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Home My WebLink AboutMiscellaneous - 717 WAVERLY ROAD 4/30/2018I� N I O-.� N� J O � 0 v Date ;//�/-? ... TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING ' ,SSAIS \ _ This certifies that ...� I ' 1�".`.................... has permission to perform ..�nn; . w ..................... plumbing in the buildings of .. (°`.f....................... . /.t ..... ,North Andover, Mass. at ....�.� ....... . Fee. 3 .... Lic. No. '�.-D .7... ....... . v.. ........ 1PLUMBING INSPE&OR Check # U �' 84i,5 MASSACHIISETT UNIFORM APPLICATION FOR -PERMIT TO DO PLUMBING {Print or Type) Date 20� Permits Type of Occupancy Replacemente Plans Submitted: Yes O Q o - 1FWPP SEPTIC # _ l nstalling Company Name address lusiness Telephone (j 3 tame of Licensed Plumber or Gas Fitter 044kC_.-. Check ong: 0' Corporation ❑ Partnership Certificate INSURANCE COVERAGE: I have a current liability .insurance policy or Its substantial equivalent, which meets the requirements of MGL Ch. 142. Yes �� No.0 1 4 - If you have checkedyes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy D---' Other type of indemnity ❑ Bond ❑ OWNER'S INSURNACE WAIVER I am aware that the; licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent O hereby certify that all of the details and -information i have submitted i9s,entered) In above -application are true and accurate to the best of .y knowledge and that all plumbing work and installations performe nd r the permit iss for this application will be in compliance with i pertinent provisions of the Massachusetts State Plumbing Code aVue 142 of the eral laws. Byf Licensed lumber TitleCiTyrrown ?' � � APPROVED (OFFICEUSYONLY) I :' Type of License: il4aster ❑Journeyman License Number i8 3_�3 OMMOMOMMMMOMMMMMM FaMMMMONOWWWWWOMOM im��iiii VMMWGTMM�wmii l nstalling Company Name address lusiness Telephone (j 3 tame of Licensed Plumber or Gas Fitter 044kC_.-. Check ong: 0' Corporation ❑ Partnership Certificate INSURANCE COVERAGE: I have a current liability .insurance policy or Its substantial equivalent, which meets the requirements of MGL Ch. 142. Yes �� No.0 1 4 - If you have checkedyes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy D---' Other type of indemnity ❑ Bond ❑ OWNER'S INSURNACE WAIVER I am aware that the; licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent O hereby certify that all of the details and -information i have submitted i9s,entered) In above -application are true and accurate to the best of .y knowledge and that all plumbing work and installations performe nd r the permit iss for this application will be in compliance with i pertinent provisions of the Massachusetts State Plumbing Code aVue 142 of the eral laws. Byf Licensed lumber TitleCiTyrrown ?' � � APPROVED (OFFICEUSYONLY) I :' Type of License: il4aster ❑Journeyman License Number i8 3_�3 VERMONT MUTUAL INSURANCE GROUP® 89 STATE STREET - PO BOX 369 MONTPELIER, VERMONT 05601-0369 Rio Claims 800-435-0397 Since 1828 Property/LiabiGty Claims Fax 802-229-7647 Auto Claims Fax 802-229-8941 E -Mail claims@vermontmutual.com March 30, 2015 Building Commissioner/Inspection Services 1600 Osgood Street Building 20, Suite 2035 North Andover, MA 01845 NOTICE OF CASUALTY LOSS UNDER MASSACHUSETTS GENERAL LAWS, CHAPTER 1.39, SECTION 311 RE: Insured: Claim No.: Policy No.: Date of Loss: Property Location: Type of Loss: Ladies and Gentlemen: Waverly Road Condominium BOP51147 BP21032120 3/4/2015 727 Waverly Rd North Andover, MA 01845 Ice Dam The above insured has filed a claim involving loss, damage or destruction of the above -captioned property which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, and Section 6, to be applicable. If any notice under Massachusetts General Laws, Chapter 139, and Section 3B is appropriate, please direct it to the attention of the undersigned and include a reference to the captioned insured, locations, policy number, date of loss and claim or file number. Thank you for your cooperation. Sincerely, Scott Faehnrich VERMONT MUTUAL INSURANCE COMPANY - NORTHERN SECURITY INSURANCE COMPANY, INC. GRANITE MUTUAL INSURANCE COMPANY Date. 4h G ......... TOWN OF NORTH ANDOVE A PERMIT FOR GAS INSTALLA7 This certifies that ...P,. ).. Sp /a e ....k'� has permission for gas installation .....�.4............. . in the buildings of .. . �! .! at ...%.� c1.... -.N f N (f 7..` .� .... , North Andover, Mass. Fee ... Lic. NoJ. l� ... ...... .t..�.-�,-,..... . G!}S INSPECTOR Check # MASSACHUSETTS UNW ORM APPLICATON FOR PERMIT TO DO GAS ffITJNG (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Logations %/ cl V Owner's Name New ❑ Renovation D Replacement 0 a V (W, W � C SU B -BASEM ENT f BASEM ENT IST. FLOOR 2ND. FLOOR 3RD. FLOOR w Q 4TH. FLOOR v, a STH_. FLOOR w O 6TH. FLOOR 7TH. .FLOOR " STH. FLOOR (Print or type) Name_ Address usmessa e1) Name ofLicensed Plumber'or Gas Fitter INSURANCE COVERAGE Date Permit #to Amount S Plans Submitted ❑ vii Check one: Certificate Installing Company Corp. 0 Partner. ' Firm>Co. 1 have a current liability Insurance, policy or it's substantial equivalent Check one: Yes 0— If you have checked ves, please indicate the type coverage by checking the appropriate box No� Liability insurance policy a' Other type of indemnity D Bond13 Owner's Insurance Waiver. I am aware that the licensee does n_ o_ t ha the Insurance coverage required by Chapter 142 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: thereby certify that all of the details and information I have submitted (or ente red) ed) in J Pplier 12 ion e an best of my knowledge and that all plumbing work and instaliati�,o..gg�� d accurate to the compliance with all pertinent provisions of the Massachusetts'tePerformed under Permit sued for this application will be in e as ode d Chapter 42 of the G eral Laws. By: Signature of Lice d Plumber Or Gas Fi r Title Plumber i City/Town, ) �v �. Gas Fitter License umber L — aster APPROVED co,ce usE oNLv> Journeyman LA w Q C z M w a v, a W W � p � w O q G Z a > q F W vii Check one: Certificate Installing Company Corp. 0 Partner. ' Firm>Co. 1 have a current liability Insurance, policy or it's substantial equivalent Check one: Yes 0— If you have checked ves, please indicate the type coverage by checking the appropriate box No� Liability insurance policy a' Other type of indemnity D Bond13 Owner's Insurance Waiver. I am aware that the licensee does n_ o_ t ha the Insurance coverage required by Chapter 142 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: thereby certify that all of the details and information I have submitted (or ente red) ed) in J Pplier 12 ion e an best of my knowledge and that all plumbing work and instaliati�,o..gg�� d accurate to the compliance with all pertinent provisions of the Massachusetts'tePerformed under Permit sued for this application will be in e as ode d Chapter 42 of the G eral Laws. By: Signature of Lice d Plumber Or Gas Fi r Title Plumber i City/Town, ) �v �. Gas Fitter License umber L — aster APPROVED co,ce usE oNLv> Journeyman Location No. r� / �� % Date NORT1y TOWN OF NORTH ANDOVER � _ • OL Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $' Check 19593 Building Inspect ' L./