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Home My WebLink AboutMiscellaneous - 1570 Osgood St Bldg 30 Suite 2200 'i vul �L"A e, 2-I LY) BUILDING FILE i i i i i i WOO 05zs s#vc� J Super ab. OversizedTab Folders 90%Larger LabelArea ■MtAG SMEA6 KEEPING YOU ORGANIZED No. 10301 PATENTPEMM A�1ABIf Mal ��N CONT@R101�® � POST-0ONBIp,Bt enmaro MADE W USA GET ORGANIZED AT SMEAD.COM PISS�T URBELIS & FIELDSTEEL LLP � 155 FEDERAL STREET .A'.a3:: .:F1,,� }.� Z BOSTON,MASSACHUSETTS 02110-1727 ��PITNEY SoWiES .`i 02 1P $ 000.465 0001848295 AUG 23 2016 MAILED FROM ZIP CODE 02110 Donald Belanger Town of North Andover 1600 Osgood Street Building 20, Suite 2035 North Andover, MA 01845 w. _ j: w — Tj -` If.Ij1 jllfllloll}!11 Date......... ..................ttel' ' k -`NORTH o?° �, TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION 8`4'�CHUSE V. °9 This certifies that .............. has permission for gas installation ....... . .tr....... ........................ inthe buildings of. ................................................................................ at..... k�� ?1,� ..Q.Cgr?� ... .............., Nd'rth Andover, Mass. DU Fee.7.Z.U.....:.. Lic No 14...f7 G ....._ .. AS INSPECTIaR./'4 ............................ }� 3�6� Check#�..---,�. ,., MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY MA DATE[ r TbZ 1=PERMIT# JOBSITE ADDRESS LI i�tk� pT��u S . ]OWNER'S NAME /�/. t'•i TS OWNER ADDRESS S� ,,,� l TE 7(Y- y 2 FAXW41 TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ® RESIDENTIAL❑ PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ APPLIANCES Z FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER ----_- _, _ _—_ _ BOOSTER CONVERSION BURNER COOK STOVE - DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM 1 SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER ' OTHERJ INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES Q NO ❑ I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY M OTHER TYPE INDEMNITY ❑ BOND ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER [:] AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true anclAccurate to the best of iny knowledge and that all plumbing work and installations performed under the permit issued for this application will be in co wit nt provis n of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME I Marts Caples LICENSE# 15985 q SIGN URE MP❑ MGF❑ JP❑ JGF❑ LPGI❑ CORPORATION Q# 3547 C PARTNERSHIP❑#0 LLC❑#� COMPANY NAME:Central Cooling&Heating, Inc. ADDRESS 9 North Maple Street CITY lWobum STATE MA ZIP 01801 TEL 781-933-8288 FAX 781-932-9017 CELLI 781-844-4939 EMAILImcaples@centralcooling.com ,( ��ic� `��,1 �ir� I� � -� ��` �✓� --� h=� � - C�,►�� f �1 ,�,�� ,nKl 743 ,c = ZZ The Commonwealth of Massachusetts Department of Industrial Accidents O,f,�ice of Investigations Map# Lot# UT 600 Washington Street Address: Boston,MA 02111 Permit# www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aflulicant Inlformatio». Please Print Legibly Name(Businesstowmizahiowindividual): Cerr+rn,l (161 ,"q �iC(.1-�-•�o �/tC. Address: 9 A/d r-'k A o.n 1 k Sfr-C 4 City/State/Zip: W oh wm . !�A- d i 8o i Phone#: 7 r/-933 7nW2r Are you an employer?Checit the appropriate box: Type of project(required): 1.2 I am a employer with O 4. E) I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listpd on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp,insurance comp.insurance.$ 9. ❑Building addition required] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner do' work officers have exercised their 11. Plumbing r � Q g epairs or additions myself.[No workers'co right of exemption per MGL c. 152 § ( ), ❑ insurance required,].t 1 4 and we have no 12. Roof arts employees.[No workers' 13..90 Other H A/6: comp.insurance required] *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 subcontractors and state whether or not those entities have employee`s. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and;job site information. Insurance Company Name: 61 o t oj TnsL ro4,c +-_, Ac, Policy#or Self-ins.Lic.#:_ p n 7 9 GG Expiration Date: Job Site Address: s 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 Investi tions of the DIA for ins cov a verification. - utance era¢ Ido �V�Prti nder pains and penalties of perjury that the information provided above is true and correct Date: / Phone#: b`I— C' 8' [QQ'leial use only. Do not write h;this area,to be,completed by or town oB`IclaL 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#• Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer," MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting auhority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to.your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the.Department of : Industrial Accidents. Shouldyou have any questions regarding the law or if yon are required to'obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured.companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom •-' of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number: In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town).