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HomeMy WebLinkAboutMiscellaneous - 89 LINDEN AVENUE 4/30/2018N O O � _ N N r O Z o Om o z OD Z N D O C o Z P m 0 Location---�—� No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ ',S • Eta tMUs Building/Frame Permit Fee $ SA Foundation Permit Fee $ P Other Permit Fee $ TOTAL $ Check #14443 ,- Building Ir?spector 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 Commissions ildin Date — -aaz- SECTION i- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel 0 ZZ Map Number Number: 0097- Parcel Number 8 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area (sf) Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R red Provided Required Provided 1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 Municipal Sewerage Disposal System: ❑ On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHW/AUTHORIZED AGENT 2.1 Owner of Record N�- a04- IL k Q C- CLI L;nAtn Name (Print) f p Address for Service : h C o r� V i^ t. T' �1 U Z . A V Ao vcc r, M q . 01 9 S Signature Telephone 2.2 Owner of Record: Ar 9 e r Address for Service: A00) 7S6-6666 SECTION 3 - CONSTRUCTION SERVICES 3.1 Ltcensed Const Supervisor: Not Applicable ❑ Licensed nstruction Supe 'sor: License Number Addr s Expira n Date S nature Tel one 3.2 Registered Home Improvement Contractor Not Applicable ❑ 140rf,�- flepo+a) AA0MSU-vlCeS -Inc- it- )2-0q3 Company Name 3' 1 GS �-t�\WO O � S� ' ( 1 . /o�c A ( Registration Number �� A dr s � j (`'I c�.. 01 bd-1 \�/� 8.3•°Z 6 — 66 G ` Expiration Date SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildWpermit. Signed affidavit Attached Yes ....... No ....... ❑ SECTION 5 Descri tion 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: aws , r. el 5 �ry c, �vrgl a �. S b SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant ` �$ Q�CL USEiNLY 1. Building r Q 6 8 (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) �`vI• 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 BUILDING PERMIT 1, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED` AGENT DECLARATION R " A11.1- as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief \ Print Name ^ 1 � • 1� • O Signatune of Owner/Aent ( v Date _7 NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TMERS 1 2 ND3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE uepartment or Industrial Hcclgents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Aff1davit Please Print U Location. L \, V--\ t"ity Aor400tr . Phone (R-Iy� 6 4 2 - 9 SSS 1 am a homeowner performing all work myself. 01 am a sole proprietor and have no one working in any capacity (-- m an employer providing workers' compensation for my employees working on this job. ,, Company name- � `F'��� CD 40Y�,- J2 rvl C-2, r Ln.in FSC\ Comyany name: Address ,non_ e�122 I " J 16 olicy.# Zo�4Zl.�rC,OQ073S� �OD City- Phone*. Insurance Co Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the p942ss and Si Print of pedurX that the information provided above is true and correct Official use only do not write in this area to be completed by city or town official - []Check if immediate response is required Building Dept Contact person:_ Phone FORM WORKMAN'S COMPENSATION a `-q-0' neSv0 756 -6686 [] Building Dept El Licensing Board [] Selectman's Office m Health Department [] Other �anamco.uedtiaac�ivaeila i Board of Building Regulations and Standards lug HOME IMPROVEMENT CONTRACTOR r Reglstr IA 126893 Expirat on.'08/03/2002 ,. _Type Supplement Card i Home Depot At-Home_ services. PAUL VENTRE 3200 COBB GALLERIA PKWY #26 ALTANTA, GA 30339 Administrator i A �CERTIFICATE OF LIABILITY INSURANCE SHEPA M S SCOTT CORP, 352 91WENTH AVENUE - SUITE $05 NEW YOPM NIvWi YORK 1001 AWta RW NOME SERVICES, INC. 3200 0088 GALLERIA PARKWAY ATLANTA, GEORGIA 30339 THIS CERnFICATE IS WSULD AS A A KrR ONLY AND COWIRS NO RIOM UPON Y oLDEx. Tmis CIERTIFICATR OM NOT A INSUAIRS AFFORINKI COVIlIIRA01E OMMMA: GREAT oATIII e01111MM I/IStd 0! Mu f W%M, 0,tIi. IFITW- v ,-- vv. INiURtRC. �,�� ».auRw 4: THE POLICIEY OF INNURANCL LISTED OF LOW Ni.