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HomeMy WebLinkAboutMiscellaneous - Exception (117)co �mm G amm owmm 7/1/2016 20825 This is an e -permit. To learn more, scan this barcode or visit northandoverma.viewpointcloud.com/#/records/20825 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that Jeff S Agnew has permission to perform kithen remodel, bath remodel plumbing in the buildings of Lindsey Riordan at 60 EDGELAWN AVENUE 3, North Andover, Mass. Lic. No. 12060 Date: July 01, 2016 1/1 oPlumbing Permit RevieW itsrm., {/�� G^�icfswm. V Ftt o k t Y3: YY2 le.F. 60 EDGELAWN AVENUE ;at NORTH 'ANDOVER, MA -OTIFMI701 F_Fri jut 01 2016_ 13:16:.PDF Friday, Jul 01, 2016 09:16 AM 4l'4-�' y The Commonwealth of.iMassgehusetts z.. Department of'IndnstrialAccidents X Congress Street, Suite 100 Boston, MA O2X142017 www.mass.gov/dia yV• Workers' Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plumbers. TO BE, FMkD WITH THE PERMITTING AUTHORITY. Name (Business/Organization&dividual): .Address: City/State/Zip: �' eTVft- A.re you an employer? Check the appropriate box: e Phone #: I f I T am a employer with employees (full and/or part-time).' taam a sole proprietor or partnership and have no employees working for me in ny capacity. [No workers' comp. insurance required.] 3.. [] I am a homeowner doing all work myself [No workers' comp. Insurance required.] t 4. ❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5. ❑ I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.t 6.F] We are a corporation and ifs officers have exercised their right of exemption per MGL G. 152, § 1(4), and we have no. employees. [No workers' comp. insurance required.] * h ks li #1 t a1 'fill out the section below showing their workers' compensation Type of project (xec�uirW): 7. 0 New construction 8 emodelhig 9. Demolition 10 ❑ Building addition 11_. ❑ Electrical repairs or additions iiE] plumbing repairs or additions 13.0 Roofrepairs 14. E j Other Any applicant that c ec ox mus so i Homeowners who submif flus affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tConiractors that check this box must -attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. if the sub-coriiractors have employees, %ep must provide their workers' comp. policy number. X am an employer that is pi'ovidiiig workers' compensation insurance for my employees.' Beloit/ is the policy and job site information. Insurance Company Policy # or Self -ins, Lic. #: Expiration Date: Job Site Address. City/State/Zip: �GF Ac - Attach a copy of the workers' ompensationi policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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 flue of up to $250.00 a day against the violator.'A. copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ofperjuay that the information provided, fhote is true and. correct. y-3 � 5__ Off tial 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): i 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. PIumbing Inspector 6.Other Contact Person: Phone #: i $: a ,.-�_ _ .:-� =^ .. y ,, +�;. ...c _. '�+...� - �t:�t s Ti: a4;- ;< �.' .t 4,._. 9,. --..N.�y� .. s T - - t � '�y� intif �zz.a���f�® . �. . � � . ..���\\���� ` - ^�f{\� �\ � //� � � �\�.�� � ^�^ 2�� � 2 ° � .� : . . . » �� . : U) m X m m m v m CO) C � 0) CO) C) 10 0 CD n Z y CD O 'v CL � � o CL CO) O � c v co CLCD O Q "Cd CD CD CD w w a. C. O CO) Q O CO) �O C � v CA O CD Z O � CD 0 CD E LW FA cn cn n O VI a PIV �. c O e E -t O y O =R ® CL C09 CD Cl) _A O .w C �. ?