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HomeMy WebLinkAboutMiscellaneous - 81 LACONIA CIRCLE 4/30/2018 (2)359Date ...f�//I....... .: . NORTH TOWN OF NORTH ANDOVER "• a ' OL PERMIT FOR MECHANICAL INSTALLATION P This certifies that .(A. L... ... ...... ..... . has permission for mechanical installation ."ea in the buildings of .. E t �.►� .�.1�:�--�--- .................. at .... �....U, ,C 01.✓�....C.t r.., North Andover, Mass. Feet -o.> Lic. No...%10.1(.. .....:...�r-v-r�........... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer TOWN OF NORTH ANDOVER 1600 OSGOOD STREET Building 20 Suite 2-36 NORTH ANDOVER MA 01845 _ERS. ROOF TOP UNITS. AIR CONDITIONERS. EMERGENCY GENEREATORS Date: The undersigned applies for a permit to install the following at: Owner of premises mas e!_ Address ti Name of mechanic 6\,IQI 6\,Address up Building occupied for ���1` - NR t Material of building Kind of fuel elu!'W Chimney No. Of flues Size_ Chimney Thickness Lining If steel stack location Diameter Height DESCRIPTION OF HEATING APPARATUS Kind of heater how many BTU I Location in building make Protected against fire as required How protected See the State Code (Pertaining to Chimneys, Smokestacks and Heating Apparatus) ROOF TOP UNITS OR EMERGENCY GENERATORS Make Weight Dimension Length Width Height Location of building how supported Size of roof timbers Material of roof timbers Span of roof timbers Distance on center Protected against fire as required How protected / jAIR CONDITIONS Kind of apparatus 1�.i94ya t ,uhf ,/�� make C1 � � w"(--) HVAC FORM REVISED 11.04 o ISSUES TNN FO LOWtMrWA Ek rt'MO 93 FTHIEi•, ROYAL ATZ MST a �•, W. t)' te- r" ti y�sY' n;�, -°n�/ 8` 1933 �� R� t.- Commonwealth of Massachusetts Department of Public Safety License: PMU-00,1265 " rn Pi efitter Unrestri_cf' d Master', `�►_, ARTHUR A PICKETT w • - 48 CHESTNUT ST ! N READING MA 04864, // y Expiration: Commissioner 04!04/2046 Clienl#:.74206 ROYALAIRSY ACORD CERTIFICATE OF LIABILITY INSURANCE FDATE (MWDDNYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFIERS`NO RIGHTS UPON THE CERTIFICATE. 9/26/2614 HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE13 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: It the certificate holder is an ADDITIONAL INSURED, the _Policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain Policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), PRODUCER N7 CT 7� HUB International New England INA rDept _–RbWe7 Certificates--- — . I --- -------- 299 Ballardvale St .�Z No, Eli: 978.657 5100 FAx - E-MAIL** ­_'­******_­* -­--­"­— ­M,.Nol. _866.475-7959 Wilmington, MA 01887 _600k nee.certificates@hubinternational.com ...... . ....... 978 657-5100 AFFORDING COVERAGE NAIL # INSURED 114SURERA: Travelers Indemnity CoofCT NSURER 6: Hanover Insurance Cornp�any. ir , Inc I Systems Royal A7 210 MainStreet LINSUIRER C: Independence Casualty ins Co North Reading, MA 01864 1 INSURER D. Safety indemnity Insurance Co 'INSURER E: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE 13EEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT; TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH. RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR 'MAY PERTAIN THE INSURANCE AFFORDED 13Y THE POLICIES DESCRIBED HEREIN IS SUBJECT To ALL THE TERMS, EXCLUSIONS AND CONDITIONS` OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY I PAID CLAIMS. INSR A GENERAL LIABILITY - 9 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE _7111 5XI 0OULIR IL Pkw_f) OPOM i