\/E 6EEN ISSUE TO THE INSUR60 NAVE 0ASBOVE FOR THE P'OUCV PERIODINDICATEn. 1' OTWTHSTkd+IOOK jO(Y REQUIREMENT, TERM OR CONDIT" Of ANY CONTRACT OR OTHER DOCUMENT WITH REtsPECY TO W*oCH THIS CLRTIF"Ti MAY LL 18"0 CMF mAY PWA►N, THE INWAA.NCE AFFORDED BY THE POLICIES O£'SCRIISEO NEOWN 1 SUBJECT IO ALS. THE 7ERM$. IEXCUJS*N& AND OOPeWIO" OF WCC AOUCIES, AGWEGAAT& WAITS SHOWN MAY HAVE BEEN RC-DUCED BY PAID CLAIMS, "K OF NGUOANN ovioJo1 A j ®111 w LtAI{fJITY x OWWO& 0900%AL U*UTY CON Mum L.^_J OWIA PAC M938 031161 0 L11Lil OL7 i'0001 I" wm m m — goa,cx� ww to ov aft powo ft • paw Owiff i N 11000,ti�I ___ owNaoa► ►m 2,000,00 aim% pacmI ►Tt UST AM&& m:� Xro►�cY ts�c PIROaJCTY • Qq�MYQP AON3 � I �o0ow A j Ii Wilrobaw X X X I. Aak m aaY Avov Au OWMW WPM HM AVn* roc AUTQB , ..._.., �M .__.._....�. 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Q 0 ^ c / 0 o ro a = V-. y O t0 VJ S ti �• C my d O 140 0 mcl 0, O O 0 .. zo CD o 33 ti bd �z �o: ~ m vJ CD i.i �•CD ..moi CCA C _� c. •o soc 0 c o O = eo omi 0 0 c z ►� p ro yid 101 x C=f n w b r p b w C w o r p o y 0 C a\ to p a p 071 M 7d omi 0 0 c Location�N / '�'� (/-c_ No. 13 Date MORTN TOWN OF NORTH ANDOVER f 9 qjaCertificate of Occupancy $ Building/Frame Permit Fee $ d Foundation Permit Fee $ Other Permit Fee $ TOTAL $� 03( Check # 0 14 3 -L 8 / Building Inspector I(_ 1.1 Property Address: 9'l �a- 1.2 Assessors Map and Parcel Number: Z Z Map Number Parcel Number � . �,r \ O J a- 111 kc ` o i b t .I -S V U 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R aired Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public 0 Private ❑ Zone Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System ❑ NEA- I1U.N L - rKUYEKI Y UWINEKSffW/AUIHUKtZED AGENT 2.1 Owner of Record "-,&, - —�� Name (Print) r hn) Address for Service Signature / Telephone 2.2 Owner ecor Narife Print Address for SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Construction 1 T Registered Home Impro`v`ement Contractor Company Name m � wood �:\F. Mresla�V� (r-1-i©� boy License Number Date Not Applicable ❑ [2W-3, Registration Number Bm3soz Expiration Date OU rn W SECTION 4 - WORKERS COMPENSATION (M G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildi permit. Signed affidavit Attached Yes ....... V No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction 0 Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: WCLCQ � Vkr1 (AowS fVJUCa. Gt�Gc� `c eS V � SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant .OFFIIA USE {>NLY' - 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (e) X (b) / 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATI N TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b AGENT VOWNER/AUTHORIZED DECLARATION 1, vo'a as Owne Authorized Agent o subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief (� j Print Name 00 Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TMMERS 1 ` 2 3 PM SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978)688-9545 Fax(978)688-9542 DEBRIS DISPOSAL FORM f,, y In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in /at: H-�-5 5 Y�'k c-�c-c-L-)n I Facility location Signature of Applicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. 