HomeMy WebLinkAboutBuilding Permit #Exception - 1679 OSGOOD STREET 5/1/2018 L
�DING PERMIT F NORTH
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3r�`Z
TOWN OF NORTH ANDOVER o
Permit NO: APPLICATION FOR PLAN EXAMINATI N 7D
Date Received 10 q 1j
Date Issued: 4`""""�`•
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IMPORTANT:A licant must coil plete all items on this a e
LOCATION
PROPERTY OWNER Print
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MAP NO: �PARCEL: (.0
Print
_ ZONING DISTRICT:If— Historic District
yes no
Machine Shop Village yes no
TYPE 7 FIMPROVEMENT PROPOSED USE
Residential
ew Building Non- Residential
.❑ One family
❑Addition ❑ Two
..or more famil
❑Alteration y ❑ Industrial
❑ Repair, replacement N • of units: ❑ Commercial
❑ Demolition Assessory Bldg ❑ Others:
❑ Septic ❑Well ❑ Other
Wetlands,❑ Water/Sewer ❑ Floodplain ❑ W ❑ Watershed District
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Identification Please Type or Print Clearly)
OWNER: Name: 1{ Loi
'kddress: 57
Phone: `��� •a(�S= �175� I'
CONTRACTOR Name:.
gG _Phone: "8(oct - (ol
K ( ay '
Address-
CONT"
ddress: �!
fn -80x 13-2-
Sup
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Supervisor's Construction License:
Exp. Date:
Home In License:
Exp. Date:
ARCHITECT/ENGINEER C gsco eq
Address: Phone:_ �'�- f .CZ- o1F nc7
T Pa��a R1 Reg. No._ ���3i
FEE SCHEDULE:BULD/NG PERM/T.•$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $_ I�a 4 �.� -"--
Check No.: FEE: $
NOTE: Persons contract' Receipt No.:
ith u registered contractors do not have ac s to the guaranty fund
Si nature of Agent/Owne
Sign ,wre of contractor �-
,y i
li
Plans Submitted ❑ Plans Waived ❑ Certifie Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Taming/Massage/Bod Art
y ❑ Swimming Pools ❑
Well ❑ ❑
To Sales Food Packaging/Sales ❑
Private(septic tank,etc. ❑ Permanent Dwnpster on Site ❑
I
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
/ INTERDEPARTMENTAL SIGN OFF - U FORM
V PLA NING DEVELOPMENT Reviewed On jt�1 LK
to < \ ��. Signature_
p�$ f1(IMENTS Q
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{��t �0 DI Zu5 i NE56 MIT—( ow!*
q ( J\I 1
CONSERVATION Reviewed on 1
Si natur
COMMENTS
1144EALTHRr
eviewed on 0) � Si nature
ti
11 COMMENTS
3 �
Zoning Board of Appeals: Variance, Petition No:
Zoning Decision/receipt submitted yes
Planning Board Decision:
Comments
Conservation Decision:
Comments
Water& Sewer Connection/signature& Date
Driveway Permit
DPW Town Engineer: Signature:
FIRE DEPARTMENT - Te p ®urnestwillillillillipi er o site es Located 384 Osgood Street
Located at 24 Main StUPPt no
THENORFOLK DEDHAMGROUP®
May 29, 2015
FORM OF NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B
Building Commissioner, or Inspector of Buildings
c/o City or Town Hall
1600 Osgood Street
North Andover, MA 01845
Board of Health or Board of Selectmen
c/o City or Town Hall
1600 Osgood Street
North Andover, MA 01845
Fire Department or Arson Squad
c/o City or Town Hall
1600 Osgood Street
North Andover, MA 01845
RE: Our File No.: P1595340
Insured: NELLIE SARACUSA
RUSSELL & SAMU MOSCHETTO
Address: 1679 OSGOOD STREET, NORTH ANDOVER, MA
Policy No.: H1409979A
Loss Date: 05/27/2015
Loss Type: Building or Other Structure Damage
A 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. Laws, Ch. 143, Sec. 6 to be
applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct
it to my attention and include a reference to the captioned insured, location, policy number, loss
date and claim or file number.
If no reply is received from your office within ten days, we will assume you have no liens of any
type against this property, and the claim will be paid in our customary manner.
Sincerely,
Michelle M. Roust
Senior Property Claims Examiner
1-800-688-1825 x1171
NORFOLK&DEDHAM MUTUAL FIRE INSURANCE CO. 222 Ames Street,P.O.Box 9109,Dedham,MA 02027-9109
DORCHESTER MUTUAL INSURANCE CO. Telephone:(800)688-1825
FITCHBURG MUTUAL INSURANCE CO. p Fax:(781)329-1818