Loading...
HomeMy WebLinkAboutMiscellaneous - 742 BOXFORD STREET 4/30/2018MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108.1904 (617) 723.3800 Ma Only (800) 392.6108, FAX (800) 851.8424 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch.139, Sec.36 NORTH ANDOVER BUILDING COMMOSSIONER NORTH ANDOVER TOWN HALL NORTH ANDOVER MA 01845 Re: Insured: JOAQUIN C. AND DIONNE TORRE Property Address: 742 BOXFORD STREET, NORTH ANDOVER, MA 01845 Policy Number: 1016862 Type Loss: Windstorm Other than Hurrcane or Tornad Date of Loss: 0112012013 Claim Number: 309279 Claim has been made involving loss, damage or destruction of the above captioned propert, which may either exceed $1000.00 or cause Massachusetts General Laws, 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. MPIUA Claims Division CMA00021 1123/2013 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108-1904 (617) 723-3800 Ma Only (800) 392-6108, FAX (800) 851.8424 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch.139, Sec.313 NORTH ANDOVER BUILDING COMMOSSIONER NORTH ANDOVER TOWN HALL NORTH ANDOVER MA 01845 Re: Insured: JOAQUIN C. AND DIONNE TORRE Property Address: 742 BOXFORD STREET, NORTH ANDOVER, MA 01845 Policy Number: 1016862 Type Loss: Water Damage: Plumbing Systems Date of Loss: 12/17/2013 Claim Number: 319029 Claim has been made involving loss, damage or destruction of the above captioned propert, which may either exceed $1000.00 or cause Massachusetts General Laws, 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. MPIUA Claims Division CMA00021 12/18/2013 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108.1904 (617) 723.3800 Ma Only (800) 392-6108, FAX (8001851.8424 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch.139, Sec.3B NORTH ANDOVER BUILDING COMMOSSIONER NORTH ANDOVER TOWN HALL NORTH ANDOVER MA 01845 Re: Insured: JOAQUIN C. AND DIONNE TORRE Property Address: '742 BOXFORD STREET, NORTH ANDOVER, MA 01845 Policy Number: 1016862 Type Loss: Water Damage: All Other Water Damage Date of Loss: 0810212012 Claim Number: 303510 Claim has been made involving loss, damage or destruction of the above captioned propert, which may either exceed $1000.00 or cause Massachusetts General Laws, 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. MPIUA Claims Division CMA00021 81312012 Rf0l 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance -with the provisions of M.G.L, c. 143, § 3L, the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c.143, § K. Permits shall -be limited as to the time of -ongoing construction activity, and may be.deemed.by the Inspector -of -Wires abandoned-and.invalidif_he—._ . or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this puipose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was t "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending"through August 15, 2012. ule8 —Permit/Date Closed:/5 *** Not : Reapply for new permiw k6ermit Extension Act — Permit/Date Closed: D Date... "':02-o..f....... NORTH TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SgAC14USE� Thiscertifies that .............................1 ....!....................................................... has permission to perform ..... L`-� % st�..4'.7.zAve..�.............. ........... .... wiring in the building of .......................... .............................. ................... at................................................. ... ST' , North Andover, Mass. Fee.......... Lic. No./............. ............ .� C., ........�.� ...... ELECTRIAL INSPECTOR e. Check # 1 �Zo I3 P Rq'79 - �iPar%mucf a�}ire �s.wicd IOU BOARQ,OF FIRE PREVENTION REGULATIONS Official U* -C Or,iy Permit No. 71 Occupancy and Fee Checked _ (Rev. 1107] leave blank) APPLICAT.I,ON FOR PERMIT TO PERFORM ELECTRICAL WORK All wort; to be performed in accordance with the Massachuscros Electrical Code (MEC), 527 CMR 12.0 (PLEA S.E PRIM LV 41K OR TYPE ALL INFORMATIOA9 Date: KI a -y, City or Town of: /t%7,ci�FTo the Inspector of Wires: By this application the undersigned gives notice of his or er intention to perform the electrical work described below. Location (Street & Number)��y�-- Owner or Tenant - �f /o��� �� Telephone No.� �. Owner's Address Is this permit in conjunction with a buildirtg'permit? Yes ❑ No (Check Appropriate iiaX) Purpose of Building Utility Authorization No: E;�isting Service Amps _ ! Volts Overhead ❑ Undgrd ❑ No. of Meters Nr:w Service Amps ! Volts Overhead ❑ Underd (J No.:of Meters Number of Feeders and Ampncity L nration and Nature of Proposed EIectrical Work: �J71`h Q� i �, r, eC�r't"Ct{ _ cit tLa ra, 1-'-- •- r•.,.�.,t,.,., „r.r.. int L..... .LY_ 1_ '• _J L_..L_ - No. of Recessed�Luminaires I INo. otCeiL-Susp. (Paddle) Fans o: o ata Transformers_ KYA No. of Luminaire Outlets. No. of Hot Tubs I KVA Generators of 1 uminaires 'A ov iBc eiyLi*Fian a swimming Pooi mJner"�s Qrnd_ d_ a—tt�e`ry ,No, nfo. of Receptacle Outlets No. of Oil Burners FIRE ALARMS M. tf i ones JNo. of Switches _ INo. of Gas Burners t`1o. o Uetect7on an _. No. f a� _;,nitrating Devi, -es L Fin es g No. of Air Cond. d Tans No. of Alcrtino.De-••ices eat. ump ,r um er I o is _ 4 _ o�Jell�catatned- Totals: 1 _ - IDt'e +ilrtcicrl' el -ccs _ No- of Waste Disposers _ P No. of Dishwashers Space/Area Heating KWoral QMunicipal ❑ Othe Connection No. of Dryers Heating App:iances KW ecuriry yys',rrns:'° No. oiDev' it E uivalent No. o Atero. Heaters KW of o- o 5i�ns Eallasts Data trrrig: No. of Devices or E uivalent No. Hydromassage Bathtubs No. of otors Total HP e ecommunicat:ons• tang: No. of Devices or E uivalent OTHER: � L-' Armen aaartronal derail rJ desired, or as required try the Inspector of Wires. Estimated Value of Electrical Work - (When required by municipal policy.) . Work to Start: Inspections to be requested in aecordanrc with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no ocrmit for the pe,'mrmance of electrical work may issue unless the, licensee provides proof of liability insurance including "completed operation" coverage or its substantia) equivalent- Tse �c is in force, and has exhibited roof of same to the permit issuing office. 1 undersigned certifies that such covcra� p CHECK ONE: INSURANCE ® .BOND ❑ OTHER ❑ (Specify:) I certh•, under the pains and penallies of perjury, that the information on this application is true and completf- FIRM NAME: Pt, -O -C Sd-CUrtT SGrI)CCPS LIC.NO.:. 15-3 3 C - Licensee: /7 iy, 7-¢Y7o%L- Signature IC_NO., (Ijapplicable, enter "exempt" in the license numcr fine.) Bus. Tei. No.: Address: ;1 () L ! IJJ-Fr1 V- ;�, /�r5 , ,UH "004Q AIL Tel. No.: S% 'Per M.G.L. e. 147, s. 57-6 I, security work requires Department of Public Safery "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normal required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's age .L Owner/Agent ,, Signature Telephone No. PERMIT z"EE: % , I i' CO I a nCD 4� O cz liJ O (� p ?