9a, 01-7Z) Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 126893 Expiration- 08/03/2002 Type:.8upplement Card Home Depot At -Home Services PAUL VENTRE 3200 COBB GALLERIA-PKWY #26�,� ALTANTA, GA 30339 Administrator lIl(: L1U/11/IIUIIWCdIII/ UI /Vid3odU11UJCItJ Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print �j Location: r-_ City _ V40 2 Gt ..Phone am a homeowner performing all work myself. �I am a sole proprietor and have no one working in any capacity am an employer providing workers' compensation for my employees working on this job - Company ob_Com an name: Address 3 2b� CCS lcC\ �-� �- KkA) ta�1 k4�aa�,VL -�A. _Policv.-# ZOA2-000 353--00 Company name: Address City Phone # Insurance Co -,Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under tie paiN and pens/ties Signature - , !L Print name V(U\K - v Q the infognKon provided above is true and correct. 0 Official use only do not write in this area to be completed by city or town official' QCheck if immediate response is required Building Dept Contact person-_ Phone #.- FORM WORKMAN'S COMPENSATION 01' 7A b 0 e Building Dept C] Licensing Board E] Selectman's Office F-1 Health Department E Other Cl) m m 0 m CO) CD.p a z O06 O c O o p CD Cr CCD O ".-.j O CC CD CO) CD O O CO) 0 CO) d n CD O r� CD a, y CD CA O O CCD 0 t CD <W -*= O d 2 O -•NOcr h 4c ca mCO CC2m C'! O H C! a C! T CO Z ? CM _1 mCL 0T =rCD nod O y O H OCD -� O O C C2 •�•� m z O O OH• C! ' c . o :� �CA CA C .. �c o s � CD N toao COD ? 7� O : co, ad . C a m Nco N NQ m � w N 3 m oo 55 66 W ��:� m .� Ju Vl CD :d' om:0 an, �CD o K d ~ B o ~ rD w G w tom" 7d w �- '� r w a' G a. W ^ r) 0 a ?� ►TJ 9M9 W M r N2 3334 Date........ TOWN OF NORTH ANDOVER o p PERMIT FOR WIRING This certifies that ......Co .�...t(-- ........�. ec....................�............. Chas permission to perform ....... 6 o. �.....t`..... ....................... wiring in the building of .... ✓� Ax. a ............... ....................................... . North Andover Mass: Fee ... f� %� .. Lic. No. . Ab!r%f r.... ELECTRICAL INSPECTOR Check # 7 i WHITE: Applicant CANARY: Building Dept. PINK: Treasurer A 0 l _.wnwea1dz of /l/aijaG/twelb APPL�Gf- 5&'j - (PLEASE R C i t bt'16-�Jq By this appli Location (St Owner or T Owner's Ad Is this perm Purpose of I QJQ��� VU J✓"CJ gTIONS Official Usc On! Permit No.�4 Occupancy and Fee Checked _ Zev. 11/99] (leave blank) 'ERFORM ELECTRICAL WORK tchuscus Electrical Cock (MEC), ;t7 CMRA 2.00 llate: t To the Inspector of bY'ires: tion to pxerf,m the electrical work described below. Telephone No. s ❑ Nheci: Appropriate Box) Utility Authorization No. Existing Service—. _ `-fiend ❑ Undgrd ❑ No. of riNIeters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters. _ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: r44G U ("amnL.rrnn 1)(111P (rilbliviuv lnhh, mm? hr irnior,l by th, h,cnrrhnr of ff/i .,c No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fan s�1 l�io. Of Total •transformers IhV;\ No. oCLighting Outlets No. of Hot Tubs 'r Generators hVA . No. of Lighting Fixtures Above �-� 111 S1Slllrrlling Pool arnd. �7ffT'--� r 0. o mergence lg lting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALAYLMS INo. of Zones No. of Switches No. of Gas Burners of No. In Detection and nitiating Devices No. of Ranges No. of Air Cond. totem— Ins No. of Alerting Devices HcatYump 1`lumber_ Tons K1 No. of Scll•-Contained :\'o. of Waste Disposers P Totals: _ �'-- Detection/Alertino Devices No. of Dishwashers Space/Area Heating Local ❑ Nlunicipal ❑ Otl Connection No. of Dryers Heating Appliances Security Systems: No. of Devices or E uival No. of `Yater No. of N�._oJ�-------� IDatn Wiring: TI at Sjutls 13 Il'1Sts No. of Devices or E uivalen No. Hydromassage Bathtub Hydromassage No. of Motors Tota Tr- -- 1'elecomnlunications \\`firing: No. of Devices or E uivalent OTHER: the licen! undersis: CHECK--f� 15 ' I- -- f (L96, l a /Ir CY A llucll U(IU(1lu/ful uC-14 J uC�u Cu, V. uv .uf,w." ,.,c u,arcuv. l11.,.... " 'trical work may issue unless ubstantial equivalent. The ssuing office. Estimate Work to I cer•tifj" FI IZUN I IN., Licensee (If applica Address: OWNER required t Owner, A Sionatur (Expiration Dote) u n cornpletion. I complete. C.NO.: tai(l�y� LIC. NO.: Te1. No.ITi 1 7(J:LArC:011 Tel. No.: Trance coveraze normally o%vncr ❑ ov:ncr's 1_cnt. 'IT T- E L: , f�j • 00 ( ommonwea(Ui of M�aJJaCILUJedd 2epartntenf'`..tire Jerr/ice9 BOARD OF FIRE PREVENTION REGULATIONS Official Use Onl� Permit No. (y Occupancy and Fee Checked Zev. 11/99] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the iviassachuscus Electrical Code (h.IEC), 7 COIR 2.00 (PLE•.1SE PRIiVT IiV liVK OR TYI L .-ILL V�OIZ1 1,.11'101V) Dntc: �'j City or Town of: vim` To the Inspector of !•Y'rres: By this application the undersigned ti;ivcs notice ofhj or her in ntiou to perf m the elccn•ical work described below. Location (Street & Number) `— (/��+-L $.� Owner or Tenant t� Telephone No. Owner's Address Is this permit iu coujuntot with a []dill; pernni(". Yes El N�-- Beck Appropriate Box) Purpose of Building GJT. 6vr't Utility Authorization No. Existing Servicc Anips / Volts Overhead ❑ Undgrd ❑ No. or iNIeters . New Service Anips / V01ts Overhead ❑ Undgrd ❑ No. of Meters. - Number of Feeders and Anipacity Location and Nature of Proposed Electrical Work: ) r --r— r4G Comoletion o0he folluiving table maty be ,vaivcd by the hisocctor o%IVires. No. of Recessed Fixtures s No. of Ccii: Susp. (Paddle) Faus�1 No. 01, Total Transforiners KVA No. of Li4hting Outlets No. of Ilot Tubs .r Generators KVA . No. of Lighting Fixtures Above n Ill- n Swimming Pool orad.-, ' 1 0. o mergence ig [ting Battery Units No. of Receptacle Outlets No. No. of Oil Burners FIRE ALARAIS IN of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Rangesr 'total ir Cond. ons No. of Alertina Devices No. of Waste Disposetals: mp i`lutttber :i'ons K1K _ No. of Self -Contained Detection/Alertiniz Devices No. of Disltu asltersh----'—•� rea Heating Itilwiicipa! Local Connection ❑ Otl No. of Dryers g Appliances Security Systems: No. of Devices or E uival No. of Water lie ltct'Sis N IDatn ]lasts Wiring: No. of Devices or E uivalen H�dromassage BIotors Tot ' T',.----- 1'clecommunications \Vining•No. No. of Devices or E uiralent +OTHER: t db 1. I IV Attach addrtronat detail f n desired, or as require y te sHector of n e . INSURANCE COVER,\GE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the license-, provides proof of liability insurance including "completed operation' covera�ze or its substantial equivalent. The undersiened certifies that such coverage is in force, and leas esltibited proof of same to the permit issuing office. CHECK ONE: INSUR.,\NCF D D ❑ O-I'hIER ❑ (Specify-.) (Expiration Date) Estimated Value of EI cu-ica Work: j (`Vlien required by niunicipal policy.) _ Work to Start: OZ22 G Inspections to be requested in accordance '.vith I cel•tifj•, imide, the pours and penalties of perjurj•, that the infornrion on 1111*5 y FIIL-NI NAME: Licensee: V1.I (If applicable, entc Address: R tc 0\VNER'S INS required by la%v- Ow•ner''Agent Signator-, Rule 10, 1 u n completion. tion is t r t Complete. C. N 0.: LL Siguatur % LIC. NO.: in the license number line.) Bus. Tel. N o. �.i1� I�' Alt. Tel. ,No. NCE Vf"AIVEIZ: I am awLarc that ice:isec docs not have the liability insurance coy Braze normally I3%my si nater-, below, I hereby wuive this requirement. Telephone No. I ain the (cheek onc) ❑ oxvncr ❑ o\,:ncr's aeCnt. Date. //. . 