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Home My WebLink AboutMiscellaneous - 114 BOSTON STREET 4/30/2018 (3) /, TON STREET _ X14 g08 00$'�p0 0 J NEW ENGLAND CLAIMS SERVICE, INC. Incorporated 1985 Reply To Reply To Mansfield, MA 02048 131 Dodge Street, Suite 6 P.O. Box 345 ASSOCih1I Beverly, MA 01915 MDEMNDCNT DNAW TEL. {508) 337-8058 �"" TEL. {978)927-3000 �. FAX{508)339-5835 FAX{978}927-3002 wrandall@newenglandclaims.com Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec 3B To: Building Commissioner or Inspector of Buildings City Hall North Andover, MA 01845 RE: Insured: Donald&Nnacy Johnston Property Address: 114 Boston Street, North Andover, MA 01845 Cause of Loss/Date: Windstorm Loss of 7/3/2014 File or Claim No: BOS052492 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, policy number, date of loss and claim or file number. Section 3B. No insurer shall pay any claims(1) covering the loss, damage, or destruction to a building or other structure, amounting to one thousand dollars or more, or(2) covering any loss, damage or destruction of any amount,which causes the condition of a building or other structure to render section six of chapter one hundred and forty-three applicable, without having at least ten days previously given written notice to the building commissioner or inspector of buildings appointed pursuant to the state building code,to the fire department or arson squad of the city or town and to the board of health or board of selectmen of the city or town in which the same is located. If at any time prior to payment the said city or town notifies the insurer by certified mail of its intent to initiate proceedings designed to perfect a lien pursuant to section three A, or to section nine of chapter one hundred and forty-three, or section one hundred and twenty-seven B of chapter one hundred and eleven, the said payment shall not be made while the said proceedings are pending;provided, however, that said proceedings are initiated within thirty days of receipt of such notification. Any lien perfected pursuant to section three A, or to section nine of chapter one hundred and forty-three or section one hundred and twenty-seven B of chapter one hundred and eleven, shall extend to and may be enforced by the city or town against any casualty insurance policy or policies covering any loss, damage, or destruction pursuant to which the proceedings to perfect the lien were initiated. No insurer shall be liable to any insured owner, mortgagee, assignee, city or town, or other interested party for amounts disbursed to a city or town under the provisions of this section, or for amounts not disbursed to a city or town under the provisions of this section. On this date, I caused copies of this Notice to be sent to the persons named above at the addresses indicated above by First Class Mail. Very Truly Yours, andall kZt Adjuster m.randallnecs@comcast.net {978}223-7332 cell Location / ��A) k D Date I t No. � , TOWN OF NORTH ANDOVER 4 3? o°c sI Certificate of Occupancy $ �'��°' •'t�' Building/Frame/Frame Permit Fee $ sswcMuse 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ —3 Check # Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT' APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMyrOLISH A ONE OR TWO FAMILY DWELLING Ma BUILDING PERMIT NUMBER DATE ISSUED: l D M SIGNATURE: ,#uildin-g CommissionerA for of Buildings Date 3 / Z m SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: AP178 a Map Number Parcel Number 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 Itequired 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 ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Name(Print) Address for Service �a Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone ECTION 3-CONSTRUCTION SERVICES 90 .0.1 Licensed Construction Supervisor: Not Applicable Licensed Const cti on Supervisor: ,/ /� "e d L/ License Number 0 Address- �/►' Expiration Date ic Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable Company Name Registration Number Address Expiration Date Signature Telephone r � i 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 building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition's ❑ Other ❑ Specify Brief Description of Proposed Work: (L t P d-- R r A) L S A/-1 t N `e P lAC.-Pr.va�v� Ufk— AOu, � SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be 0FACIAL USE,EE�N�.Y �. :.; Completed bypermit applicant 1. Building � � (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction ��s �' 3 PlumbinE Building Permit fee(a) x(b) 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 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 OWNER/AUTHORIZED AGENT DECLARATION i I, 2;) k " n,S AOwner/ orized 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 j 71)f) ) -ion-, j Print Name //,, ///Q V Si ature of Owner/Ant Date_T NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIIVIBERS iST 2 ND 3 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 NORTH Town of F 4 Andover A No. 098 h 3 J, � o 0 L Adover, Mass., COCHICHEWICK �t A0RA7ED P'1' Cl S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System :P*fJ P4 19 � BUILDING INSPECTOR THIS CERTIFIES THAT...... Foundation ...... .I. has permission to erect.31".'rA ..