LIMITS 4 0912912015 EACH OCCURRENCE AMAGE T RENT ffffff EDREMISES Ca ocwuLe nqq MED EXP (Any one person) PERSONAL &AbV INJURY S BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE —' - Ml EACH OCCURRENCE ---qE$qRlp,n';LN,gEOPERATIONS below POLICY A MTCargo I LE.L DISEASE 09/2812014 09128/201$ 25,000 A Installation 68074990764 9128/2014,09/28/2015 i 25,000 DESCRIPTION OFOPERATIONS ILOCATIONS /VEHICLES (Aftnh ACORD,1101, Additional Remarks Schedule, ffmore space is required) Blanket Additional Insured Status and Waiver of Subrogation In favor of certificate Holder on the general and auto liability policies as respects to operations of the named insured when required by executed contract prior to any'loss/claim. Evidence of Coverage. S Evidence of Coverage.Only SHOULD ANYOF THE ABOVE DESCRIBED POLICIES. BE CANCELLED 13EFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE P ACORD.25 @ 1988-2010 ACORD CORPORATION. All rights reserved, .(2010105) 1 of 1. The ACORD. name and 1090 are registered marks of AC6RD *S12223I6/M1222238 MCOO!5 GEN'LAGGREGATE LIMIT APPLIES PER: XPRO­ POLICY i LOIC AUTOMOBILE LIAWL" 1 1710990 0912812014 09/281201 ANY AUTO ALL OWNED SCHEDULED AUTOS NED Fy AUTOS X HIRED AUTOS T NON -OWNED AUTOS -u�MBRELLAUA B - X XOCCUF,4­ EXCESS Llke UHNA1046.86 09128/2014 091281201 ' CLAIM' -MA JDED _F_X1,RETE ONS5006. C WORKERS COMPENSATION, AND EMPLOYERS, LIABILITY WC100110901 10/1012014 11011101201 Y. t N ANY PROPRIETORIPARTNER/EXECUT .1VE OFFICEWMEMBER EXCLUDED? � �N/ A (Mandatoryln:Nli) S BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE —' - Ml EACH OCCURRENCE ---qE$qRlp,n';LN,gEOPERATIONS below POLICY A MTCargo I LE.L DISEASE 09/2812014 09128/201$ 25,000 A Installation 68074990764 9128/2014,09/28/2015 i 25,000 DESCRIPTION OFOPERATIONS ILOCATIONS /VEHICLES (Aftnh ACORD,1101, Additional Remarks Schedule, ffmore space is required) Blanket Additional Insured Status and Waiver of Subrogation In favor of certificate Holder on the general and auto liability policies as respects to operations of the named insured when required by executed contract prior to any'loss/claim. Evidence of Coverage. S Evidence of Coverage.Only SHOULD ANYOF THE ABOVE DESCRIBED POLICIES. BE CANCELLED 13EFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE P ACORD.25 @ 1988-2010 ACORD CORPORATION. All rights reserved, .(2010105) 1 of 1. The ACORD. name and 1090 are registered marks of AC6RD *S12223I6/M1222238 MCOO!5 210 M NAME; cyst Amok �i I i Tummy Chase anot.Es . 81 Laconia Circle is 41864 oe:1. '**'E 3-781-63-3538 -DATE: Other. 05-14-15 f TOWN: North Andover, MA 1845 E-llflt'.iL: we ht Vftifieatioris and solutiand solutions for_ Fumisfxiug and installirru cs tnEw hzgkh efficient CeTitral air ccniditiorf;ng syslerni YCti yow home. { C�uad.c:u ing watt will i?s lir-talled ouiside the lime ori a new pre-ras•,i pans. ,'sir handler will be twAlkl1 m the attic. Air liandler will lie %tu; b -em elle leaf ration ffiuc-adcd roti_ UTA=neath will be an rrnr.rgeacv dmiu pan, gravity drairt, EZ trap, and float switch. All dm`4 piping deeded. e-;" i;Pa3ut lines will be ,,.o.:ixlxted from the indoor unk jay -die outdoor anti ao tit(; e;aeriot of the hoose„ Cncased in critiie - histic' conduit. Ali connections will be brazed. F3hri.c&tiotn, msr:lating, s; aline .. and imtallation of all .nrcFSsary duct wars: rap to Mas :,tatD sI cEt me ,l cow. Instillation of a b7K% zone ec,nrrri.l paA�kagc. I Vio tCw- progarnfxiatde thftrmostats. All Nviring needed, All Llecziical wiri.rt to -the existing Lane. E, -c=.