-O N �I O d .Oi O N CD aim m O O N ti �CD CD 0 CD ZS:c�. o m C, ,..... 0 aC � O y : ,off a� CD caIN 7 H nom'\Q G w :v Z c z IE O N (D �CD pv w C2,ma: CDo fi o Oro- x r ►d wEj a =o 0 �: Wim: o a d7 r� n �o Fcn 0 w R. �x to o y F� im .) >H C2C ted: c'g nom: !� O 0 cD cn cn w :v Z c z n 7� (D pv w o UQ x H o Oro- x r ►d wEj a M � oda o a d7 r� n �o Fcn 0 w R. �x to o y F� I z O I O C fD GENERAL BUILDING NOTES/CHECKLIST- NOT LIMITED TO ITEMS BELOW POST ALL LOT NUMBERS, ADDRESS, AND PERMIT (COPY 0K)..or no inspections INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, Insulation, Final. FOOTINGS: Continuous Full 2x4 Keyway Continuous strip footings for interior columns FOUNDATION: Rebar as required Anchor bolts or straps Damproofing Foundation drain - pipe/stone/fabric filter/cover and outlet connection. FRAME: Fireblock - over girts/plates between floor joist Penetrations for plumbing, heat, elec, etc. Walls at stair stringers. Windbrace corners and center bearing partitions. Size ridge to provide full bearing at rafter cuts. Hip and Valley rafters - watch bearing at walls. Ridge & Hip - Provide proper connections. Cathedral roof rafters provide proper connections and use "Hurricane Clips" tie to plate. Stair stringers - watch cuts and heal support. Joist hangers - fully nailed w/ hanger nails. Sill plates 2-2X6 (I PT) w/silt seal. Girls - solid brick or steel plate bearing at foundations '/ " air space at sides in foundation pockets. Lateral bracing at ends. Certified calculations. required for Beams/LVL's Trusses. Solid bearing support for Headers/Beams etc. Check headroom clearances - stairways, under beams Attic Access. (min. 22x30 w/3' headroom above). Crawl space access. (min. 18x24). Bath exhaust fans to have metal duct to exterior (not in soffit). Firecode S/R wood frame of "0" clearance fireplaces & stoves Window Schedule or Every Habitable Room Must Have: Natural light equal to 8% of floor area. % of required glazing shall be openable. Bedrooms required min. 20x24 egress window or door. Vent attic spaces - "proper vent", soffit and required ridge vents. Firecode under stairs if used for storage FIREPLACES:. -Separate permit required. Inspections at Footing - Smoke Chamber - Finish Smooth parging, clean joints, 8" solid @ combust. DECKS: Lag to house, provide flashing. Rails min. 36" high, Baluster max space 5" on center. Over 8' above grade, use 6x6 posts w/lateral bracing. Lag all posts and rails. Pier footings down 48", Conc. pad at stair base. FINISH: Handrails returned to wall/newall post. Guardrails required alongside open cellar stairs. Exterior grading complete. Certificate or occupancy required prior to occupying structure. Temporary Stairs required for inspection. Re -inspection fee - $30.00 (Be Ready). Certificate of occupancy required prior to occupying structure. Date .... .. ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... ............... ........... I .............................. has permission to pe /form ....... .......................................... wiring in the building of Jk ........... ....................... . z at ..1:.1 Z1. ..:::.........../.I1 .......................... . North Andover, Mass. Fee.../.��-.. ... Lic. No.