6/. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ...: .-7.741 !...... /.................. has permission to perform ...... (........................ plumbing in the buildings of ... .................. . at ... `1... .i. .a� :j... ........ Norah Andover, Mass. Fee .. Lic. No.. 2 %.1 `� `� ......... �..... . PLIBING INSPECTOR Y Check # L� f 5016 11) MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO ;DO PLUMBING (Print or Type) Z ,or 81 .. X,�0�vod vz- Mass. Dl to "� _ X' o 0 City, Town Permit Building �' t t�N�✓� Namn9r-s L�e� AT: Locatlo -- P I New ❑ Renovation ❑ Je0- Dr. -A , I.*%,O" A N Type of Occupancy: 85' u e4) Replacement LTJ FIXTURES Plans Submitted Yea ❑ No ❑ (Print or Type) ,P�4Check One: Certificate Installing Company Name 90,5-r mL. ❑ Corp. Address s;.y S ./jI�) ' +� ❑ P ncrship ani fi`i�i z! 6 0 ( Firm COnI an r is5l I n� �. _ � n y Business Telephone �,lbd Al tZ -69 XX Name of Licensed Plumber or Gasfitter �, � So .srr,•�.: o I hereby gertify that all of the details and information I have submitted for entered? in above application are true and accurate to the best or my knowledge ind 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 t:'bapter 141 of the Cenral laws. I have Informed the owner or his agent that I do not have liability insurance including completed operations coverage. :. Sisauure at tamer! App e 1 have a current liability insurance policy to include completed operations covtrage. LZ�-- BY 011gnature of Licensed Plumber Title Type of Plumbing License,.,/ City/Town �32 _ ❑ Mttcter Ls''l Journeyman APPROVED 10FFICE USE ONLY) j License Number Date. /'�/.. � ..�.:........ �.ao ,eye O TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .. ; ( -3f / is ; f' f has permission for gas installation .... > s-. I..................... in the buildings of ....l?.� .�..:............................. . at .....'...... /. ' :.: *..... ........ , North Andover, Mass. Fee.. !.'.:... Lic. No.......... Check # (� r 3811 ..........�................ GASINSPECTOR MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) /LsaFad , Mass. City, Town Building® Location l Dayyte Z� ao o V'" Permit # Owner's Name Type of Occupancy: 8 e S I D e oc e Renovation ❑ Replacement New ■ Plans Submitted Yes [] No ❑ / (9 HAS A 19"Al CQm pl- e're o (Print or Type) Check One: Certificate Installing Company Name ��� O� ip A/ ❑ Corp. Address $ '� G G I JAS A J ❑ Partnership �� ��►'1 ��n C, RANI , 01 o I E3Fir./ Company Business Telephone �S� $) g SZ Name of Licensed Plumber or Gasfitter 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. 1 baVe informed the owner or his agent that I do not have liability insurance including completed operations coverage: � ex.. a nra • `x.-..... v .-. ....+�. ..• .. ... ... .,.Y ... . v .' ....-.."'Y � j ..� �.... .- .-... v.- ter, Sgwt— a(0—/A/- I have a current liability insurance policy to include completed operations coverage. By Title City/ Town APPROVED (OFFICE USE ONLY) TYPE LICENSE: El Plumber Signature of Licensed Plumber or Gasfitter ❑ Gasfitter ❑baster ®/Journeyman License Number Y • • a. • (Print or Type) Check One: Certificate Installing Company Name ��� O� ip A/ ❑ Corp. Address $ '� G G I JAS A J ❑ Partnership �� ��►'1 ��n C, RANI , 01 o I E3Fir./ Company Business Telephone �S� $) g SZ Name of Licensed Plumber or Gasfitter 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. 