* -1 pertait wrid irL u:ction. Shi ct metal permit and insp �ctioti. ;plere Stant up and tests. A or.C?.r' s� C oO—nact 4n the Solution I Systt rn Dt. scripfvon Lexington t3 8 condenser 1T-SSEE 11,. 13 EER, 4tort Lexington AVPTC weriable a�3ta6ii airrandier Rebates: Sn!Nrt:-tdate. Milli receive art(ar j.ob is aOmpiete and balance is palet in full., Standard Guarantw and warranty information- This installation includes a �0 year unit repl2rerr!ent warranty, limited ( lifetirronompressur, and 10 year parts warranty. A 'MUMS perfori~narice guarantee. A one year seri+ica-- contact on pit revr produm. _ use yrov�se herebyto Svrrrisr rrdteriaJ end labor - complete k a,;�preti a wltla thri. ahoVC speeiPptio -� � we ac-ept 0000 #.—__ for the sung of- � 1'GyMent to be as follows. Ej Financino, ;pib:`l 4-3 riowii, 1./3 at the star, i/a opon completion Ali mak-iali6a^uwra:rte,bYobear.so ;emworf:tobecornple!edin:rprofes.tlmairnaa�neraccording�c,standardpract;ces.Anyalterationordeviw•ion h om Involving extra tats wil: be tzecutod only upon written orders, and will Lemaiie an e)rrra :harge avec and atbvethe estimate. Title to the. eouiprx ni'aremain Wrath Royal "*r Systems, Inr. until the final pay n.,rtit is Made. A!+a�rccrnents Gtnling:nt upon ftsikes, arrldents, or delays beyond our control. t)W orr to carry 9re, for nado and other necessary insw•anre. f:•x_wr cker rs tuitycove:ed by'kurt er s mpe++Satirn kesurarre. Pete, twice of proposal: The -above prices, ;peurticaUorc:arid caedrr ns ere sats fact" am xre herskry attepxc0. You are autho,'izeJ t,i do ih work a4 s ,erific:d. pay r.(pntwi!t be rrtede 05 ovdined above. ihts Proposal may :a withdrawn If rntt accepted wiENn 15 days fres the atxwe d*%-., C40t , er _4:cepuni:e Si Lure i .� X�r �-- - � ~— ._._.. €w'. _ DATE ROVO SYSWM,!n;.Aahovl;utionS;jMr t;,rt Qalc Al Project Summar/ Job: wrightsoft" ' 7 Date: 6/29/2016 Entire House By: Projec# Information For: Chase 81 Laconia circle, North Andover, MA 01810 Notes: Mrsighli nf-ormation Weather: Boston, MA, US Winter Design Conditions Outside db Inside db Design TD Summer Design Conditions D °F Outside db 75 °F Inside db 75 °F Design TD Daily range Relative humidity Moisture difference Heating Summary Structure 61150 Btuh Ducts 0 Btuh Central vent (0 cfm) 0 Btuh Humidification 0 Btuh Piping 0 Btuh Equipment load 61150 Btuh Infiltration Method Construction quality Fireplaces Simplified Average 0 Efficiency Heating input Heating output Temperature rise Actual air flow Air flow factor Static pressure Space thermostat 0 AFUE 0 Btuh 0 Btuh 0 °F 1624 cfm 0.027 cfm/Btuh 0 in H2O 88 °F 73 °F 15 °F L 50 % 31 gr/lb Sensible Cooling Equipment Load Sizing Structure Heating Cooling Area (ft2) 2450 2450 Volume (ft3) 22050 22050 Air changes/hour 0.32 0.16 Equiv. AVF (cfm) 118 59 Heating Equipment Summary Make Use manufacturer's data Trade Btuh Model 1.00 AHRI ref Equipment sensible load Efficiency Heating input Heating output Temperature rise Actual air flow Air flow factor Static pressure Space thermostat 0 AFUE 0 Btuh 0 Btuh 0 °F 1624 cfm 0.027 cfm/Btuh 0 in H2O 88 °F 73 °F 15 °F L 50 % 31 gr/lb Sensible Cooling Equipment Load Sizing Structure 32146 Btuh Ducts 0 Btuh Central vent (0 cfm) 0 Btuh Blower 0 Btuh Use manufacturer's data y Btuh Rate/swing multiplier 1.00 ton Equipment sensible load 32146 Btuh Latent Cooling Equipment Load Sizing Structure 2235 Btuh Ducts 0 Btuh Central vent (0 cfm) 0 Btuh Equipment latent load 2235 Btuh Equipment total load 34381 Btuh Req. total capacity at 0.70 SHR 3.8 ton Cooling Equipment Summary Make Trade Cond Coil AHRI ref Efficiency Sensible cooling Latent cooling Total cooling Actual air flow Air flow factor Static pressure Load sensible heat ratio Soldldatic values have been manually overridden Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. 