Loading...
HomeMy WebLinkAboutMiscellaneous - 81 PEACH TREE LANE 4/30/2018A4 SPY �z A/C C-3 li /--i� //L-� C,4-t6l s 4 North Andover Board of Assessors Public Access Click Seal To Return Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial s Page 1 of 1 roperty Record Card Location: 81 PEACH TREE LANE Owner Name: PH BUSINESS ENTERPRISES, LLC Owner Address: 81 PEACH TREE LANE City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 9 - 9 Land Area: 0.32 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 2828 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 586,800 586,800 Building Value: 380,900 380,900 Land Value: 205,900 205,900 Market Land Value: 205,900 Chapter Land Value: http://csc-ma.us/PROPAPP/display.do?linkld=1893853&town=NandoverPubAcc 5/18/2012 N O N LL LU Z J w w H 2 L) Q w IL oo U) aU) @W U a `o Q 0 J W TU CL ami Q O a d �p O 0 O O LL. r O J N U 0 J 00 O O O 0 - CO O O O O 0 N 0 O O O N Ji w U Q d 010 00 00 o !CD N aN N rn LO Lf)O :O 04 104 -gggggg ( ' m £: N (� O O NN O O N p Ut ;. _j � 'LO J J CO6 0 c6 - N � N � m y CO Y Y r m V U 0�: .t� j rb,CD:C LC,g'W tO U c d 0Zp Ln L H Z N N04 g y 0 3 OZ� r Hca r c c J J Qw I o o 1 L.1ir N ,M O Q o L- O o Z O o $_5�` 0 a `-U-�- `t m LL Z ° Z OO' 0 0000 Oil LL.O ( W Z J Qy{� '1 J�'a# aa -o Q� s W m m W w�l2 r(D cc rn 0 eL t Z CD CD o0 cc - liq 3: i� I 0 0 o I W! }� cl � °f o o Ou 0 0 LO 0 N i0 �, i wf d. w 1 a. ao Imo. O v L O `O 2 ~CD, O ❑ Z; o 0 ~ 0 o V; `Lu O Im Z �'� `d U _ d ti'O a .a An '.Co 00 a o > 01 0 zi»m yN,O # m m _0 � N "�NJ [ �V/VI �/V/ V LL `l Q) ' t nl kN m Ml V '> a i>ul JE �' N r: U �Q00� Z M¢ j Fmk a ID LL �' N `i n m: O 77 M N ` y Q LL CO U)U Q @� m .:m Q 0qy Z [m axe 9 OO)�: 60� 4 v ,, t N p O O °� x, V N Mte N (n to m O c 4 N FN N ui -O 6 i 0 .a iy i0a" E 0 ccoo 0 0 t£ X @@cr m co � b a) W ; w cr- Vf $A O. �O H l 'H w � too{� � � � LL Qom, m cad m C+ A L6 LLE LL c Qac m o} Z c p� r� c LL ;} � .a U' 0 LU mini, c;o telco U.C9 0 J g 9 i c0 LOi� v)�� [2 m f E C .N l4 gy Q N Lu v W vi x' U �:.. ch co N jig LLF- mj u c" LM cn °° c �a�tLL o co co EEEw!c �� L imam a .- 040 co mim C31 U U `o �'' .• v O LL Q. w Q Z m to 12 �' p -o r p U a) mix cu� X Z w JQ, O & F-mLL2wmYW mm,Q N J w Z w w W W, 1", 14'u, r ul Jr Z Q° L) O 0�r,O7 LL L) _LL;0 r i Q co w ~z C_ Q = ~0a°�jmhVi 2 iiiwF M w N. 2: �m coo F-'- mJ� t F- m= 2,0 d co Z ai �qs� 01c t_�a.-i '$ o�x ��� am IV W O Q o rn Uy ' W LL 2 LL LL'U d d Date ..... 1-2- —,9,6 ..................... TOWN OF NORTH ANDOVER, PERMIT FOR WIRING This certifies that ........ ..... ........... has permission to perform .......... ......... wirmlof .... in the building g7l at...................................................................... North Andover, Mass. Fee... W.. --- Lic.No. ..142#.z) ........................... ......................... ....... 55 7 IELEcrRicAL INSPECTOR jj -7 ?/0 S-�5- Check 8035 a l.oinmonivQafLh �� ' . / i�%iQ�/biUQ� �aParfinenf o��ira �arvica� BOARD OF FIRE PREVENTION REGULATIONS Official Use Only---_— Permit No. CFO 3S Occupancy and Fee Checked ,ev. 1/O. J PAVP kj_L, 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: c3 —1 d -0 � City or Town of: To the inspector of Wires: By this application the underersigned gives notice of his or her intention to perform th:: electrical work described below. Location (Street & Number) 'caLA_&_-4 Owner or Tenant ,[ Telephone No5 Owner's Address ��T—= -Ca ^- Is this permit in conjunc n with a building permit? Yes No (Check Appropriate Box) Purpose of Building _ Utility Authorization No. Existing Service Amps / V It o s New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: No. of Recessed Luminaires No. of Luminaire Outlets No. of Luminaires No. of Receptncle Outlets No. of Switches No. of Ranges No, of Waste Disposers Overhead ❑ Undgrd iJ No. of