1 baVe informed the owner or his agent that I do not have liability insurance including completed operations coverage: � ex.. a nra • `x.-..... v .-. ....+�. ..• .. ... ... .,.Y ... . v .' ....-.."'Y � j ..� �.... .- .-... v.- ter, Sgwt— a(0—/A/- I have a current liability insurance policy to include completed operations coverage. By Title City/ Town APPROVED (OFFICE USE ONLY) TYPE LICENSE: El Plumber Signature of Licensed Plumber or Gasfitter ❑ Gasfitter ❑baster ®/Journeyman License Number U Date .(. -,:If.'. <......J..... . TOWN OF NORTH ANDOVER O 9 41 a PERMIT FOR GAS INSTALLATION This certifies that ... ..� . ........... has permission for gas installation . r' . .............. in the buildings df ....................... at North Andover, Mass. a ` Fe t .'.... Lic. No. 9- ..3 ... ,�eA �.1 r-/— :.......... . Check # (i 5449 Dat"., �16. ,Y 40R7M OWN OF NOR TNDOV=E.R. fir. 0� ,�•o ,•'�h.0 PERMIT F R PLUMBING SUSE� This certifies th t.. �`. ........... .-� ............... . r. has permission„to perform .... ........................ plumbLng in. a buildings of ...=... . .......................... at.- .... �.. .. J... North Andover, Mass. Fe d.."`.... Lic. No.......... . ! . ........r. .............. . NG QQ qq PL MIINSPECTOR Check # 6835 tPrint or r--' '—"'""` ` ' J ""e•'�uiZ1y APPLICATION FOR PERMIT TO DO GASFITTINGla f'— i �yMass. Date Building L tion �� Perm) / ' owners /�Gl so TYpe of OtXupancy New[) Renovation p Replacernertt� Plans Submitted: Yes 0 No 0 z Q } J W 1ST estalling Company Name Sdress . P /.... s;InFM Telephone nme of Licensed P Check one . cerdtieate o corporation URANCE ienus;ewr,e. a wrrentll lilty Insurance policy or its substantial equivalent, which Yes p/ No p msec the requirements Of MGL eiL 142. f you have.checked yes, please indicate the•` type of coverage by eheeldnp the appropriate box 1 liability insurance policy 0/' other type of Indemnity 0 Bond 0 l� d6LittNACPc WAIVEk 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 s pe appOcatlon Waives this requirement gna ra o caner or , cane t Agent Check one: Owner a Agent 0 'r!eby t eetiM Mat O of the demes and Information I have submitted for entered! In above a Plication are true and accurate is tt+e best of knoweedge and that all piumbino wort and Installations performed under elle permit r Mia application be In compliance wt eh pertinent provisions of Me AAassaehusetes State Gas lode and C haptu 9Q2 of Me o by Type of License: 0 Plumber Title o GasAtter re o cense P u er or Gas F tter CityRcwn p.i tAter APPROVI (OFFICE USE ONLY) License Number�� 13 Journeyman 3 30 49 5 i o � o , • o ---"-'North Andover Board of Assessors Public Access Click Seal To Return Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial Page 1 of 1 COZIK roperty Record Card Parcel ID :210/022.0-0082-0000.0 FY:2012 Community: North Andover SKETCH Click on Sketch to Enlarge PHOTO Click on Photo to F Location: 89 LINDEN AVENUE Owner Name: DE LUCA, ANGELO ALANE R DE LUCA Owner Address: 89 LINDEN AVENUE City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 5 - 5 Land Area: 0.23 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 1499 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 287,700 287,700 Building Value: 123,300 123,300 Land Value: 164,400 164,400 Market Land Value: 164,400 Chapter Land Value: http://csc-ma.us/PROPAPP/display.do?linkId=1888332&town=NandoverPubAcc 1/18/2012