0 SEER 0 Btuh 0 Btuh 0 Btuh 1624 cfm 0.051 cfm/Btuh 0 in H2O 0.93 lz�: wri htsoft2015-May-2910:32:46 Right-Suite®Univ ersa1201515.0.17 Right J® Mobile '46a _.\wstmp\65fce628-bc9d-4ce8-8807-9fe881475c7f.rup Calc = MJ8 Front Door faces: N Page 1 tea. Ri ht J® Mobile Re ort Job: w�iL�h��(�i �� � � Date: 5!2912015 Entire House By: Pro'ect lnforrnati_on For: Chase 81 Laconia circle, North Andover, MA 01810 Component Btuhlfi? Btuh % of load Walls Location: 16688 Indoor: Heating Cooling Boston, MA, US 25.5 Indoor temperature (°F) 75 73 Elevation: 16 ft Ceilings Design TD (°F) 75 15 Latitude: 42°N 8.3 Relative humidity (%) 30 50 Outdoor: Heating Cooling Moisture difference (gr/lb) 34.4 30.9 Dry bul b (°F) 0 88 Infiltration: 0 Daily range (°F) - 15 ( L ) Method Simplified 0 Vlfrtbulb(°F) - 72 Construction quality Average Adjustments Wind speed (mph) 15.0 7.5 Fireplaces 0 1 Component Btuhlfi? Btuh % of load Walls 7.3 16688 27.3 Glazing 42.8 15568 25.5 Doors 29.2 1228 2.0 Ceilings 5.3 6956 11.4 Floors 8.3 11013 18.0 Infiltration 3.6 9696 15.9 Ducts 0 0 Piping 0 0 Humidification 0 0 Ventilation 0 0 Adjustments 0 Total 1 1 61150 100.0 Cooling Component Btu hff Btuh % of load Walls 2.5 5785 18.0 Glazing 39.7 14445 44.9 Doors 11.1 465 1.4 Ceilings 3.6 4814 15.0 Floors 1.6 2144 6.7 Infiltration 0.3 944 2.9 Ducts 0 0 Ventilation 0 0 Internal gains 3550 11.0 Blower 0 0 Adjustments 0 Total 32146 100.0 Latent Cooling Load = 2235 Btuh Overall U -value = 0.174 Btuh/ft2 °F Data entries checked. Gadrg ---"!M1__CeBrgs -d SoldJitalic values have been manually overridden 2015 -May -2910:32:46 I wrlghtSOf Right -Suite® Universal 2015 15.0.17 Right J® Mobile Page 1 lwstmp\65fce628-bcgd-4ce8-8807-9Fe881475c7f.rup Calc = MJ8 Front Door faces: N rrr wr ghtsoft` Right -M Worksheet Job: Entire House Date: 5/29/2015 By: AL 1 Room name Entire House First Floor 2 Exposed wall 300.0 ft 160.0 It 3 Room height 9.0 It 9.0 ft heat/cool 4 Room dimensions 1.0 x 1325.0 ft 5 Room area 2450.0 ft' 1325.0 ft' Ty Construction U -value Or I HTM IArea (') I Load IArea (ft') Load number (Btuh/ft°-°F) (BtuNft2) or perimeter (ft) (Btuh) or perimeter (ft) (Btuh) Heat Cool Gross N/P/S Heat Cool Gross N/P/S Heat Coot 61213-Osw' 0.097 n 7.28 2.52 810 728 5299 1837 405 364 2649 918 - G1D-c2ow 0.570 n 42.75 19.01 82 0 3491 1553 41 0 1746 776 1213-0sw 0.097 a 7.28 2.52 540 486 3534 1225 315 283 2061 715 1 Dc2ow 0.570 a 42.75 60.87 54 0 2316 3297 32 0 1354 1927 11 1213-0sw 0.097 s 7.28 2.52 810 636 4624 1603 405 272 1975 685 � 1D-c2ow 0.570 s 42.75 32.80 153 0 6555 5030 113 0 4809 3690 11DO 0.390 s 29.25 11.08 21 21 614 233 21 21 614 233 1213-0sw 0.097 w 7.28 2.52 540 444 3230 1120 315 242 1757 609 1D -clow 0.570 w 42.75 60.87 75 0 3206 4565 53 0 2244 3195 IIL���pp 11DO 0.390 w 29.25 11.08 21 21 614 233 21 21 614 233 C 166-13ad 0.070 5.25 3.63 1325 1325 6956 4814 200 200 1050 727 F 19A-Obscp 0.295 8.31 1.62 1325 1325 11013 2144 1325 1325 11013 2144 6 c) AED excursion 01 0 Envelope loss/gain 1 51453 27652 1 1 31887 15852 12 a) Infiltration 9696 944 5171 503 b) Room ventilation 0 0 0 0 13 Internal gains: Occupants Q 230 5 1150 5 1150 Appliances/other 2400 2400 Subtotal (lines 6 to 13) 61150 32146 37058 19905 