-r -+.- cv Cf) Z Q G N i6 Q CO (DQ < u w U 1L LL U.. W Ln " U- p �u C� W U u ' � C L -2 U -J � ` On i CO I a aLU0 c Z •� F Y w U - U w LL.. _ .. - '• Q y } WA � w W O U LU Z 1 00 w � ,1 cn Z o > Q N J Q h N �^ = U M I - - mw n U Z Ll \ U O _ U i N N S Lal. O U O Q1 U lJ Q �l� Z LU Ii O Q F W v W Q x LL cn a Q `. _ r- F F- Q r '� �aW � } W r rt ,�.,x �Oz d www a N C ,J G m a U E a x 0 rn u1 p W �' t I x .] CD = fl O1 pW Z .O S (1: O oz H 4 :� CL LoBation / Z No. ly Date ` NORT01 TOWN OF NORTH ANDOVER O?0•`..0 ,•�MO0 � A Certificate of Occupancy $ ♦ i # Building/Frame Permit Fee $ �','°"""'•'�t�' Foundation Permit Fee $ ss�CHust Other Permit Fee $ 1 Sewer Connection Fee $ 1 Y Water Connection Fee $ TOTAL $ '// Building p Inspector 127 OM 98 G7OM98 06:39 260.00 PMD Div. Public Works ! ! -� ! L __ l Location �- ��� 'r - = �� No. �`- � t `� Date G - i NORTH TOWN OF NORTH ANDOVER 0 a a Certificate of Occupancy $ C fir's % w i Building/Frame Permit Fee $ • °1 «ter... cMCH u•'�� s�sa Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ s Water Connection Fee $ _A } TOTAL $ Building Inspector -'29/98 08:39 280.00 PAM • Div. Public Works Date 3879 - MpRTti TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING ♦ i,_ a .� �SS.gCMUSi This certifies that �.� �..Z.�.....t �. ............. Chas permission to perform .... P 6'.tf/1 .f............... . plumbing in the buildings of................... . at .. 7 0 Q. V. � ............ yt . , North Andover, Mass. Fee. .��V . Lic. No../.)-//()? . ? :�.e - .-__. .•. UMBING INSPECTOR 12/03/98 15:03 52.50 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer D C Ll W I 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. ************************"***APPLICANT FILLS OUT THIS SECTION APPLICANT 46W l 4lo J./_JjPHONE LOCATION: Assessor's Map Number q 0 PARCEL A'`&t." SUBDIVISION LOT (S) STREET ST. NUMBER_ USE ONLY*************** RECO ENDATIONS OFF TOVGENTS: - CONS RVATION ADMINISTRATOR ' DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED P IC PECTO -HEALTH DATE APPROVED L DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE t ,. 1i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) 02 � W NORTH ANDOVER Mass. Date 12/31 19 96 Permit # -320/ �1b7 -(h Building Location 742 Boxford St. Owner's Name Ed Parolisi Type of Occupancy Residential New ❑ Renovation ❑ Replacement N Plans Submitted: Yes ❑ No ❑ FIXTURES Installing Company Name Heritage Htg. 01g. CO. Inc. Check one: Certificate Address 35 Pleasant Street IXCorporation 714 Stoneham, Ma 02180 ❑ Partnership Business Telephone 617-438-7776 171 Firm/Co. Name of Licensed Plumber Gordon Switzer INSURANCE COVERAGE: I have a cu o ❑ current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have checked Vis, please indicate the type coverage by checking the appropriate box. A liability Insurance policy IN Other type of indemnity ❑ 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 that my signature on this permit application waives this requirement. Check one: 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 the permit issued for this application will be in compliance with all . pertinent provisions, of the Massachusetts State Plumbing Code and apier 1 of the General Laws. By Signature of License lumber Title Type of license: Master [X Journeyman ❑ City/Town IAA- — APPROVED FIE S� NL License Number 8322 z :r;,YAi N y N J N O 2 H Z y W?tl�� W OJ Y � UJ N J 1" N WN Y ~ V 4 Y y W fel ¢ CA x Q W N y � ��Iy1 W < S ~ > ~ r W O N O y x 7 =Y a f J a Z O C p 2 z "t w W LL 0 Y U W x Q ,jQ�1� SCG• r1 •f-1 3 Y J m H D J = IA o D d C o I F LL 6I 33 33�' SUB—BSMT. BASEMENT 1 1 IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name Heritage Htg. 01g. CO. Inc. Check one: Certificate Address 35 Pleasant Street IXCorporation 714 Stoneham, Ma 02180 ❑ Partnership Business Telephone 617-438-7776 171 Firm/Co. Name of Licensed Plumber Gordon Switzer INSURANCE COVERAGE: I have a cu o ❑ current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have checked Vis, please indicate the type coverage by checking the appropriate box. A liability Insurance policy IN Other type of indemnity ❑ 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 that my signature on this permit application waives this requirement. Check one: 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 the permit issued for this application will be in compliance with all . pertinent provisions, of the Massachusetts State Plumbing Code and apier 1 of the General Laws. By Signature of License lumber Title Type of license: Master [X Journeyman ❑ City/Town IAA- — APPROVED FIE S� NL License Number 8322 2 i O z O J n in LL O W a r a W 4 0 Z m � J J Z O O W N C O O W r U_ r LL LL O O 0 w Z a O LL O LL O Z J W' O m d U J, W a w a LL d W W Y N 2 i O z O J n in LL O W a r a W 4 (Type or Print) NORTH ANDOVER Location �zl,� f34,6040 ; T Persalt 3 ?g Owners Name {� New D Renovation D" Replacement [] Plans Sybmitted II CI YTI IDCC (Print or Type): Installing Company Name y.Wf.V/- Address ",a w �-j',�h'l x'2,4 • - Business Telephone'! Check one: Certificate ❑ Corp Partner. Firm/ Co_ 4 V Name of Licensed Plumber: 4. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond Insurance Waiver: I, the undersigned, have been made aware - that the licensee of i this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner Agents. I I beabr catlify Wal all of Ilic dclaila and infalmalion I ba.c lubmirlcd lot cn(ncd) in atwisc applicalion we lost Z644 W the beat ed r1 k"wkdgc aad"all pluatbint walk and inuallationa locc(ormcd under rcimil lawcd lo( (hit application will be i pwpWalq rj{M sy Pat M PWy WWO" of (Ile Ma"a4m atlt Sla(c rtuanbiag Cade and Otiplct 142 of lho Ccnaal hwL 4 4 By Title City/Town: •aooRnvrn 70FFlCF USE ONLYI Signature of Licensed Plutubev Type of Plumbing License License Number ❑ Master El�-Yourneyww J^.r T4if`-"•-`...^:,a.�o-�.3`�. Wiz. :s.y::�s.��,•,.. }_'�`_ .�:�.,,, -w•..d• "�-.�......�.-a .: -� .. �. L • Date.... - t)3.. ,3201 "ORT" �? °.;•.',"o TOWN OF NORTH ANDOVER o PERMIT FOR PLUMBING ACHUS This certifies that XL !..� ..�! ' .� Li has permission to perform ...�`yC . P PV .1� plumbin in the-bbuild" f .7.�!? ... ..4.1w ...�/ ......... at. .........�i/. .. ............. North Andover, Mass. q w Fee 3 Z2 Z./...... Lic. No. !� ............................. . �g PLUMBING INSPECTOR 01f 12 -b 10 • PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 3113 Date.-r!..�. �...� .?...... A M Q NORTh TOWN OF NORTH ANDOVER 8 O�py y••ao '+,'S'p0� PERMIT FOR GAS INSTALLATION s io • +opo •r"' 1g r Q~ O This certifies that�.......... .. / M has permission for gas installation ...�.. ...... • • • • • •`•' in the buildings of ..� rt�t:-. .F.. at ..........: . . North Andover, Mass. Fee.2J ..:.. Lict No.., `.... ............ .... . GAS INSPECTOR r 1 C WHITE: Applicant CANARY: Buildind Dept. PINK: Treasurer M MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT or print) INVK1n ANDOVER, MASSACHUSETTS GAS FITTING Date z/ 2 � 19 7- ! Building Locations 7,V:C�i� s Permit i# Amount Owner's Name Cbl" 1, /S / New ©/ Renovation ❑ Replacement ❑ Plans Submitted ❑ or type) � Pyr G f I TG Check one: Certificate Installing Company Name ,� T7F [ Address �/ ! �!/�Gl� woe d /3/J TF�ri fiSl3�.e2� ❑ Partner. Business Telephone e -s) 5!G $w ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter r o%' GF 4• /54Q4/.tT%� INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes LSA No❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy ❑' Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insixrance 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 ❑ 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 Gas Code and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber . 5�7. ❑ Gas Fitter License Number eS r ❑ Master t7'L Journeyman � N � W W z N z z SUB - BASE,N ENT BASEM ENT ]ST. FLOO R 7�_LD. FLOOR 3RD. FLOOR 4TH. FLOOR tiTH. FLOOR 6+T 11. FLOOR 7T 11 FLOOR I- ##I 8 T 11. F L O O R 1 1-1 1 1 1 1 1 1 or type) � Pyr G f I TG Check one: Certificate Installing Company Name ,� T7F [ Address �/ ! �!/�Gl� woe d /3/J TF�ri fiSl3�.e2� ❑ Partner. Business Telephone e -s) 5!G $w ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter r o%' GF 4• /54Q4/.tT%� INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes LSA No❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy ❑' Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insixrance 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 ❑ 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 Gas Code and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber . 5�7. ❑ Gas Fitter License Number eS r ❑ Master t7'L Journeyman N° 2 I 4 i Date....l..� .. ! .......1� 14 NOR7M 1.. j, ? , . �0 TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSACMUS� Thisc`ertifiesthat.....J.�.h.pS.......-.�e.C.r�-................................ has permission to perform...�o j . ` UA - t................... ............................................. wiring in the building of .......1.... e%j U.�r..j. ............... at ......�7�j ..................... .....+.... ............................ ,North Andover, Mass. Fm...W)... �(%. Lic. No. l �W ............................................................. � (� T ! ELECTRICAL INSPECTOR 12/03/98 15:01 60.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer \ TIE00WO W L'THOFMAMMU M;'112Office Use only DEPAR771W0FPUBL1C&AFM Permit No t� I BOAW OFMREPREVEM ONRWHA77ONS527:00 Occupancy & Fees Checked APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMEDM IN ACCORDANCE WITH THE ASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date y— , 3 Town of North Andover To the Inspector of W ires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 74 � 13o X TQYJ- _ Owner or Tenant s)q PF 1z /% S / Owner's Address 7'12 aX 01219 Sl` - Is this permit in conjunction with a building permit: Yes m No (Check Appropriate Box) Purpose of Building 51411 Ir ,y,,,ll K 1�6�•7t-- Utility Authorization No. Existing Service Iko Amps .0 / Volts Overhead UndergroundtD No. of Meters New Service Amps / Volts Overhead 71 Underground r7 No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 4VIIZ,�-:- n/F1*i i91I/�/Toles f; No. of Lighting Outlets No. of Hol Tubs No of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA round 1:1round No. of Receptacle Outlets No. of Oil Burners No of Emergency Lighting Battery Units No of Switch Outlets No. of Gas Burners FIRE ALARMS No of Zones No. of Ranges No. of Air Cond. Total Tons No. of Defection and No of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Locala Municipal Other No of Dryers Heating Devices KW Connections No of Water Heaters KW No. of No. of Signs Bailasis No Hydro Massage Tubs No. of Motors Total HP OTHER 1rmr4ce Co,MT- Ptasuat tithe w4inrtetls of Mass;, > Card Laws �/ I ha`eaarrasLiabt*woePtbcy Carpal CaetaWcritssivaMe4iva6t YES u NO I haw abTtmedvalid ploofofsarnebtheOffim YES [ NO r7 Ifjwu medred(edYES plmedr*theNxcfoaaaWbyduic%the INSURANCE BOND M &R (PkaseSp*) Expit�crt Dt� E4n*dValueofEkfticaI Work $ WakloStat /� ,�1 " y Irispe�tionl*RmpesW Ra# 0 " Signed uxi lrM Penalties Of, , FIRM NAME r`I ©/yS-�3 FlZ7eTn1L IAl L - Li wN;a A /16 L Lica�e )3%Z/.fml t/(-l^l-�S Sigrrmae LioarseNo ..91 �U 5`% Btsirl�TelNa Y18- �� �0.�'3 fi ap- l,44 'eal o ./V- 6>i97 I AlTetNo. OWNER'S INSIIRANCEWANER Iamawatettratthel-=ise theimrxxoD�era�ori&bWrtiale:vdlattasraLmWbyNia%adeaemCenaalLam and the mys�i{ernthis pamitappficaoatwaivFs this r�nart. (Please check one) Owner a Agent a /) Telephone No. PERMIT FEE (� CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number 3� 0 Date /(? THIS CERTIFIES THAT THE BUILDING LOCATED ON % x/0? Be X A R d �S MAY BE OCCUPIED AStti?�P1e ��n1�� 2�S�N �������t/ IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. • MORTq O � ��sscNusf� CERTIFICATE ISSUED TO e�_ Pe le 0 L l S 1 ADDRESS 7' ` X/� �� I Building Inspector j v y C � � d 'O Cl)ce CD C7 Z CO) CD CL CO) 0 n c v CD CD O Q CD CD O CD C CDCD y� �O CO) CD I O C', b VI O O VI VJ .0 C/! 0 O O _n o -.3 m 0 ro Oq 4=0 wnn� d` m O� ..� O • y A Mu m m o+ a� C', 0 O �• y C Q m VJ .0 C/! ro _n o -.3 m 0 ro O 4=0 wnn� W m O� ..� O • y - M ? m a=rMCD y y O-.1O 64 = m p m 7 Amo: m �p = C, ZS.� O y' m �_ C CL y = �.m CL �« : o -�: CD y M m y l+J 0 OF) WN m 0 � C _ uC O r^ V/ .yr mCs y C9 1 CDA O m �i N :: Mu m m o+ a� C', 0 .� o .� ro ro W N 'T\' J T * W3 rA W -9 j. y 0 9 0 m rA s; ►P �1 0 0 EM4 FM 0 WN Iz CL :U ru U L m m c 0 ,A .0 :O CO w r ;mac Cf) mo Boa z E c QClf 0 t O O O (� CL's . ` m OCD v, m 3 jj TT �l N C O rr1 O E L c U N m � C _ 1 Tkip H Q m C� m O 0 N O Z O cm C O C_ F" m H CL C C C = m mrLr� N :d y w A m m m c N •N dt C Z rr LLA V •PL V m C V� CD _ d V N = 0 F- z sasm > �' co O O i � O O v z °' CL O H D = I C Q' CA 'fl CO ca 'ff m m CL F— O CO co 0 _O O CL �Q CO2 C cc 9 .0 ' Li `CD CL V� C C R h 0 inow �C O U w W O F u A A Cz Q e A a u m u w c z U w � w c�° w n°' cy w rA' cn V) �1 0 0 EM4 FM 0 WN Iz CL :U ru U L m m c 0 ,A .0 :O CO w r ;mac Cf) mo Boa z E c QClf 0 t O O O (� CL's . ` m OCD v, m 3 jj TT �l N C O rr1 O E L c U N m � C _ 1 Tkip H Q m C� m O 0 N O Z O cm C O C_ F" m H CL C C C = m mrLr� N :d y w A m m m c N •N dt C Z rr LLA V •PL V m C V� CD _ d V N = 0 F- z sasm > �' co O O i � O O v z °' CL O H D = I C Q' CA 'fl CO ca 'ff m m CL F— O CO co 0 _O O CL �Q CO2 C cc 9 .0 ' Li `CD CL V� C C R h 0 i Jennie Elliott Bridge 62 no me Peter 6 _.� �%� N ��` otic° — Ikon /SS — Dw �g S 170 h ¢s2 oO S0 N 300 00 _ ►.