05 TORYTLu+rs I I OTHER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT B ANY PROPRIETOR/PARINER/EXECVRRIE $ 100,000 OFFICRR40HEMREREXCLWEDP E.L.DISEASE-EA EMPLOYEE $ 100.0m w rN,dNtIRN YMbf SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER: DESCRIPTION OF OPERATIONSILOCA riONSIVEHICLESIEXCLUSIONS ADDED BY iNDORSEMENTI SPECIAL PROVISIONS ELECTRICIAN CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER MOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE TOWN HALL EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO NORTH ANDOVER,MA. DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,IT'S AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE AtteMlon: FX:978-68841542 ACORD 25(2001108) CertlBcate N 1405 111ACORD CORPORATION 1989 i � I -x Sept.. 13, 2006 To Whom it May Concern, As of July 15, 2006, Barrett Electrical Co. services have been terminated at the home of Peter Tomasz, 69 Milk Street, North Andover. We have documented eight dates that the employee of Barrett Electrical was scheduled to work at the home and did not show up or call with any explanation. Therefore we have decided to hire Paul Denton to complete the electrical work at our home. Any questions or concerns about this please feel free to give us a call. Home phone is 978-689-8599. Peter's cell is 978-886-1158 and Brenda's cell is 978-886-1157. Thank You, Peter and Brenda Tomasz 69 Milk Street North Andover, MA 01845 Date.........r..... .....`O ' + AORTil °!t •-4 TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSACNUScf This certifies that ........... %................. has permission to perform .'l��Sl�// D ,(Jio� q�-[ . . ...................... wiring in the building of...................... .......77 M. z........................... at...........................................�`.........T ........................ ,North Andover,Mass. Fee... - .��p'. Lic.No.C/.S-Z© ,� Gu ...................... ............... ....... ELECTRICAL INSPECTOR `Check # 15 7174 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. Occupancy and Fee Checked a BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] (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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ( — -L,3- O 7 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) M i (, 6r Owner or Tenant T"C 0 Telephone NOV-9-4 Owner's Address 6Yh Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building / 0Utility Authorization No. Existing Service 206, Amps f�(/ 2VNolts 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: E ( Y1 YI57`) d I N 0v l i Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Tota Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- o.o mergency Lighting No.of Luminaires Swimming Pool rnd. ❑ rnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of Detection and No. of Switches No. of Gas Burners No. Initiating Devices No.of Ranges No.of Air Cond. TotalTons No.of Alerting Devices Heat Pum Number Tons KW No.o Self-Contained No.of Waste Disposers Totals Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No. of Water Kms, No.of No. of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring:No.of Devices or Equivalent OTHER: t Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. 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:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: L)( t,I )t" e I.7 �-b M U P I LIC. NO.: C-:z W6 Licensee: P601 /�, D rW IVAI Signature LIC. N�0.• (If applicable, enter "exempt"in the license number line ,n� Bus.Tel. No ��,`S—7�1v Address: Z, U 1�(11�j"j LOO , PWA Alt.Tel.No.: *Security System Contractor License required for this work; if applicable,enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. 