Meters Overhead ❑ Undgrd ❑ No. of Meters )-fi�CGt�l-^ Completion of the No. of Ceil: Susp. (Paddle) Fans No. of Hot Tubs Swimming Pool -move g \'o. of Oil Burners No. of Gas Burners No. of Air Cond. oTons eat ump _ um 'er onsi Totals: No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Appliances KW o M ater TIT�o o�----- �f_- he4ter•s . KW Sigus Ballasts No. Hydromassage Bathtubs iNo. of Motors Total HP OTHER: X97- Q.3O40 (..a, -r>-) S t { 5 -rem cable may be waived by the inspector of Wires. -110.01 - Tot-27— Transformers KVA Cenerators KVA ,v. w c,rrrergency 1,rgntrng — d. 3atte Units 'TIRE ALARMS No. of Zones o. o etection .an Initiating Devices I'l.. o. of Alerting Devices oSelf-Containe 3 Detection/Alerting Devices Localunrcrpal Connection El Other Security. Systems:* No. of Devices or Equivalent Data Wiring: No. of Devices or E uivalent e:ecommunrcatrons 'rang: I No. of Devices or Equivalent Estimated Value of Electrical Work: 36, Attach additional detail ifdesired, or as required by the Inspector of Wires. -3 . (When required by municipal policy.) Work to Start: CSD _ Inspections to be requested in accordance with MEC Ruie 10, and upon completion. INSURANCE COVE 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 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 ofperjury, that the information on this application is true and complete - FIRM NAME:' -T S1✓CUri Scrt)« LIC. NO.: X533 Licensee: Signatur LIC. NO.: / Z (lfopplicable, enter "ex`empt" in the license num er line.) ti Address: )< rf (_ L I IJT-e'7 %�o /�t5 dJH a��LIC. Tel. No.: 9 Alt. Tel. No. *Per M.G.L. c. 147,s.57 -6 1, security work requires Department of Public Safety "S" License: Lic. No. -SS C OWNER'S INSURANCE WAIVER: I am aware that the Licensee.does not have the iiability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner 11 owner's agent. Owner/Agent Signature Telephone No. _ �PEBMIT FEE. S 4AS�FEE: S , COMMONWEALTH OF MASSACHU E'TTS OF ELECTRICIANS REGISTERED SYSTEM TECHNICIA' ij ISSUES THIS UCENSE TO I • + " ti ARTHUR W PIERCE \� r 1 UPHAM ST - SALEM MA 01970-251,6 1024 D 07/31/10 320257 � "• GTS-��,:mu�. �✓G✓.��r. • DEPARTMENT OF PUBM, SAFETY. License: SEC SYS CERT. CLEARANCk •L Number: SS CC 060517 S birtttdate: 08/30/1945 Expires: 08/30/2008 Tr. n4:: 97.0 I: Restricted: 00 ARTHUR W PIERCE 1 UPHAM ST SALEM, 'MA 01970 Commissioner y 7391 Date .. pf .ao ,°,tip of '` •° OWN OF NORTH ANDOVER X,.HERMIT FOR GAS INSTALLATION This certifies that ../V'�%1.. k . ..t.f ... P t � ............ has permission for gas installation �t B.O. � �" l ................. in the buildings of .. lf.... ... at�..�J ...x....11 ..... , North Andover, ass. Fee. SCS. C? Lic. No...t l j.. ALwmz . GAS INSPECTOR Check # 4: _ i; N. L SSAG SEYI'S UNIUO M APPUCATON FOR PER -Hr TO DO GAS,,FMING (Type or print) Date L NORTH ANDOVER, MASSACHUSETTS Building Locations 2z4A : - c Permit # Amount $ Owner's Name New ® Renovation Replacement ® Plans Submitted (Print or type) �a Q/ pre Pf� Names D/ cJi/ J 1606- Z e -d /)11- -7-a rAl ess Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company Corp. ® Partner.. Firm/Co.- INSURANCE irm/Co: INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ® No If you have checked M, 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 Insurance coverage required by Chapter 142 of [tie :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 sAlmitted (or entered) in above application are true and accurate to the - hest of m} knowledge and that all plumbing work and inst at' ms performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Nlassach sett State Gas C e id Cha ter 1 of the General Laws. By: )wn VPROVED (OFFICE USE ONLY) 0 r Signature Licensed Plumber Or Gas Fitter Plumber /41-" Gas Fitter License i um er Master Journeyman rA U U C co xa x aO 4 x H o Ems•+ :�+ p xi m q n H O O `7 0 F W 0 Z, c� w c a w o W F SUB -BASEMENT B A S E M ENT 1 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR . 4T I1. FLOOR 5TH. FLOOR 6T H. FLOOR 7TH. FLOOR t 8TH. FLOOR (Print or type) �a Q/ pre Pf� Names D/ cJi/ J 1606- Z e -d /)11- -7-a rAl ess Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company Corp. ® Partner.. Firm/Co.- INSURANCE irm/Co: INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ® No If you have checked M, 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 Insurance coverage required by Chapter 142 of [tie :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 sAlmitted (or entered) in above application are true and accurate to the - hest of m} knowledge and that all plumbing work and inst at' ms performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Nlassach sett State Gas C e id Cha ter 1 of the General Laws. By: )wn VPROVED (OFFICE USE ONLY) 0 r Signature Licensed Plumber Or Gas Fitter Plumber /41-" Gas Fitter License i um er Master Journeyman Date .0 W,.. 1. ?.,. -. 4 ��. ... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .��. Xn ... ........................... has permission to perform Tl a -t. e --e .......................... wiring in the building of .... ..... . To .................. I ............ at ... RA ..... P!..4ZJ±T.L?.t . Lam ............................. . North Andover, Mass Fee .-K .............. Lic. No, (0w�:F ................... AL INSPECTOR Check # Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS I )Ili�ir�l I .� 1lnl�� 11CI-mit N,0. Occupanc\ and Fce Chccked [Rev. 9 u,) 1�a�� la;ulkl APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORM .\11 '.%ork to lie 1-crtcrwed in ,Icuu,.l;ulce with the \la„achu<eu, I Iccli"C.tl ludc I\IFF. i?” (A IR 12.1; e5F��--071 ��T.":! Date TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... al. has permission to perform ... plumbing in the buildings of ...... )O�........ .... at. ........... North Andover, Mass. F e e4 * - .2d-.0.0. Lic. No..(�& . .............................. PLUMBING INSPECTOR Check# iV1A AC�CU TT TTNUO APPLICATION FOR PERART TO ]D O PLUAEBI SIG (Type or print) NORTH AND OVER, MASSACHUSETTS --�'` pate L Permit - BuildingLocation Ag!*4I_ree- Owners Name Amount Tvob of Occupancy J//✓ /� �� fey,, Renovation Replacement El Plans Submitted Yes [] No - Check one: t exrtncate (Print or type) a� L �� n Cozp- Installing CompanyName 2- '14 El Partner. Address Firm/Co. Name of.LicensedPlumber: Insurance Coverage- Indicate e type of insurance coverage by checking the appropriate box: Liability insurance policy n Other Type of indemnity El ,Tnsuran ive I, the undersigned, have been made aware that the licensee o£this application does not have any one o£the above three - s ce atnre Owner Agent E] I hereby ce that all ofthe details anbdminform iaonndl atvallations perfoe s-ubmittpd oxmed nnde Ped) in ab Dve application are ermitlssued for this applicationwiill be ince best of my}.rnowledge and that all plum g 142 o£the General Laws_ compliance with all pertinent provisions of the Mas c s Stat bi od�� a pter = By: a o ice um or TyypaO Plumbingyicense Title o ✓✓ Journeyman Citynovm icense um er MasterYm APPROVED (oFFiCE USE ONLY - 4 The ComM017wetzlth of llfassachusefts Depattnenf. of ndusfi•iaj_4ccidents Office of bivestigations ' 600 was -Ring -ton Street BOst-M, ALL 02-111 WWW masagowd'ia Workers' Compensation Jusurance Af C1'avjt: BRUders/Contractors/LF+',iectricia s/�IrTm ers �_D) icant 7]nfot•rrtafinn . ' Namae (Business/Oro nization&dividual):�,�� _SAP Address: - 74t ' City/Mate/Zip: 64 Phone #:�f'%Y' ,Areyou an employer? Check the appropriate box: am a employer with _ _ 4. ❑ I am a general contractor and I employees (full and/or part --time) * have hired the sub -contractors .2.0-1 am a sole proprietor or partner- •listed on the attached sheet. I ship and have no employees These sul}coiltractors have working for mein any capacif3r workers' comp, insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] 3.0.1 am a homeowner doing ail work afiicers have exercised their right of ex:empfon per MGL myself, [No workers' comp, c. 152, §1 (4), and we have no insurance required.] t employees_ [No •workers' comp. incr,rancq.required.] Type of project (required): 6.. ❑ Neur construction 7. 