&/ .......................................................... ELECTRICAL INSPECTOR Check 4 45;0 Commonwealth of Mas Department of Fire - BOARD OF FIRE PREVENTION hs Oficial Use Only Permit No. 0go Occupancy and Fee Checked TIONS Rev. 11/99) leave blank APPLICATION FOR PERMIT V PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ;6 tai S� �,7aa City or Town of: 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) Owner or Tenant A Owner's Address J Telephone No. Is this permit in conj'unctjgn with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building AIV00 f Utility Authorization No. Existing Service New Service Amps / Volts Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ No. of Meters No. of Meters r_,, r— .. „'Ihe fn1lo no, tahle may be waived by the Inspector of Wires. Ariach additional arta!! y --d. — —C-1-1-0 cy.... 0 . — -. -- -- 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 El OTHER ❑ (Specify:) , O/Y�/� e U a06 ( xpi ion Date) Estimated Value of lectri al Work: (When required by municipal policy.) Work to`Start: / ojo? O Inspections to be requested in accordance with MEC Rule 10, and upon completion. Icertify, under thepains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: !? � /� 6 / 6 �/ - LIC. NO.: % fl Licensee: 4 19A1hW0.__Signa r LIC. NO.: ly l�/G (Ifapplicable, enter "exempt" inthe plicense number line.) Bus. Tel. No.' `��L'�s'�— y�°d Address: J� Q �d X ii" ,(z LGA%(rS'U��� sl Alt. Tel. No.: OWNERS I)tiVSURANCE WAIVER: I am aware that t1x�Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑owner's agent. Owner/Agent [PERMIT FEE: $ Q� Signature Telephone No. Receip-t 0 . �,...�... No. of Total No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures AboveIn- Swimming Pool rnd ❑ rod ❑ o. o Emergency ig ing Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Detection and No. of Switches No. of Gas Burners Initiatin Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices Heat Pump Number Tons KW No. of Self -Contained No. of Waste Disposers Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑Municipal ❑Other Connection No. of Dryers Heating Appliances Key Security Systems: No. of Devices or E uivalent No. of WaterNo. KW of No. of Sias Ballasts Data Wiring: No. of Devices or E uivalent Heaters Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors Total HP No. of Devices or Equivalent OTHER: ..-_rr 6., ihu[nrn tnrnfWiros- Ariach additional arta!! y --d. — —C-1-1-0 cy.... 0 . — -. -- -- 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 El OTHER ❑ (Specify:) , O/Y�/� e U a06 ( xpi ion Date) Estimated Value of lectri al Work: (When required by municipal policy.) Work to`Start: / ojo? O Inspections to be requested in accordance with MEC Rule 10, and upon completion. Icertify, under thepains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: !? � /� 6 / 6 �/ - LIC. NO.: % fl Licensee: 4 19A1hW0.__Signa r LIC. NO.: ly l�/G (Ifapplicable, enter "exempt" inthe plicense number line.) Bus. Tel. No.' `��L'�s'�— y�°d Address: J� Q �d X ii" ,(z LGA%(rS'U��� sl Alt. Tel. No.: OWNERS I)tiVSURANCE WAIVER: I am aware that t1x�Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑owner's agent. Owner/Agent [PERMIT FEE: $ Q� Signature Telephone No. Receip-t 0 Location ('0 No. �a Date NORTH TOWN OF NORTH ANDOVER 00 9 Certificate Occupancy of $ s�cMust Building/Frame /Frame Permit Fee $ 9 3�b Foundation Permit Fee $ - Other Permit Fee $ TOTAL $ SO O' - Check # 2v C- 17112 17112 ✓ Building Inspector t k TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING „r.•t x'.,.. },',<.....;ks.4 : e 3`This Section for Official Use Onl �.:_ .