�.... buildings on ... �......... .......�... .�. gh ........... Routo be occupied as...r.rov...... .......v��.�.1.....�� ... /...j...��/ �M ... Chimney provided that the person accepting th permit shall in every respect con"forrfftdthe 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. &tom ��, PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final UNLESS PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTN S TS Rough PuA ..... ....X.............................................................. ....................... Service 9 BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final 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. BUILDING DEPARTIMENT DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 S 54,a condition of Building Permit Number Is that the debris resulting form this work shall be disposed of in a properiy licensed solid waste disposal facility as defined by MGL c 11, S 150A The debris will be disposed of in: S�21 JI Location df Facility Signature of Pe t Applicant i ' Dae NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector •1 t ISI PEaaciT Ho. ,"AMUCA71bT��OR�E�MI�LO BUILD — ORTH ANDOVER, MASS. PAGE -. MAP id0. eOT NO. Ol/S3 2 RECORD OF OWNERSHIP IDATE IB-� �I AG a ZONE ALV- LO'I IVO. �- LOCATION i/�uSl fprl- *ffrl PURPOSE OF BUILDING Ow�LL�Ae J' Achy �l S J G G�Itd OWNER'S NAME D -T ij a"T% 1:CO r c- NO. OF STORIES SIZE OWNER'S ADDRESS 1IN 1803,roA VT- IVj,3. IS MA' BASEMENT OR SLAB ARCHITECT'S NAME- SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME Q N Tj 4Igj SPAN DISTANCE TO NEAREST BUILDING &O .} DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS vjG DISTANCE FROM LOT LINES—SIDES REAR V GIRDERS f7 AREA OF LOT L.C.1Ti,0 S-4 grq FRONTAGE �j0' HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW yfj SIZE OF FOOTING X IS BUILDING ADDITION i MATERIAL OF CHIMNEY IS BUILDING ALTERATION '-j J sS ZX /� R,u�- IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO(REQUIREMENTS OF CODE Y fS IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES - EST. BLDG. COOT " 000 PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS i - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED �( BUILDING INBPRCTOI GNATURE OF OWNER OblAOTHORIZED AGENT • F E E 30 OWNER TEL x (Sa8 G�9 l6 l9 PERMIT GRANTED CONTR.TEL Il SA wl>< CONTR.UC.t t H.I.C.x j a go LOR own of over V -_ . No. o ' LAK adower, MASS., -0 00 "ICHEWICK AC TE6 U BOARD OF HEALTH Food/Kitchen PERMIT T Septic System THIS CERTIFIES THAT.............................................. ...........sa.4 . ................................................. BUILDING INSPECTOR Foundation has permission to erect.........(k.-b.b.................. buildings on ......IJA.... ............9-7-- ------------------ Rough ... .... ..... to be occupied as......................... .......... ................................................... Chimney provided that the person accepting'6i*peiiii shall in every respect conform to t.he.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 PERMITEXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST T ELECTRICAL INSPECTOR. Rough .............................. .... . .. .. ........ ................................................. Service AeING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR F Display in a Conspicuous Place on the Premises — Do Not Remove nal No Lathing ,br Dry Wall To Be Done FIRE DEPARTMENT until Inspected and Approved by -the Building Inspector. Burner Street No. Smoke Det. /.�/?,q WN ,(�f/ /.'a/✓ �/fes S>`O�v G� .��/� 97 Ixlo rM.Q Lop P��t Fiu fi/f Oow� 0 C• N H'% gip,. 1�cadca Ai'L 4 yl,%I v � pT /6 4 L. SLidir6 012 a J f i i i i •3h `I fi I. i r. l '(AGI� d/9/1 D�iY� •P/y //V NO* AND 0 VER IVA 55* SG4LE. 1~ f0 OCTOBER J, 1996 HAYES ENC/NEER/NC, INC noS&EY. STREET C/NL ENC/NEERS WAKEFIELD, MSS01880 LANG SUIi'V2rYORS TELT (6/7) 246-2800 / CERTIFY 7mr TH/S FOUN4117GW /S LOG47ED ON THE GROUND AS SHOWN, AND 7mT /T CaVMRMS TO 7T/ ION/NC BY-LAWS QF 7HE rOW/V OF NORTH AND0WR / FURTHER CERAFY 7NAT TH/S PROPERTY DOES NOT LIE WJ7H/N A nOOD HAZARD AREA (LONE A OR V) AS SHOWN ON FLOOD /NSURWCE R47E ANP COMMUN/7Y PANEL NUMBER 250098 0010 B. �N OF A��S EFFEC77W a47E ✓UNE /5, 198-T LZ47� �cTO 3 l9 THOMAS . WINSLOW .� PROFESS/OVAL LAND SURI2�YOR3032 .� 118.62 e •,0 5gT 096 Ci LOT 3 • so�•1827~E� :< �u=. 43560 S. s2.01 , . V� V�► Y7 5. 5 0 7, `� EX/ST/NC .0 0 E FOUNDA7ON ti roP Mo. i �