0 Remodeling 8. ❑ Demolition 9. [] Building addition 10.C1 Elecirical'repairs or additions 11. [] Plumbing repairs or additions 12.[] Roof repairs 13.W Other iQ,/t4�/��/L A' �:'.'_T`PTir­t that C �Yo iJO ::%=. 2.1"—'.°=X50126: C•�i Lesei'C'L`^C�w�:• nnss.i . IIa10eowners who submifyus affidavit Lino tdavit indica h : ey, a ^_� ^ei won s` w�ii and . _ 4d -'.t L :, 4contraebrs that rhe* this box M+ un a� Lteen hireouYside 4arztrar+o ed an additional sheet showing the 's " "II4 a new atadavit indicating such. name'of the sub -cont 7.ctors and theirworkers' comp. policy informatim lam an employer that isproviding workers' cornperzsaiian irrszcrance fvr my empl'dyees $eloitr is Jze policy and job site. ZttfOT?!t[LtZpn„ Insurance Company Policy # or Self ins.11c. Expiration Date: J'ob Site Address: City/3tate/Zip: Attach. n copy -of the workers' compensation. policy declaration page (slaavv;ng thepolicy humber•and expiration date). Failure to secure coverage as required under Section 25A ofMGL c. 152 can lead to the imposition of Criminal penald of a nne up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to X250.00 a day against the violator. Be advised that a copy of this statement may be forwarded tp the Office of Investigations of the DIA for insurance coverage verification I do here/iv c �u, n�%der the pa' s nd peizalties afperjury three foron provided abnve'is true and correct: Si�aturc _ Phone#: �n� is 3oy� Official use only. Do not wrzte'in this area, to be completed by city or town official City or Z oven: p ermit/I,icense # Issuin, A.uthoriiy (circle one): I- Board of Health 2. Building Department 3. City/Tawn Clerk 4. Electrical Inspector 5. Plumbin.- Inspecfar 6. Other Contact Person: Phare W. IN PLUMBERS AND GASFITTERS i,s &!�,f`LUMBER 'W' LICE Al I PAUL J CASALETTO 2605 2ND NH TPK 2 ..,.,:-.-DEERING NH 03244-62s"'...', L---O;;n 1 7 Fold, Then Detach Along All Perforations COMWON MUTH OF MAS�A&46jE'jTs Ow IN PLUMBERS AND GASFITTERS LICEN�R, qr,80PAALP.TNE�R..ASFITTE PAUL ,J CASALETTO .2605 2ND NH TPK DEER . ING NH 03244-6Y1�! ;5 0540](32 -um 'In Fold, Then Detach Along All Perforations NORTF� 646 Q • 'D_ COCNICNCWKIt . CONSERVATION DEPARTMENT Community Development Division September 1, 2010 Dillan & Juliana Jones 81 Peachtree North Andover, MA 01845 RE: Removal of a damaged tree within the buffer zone of a wetland resource area. This is a follow up letter pertaining to your request to remove the one (1) large white pine tree which snapped in half during a storm. The tree was identified during a site inspection conducted by me on August 11, 2010 to review the location of the tree to be removed and its distance to the wetland resource area. Upon review of the site, it was determined that this tree is located just outside of the 25' No -Disturbance Zone pursuant to the North Andover Wetlands Protection Bylaw (C. 178 of the Code of North Andover). Removal of vegetation, including pruning and cutting, is prohibited within the No -Disturbance Zone except in rare circumstances, such as for safety. Please see the attached photograph. Due to the fact that the tree has snapped in half and is in close proximity to the fence and yard, the Conservation Department will permit the removal to prevent