Less external load 0 0 0 0 Less transfer 0 0 0 0 Redistribution 0 0 0 0 14 Subtotal 61150 32146 37058 19905 15 Dud loads 0% 0% 0 0 -0% 0% 0 0 ITotal room load 1 61150 32146 37 058 19905 l Air required (cfm) 1 1 1 1 984 1 10061 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed -c wrightsoft` 2015 -May -2910:32:46 Right -Suite® Universal 2015 15.0.17 Right J® Mobile Page 1 \wstmp\65fce628-bc9d-4ce8-8807-9fe881475c7f.rup Calc = MJ8 Front Door faces: N wntsalt Right -J® Worksheet Job: Entire House Date: 5/29/2015 AL 1 Room name Second Floor 2 Exposed wall 140.0 ft 3 Room height 9.0 It heat/cool 4 Room dimensions 45.0 x 25.0 ft 5 Room area 1125.0 ft2 Ty Construction U -value Or HTM I Area (ft') I Load I Area I Load number (Btuh/ft2-°F) (Btuh/ft2) or perimeter (ft) (Btuh) or perimeter Heat Cool Gross NIP/S Heat Cool Gross N/P/S Heat Cool 6 V►I 12B-Osw 0.097 n 7.28 2.52 405 364 2649 918 1 D-c2ow 0.570 n 42.75 19.01 41 0 1746 776 12B-Osw 0.097 a 7.28 2.52 225 203 1473 511 1 Dc2ow 0.570 a 42.75 60.87 23 0 962 1369 11 126-0sw 0.097 s 7.28 2.52 405 364 2649 918 1 D-c2ow 0.570 s 42.75 32.80 41 0 1746 1340 11 D"0.390 s 29.25 11.08 0 0 0 0 1213-0sw 0.097 w 7.28 2.52 225 203 1473 511 1 D-c2ow 0.570 w 42.75 60.87 23 0 962 1369 LL__..pp 11D0 0.390 w 29.25 11.08 0 0 0 0 C 166-13ad 0.070 525 3.63 1125 1125 5906 4087 F 19A-Obscp 0.295 8.31 1.62 0 0 0 0 6 c) AED excursion 01 1 Envelope lossfgain 1 19566 11800 12 a) Infiltration 4525 440 b) Room ventilation 0 0 13 Internal gains: Occupants Q 230 0 0 Appliancestother 0 Subtotal (lines 6 to 13) 24091 12241 Less external load 0 0 Less transfer 0 0 Redistribution 0 0 14 Subtotal 24091 12241 15 Dud loads -0% 0% 0 0 LTotal room load 24091 12241 Air required (cfm) ( I 640 6191 Calculations aaoroved by ACCA to meet all requirements of Manual J 8th Ed wrightsol t' Right -Suite® Universal 2015 15.0.17 Right J® Mobile 2015 -May -2910:3322:46 \wstmp\65fce628-bc9d-4r-8807-9fe681475c7f.rup Calc = MJ8 Front Door faces: N 9e 2 Cunningham Lindsey U.S., Inc. P.O. Box 703689 Dallas, TX 75370-3689 Telephone(888)738-8714 CLCAT@CL-NA.COM Facsimile (214) 488-6766 ***********************AUTO**3-DIGIT 018 815 T3 P1 95000059005 Building Commissioner or Inspector of Buildings L' 120 MAIN STREET NORTH ANDOVER, MA 01845 H Claim Number: Policy Number: co Company Name: LO0 CD Cause of Loss: LO o Date of Loss: , Insured: 0 Property Location Cunnin fiham ` l�Lindsey Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS Ch. 139, Sec 3B 3080436 3083436 MERRIMACK MUTUAL FIRE INS ICE DAM 2/18/2015 TAMARA CHASE 81 LACONIA CIR 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 applicable. If any notice under Massachusetts General, Law, Chapter 139, Section 313 is appropriate, please direct it to the attention of the writer. Kindly include a reference to the captioned insured, location, date of loss and claim number. Section 36. No insurer shall pay any claims (1) covering the loss, damage, or destructions,to a building or other structure, amounting to the one thousand dollars or more, or (2) covering any loss; damage or destruction of any amount, which causes the condition of a building or other structure to render section six of chapter one hundred and forty-three applicable, without having at least ten days previously given written notice to the building commissioner or inspector of buildings appointed pursuant to the state building code, to the fire department or arson squad of the city or town and to the board of health or board of selectmen of the city or town