1 am the(check one)❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ FL4-\d a � i � �-a7 (2 r r f f Location % � No. Date ,1ORTN TOWN OF NORTH ANDOVER - Ott � o ; '1�•0 f41 ? • • L9 Certificate of Occupancy • �> • $ s�CMUsE<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 46� Check # 17868 ,' _Building Inspector v 1 r TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: ic SIGNATURE: - Building Commissioner/I for of Buildings Date z SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 59 NO. A ndo Jer Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Z-3 6,cClio Zoning District Proposed Use Lot Area(so Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided a b 2-01-ZD 1 -30 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No M 2.1 Owner of Record /Name(PriA Address for Service: Ci- 1 7 Q 1.3 Signature Telephone � L t 2.2 Owner of Record: Name Print Address for Service: M Signature Telephone go SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable rt Licemsed Construction Supervisor: O License Number on Adel&ess Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address z Expiration Date G) Signature Tele hone �1 SECTION 4-WORKERS COMPENSATION(M.G.L.C 152 § 25c(6) F 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 Descri tion of Proposed Work check all a Ucable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: I nckc�.�-�,`Oa\ w i#\ C>' (�{ X t 6` �(A�;(e 12Jd room G.++C C-V)ect )C ty �-he fxis�ie�y si �� cf�c� , o.che�, t� fie i'-ltb` C C,0 M t e G aLf x o, c. 14 k 5,2 \r\d; l ev-e� SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be pT�'F1tC�,�JSE�}iVLY , Completed b ermit a licant s 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X(b) 4 Mechanical HVAQ ^� 5 Fire Protection 6 Total 1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, ,as Owner/Authorized Agent of subject property ereby authorize Oval to act on t My behalf,in all matters relative to work-authorizea by this building permit application. Signature of Owner Date 4 SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, ,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 knowledge and belief Print Name Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CBEVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE FORM U - LOT RELEASE FORM IZ '' c rdLv INSTRUCTIONS: This form is used to verify that all necessary approvals/permits fron Boards and Departments having jurisdiction have been obtained. This does not relieve the,applicant and/or landowner from compliance with any applicable or requirements. *APPLICANT FILLS OUT THIS SECTION APPLICANT ? JE(_' O NACkS Z PHONE G 7=9 - 59 q H LOCATION: Assessor's Map Number J ! PARCEL 3� SUBDIVISION // LOT(S) STREET ST. NUMBER ** *********************.OFFICIAL USE ONLY /ARECMENDATIONS OF TOWN AGENTS: W CONSERVATION ADMIN! TOR VED /� f 11D COMMENTS COMMENTS ({)' oj� Td E^L�tf k!//� /O/j� ahlromc�s'e� Wp�K-�MuS �l s �nnl nc{��,ad TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED. DATE-REJECTED COMMENTS 'UDLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT - IRE DEPARTMENT ECEIVED BY BUILDING INSPECTOR DATE vised 9197 jm S & W LANDTECH EN.G N=WMG & SURVEY SERVICES This eertiiftcation'on this pian is not to be used for.'bounderies, fences, planCings, additions, special perldibs or variances. ASSESSOR'S � . MAP 59 LOQ' 39 h J 3'� 26,058 S.F.t ` waan I rn ov6A IS(-E Cp 040 'fl a h -- F p I �p 0 PaRL i 1~ f 17$,67 t M I ��� �- Snt6w CvVFfZ. MIZISA 4 TGAGE JUA S C nC) �'0 FINANCIA RNSEa L PURPO IS ONIy, 1.000ON: NORTH ANDOVER DATE: 31—JAN-1994 DEED AND PUN REFERENCE; SCALE: 1 INCH — _30 FEET. � ESSEX REGISTRY Of DEEDS. ".FSIAuL'r DFFn gnr;t .. 196 N- 141 — PACE: PL BK OF TITLE PROVOSZ;Jr. CERTIFICATENUMBER: PLAN 10807 PLAN N0. �s� pf6 CERTIFICATION IS HEREBY MADE T0: GREAT WESTERN MORTGAGE COMPANY PETER A. & HRENbA L. TOMASZ A T. JR1250 That the exlatlnq structures as rhown are situratad on • pplloable Zoning B.—Laws for setback, area and frontage erequiremlot e requirements lthe municipalltlOnce yltwh when conatruCte'd, except where otherwise noted, Certification to hereby made that the structures shown on this plan IS NOT located within a P.O. Box 5355 spealol Flood Hazard Area an delineated on the Flood Insuronce Rote Atop for: BRADFORD, COMMUNITY No. O MA Oi 838 PANEL No. O DATE A.