��. - x�. •{ BUILDING PERMIT NUMBER: DATE ISSUED: – JD– D C SIGNATURE: /44 Builln& Commissions I or of Buildings Date 1.1 Property Address: 1.2 Assessors Map and Parcel Number. 3 4- � � Map Number Parcel Number C�ellJl�QtCL� %S�2.y1't C2io/L;L;R - Dobe- voDI.O 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide Required— Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal On Site Disposal System ❑ 2.1 Owner of Record Name (Print) Address for Service: Signature i Telephone 2.2 Authorized Agent Name Print Address for Service: Signature Telephone 3.1 Licensed Construction Supervisor Not Applicable ❑ ?r&—,j L— 67?9-� CS (0U ff, (,--- Address License Number p �Ct, U 1. t A.1 FAA -- _:4(— Licensed Construction Supervisor: Eviration Date �G tgnature Telephone 3.2 Re isrtered Home ImprovementContractor Not Applicable ❑ Company Name. Registration Number f Ad s ' © " 7 Expiration Date (/ b � — Si ature Telephone Z 0 v m I 0 m X D Z 0 Z em t� 0 r sv r r z G) 6 I, / as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury Print Name Si Fnof Owner/Agent Date Y�Ntl�F�" Z. Si Item Estimated Cost (Dollars) to be ` ,�*� pt f �s e s Completed by permit applicant�' �� , r r 1. Building© (a) Building Permit Fee Multiplier 2 Electrical • �/ (b) Estimated Total Cost of -- Construction from (6) 3 Plumbing �] Building Permit fee (a) X (b) U Z Z 4 Mechanical (HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) —� a d Check Number so- d 2fi&lama a s F Lite'M.rn..-o'`ak�2'.,� �Y, v �..s` MIN P, SF7 t5;; �L{%S4 ..`i. ASM t . A>'ki r 5 2 S.a �C1�S u A §; L t� �/l. ' .T'� � a'... :•/ia .. , o.�. W'. � � � i+. 2.n .� . }.i. A * F'. ��:V :. i..+�i, �b . �"i. �v.` ., �, t. rX�.. �.:J � A�, A h t`Ep.t nH r TYl>'� S`�. 6�µ. �c �' a. ' Ath {.4VN'•a V' a4t . Y Gis ; ifa ! Y*�4 1_ Pi. F NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TMERS 1 sr 2 ND 3R SPAN DEMENSIONS OF SILLS DEMENSIONS 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 �a c i Name: Address Signature Telephone Signature in Charge of Construction Telephone Expiration Date . _ Not Applicable ❑ Area of Responsibility Name: Address: Registration Number Expiration Date Signature Total Not applicable ❑ Name: Registration Number Address Signature Telephone Expiration Date Name Address Area of Responsibility Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature in Charge of Construction Telephone Expiration Date . _ Not Applicable ❑ s��v�+�,��T�►� +�1���� c1�:all,�►l��s New Construction ❑ Existing Building Repairs) JAlterations(s) ❑ Addition [I Accessory Bldg. ❑ Demolition 0 Other ❑ Specify Brief Description of Proposed Work: �ti9L5 *-C_ too r ti,-,"- �o rD A-1 ❑ A4 ❑ A-2 A-5 Independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Owner of the subject property Hereby authorize to act on My behalf, in all matters relative two work authorized by this building permit application Signature of Owner Date USE GROUP Check as a livable CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A4 ❑ A-2 A-5 ❑ A-3 0 ❑ ]A IB ❑ ❑ B Business ❑ 2A 2B 2C 0 ❑ ❑ C Educational ❑ F Factory 0 F-1 ❑ F-2 ❑ H High Hazard ❑' 3A 3B ❑ ❑ IInstitutional 0 1-1 ❑ I-2 ❑ 1-3. ❑ M Mercantile ❑ 4 0 R residential 0 R -I ❑ R-2 0 R-3 ❑ 5A 5B ❑ 0 S Storage ❑ S-1 ❑ S-2 0 U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use 0 Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND OR CHANGE IN USE Existing Use Group: Existing Hazard Index 780 CMR 34: Proposed Use Group: Proposed Hazard Index 780 CMR 34: Independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Owner