in which the same is located. If at any time prior to the payment the said city or town notifies the insurer by certified mail of its intent to initiate proceedings designed to perfect a lien pursuant to section three A, or to section nine of chapter one hundred and forty-three, or section one hundred and twenty-seven B of chapter one hundred and eleven, the said payment shall not be made while the said proceedings are pending; provided, however, that said proceedings are initiated within thirty days of receipt of such notification. Any lien perfected pursuant to section three A, or to section nine of chapter one hundred and forty-three or section one hundred and twenty-seven B of chapter one hundred and eleven, shall extend to and may be enforced by the city or town against any casualty insurance policy or policies covering any loss, damage, or destruction pursuant to which the proceedings to perfect the lien were initiated. No insurer shall be liable to any insured owner, mortgagee, assignee, city or town, or other interested party for amounts disbursed to a city or town under the provisions of this section, or for amounts not disbursed to a city or town under the provisions of this section. On this date, I caused copies of this Notice to be sent to the persons named above at the addresses indicated above by First Class Mail. Cunningham Lindsey Catastrophe Department cicat@cl-na.com 800-867-3885 PATRICK J. DONOVAN ASSOCIATES, INC. e%im and Ross . `��ljustments P. O. BOX 110 WAKEFIELD, MA 01880 TEL. (781) 245-5540 -- FAX (781) 245.7016 January 28, 2002 Building Commissioner City or Town Hall North Andover, MA 01845 Insured Property Address Insurer Policy Number Type of Loss Date of Loss -Our -File # : Christine & Robert King : 81 Laconia Circle, North Andover : Preferred Mutual Insurance Company : PHOO100608938 : Water Damage :1125/02 : WAP33305 Claim has been made involving loss, damage or destruction of the above -captioned property, which may either exceed $1,000 or cause Mass. Gen. Laws, Chapter 143, Section 6, to be applicable. If any notice under Mass. Gen. 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 file number. On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. SOF INDEPENDENT INSURANCEI ADJUSTEM of Massachusetts Steffy en J. glio, uster SJ D/so SOF INDEPENDENT INSURANCEI ADJUSTEM of Massachusetts N_ 2759 . � Date , l: �....::5......:.` :.:... �. TOWN OF NORTH ANDOVER PERMIT FOR WIRING r `•--�-..-Y�,-...tet. -G� , � This certifies that../..?........................................................:'-..r '` :`............... has permission to perform,,7!.. a"- ...... ............................................. wiring in the building of ..:!.! ...... . ................................................................ at ........ �: :�...:-r�"...............................:I ................ ,North Andover, Mass. Fee L )........... Lic. NoA� -71 ........ � .!, -P �...................... J ELEcrRIcAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Usg Ortly The Commonwealth of Massachusetts Permit No. Office Occupancy & Fee Checked �� Department of Public Safety 3/90 (leave blank) -� BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 RULE 8 Effective 1/1/78 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORI All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 1 ho 00 City or Town of Atr2jW_C6�!