-16— FAXPHO (SOB) 352--9860 his plan was prepared to conform to the regulations of the SAX (508) 352--8851 CMR 6.0e Commonwealth of Massachusetts Existing nlonumentotion, assessor's and reoord data usod for compltatlon of this plan. Job Number —940053 MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 I I I I 1 Checked by/Date I { I CITY: Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 7-7-2004 COMPLIANCE: PASSES Required UA = 145 Your Home = 137 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 252 30.0 0.0 9 WALLS: Wood Frame, 16" O.C. 911 13.0 0.0 75 GLAZING: Windows or Doors 65 0.350 23 GLAZING: Skylights 12 0.450 5 DOORS 36 0.350 13 FLOORS: Over Unconditioned Space 252 19.0 0.0 12 HVAC EQUIPMENT: Furnace, 80.0 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or Cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 ITAJ4 Builder/Designer. ` Date0 ❑ � "'"""777 MAScheck INSPECTION CHECKLIST ,Massachusetts Energy Code MAScheck Software Version 2.01 DATE: 7-7-2004 Bldg. l Dept. l Use I I I CEILINGS: [ ] I 1. R-30 I Comments/Location I WALLS: [ ] { 1. Wood Frame, 16" O.C., R-13 I Comments/Location I WINDOWS AND GLASS DOORS: [ ] { 1. U-value: 0.35 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No { Comments/Location I ► SKYLIGHTS: [ ] I 1. U-value: 0.45 I For skylights without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location I DOORS: [ ] I 1. U-value: 0.35 I Comments/Location { I FLOORS: [ ] { 1. Over Unconditioned Space, R-19 I Comments/Location I I HVAC EQUIPMENT: [ ] 1. Furnace, 80.0 AFUE or higher I Make and Model Number I I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: J 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or { gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.944 L/s) air movement from the the { conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: Required on the warm-in-winter side of all non-vented framed I " ceilings, walls, and floors. I I MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R-values, glazing U-values, and heating I equipment efficiency must be clearly marked on the building plans I or specifications. I I DUCT INSULATION: [ l I Ducts shall be insulated per Table J4.4.7.1. I I DUCT CONSTRUCTION: [ ] I All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or I joist Cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not ( permitted. The HVAC system must provide a means for balancing I air and water systems. I I TEMPERATURE CONTROLS: [ l I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: [ ] I Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified I in Sections 780CMR 1310 and J4.4. 1 [ l I SWIMMING POOLS: I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I [ ] I HVAC PIPING INSULATION: I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in.) : I I PIPE SIZES (in.) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 I Low temperature 120-200 0.5 1.0 1.0 1.5 1 Steam condensate any 1.0 1.0 1.5 2.0 1 COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 f [ I CIRCULATING HOT WATER SYSTEMS: I Insulate circulating hot water pipes to the following levels (in.) : I I I PIPE SIZES (in.) I NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS Ic HEATED WATER TEMP (F) : RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+" I 110-180 0.5 1 1.0 1.5 2.0 1 140-160 0.5 1 0.5 1.0 1.5 1 100-130 0.5 i 0.5 0.5 1.0 I ---NOTES TO FIELD (Building Department Use Only)------------------------- i 4y0RTh Q ' ` Town of North Andover R Building Department I �R4TFD '�p`• 27 Charles Street "SSa�H�SEt North Andover MA 01845 Tel: 978-6889545 HOMEOWNER LICENSE EXEMPTION Please print. DATE 1 2� _co f, JOB LOCATION /M 1 Number Street Address Section "HOMEOWNER _Ti -(n gct' 'i�`Jcl 9 (-9179-cdg6- Number ,i Home Phone Work PRESENT MAILING ADDRESS 'b Ci 1\1 (K City Town State Zip C( The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section 109.1.1) DEFINITION OF HOMEWOWNER: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one to six family dwelling,attached or detached structures ac- cessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official, a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner"assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned ".homeowner"certifies that he/she understands the Town of No.Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S-SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwelling 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0 Construction Control. i NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-954 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) 0 - - A�s 1 '5 v� _ Signature of PerAt Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector � GENERAL NOTES: 6/3 D • FOR TOMASZ RESIDENCE,69 MILK ST.,NORTH ANDOVER,MA. 1. ALL LVL BEAMS SHALL BE BOISE CASCADE,VERSA LAM OR EQUAL ALL INSTALLATION TO BE PER MANUFACTURES RECOMMENDATIONS AND SPECIFICATIONS.PROPERTIIES: E=2,000,000 PSI, Fb,= 2,900 PSI ALL COLUMS DESIGNATED ON DRAWINGS TO BE BOISE CASCADE VERSA-LAM 2200 2. ALL LVL INDIVIDUAL MEMBERS IN BUILT UP BEAMS OF THREE MEMBERS OR LESS TO BE NAILED TOGETHER WITH 3 ROWS 16 d @ 12"oc. STAGGER OR OFFSET EACH ROW BY 12" 3. ALL LVL INDIVIDUAL MEMBERS IN BUILT UP BEAMS OF MORE THAN THREE MEMBERS TO BE BOLTED TOGETHER WITH 2 ROWS OF V2" dia. BOLTS, ANSUASME STANDARD B18.21-1981 @ 24"oc. STAGGER OR OFF SET EACH ROW BOLTS SHALL BE PLACED IN SNUG HOLES, WITH A MINIMUM EDGE DISTANCE OF 2" AND WITH STANDARD WASHERS AT BOLT HEAD AND NUT. 4. ALL LVL BEAMS TO BEAR ON BUILT UP POST OF A MINIMUM AS LISTED BELOW 2 TO 3 LVLS USE 3"X 3.5", 4 LVLS USE 4.5"X 3.5" , 5 LVLS USE 6"X 3.5"OR AS DESIGNATED ON DRAWINGS OR ON STEEL. 5. BEARING ENDS OF ALL BEAMS TO BE BLOCKED 14.5" SOLID EACH SIDE 6. ALL OTHER FRAMING TO BE PER CURRENT EDITION OF MASS STATE BUILDINGCODE 7. ALL JOIST AND BEAM HANGERS TO BE BY SIMPSON STRONG TIE,INSTALLATION AND NAILING TO BE PER MANUFACTURERS RECOMMENDATIONS. USE SIMPSON H-10 HURRICANE TIE AT THE EAVE END OF EACH ROOF RAFTER 8. ALL PRE-ENGINEERED JOIST TO BE BY BOISE CASCADE, AND INSTALLED PER' MANUFACTURERS INSTRUCTION AND SPECIFICATIONS,INCLUDING BUT NOT LIMITED TO ALL ACCESSORIES SUCH AS RIM BOARDS, WEB STIIFINERS,BRIDGING BRACING,NAILING AND CONNECTION REQUIREMENTS, ETC. 9. ALL STEEL TO BE A36, STEEL COLUMN BASE AND BEARING PLATES TO BE BEAM WIDTH* 8" * %2" PLATES WITH 4=%"HOLES,BOLTED OR WELDED TO BEAM, BEAM TO BEAM CONNECTIONS TO BE DESIGNED BY ENGINEER 10. ALL SUPPORTS UNDER BEAMS TO HAVE SUFFICIENT UNINTERUPTED SUPPORT ALL THE WAY DOWN TO THE FOUNDATION OR ONTO LVL BEAM. 11. BRING ALL DECREPANCIES TO THE ATTENTION OF THE ENGINNER, IF ACTUAL FIELD CONDITIONS ARE DIFFERENT THAN DEPICTED OR EXPECTED NOTIFY THE ENGINNER. 12 .COORDINATE ALL WORK WITH DRAWINGS PROVIDED BY MARTHA MACINNIS 13. LOADS FIRST FLOOR LL 40 PSF, SECOND FLOOR LL 30 PSF,DL 15 PSF,ROOF SNOW LOAD 30 PSF,DECK LL 60 PSF 14.FOUNDATION BE CARRIED DOWN TO UNDESTURBED SOIL HAVING A MINIMUM BEARING CAPACITY OF 2 TONS PER SQUARE FOOT. ENGINEER: LAWRENCE H. OGDEN P.E. 198 EAST MAIN STREET GEORGETOWN, MA. 01833 978-352-8318, cell 978-502-5921 69 MILK ST. , NORTH ANDOVER, MA. TOMASZ RESIDENCE FRAMING PLANS Scale 1/4 " = 1'-0" JUNE 29, 2004 �.1ORTly Town of 2 Andover 0 No. .� Also am y -0 doves, Mass., // s / .'t -a o oaf T O - TAKE COCMICMEWICK V RATED p`P�t-`� U ` BOARD OF HEALTH Food/Kitchen - PERMIT T D Septic System !: 7'o � S � BUILDING INSPECTOR THISCERTIFIES THAT.......... ............................................................................................................................................ Foundation has permission to erect....�y ` .......... buildings on ........�itl... K .............. ....... ............. .......................................... Rough . .... ..... �('• N ��`f G is/�, �f.. SAI R d O N9 do SI Chimne to be occupied as.... ....... ....................................................................................... ............... ............................. ........ y 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-La .s relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 3 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELEC'T'RICAL INSPECTOR UNLESS CONSTRUCTION START < Rough ................................... . .. �. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal 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.