-A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for firiure permits or licenses: A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts I1egarttnent of IndwWal Accidents Office of investigaflons 6W Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877 MASSAFE Fax#617-727-7749 Revised 11-22-06 www.mass.gov/dia 1EXLTH 0 MASS S -S 0 r w S IS ITT rh r�r I SSU 4�.7 1 1.A,4.. 4 R� L4 ,.^V`E NIS K« L rt7�' Ws ^}1 h 1 r 275 Commonwealth of Ma � #. s��USe ttS } C vision of Registrati '4 Board Of Plumb , Y MARK S. 275 MID If�fM�FN I ly 1� i z # M« ti. ,i rvAt� .i 1 WILMIN 1 Master Plu 85- I 05/01/2014 005015 ". L,ieense No. . Expiration Date. Serie! No. INTER-DEPARTMENT DELIVERY NOTE—CROSS OUT ENT1'RELINE WHEN RECEIVED AND RE-USE UNTIL ALL LINES ARE FULL. y DATE DELIVER TO DEPARTMENT SENT BY DEPARTMENT i _ , Z 1 , r l I � i Y k i. NI y I�4 'u :a r M NOTE—CROSS OUT ENTIRE LINE WHEN RECEIVED 0 AND RE-USE UNTIL ALL LINES ARE FULL. DATE DELIVER TO DEPARTMENT SENT BY DEPARTMENT ' I I ' � f b . j. 1 ._ ' C?- I ----------- i f ��QUALITY PARK Item# 63561 USE AND OCCUPANCY CLASSIFICATION A-4 Assembly uses intended for viewing of indoor sporting portion thereof, by six or more persons at any one time for events and activities with spectator seating including, educational purposes through the 12th grade.Religious educa- but not limited to: tional rooms and religious auditoriums,which are accessory to Arenas places of religious worship in accordance with Section 303.1 Skating rinks and have occupant loads of less than 100,shall be classified as Swimming pools A-3 occupancies. Tennis courts 305.2 Day care.The use of a building or structure,or portion A-5 Assembly uses intended for participation in or viewing thereof,for educational,supervision or personal care services outdoor activities including,but not limited to: for more than five children older than 2'/2 years of age,shall be classified as a Group E occupancy. Amusement park structures t Bleachers Grandstands SECTION 306 Stadiums FACTORY GROUP F 306.1 Factory Industrial Group F.Factory Industrial Group SECTION 304 F occupancy includes, among others,the use of a building or BUSINESS GROUP B structure,or a portion thereof,for assembling,disassembling, fabricating,finishing,manufacturing,packaging,repair or pro- 304.1 Business Group B. Business Group B occupancy cessing operations that are not classified as a Group H hazard- includes,among others,the use of a building or structure,or a portion thereof,for office,professional or service-type transac- tions, including storage of records and accounts. Business 306.2 Factory Industrial F-1 Moderate-hazard Occupancy. occupancies shall include,but not be limited to,the following: Factory industrial uses which are not classified as Factory Airport traffic control towers Industrial F-2 Low Hazard shall be classified as F-1 Moderate 1 Ambulatory health care facilities Hazard and shall include,but not be limited to,the following: Animal hospitals,kennels and pounds Aircraft(manufacturing,not to include repair) Banks Appliances Barber and beauty shops Athletic equipment Car wash Automobiles and other motor vehicles Civic administration Bakeries Clinic—outpatient Beverages: over 16-percent alcohol content Dry cleaning and laundries: pick-up and delivery stations Bicycles and self-service Boats Educational occupancies for students above the 12th grade Brooms or brushes Electronic data processing Business machines Laboratories:testing and research Cameras and photo equipment Motor vehicle showrooms Canvas or similar fabric Post offices Carpets and rugs(includes cleaning) Print shops Clothing Professional services(architects,attorneys,dentists,physi- Construction and agricultural machinery cians,engineers,etc.) Disinfectants Radio and television stations Dry cleaning and dyeing Telephone exchanges Electric generation plants Training and skill development not within a school or aca- Electronics demic program Engines(including rebuilding) 304.1.1 Definitions.The following words and terms shall, Food processing for the purposes of this section and as used elsewhere in this Furniture code,have the meanings shown herein. Hemp products Jute products CLINIC, OUTPATIENT. Buildings or portions thereof Laundries used to provide medical care on less than a 24-hour basis to Leather products individuals who are not rendered incapable of self-preserva- Machinery tion by the services provided. Metals Millwork(sash and door) SECTION 305 Motion pictures and television filming(without spectators) EDUCATIONAL GROUP E Musical instruments Optical goods 305.1 Educational Group E.Educational Group E occupancy Paper mills or products includes,among others,the use of a building or structure,or a Photographic film 24 2009 INTERNATIONAL BUILDING CODE 5/8/2017 Town of North Andover Mail-Cease and Desist Order 120 Main Street North Andover, MA 01845 Phone: 978 794-1709 segan@northandoverma.gov [Quoted text hidden] https://mail-goog l e.com/m ai I/u/0/?ui=2&i k=3e210fea79&view=pt&search=i nbox&th=l 5be90f468a52bd0&s i m l=15be89aa6b77c525&si m l=15be907f558fcd83&s i m... 3/3 .za _ t` '� � + *•� t:gyp � � e d t �a �� ''. • '� "�. ■gt a�1 4C � ,�.� �� -•as Y a °tt'- tl c � �d� �� n tATTMt y4. 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