/d To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 91 Ltq LzlxljLo C2 4 Owner or Tenant 60kt CAIt fid'ec- Owner's Address L-14 c.,A/,_4 C2�(c, Is this permit in conjun on with a building permit: Yes El No ® (Check Appropriate Box) Purpose of Building Wit nnw , Utility Authorization No. Existing Service__ Amps /9-0 / ;-qU Volts Overhead ❑ Undgrd. No. of Meters f New Service b Amps 00 / Volts Overhead ❑ Undgrd. No. of Meters f Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work i ht� F94.,S nC. /122�c.C_ No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above rnd: ❑ Ernd In- ❑ Generators KVA 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 Detection and Initiating Devices No. of Sounding Devices g No. of Self Contained Detection/ Sounding Devices Local Municipal[] ❑ Connection Other No. of Ranges g Total No. of Air Cond. tons No. of Disposals No. of Heat Pumps Total Total Tons KW No. of Dishwashers Space/ Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KHN No. of Signs No. of Ballasts Low Voltage Wiring No. Hydro Massage Tubs No. of Motors Total HP Other. INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insuran Policy including Completed Operations Coverage or its substantial equivalent. YES 0 NO ❑ I have submitted valid pro of same to this office. YES E9 NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE 1 BOND ❑ OTHER ❑ (Please Specify) (Expiration Date Estimated Value of Electrical Work $ ,/ 000.0 U Work to Start Ii, Inspection Date Requested: Rough Final Signed under the FIRM NAME_ Licensee ,Address 37( Bus. Tel. -No. . c eallies, of erjury: e✓��► . � ll. ��1v►rK Signature Alt. Tel. No. — LIC. NO. d LIC. NO. 9 q?..1 - 7;;z -.GA ' - OWNER'S INSURANCE W41VEk:.l am aware that the Licensee does not have the insurance coverage or its substantial equivale, as required by^Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner ❑ Agent ❑ (please check one) (Signature of Owner or Agent) FORM 18922 (FPR11-RULE 8) A.M. SULKIN CO.. BOSTON. MA Telephone No. PERMIT FEE $ �• w Location No. Date TOWN OF NORTH ANDOVER y Certificate of Occupancy $ Building/Frame Permit Fee $ MUSE Foundation Permit Fee $ Other Permit Fee TOTAL Check # ��dv 14193 G% ` 'Building Inspe+ fir" TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/Inspector of Buildings.Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: gs �f / 9/ Air 'Num'Parcel Number avis .M Dioys 1.3 Zoning Information: 1.4 Property Dimensions: - /321 Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Pr vide Required Provided R red Provided :4 T 0(6 2 - I fool, 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 Municipal 0 On Site Disposal System SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record brrT .n in ^da ver Ai4 a Name (Print) Address for Service: q70 (2EI !q!274 Signatu Telephone 2.2 OwnerofRec d: t✓ r/1 /' P S�j �1 C A/1 G, %, 6 Chi ✓►► h�i ! /V- NFft Print Address for Service: Z Si nature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 License's Construction Supervisor: Not Applicable! Licensed Construction Supervisor: License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable �l Company Name Registration Number Address Expiration Date Signature Telephone ou M M z on v V SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 2506) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the detfiial of the issuance of the building permit. :?Si ned affidavit Attached Yes .......