� ohs° c�' C/S 4 UC p Q �1 Pe ter & Kerry Breen Location 7 No. a� 9 ' Date i o f HORTil TOWN OF NORTH ANDOVER A 3 p Certificate of Occupancy $' Building/Frame Permit Fee $ c►wsE�� Foundation Permit Fee $ i r Permit Fee $ Sewer Connection Fee $ �1 t Water Connection Fee $ TOTAL $ s q ey g� s� Building Inspector i 2 s7 1 Div. Public Works f = D P..' J D b 3 rr 5 y rn z D r m to !; C C 1 m c rr Q - G• � C. o Q z m i � Z C) Z n Zp y m v N N w m y 3 . .. z z z y m N ►y G N n z 2 �� R o O Z O m c m Z z w �� Q � -c y r7l z _ a ? a j m z z T (Zi m Z m z � n m \ N Q 70 � m D z n Q n C z z P..' J a N G —^zi n to !; C C 1 m m O rr Q G• � C. o 7 m i i Z C) Z n C m P..' m ? N N —^zi n to !; C C m m O rr Q Z ,■w� o 7 m i i Z C) Z n Zp Nm m v Lr ^ D m u y . .. z z z y m N ►y G N n z 2 �� R o O Z O m m.: r �� _ a ? a z z (Zi m 7(' \ N Q 70 � m D O � m C m P..' m ? —^zi n to !; m m O rr Q Z ,■w� 7 m i i z t- Zp Nm m z ^ �c m u y _ � N y m D 'i7 rn m V V m N ►y G N z 2 �� R o O Z O m m.: r �� d a ? n (Zi m 7(' \ Q n m m D O 1 - 2 l /r L No � a 0 L17 z d o � O � h � z C m P..' m ? m m O rr Q Nm G z ^ �c N � ,o 7 m m m N N z 2 O m.: r �� d a ? m 7(' /r L L17 z d � O � h � z c I w A TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the "reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units ... or to structures which are adjacent to such residence or building" be done by registered contractors, with certain exception, along with other requirements. Type of Work: Est. Cost Address of Work �'�kFd2oC S %�n�LU��2 rn Owner Name: 84F pii cn I I S l Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s) Work excluded by law Job under $1,000 Building not owner -occupied Owner pulling own permit Other (specify) Notice is hereby given that: For office Use Only Pemit No. Date OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FIND UNER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 146 Main Street " North Andover, Massachusetts 01845 �,'•�,,;,, ::•`',� WILLIAM 1. SCOTT SSAcNust� Dirwtor 0 In accordance with the provisions 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 a properly licensed solid waste disposal facility as defined by MGL c 1 11, S 150A. The debris will be disposed of in: 6ti (Location of Facility) Signature of Permit Applicant .A /? �, Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. HOARD OF APPEALS 689-9541 BUILDING 669-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 DEMOLITION OF BUILDING AFFIDAVIT DATE - �a-g T % F OWNER'S NAME & ADDRESS of "122 Ae, 0 Zj ; 1 J fol', 41Z LOCATION OF PROPERTY TO DEMOLISH DESCRIPTION a ��.(� _g,9a & CONTRACTOR' S NAME & ADDRESS _ lrfu' ,/� 4?� Ri,-ee.� /r/, AIJ4161 DEPARTMENT SIGN -OFFS DEPT. OF PUBLIC WORKS - WATER: SEWER: TELEPHONE rv... DUMPSTER - ON/OFF STREET DATE RECD BLDG. INSPECTOR Col KAREN H.P. NELSON�'TM }TOWII Of • m NORTH ANDOVER BUIIAING T _ CONSERVATION . ''�" '� _ DT90N OF PLA` LTH NNNING PLANNING & COMMUNITY DEVELOPMENT DEMOLITION OF BUILDING AFFIDAVIT DATE - �a-g T % F OWNER'S NAME & ADDRESS of "122 Ae, 0 Zj ; 1 J fol', 41Z LOCATION OF PROPERTY TO DEMOLISH DESCRIPTION a ��.(� _g,9a & CONTRACTOR' S NAME & ADDRESS _ lrfu' ,/� 4?� Ri,-ee.