of the subject property Hereby authorize to act on My behalf, in all matters relative two work authorized by this building permit application Signature of Owner Date North Andover Building Department Tel: 978-688-9545 .DEBR.IS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall -be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: L bob (Location of F `Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector � _ ✓le �a�;rmzanusra� o��tc%zuaeti6 BOARD OF BUILD14 REGULATIONS R• License: Number: CS 083886 Birthdate: 07/12/1960 Expires: 07!12/2006 Tr. no: 83886 Restricted, 00 PAUL L CORBOSIERO / 5 PEARL AVE WINTHROP, MA 02152 Administrator i`IUV- l 4-CUW M1 1 Ub : Cb FM b 1 UU 1 U 1% AULNUY ! HX NU r JIM. U ACORD� CERTIFICATE OF LIABIL PRODUCEk John M. Biggio Ing Agency 399 Winthrop Street Winthrop MA 02152- INSUkkU SHL Contracting 54 Pauline Street Winthrop MA 02152- ITY INSURANCE DAlE 1113 200 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURFRA. Zurich U.S. y INSUNL'RB:A8gopiated Industries of Massachusetts INSURER C: ^ INSIIRFR D' - INSURFR E, , COVERAGES — T! IE FCLIC'ES OF INSURANCE LISTED BCI -OW HAVE BEEN ISSUED TO THE INSURED NAMLO ABOVE FOR T14E POLICY PERIOD f!VUICATcD. NOTWIT-ISI'ANDIKC;.'.Y REOU;r,UALNT TERM OR CONDITON OF ANY CONTRACT OR OTHER COCUMENT WITH RCSPCCT TO WHICH TH;S CE?RTIFiCATE MAY CE ISSUED ^R VAY FERTNv . TIIE INSURANCE, AFFORDF.I) BY THE P7LICIES DESCRIBED HEREIN IS SU3JECT TO AIL TIME TERMS. EXCLUSIONS AND CONDITIONS OF SUCII P'JLD_IE AGGREGATE LIMITS SHOWN MAY )IAVE BFFN REDUCED EY PAID CLAIMS, TYPC OF INSURANCEPOLICY EFFECTIVE 'POLICY EXPIRATION POItCY NUMDCR DATE MMIDD(1^( DATE M IpplYY GENERAL LIAOILI•IY / / / / x I�COMMCRCIAL GENLNAL LIAMI.ITY A CLAIMaMADF OCCUII SCP 3320ES31 11/06/2003 11/06/2004 CSNl AGKIRF�CAT F LIMIT APPI,I7FS NEN: Im I rOL!C- I LRC7 1; I LOi: / / i rOMODIL6 LIABILITY ANY AUTO ALL CWNFO AUTOS SCHEDUILrO AUTOS hlrtc0 AUTOS N01, •O'.VNC D AIJ705 AGE LIARR.ITY !JI•( AUTO EXCELS UAiiIUTY _ OCCUR CLAIMS MAL1C ;� OCDUCTIRIF. B AWC7010475012002 10/26/2003 10/26/2004 CTHEri A CYKGFi SCP 39208831 11/06/2003 11/06/2CO4 DESCRIPTION OF OPLRATICNSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSCMENTISPECIAL PROVISIONS Fax$ 978-69S-0521 DITIONA'. INSURED; INSURER ITER: heritage Green Condo Aegocieti0n 39Farrwood Avenue $1 North Andover 14A 011345- ACORD 25.5 (7197)—' wso2 LIMITS ACHOCcuRRF1sCE S — 300,000 t'IREDAMACE(rvycnci,•c A 300 00� WE0E'wI fw� on(, poisonj 10,000 PERSONAL 6 AOV INJURY 1 3 0 0- -000 GFNEKALACGRE_GATE $ 600,'0'70, PRODUCTS.COWOrAAG S 607,000 COMBINCD SWGI F. LIMIT (C;1 acc�danl) g DOOILY INJUrY (Poi pmcn) g BODILY INJL'IiY (Fer imkim.l) PROPERre DAMAGE i I (Pot r:ccld4o) AUTO ONLY• FA ACC IDCNT 5 OTHER TI, IAN EA ACC. AUTO ONLY: CACI (1C(:URRCIJCG 3 $ _ O.CGRCRATF S b _ tNL 1,T11 I., UCRTI I• T RY I.I ' C. I..F.ACHACCICCNT S 100,000 E L, 015 CA$F• • FA E MPLOYEF 5 1 C 0, 0 0 0 E.I DISEASE! • POLICY Lim: r �S - SOt,000 Toola 6 Cqu1p 2 , 500 :ANCELLATION SHOULD ANY OF TNF ABOVE DESCRWED POLICIVS BE CANCClLEO BEFORC 1HF EXPIRATION DATE THEREOF, TIIC ISSUING INSUNER WLL ENOM,1VJR TO Ml.I, 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NANIFO TO THE LEFT. CUY FAILURE TO DO SO SHALL, IMPOSE NO OBLIGATION OR LIAEILITY OF ANY KIKC UPON THE SS I.JJ •0).01 ELECTRON':C LASCR FQRMd , INC. • (800)327.0545 f PPACORD CORPORATION 1968 H CD a Z CD O C3. O d o. MW ov CL c CD O cCCD av CO CD CA 10 CD 0 O COD O CO) W d0cm V) 9 =R mm C) Q C,* R7 d O M Z O•- y �. O rt 0.00 H TI CO)CL 0 =rm na01 O C m O m H p > > m �C O CD 1 O Ze.