possible injury or property damage. The removal activity shall be limited to the one tree identified and photographed during my site inspection. The approved cutting will be subject to the following conditions: No machinery shall enter the 25' No -Disturb Zone which occurs just behind the stone wall. •:° No work shall occur in resource areas. All tree limbs, brush, and other debris materials shall be taken off site and disposed of properly. The stump shall not be removed and shall be left in place to resprout. Upon completion of construction, all disturbed areas shall be properly stabilized. •:° The applicant shall notify this department immediately following completion of work for a final site inspection. It is understood that work may not commence for some time, please notify the Conservation Administrator or Field Inspector prior to starting work. 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9530 Fax 978.688.9542 Web www.townofnorthandover.com � � � ,:n�aq„�,.,,�„f 5- "•� '•'.8y '�'.. ,;,;. ,. ' i.' r ".'� '�s�1�1+ r 1 f..,/,s�t y� •.� "1 � y. r ... i � :c:^; �' r .�"� � �,s+.�� � k� t..'r �. ' t v Y - '4-�� .¢ r ?r�� t A c ` `•.i i� � ' j r+� �a ��•p� �,. � -•-tk + r �� � t t �z",.,a,��.s'� �?.�, :.'r„y'� -.r 4th � - ��:`z �.°t5 �� ���''� y.,: �"�°•� ' d� Iv k API. � 4 � ! "',gy�p,-��3�� �, 'd � i .�i£'•t ��� .:� *'; q,-�."F` te=e, � y�� Y' ��` �.f .,w"s.- f i 3 .�Ej�+.•c ' ti��� oA + f,� ,�i,p �° •x f ,'� � t�$� �X� .,ly �t� �.aa.,- �� E � .,fi,.-'" !e `�. t .•+I'd r. � �t� 5 �k a>y ✓ ` -a� 't � w. Li s Date41 ...... NORTH .5 Of . A ti a o� TOWN OF NORTH ANDOVER t 9 ry PERMIT FOR GAS INSTALLATION �9SSACHUSEtSy • This certifies that ... J? ............................ : . xl. has permission for gas installation . l: -.a q. r Fl. l� ! ...... in the buildings of 5. r .............................. at .... ............. North Andover, Mass. Fee.2.). . Lic. No..Yp,6.1..... ..................... GAS`INSPECTOR , Check # ) � 7 6145 INSURANCE COVERAGE: have a current OabI ty Insurance policy or its substantial equNaW which Mae% the rogtArements of MGL Ch. 142. if you have ffiecited M, please indicate the type coverage by d eddng the opproprIft box. A liability Insurance policy Other type of Indemnity 0 Bond O OWNERS INSURANCE WAIVER: I am aware that the IIoeMM does nd.hms the Insufant7e coverage required by Chapter 142 of the Mass. General Laws. and that my signature on thla.permlt spploat n waNes this requirement Cho* ON: Owner o Agent D Signature of Owner or Owners Agent I hereby car* that an of the details and Information I have subm (or entered) In above application are ae and accurate to the best of r knowledge and that an plumbing work and Installations performedtho oarmn Issued fbr this acokefth wM be in comollance with all rtlnerd provisions of the Massachusetts State Gas Code and Chapti By Type of Lkense: • (lumber Title -Gas fitter -Master City/Town • -Journeyman APPROVED (OFFICE USE ONLY) License Number !q (0 d 0 i I s Aj!Tleb . f RJ'maa Iaaaraace Agency Inc. 15Z coaaat St. Severily, 3A 01915 S.Nraa NblA INSURED 1111climml A. Bryson j OSA: c/• TTS, Lc. 140 S. Na" St. Yiddltes, MA 01949 rnvFaer_Fc ONLY AWCONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR INSURERS AFFORDING COVERAGE NAIC A INSURERA: Natloaal Crane Insurance Co. 14738 INSURER E: ENSURER C: ENSURER D: ENSURER E: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAZ CLAIMS. iNSR TYPE OF INSURANCE POLICY NUMBERE P LIMITS GENERAL LIABILITY TID 11/01/2006 11/01/2007 EACH OCCURRENCE f 1 000 X COMMERCBAL GENERAL LMBLITY DAMAGE TO RENTED f CLAMS MADE ®OCCUR MED EXP ,(My ons P-11 f Ij A PERSONAL A ADV INJURY f 1 000 GENERAL AGGREGATE f 210", GENT AGGREGATE LMAPPLIES PER R PRODUCTS - COMPIOP AGO f Z OOO POUCt PRO-JECT LOC MITOMOI LE LIABILITY COMBINED