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Home My WebLink AboutMiscellaneous - 110 MARBLEHEAD STREET 4/30/2018 110 MARBLEHEAD STREET l 2101009.000.0 Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 RE: Insured: Carol Declercq Property Address: 110-112 Marblehead Street Policy Number: BDJPCY Date/Cause of Loss: 3/28/2014, Pipe Corroded File or Claim Number: 29479-R Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, olic number, date of loss and claim or p Y file number. Ryan Werner On this date, I caused copies of this Notice to be sent to the per ons named above at the addresses indicated above by First Class Mail. Signafu and Date ANDERSON ADJU MENT CO., INC. 50 Nashua Road, Suite 303 PO Box 1098 Londonderry, NH 03053 3281 Date.X/""...a') f. . .! -�..... n NpRTM TOWN OF NORTH ANDOVER pf ,.ao ,+1ti0 a� a PERMIT FOR GAS INSTALLATION p � L_ 9 t • ++no•p� 4h SSAC14USES This certifies that . .. : z. . . . has permission for gas installation . .: . . . . . . . . . . . . . . . . in the buildings of . . ! :'. . :. . . . .i7 ?. . . . . . . . . . . . . . . . . . . . . . . . . . . at r /,: .... . . . . . . . . .I North Andover, Mass. Fee. .-,.". .,. Lic. No.. J.`. .'.r. . . . . . . . . . . . . . :. . .:. . . .. . . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Z MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING Type or print) Date 19 NORTH ANDOVER, MASSACHUSETTS Building Locations �!� �� p✓ �J Permit# �q Amount$ Owner's Name A ��/� New I iX Renovation ❑ Replacement ❑ Plans Submitted ❑ n Cn C E• C 'r z zz C z w r w C C Z N w :� SUB.-BA SEM ENT 1 4 BAS <'-M ENT I S T. F L O O R 2N D . FLO G R 3RD . FLOOR 4TH . FLOOR .5T It FLOOR 6T It . FLOG R 7T If FLOOR 8T if FLO G R (Print or type) / Check one: Certificate Installing Company Name tom/ F-1Corp. Address / ❑ Partner. Business Telephone s ❑ Firm/Co. Name of Licensed Plumber or Gas Fitters C � INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ®� No If you have checked ves, 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 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 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 p rformed under Permit Issued p r this applic ion will be in compliance with all pertinent provisions of the Massachusetts Stat as Code Ch 4� he G I ws. t By: Sig re of Licensed Plumber Or Gas Fitter Title ❑ Plumber . City/Town Gas Fitter Licen§e Numner 2-711aster APPROVED(OFFICE USE ONLY) ❑ Journeyman ` Location No. —r�� Date NORTH TOWN OF NORTH ANDOVER n Certificate of Occupancy $ s Building/Frame Permit Fee $ �5 'ss�cMuset� Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ — Water Connection Fee $ TOTAL $ t f Building Inspector If 'I 541 Div. Public Works 07/16/99 14:23 65.00 PAID IIER? NT'NO. p2 C/ APPLICATION FOR PERMIT TO BUILD********NORTI ANDOVER, MA nlArNo. �� Lor No. 2. RECORDOFOWNERSIIIP TATE ROOK PAGE ZONE SIIB DIN'. LrO/I NO. �-�-- r� /�j� //� Ly ^T,p;/� ,/� ) �,[ �'q� C LOCA I[ON ; `�� iPURPOSE OF BUILDING /`- jybVT7_1Q� ,1�)C Wt1J � !>11�11' � -'"�C�o •WN I:R'S NANIE i�� r NO.OF STORIES SIZE •WNER'S:\DDItI'S S //D /�YI�, LLp J{ BASEAIEiN10RSLA13 ARCIIITECI'S NAME / K� ` SIZE OF FLOOR TInn2ERS 1 I 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST Bl11LDING DIMENSIONS OF SILLS DISTANCE FROM STREET DIMENSIONS OF POSTS DISTANCE FROM LO'I'LINES-SIDES REAR DIMENSIONS OF GIRDERS AREA OF LOT FRONTAGE S� 1 IIEIGHTOF FOUNDATION "THICKNESS IS BUILDING NEW SIZE OF FOOTING x IS BUILDING ADDrrION MATERIAL OF CHIMNEY IS BUIL.DIN ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORNI TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SE\YER IS BUILDING CONNECTED TO NATURAL GAS LINE 1NSTLICTIONS 3. PROPERTY INFORNIA'TION LAND COST EST. BLDG.COST PAGE I FILL OLIT SECTIONS 1-3 EST.BLDG. COST PER SQ. FT. I /0 EST. BLDG. COST PER ROOM EI.EC1T11C NIE,rERS NIIIST BE ON OII"►'SIDE OF BUILDING SEPTIC PERMIT NO. ATI'ACIIF.D GARAGES MUST CONFORNI TO STATE FIRE REGULATIONS d. APPRON'ED BY: i PLANS MUST BE FILED AND APPROVED BV BUILDING INSPECTOR BIIILDINC INSPECTOR 1)ATE F11.FD / 015'NERS TELL (n]79 3.73 CONTR.TELN SIGNAT'URt: OP OWNER Oil A11T110RIZED AGENT M1 ^�I FEF: $ "'� ILLC•N t If [..r 1 . �I 11 1099 it PERMITCIt NTE1) 19 ! Revised 5/5/99 ,IN1 —__ (( F_ `�� , 5 � v► Town of North AndoverNORTH OFFICE OF 3�oy 4, !O ,,'6A, r COMMUNITY DEVELOPMENT AND SERVICES p 27 Charles Street oq WILLIAM J. SCOTT North Andover, Massachusetts 01845 �9 gSACHSAcH uSE° �5 S � Director (978)688-9531 Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print. DATE .7 �� / JOB LOCATION //O /;a,/�Ie, � ; �--L I Number Street address / Section of town o "HOMEOWv }-ER" ' ' \C( KA0 �!-3� Ylt� l3-0tIO6 Name Home phone + Work phone PRESENT MAILING ADDRESS b r�4"U'Vl frJ(�(C�rJ l QA' 1` � o o Z City/Town State Zip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Sec- tion 109.1.1) DEFINITION OF HOMEOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one to sic family divelling, attached or detached structures ac- cessory to such use and/or farm structures. A person who constructs more than one home in a two-vear period shall not be considered a homeowner . Such '.'homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0, Construction Control. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 ;- NORTH Town of ` L Over No.OZ95 70 0A-oCH,�Q dover, Mass., 7 �I ORATED P'P�L C, S 5` BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT..........Alt!"&*lBUILDING INSPECTOR ................. .. ..!V "� I�M� �......... ...... Foundation has permission to erect........ ....... .0 .. buildings on .......� ....�� ..../ l4 �t r.t Rough to be occupied as....../�Ci. ..C +y '....., A �Y4 �a/O�r�VT/r Chimney ............................... ...................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PM a/ PERMIT EXPIRES IN 6 MONTHS Final PO UNLESS CONSTRUCTI S ELECTRICAL INSPECTOR Rough 1 R10C, 3 9 44 / ........ ................... ........................................ .. .. ... ........... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.