�:• W � o CD =r ='a lb� CA O:� C/)�o m ®y : :.► co lJ am �m y = 0 1 N e� H CnCD CA N -4 N CD Cn H CD • Cn CD O c J . y O m � � Im�Vt 0 :31 :t O O =w =1 C/) C/) :v -x n� o c 0 w o o CP1 7d w o ro w �^ o O. W� 8 omi 0 0 c GENERAL BUILDING NOTES/CHECKLIST- NOT LIMITED TO ITEMS BELOW POST ALL LOT NUMBERS, ADDRESS, AND PERMIT (COPY OK)..or no inspections INSPECTIONS: (Minimum) Excavation, Footing, Foundation, Frame, Insulation, Final. FOOTINGS: Continuous Full 2x4 Keyway Continuous strip footings for interior columns FOUNDATION: Rebar as required Anchor bolts or straps Damproofing Foundation drain - pipe/stone/fabric filter/cover and outlet connection. FRAME: Fireblock - over girts/plates between floor joist Penetrations for plumbing, heat, elec, etc. Walls at stair stringers. Windbrace corners and center bearing partitions. Size ridge to provide full bearing at rafter cuts. Hip and Valley rafters - watch bearing at walls. Ridge & Hip - Provide proper connections. Cathedral roof rafters provide proper connections and use "Hurricane Clips" tie to plate. Stair stringers - watch cuts and heal support. Joist hangers - fully nailed w/ hanger nails. Sill plates 2-2X6 (1 PT) w/sill seal. Girls - solid brick or steel plate bearing at foundations '/Y " air space at sides in foundation pockets. Lateral bracing at ends. Certified calculations. required for Beams/LVL's Trusses. Solid bearing support for Headers/Beams etc. Check headroom clearances - stairways, under beams Attic Access. (min. 22x30 w/3' headroom above). Crawl space access. (min. 18x24). Bath exhaust fans to have metal duct to exterior (not in soffit). Firecode S/R wood frame of "0" clearance fireplaces & stoves Window Schedule or Every Habitable Room Must Have: Natural light equal to 8% of floor area. of required glazing shall be openable. Bedrooms required min. 20x24 egress window or door. Vent attic spaces - "proper vent", soffit and required ridge vents. Firecode under stairs if used for storage FIREPLACES: Separate permit required. Inspections at Footing - Smoke Chamber - Finish Smooth parging, clean joints, 8" solid @ combust. Surf. DECKS: Separate permit required: Lag to house, provide flashing. Rails min. 36 " high, Baluster max space 5" on center. Over 8' above grade, use 6x6 posts w/lateral bracing. Lag all posts and rails. Pier footings down 48", Conc. pad at stair base. FINISH: Handrails returned to wall/newall post. Guardrails required alongside open cellar stairs. Exterior grading complete. Certificate or occupancy required prior to occupying structure. Temporary Stairs required for inspection. Re -inspection fee - $30.00 (Be Ready). Certificate of occupancy required Rrior to occupl inn structure. Date 3 ............... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... ...p ........... ........:................... ............................ has permission to perform. -:r U...... . /-,% . ................................. wiring in the building of ......., t! ..... ...................................... at ..6 .. �--.. ' `'•........?! 4`t..... , North Andover, Mass. �,. Fee... .......... Lic. No���.�c��..............C��...........