❑ No...... SECTION 5 Description of Proposed Work check all applicable) New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) , ❑ Addition Accessory Bldg. ❑ - Demolition ❑ Other ❑: Specify Brief Description of Proposed Work: - p R(�Mave exISr^ti d mrwd bricy, s-TarS&CC111Grefe do i� 4 ��r/I-�S�(/tG A*F/"V,;A r QA FAV -I Of k 06 �eM(Ye Q� (2C,l U/014n St��f �� r��, a s► idly COvtrec/ aG� �► �► r L,U �. SECTION 6 - E TIMATED CONSAUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant �' QFFiCI ONLY �. USE 1. Building WW 3 ��y�..a _v (a) Building Permit Fee Multi lier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing rr Building Permit fee (a) X (b) 4 Mechanical (HVAC) - 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 BUH DING PERMIT I, Ro6prwr 11 o- ! < I n & , as Owner/Authorized Agent of subject property Hereby authorize C o"IS 11 �G _164 V to act on My behalf, in all matte r lative to work authorized by this building permit application av Signature of Own Date SECTION 7b O NER/ ORIZED AGENT DECLARATION I, Pc�e (71- 6 as Owner/Authorized Agent of subject property h Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge, and belief &l��P (2. �� ► �� Print Name/7/oa Signature o ent Date NO. OF STORIES SIZE 3 7f3 561 F_T BASEMENT OR SLAB RD SIZE OF FLOOR TIMBERS x 1 ;2,X0rr-_&7r 2 3 SPAN J?' PlAd DINIENSIONS OF SILLS ZX r_e CFAO r h aA r @ ;DTF bjje-i 2,8 rA17fF �+ DIMENSIONS OF POSTS X'4 ( r DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING ACr-'f " e 011 rA4/ 1 bAXX MATERIAL OF CIEVINEY �---• IS BUILDING ON SOLID OR FILLED LAND G ( G n e ^ t 11 At kFj 114 w k e n hvvie VVA IS BUILDING CONNECTED TO NATURAL GAS LINE FORM - U - LOT RELEASE FORM a INSTRUCTIONS: This form is used to verify that all -necessary approval/ permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. Ism ■ sea ■u■■amass ■■■.■■ Sam soon ■■ non "aBoons ■■■■■■■■■■■■■■■■■■■■■■■■.■■■o■■■■■■ I - APPLICANT � 2 1'(A K Kk!NHONE &F Z _� % % L ASSESSORS MAP NUMBER L) LOT NUMBER M_/ SUBDIVISION LOT NUMBER ST�cREET�l LQ -c -o �o, ` STREET NUMBE i■■■■■■■�■■■■■o■■■■■■■■■■■■■■■mods■■r■■■■■■■■..............■ ■■■■■■■■■■■■■■■ OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS �/\ DATE APPROVED O CO SER ATION ADMINISTRATOR DATE REJEC DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSP TOR - HEALTH DATE REJECTED DATE APPROVED CIN CO - HEALTH DATE REJECTED CON B& -NTS //�e� ✓��� tom, ���r� i - ����-q� . PUBLIC WORKS — SEWER / WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED CONQAENTS RECEIVED BY BUILDING INSPECTOR L'111 D. Robert Nicetta Building Commissioner (978) 688-9545 688-9542 Fax Please print DATE 01 08 LOCATION Number OMEOWNER AZ 1 Name Town of North Andover Building Department 27 Charles Street North Andover, MA. 01845 HOMEOWNER LICENSE EXEMPTION C�-� Street Address Home Phone RESENT MAILING ADDRESS �(U1 City Town State Map / lot 79773� -�/yo Work Phone Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of two 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 108.3.5.1) DEFINITION OF HOMEWOWNER: Person(s) who owns a parcel of land on which helshe resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures ac- cessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. 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 requir en . A HOMEOWNER'S SIGNA APPROVAL OF BUILDING OFFICIAL I 0� 0� � .ts c z 4. O N CLcc_ C rN. N 1' COCF �ES� O �.00 �!4ftw. CD c E a:rE N W Q m ®D N H N �ID�p : cp 0 CO z Cz Z N C O —:gym w U Cc L m C/) Q�==0 CDw 0 Lj; c,c m, r � m cm faCD _ O sime m= 3 C O H .N •__... W Z C W •E V -0 V .N O C.o CN:Cc a Go CL o 5 _7 cc 0 CD 4-m � e 0 H O y E L- O r c O cc CL W O O CL W3 0 ev ,c _cc 0. 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