SINGLE LIMIT f ANY AUTO (Ea -dd-Q ALL OWRED AUTOS ODDLY INJURY f SCHEDULED AUTOS (PK pm- ) BODILY INJURY i MIRED AUTOS I NON -OWNED AUTOS (Pw oda PROPERTY DAMAGE S (P- ) aARAOE LIABRlTY AUTO ONLY - EA ACCIDENT f OTHER THAN EA ACC f ANY AUTO AUTO ONLY: AGO S FXCES31UMBRELLALIABIITY EACH OCCURRENCE f AGGREGATE f OCCUR ❑ CLAMS MADE f f DEDUCTIBLE RETENTION f f WORKERS COMPENSATION AND WC STATLL0TH• TORY t SM ER EMPLOYERS' IJABLRY E.L. EACH ACCIDENT f ANY PROPRIETOWPARTHERIEXECUTIVE OFFICERIMEMBER EXCLUDED? ! ' E.L. DISEASE - EA EMPLOYE4 f It r m. Describe ur4w E.L. DISEASE - POLICY LMR f SPECNL PROVISIONS below I OTHER i I . DESCRIPTION OF OPERATORS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS For Lfirnatian Only SHOULD ANY OF THE HOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER W LL ENDEAVOR TO MAL DAYS WRIT'TON NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT, BUT FAVOR TO MAL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. MftHORD=D REPRESfIIRATNE W-- Q1�NPL6,�IQMTf 11 E ACORD 25 (2001108) 'DF created with pdfFactory Pro trial version www.DdfFactorv.com CACORD CORPORATION 1988 M Date .... .J�..�. a.;7 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....... ..) .. ... . .............................................................. has permission to perform ..... wiring in the buil#ing of ...........................w. ....... ............................... at ...... !F1 .... North Andover, Mass. ...................................... Fee..S-'`.. No. ............... RICY!SPBCi;R Check # 7409 Commonwealth of Massachusetts b - Department of Fire Services 4 r' BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. Occupancy and Fee Checked [Rev. 1/071 (leave blank) 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: -c;2.57-' 07 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) 1 i Pc�G6 f� Owner or Tenant D 'i `0,n � -7-')\s ana —\ 0 -) Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes 11"No ❑ (Check Appropriate Box) Purpose of Building i? 1�5 k /7< 5 Pr—P Utility Authorization N . Existing Service rP-Uy Amps /"/OLiO Volts 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: Completion of the.following table may be waived by the Inspector of Wires. No. of Recessed Luminaires �76 No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ rnd. grnd. o. of Emergency Lignting Battery Units No. of Receptacle Outlets () No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers :) Heat Pump Totals: I Number I Tons KW No. o Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Mun'c'pal ❑ Other Connection No. of Dryers HeatingAppliances KW pp Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: 006 cC>.o (When required by municipal policy.) Work to Start: S o?XJ , 4o-7 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. f pp � P , .,•. FIRM NAME: )PC'�-r�`� LIC. NO.: / Jl Licensee: J" S Signature LIC. NO.:p 11&LlZ (If applicable, enter "exem t" in the license number line.) Bus. Tel. No.: Address: �aN�So,n l4 -e f'k� r; Ma- ,. N �1 a3 "t'+A Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By mu signature below, 1 hereby waive this re��elnent. I am the (check one) F] owner [I owner's agent. Owner/Agen SS Signature Telephone No. .114 • S -17 1 PERMIT FEE. $ � �( QIt 2-2>---7 /� The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 s� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): ��� to C Address: %► -C / City/State/Zip:pr-2rr ; 4ngt& t. A) W 0346`APhone #: C 5- 7 7 Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2.F>!J_l am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. [ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un*r the pains andpenalties ofperjury that the information provided above is true and correct. Si nature: A_1� Date: .S d Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Date. TOWN OF NORTH AND ER PERMIT FOR PLU14diNG This certifies that ... '. ?'