� /r/, AIJ4161 DEPARTMENT SIGN -OFFS DEPT. OF PUBLIC WORKS - WATER: SEWER: TELEPHONE rv... DUMPSTER - ON/OFF STREET DATE RECD BLDG. INSPECTOR Col O O CP CP rn m O 0 O i � Q y '-' O 2 LU N •c .5 cz U O o 5 m b `p 1 0" • � � J V LQL H IN w 2 z �. W [C w z a (D W ir o a ij z F- O F- a 0 Z W J U Z J J m Z J J m U cc W cn U H a W W J U U W d a cu � T W E Q Z ro U) C L 0 1- Q) z Q) m W m 2 U z 4E O E .G ',E z W �L 0 O Z Q a � ^W^ V IL O Ir IL J W 2 z J z W w z c9 z W cc IL A ,I 13 IN w 2 z �. W [C w z a (D W ir o a ij z F- O F- a 0 Z W J U Z J J m Z J J m U cc W cn U H a W W J U U d a cu � T W E Q Z ro U) C L 0 1- Q) z Q) m W m 2 U z 4E O E .G ',E z W �L 0 O Z Q a � ^W^ V IL O Ir IL J W 2 z J z W w z c9 z W cc IL A ,I 13 0 H C � SCD d n z vi CLCD 0 0� C ? C C. a. y aCO -0 O O CD d� O Q CD Cm o C CCD n0 y � C I CD C C? -O d 2 O �• N O tS N d0�• = CO) mSma m m O N s CL C2 z P-0 CL =rto =r d O y O O m y p C �� :,fr mm: x Ay: �n'1 O O0 psn N n o CD . = y CL CL fa O � { h . 170 tG C'!= C H d dCL C aEL CA O .� y N cd .� t0 m v O ~2 � N Sr 'C O C/) '�11 ;12:1 � co) 0;12:1to d CD � s n o y 0 9 r;, Cn j A m = r •� O 7 �' ')d C G S°' Com" A, w �°' I'd PIZ m EL Cn Cn j A 7 �' ')d C G S°' Com" z :3G w �°' I'd PIZ m EL n Poo "op w a! R.Cb � CL 0 c N2 2289 *_1 0 IN " A u Date.. . .... ....... ... .......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that 4- -/ has permission to perform wiring in the building of .... at..... ....... Feer. ,-?..?............. Lic. No. ............... ................... ............. ................ I North Andover, Mass. .......................... ...... —� ELECTRICAL MpEcrolit WHITE: Applicant CANARY: Building Dept. PINK: Treasurer I The Commonwealth of Massachusetts It No. lug Qccupanev 4 tree Checked Department of Public Safety 3/90 (leave blank) BOARD OF FIRE PREVENTION REGULATIONS R 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Ma"achusetts Electrical Code. 527 CMR 12:00 (PLEASE PRINT IN INR OR TYPE ALL INFORMATION) Date —3-1 _q 9 City or Town of � . 0 -ver To the Inspector of Wires: REG CPY The undersigned applies for ap-e�rmitt�to perform the electrical work described below. RCT ACT Location (Street & Number) llgcl L�—UY� Pin Owner or Tenant C� t%Ce_GP T la-ro I ( .S Owner's Address Is this permit in conjunction with �abubuilding permit: Yes ❑ No � (Check Appropriate Box) Purpose of Building I�es I- 71 ,C Utility Authorization N0. existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. o= Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Yzte-s i N,—ber of Feeders and Ampacity �1 Location and Nature of Proposed Electrical Work . r No. of Lighting outlets No. of Hot Tubs 1 No. of Iransformers iKVA" No. of Lighting Fixtures SwimmingPool Above In- oogrnd. ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners lBattery No. of Emergency Lighting Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Total No. of Ranges No, of :air Cond. tons Initiating Devices No. of Sounding Devices NDeiec Self Contained Detection/Sounding Devices _ Local ❑ Municipal ❑Other Connection No. of Dis osals P No. of Heat Total Total Pumas Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No, of No. of Low Voltage /U .. M Si s Ballasts WiringAft_ No. Hydro Massage Tubs INo. of Motors Total HP OTRER: 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 M I have submitted valid proof of same .to this office. YES ❑ NO [] If you. have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE & BOND ❑ OTHER ❑ (Please Specify)' �Expization Date) Estimated Value of Electrical Work S Work to Start Inspection Date Requested: Signed under the penalties of perjury: FIP-11 NAME_ r h ks Ha.�„ SGC�.a r� i•.r Licensee Me, 1-k J SY �LeZJe_P Signature Address Rough Final LIC. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its suo- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) n V Telephone No. PERMIT FEE Sl-_ Signature of Owner or Agent