-............................... ` ELECTRICAL INSPECTOR Check #- 5[53 OFFICE USE ONLY The Commonwealth of Massachusetts a - - Permit No. Department of Public Safety Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR,,,' 2:00 (Leave Blank) APPLICATION FOR PERMIT' T., PERFORM ELECTRICAL WORK All work to be performed in accordance;wi the Massachusetts Electrical Code. 527 aaCMR 12:00 (PLEASE PRINT IN INK OR TYPE LL INFORMATION) Date U City or Town of To the Inspector of Wires: The undersigned aunlies for a vermit to nerform the PlPrtrirnl wnrl; iPcrr;hP i halnw Location (Street & Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building — nn. (i k2Q 111 It IB Utility Authorization No. Exixting Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders an 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 Grnd ❑ In-Grnd ❑ 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. bf Ranges No. of Air Cond. Total Tons\Q' (kf No. of Detection and Initiating Devices NoJof Disposals l No. of Heat Pumps Total Tons Total KW No. of Sounding Devices No. of Dishwashers C Space/Area Heating KW No. of Self Contained Detection/Sounding Devic 1 6� No. of Dryers Heating Devices Local Municipal Connection ❑ Other No. of Water Heaters KW No. of Signs No. of Ballasts Low Voltage Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: B INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws �,�" I have a current Liability Insurance P cy including Completed Operations Coverage or its substantial equivilent. YES EI NO ❑ I have submitted valid proof of same to this office. YESZ NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate bo �" INSURANCE [" BOND ❑ OTHER ❑ (Please Specify) Fri. L) r W Ckl Estimated Value of Electrical Work $ I (xpiration Date) Work to Start Inspection Date Requested Rough Final Signed under the pe allies of perjury: FIRM N - l' LIC. NO._ /O 7 9� --i Licensee Signature LIC. NO.__��� Address jt/ Zmri Q„tea-f.4a Bus. Tel. No. tS/I .%�/�% 2rJr� Alt. Tel. No. - %� 2 s(Z � �6 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent 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 of Agent) Telephone No. PERMIT FEE $ To Reorder celi NEBS PrtnHiog (617)246-54S4 Wakefield. MA 01660 Ref. No: 986762376 Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING C This certifies that -- l� '::... : %.. . has permission to perform .�'.`. ! 1 :............../........ . plumbing in the buildings of ...A ....... - ............ . at ..� .'� .... �s,....--,G','�voth An over, Mass. UL Fee .`Sf..... Lic. No. .. ..../:,. 7 ..�-+ -✓1 rOR PLUMBING INSPEv- Check # /UkZ` 5928 MASSACHUSETTS UNIFORM APPLICA (Type or print) NORTH ANDOVER, MASSACHUSETTS 60 edje LAwn/ S7 Building Location (J AJ 17 Ad T Owners Name New Renovation Type of Occupancy Replacement FOR PERMIT TO DO PLUMBIN( 6-R&A1 Date 3-4_QS Q 4 Permito2 Amount FIXTURES Plans Submitted Yes 0 No ❑ type)(Print or `` Check one: Certificate Installing Company Name S p re✓ 1.' 1a PT G7 l _ �i ` Corp. Addre s % s �'°��� Partner. 2_.4_S71Q o4 A Business Te ep one /a j /2 _ /� t7 �/ .CJ l//, HT-Firm/Co. Name of Licensed Plumber: , d 1, -4 1zd 'S)0LC� 1.A l to Insurance Coverage: Indicate the type insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of 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 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 MassaclWettg State Pluming Code ay/d Chapter 142rof tip General Laws. VED (OFFICE USE ONLY Type of Plumbing License ' '�- icense NumDer — Master Joumeyman ❑ Date: 01/05/2010 Adjusting Associates, LLC PO Box 660 Hudson, MA 01749 Tel: (978)562-3763 Fax: (978)293-0202 Email: Milleradjs@aol.com NOTICE OF CASUALTY LOSS TO A BUILDING Under