� has. permission to perform ......�Cft . .0....Lt 4r..................... . plumbing in the buildings of ..... ................... at .... F.!... j�r� �...�? .t..,........ , North Andover, Mass. Fee. . `%!� .. Lic. No.. D. 3 . ........... 1 PLUMBING INSPECTOR Check # 7388 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS / �dcc T q AIC -S Date -621191-2-0-97 Building Location l Owners Name Permit # 7 Amount Y j Type of Occupancy New ® Renovation E] Replacement Plans Submitted Yes [] No E[ (Print or type) Check one: Certificate Installing Company Name�Q. "Mfr Corp. Address AM Partner.' Business Telephone 7 7 — t� Firm/Co. Name of.Licensed Plumber. § ✓1, l/l / U �/�� Insurance Coverage: Indica the type of insurance coverage by checking the appropriate box: Liability insurance policy rj Other type of indemnity 1:1 Bond D Insurance Waiver I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I hay s bmitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and ' tions peFjq� it Issued for this application will be in compliance with all pertinent provisions of the Mass us St,�te PlC p 142 of the General Laws. t. r By: r a o rcens umDer Type of Plumb ' g License Title —3 City/Town rcense um er — Master ® Joumeyman ❑ APPROVED (OFFICE USE ONLY Date....�.�/ `'..1......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING • Nsr.Ylt/ This certifies that ...............................%...!............................................. has permission to perform............................................................................... C. wiring in the building of .. ................ ..............�......................................... at ....... l ................................ o'?........................... , North Andover, Mass. Fee..! ........ Lic.No. l ©�a�......................:............'................ ELEcrRicAL INSP*'& OR Check # 553' TRE COMMONN ALTHOFARS94CHUSETIS Office Use only DEPARTMENTOFPUBIICSAM'YY Permit No. BOARDOFFMEPREVF.IMONREGULWONS527CM]2'W Occupancy & Fees Checked ` APPLICATION FOR PERMIT TO PERF RMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHU TS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date O cl Town of North Andover To the Inspector of Wire The undersigned applies for a permit to perform the electrical work descn d below. Location (Street & Number) ?I Pe��ree IAA2 Owner or Tenant Owner's Address oZ 31u44bti Is this permit in conjunction with a building permit: Ye No L_J (Check Appropriate Box) `q J 5-3 O Purpose of Building Pews, / r Utility Authorization No. Existing Service Amps �Volts Overhead E] Undergro 1:3 No. of Meters New Service 0?w AmpsId DVolts Overhead Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA round round No. of Emergency. Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond.. Total Tons No. of Detection 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 Local Municipal Other No. of Dryers Heating Devices KW Connections rI No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER• I "Mi .I .• • . •. - NIsTr is ii- Ill. - :•i it : . 'A Y .... �`:IA YES M--- NO YES, pleasenx ic*thetypeofcoverageby �i Esti maW Vahr dEkbical Work $ WorktoStart o ktspecttmDateRec Rough Gv G Fmal )S7RMN ME °f Pg'`aY ZZI Xt /L Iioa>seNo. A� lioeresee ��I! V FC.Q J V \r l�l�l� n !� Sigrvure Li=eNo BumvssTel. No. l7? 6 a 9 Ads.— se k)e- _ G�7 U /� �/ �" Alt Tel Na. y 767 7- OWNWS INSURANCE WAIVER; Iamawatetlaftl ioatsedoesmthavetheirm iancecoNuageorils substmIlial WialaltasroquiredbyMassadugelts Galaal Laws and that my agnakm on this pemmit apphcafton wanes this regimertalt (Please check one) Owner 1-1 Agent Telephone No. PERMIT FEE $ signature ot Owner or Agent