Massachusetts General Laws, Ch. 139, Section 3B To: Building Commissioner or Inspector of Buildings Town Hall North Andover, MA 01845 RE: Insured: Loss Location: Policy Number: Co. Claim Number: Adjuster File Number: Insurer: Date of Loss: Cause of Loss: Board of Health or Board of Selectmen Town Hall North Andover, MA 01845 Kenneth & Stacey Carpenter 60 Edgelawn Ave #6, North Andover, MA HP 5040054 1000065460 M10 LIM 001 New England Guaranty Ins. Co. 12/31/2009 Water RECEIVED JAN 0 8 2010 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT As representatives of the above captioned Insurance Company, we hereby notify you, on behalf of said Company, that claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1.000.00 or cause Mass. Gen. Law, Chapter 143 Section 6 to be applicable. If any notice under M.G.L. Chapter 139, Section 3B is appropriate, please direct it to 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 departments named above, at the addresses shown, by first class mail. Adjuster: Bruce A. Miller SIMSOL® FORM REP-1/3.0-SP4 E Date ... c? -OX( ...... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION hL- This certifies that . . q . '.1 -.A� . (� ............... has permission for gas installation .......... . ............... in the buildings of ... el-� ..... ........... at North Andover, ass. 11 M FeeLic. No. -�I:I NSPECTOW Check # It) 6 -z.- 4661 MASSACHUSEFIN (Type or print) NORTH ANDOVER, Building Locations U Iii �` 7- � ,5 � OW New ❑ Renovation Replacement TO DO GAS F1T NG Date lee 14�1 Permit # is Name17�Amount $ ��ri!A•Tev c:3o5 v i�G 4S�G�f Plans Submitted ❑ (Print or type) S n�C e� � l� ��� �) /pi/ Check❑ Corp. Certificate Installing Company Name /' !7 �/ S -77e e-7— oai Name of Licensed Plumber or Gas Fitter ❑ Partner. fflit Co INSURANCE COVERAGE Check one• I have a current liability Insurance policy or it's substantial equivalent. Yes No Q If you have checked yes, please indicate the type coverage by checking the appropriate box. ❑ Liability insurance policy 0-11, Other type of indemnity 1:1 Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information 1 nave suorrnttea kor enterea) in aoove appucauun aw uuc anu accuiaic to We 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 Massachu tts Sate Gas CTle and C1 ter 142 of the eneral Laws. ICity/Town APPROVED (OFFICE USE ONLY) Signature of LicebseTPlurober Or Gas Fitter ❑ Plumber l /' y d ❑ Gas Fitter Icense FlumDer �Iaster ❑ Journeyman x � v� U F a O O W a0 O O W F wa a w w z ` w w o w H W C rA O zzW °o Cz¢ W�wgg~ d O w F-4. SUB -BASEM ENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR (Print or type) S n�C e� � l� ��� �) /pi/ Check❑ Corp. Certificate Installing Company Name /' !7 �/ S -77e e-7— oai Name of Licensed Plumber or Gas Fitter ❑ Partner. fflit Co INSURANCE COVERAGE Check one• I have a current liability Insurance policy or it's substantial equivalent. Yes No Q If you have checked yes, please indicate the type coverage by checking the appropriate box. ❑ Liability insurance policy 0-11, Other type of indemnity 1:1 Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information 1 nave suorrnttea kor enterea) in aoove appucauun aw uuc anu accuiaic to We 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 Massachu tts Sate Gas CTle and C1 ter 142 of the eneral Laws. ICity/Town APPROVED (OFFICE USE ONLY) Signature of LicebseTPlurober Or Gas Fitter ❑ Plumber l /' y d ❑ Gas Fitter Icense FlumDer �Iaster ❑ Journeyman