Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 12 ALCOTT WAY 4/30/2018
12 ALCOTT WAY 2101025 012.0 Claim # Advantage Claim Services Adjuster Assigned: Glenn Guarente 522 Chickering Road #B North Andover, MA 01845 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec. 3B I To: Building Commissioner o/ Board of Health or Inspector of Buildings Board of Selectmen Town Hall Town Hall ' North Andover, MA 01845 North Andover, MA Re: Insured: William Collins j i Property address: 12 Alcott Way North Andover, MA 01845 Policy #: 2671436 Loss of: 2015/02/02 File or Claim No. AD 1679 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,_Chapter_143, Section_6 to be applicable. If any notice under Mass_Gen_Laws,—Ch.-139—Sec.-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. Glenn Guarente Title: Adjuster On this date, I caused copies of this notice to be sent to the persons named at the addresses indicated above by first class mail. 02-23-15 Signature and data MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston,Massachusetts 02108-1904 (617)723-3800 Ma Only(800)392-6108,FAX(8001851-8424 7/18/2009 Form of Notice of Casualty Loss to Building Under Mass.Gen.Laws,Ch.139,Sec.3B NORTH ANDOVER HEALTH DEPT. RECEIVED NORTH ANDOVER TOWN HALL NORTH ANDOVER MA 01845 JUL 2 7 2009 TOHEAOLTH DEPARTMEF NORTH ONTER Re: Insured: ROBERT CERCHIONE Property Address: 12 ALCOTT WAY,NORTH ANDOVER,MA 01845 Policy Number: 0898829 Type Loss: Water Damage:All Other Damage Loss Date of Loss: 07/06/2009 Claim Number: 265274 Claim has been made involving loss,damage or destruction of the above captioned propert,which may either exceed$1000.00 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. MPIUA Claims Division CMA00021 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston,Massachusetts 02108.1904 (617)723.3800 Ma Only(800)392-6108,FAX(8001851-8424 5/11/2007 Form of Notice of Casualty Loss to Building Under Mass.Gen.Laws,Ch.139,Sec.36 NORTH ANDOVER HEALTH DEPT. `p %D NORTH ANDOVER TOWN HALL NORTH ANDOVER MA 01845 MAY 1 7 2007 TO EALTH`` ER DEPARTMEORI 1-1 NT Re: Insured: ROBERT CERCHIONE Property Address: 12 ALCOTT WAY,NORTH ANDOVER,MA 01845 Policy Number: 0898829 Type Loss: Water Damage Date of Loss: 02/14/2007 Claim Number: 241907 Claim has been made involving loss,damage or destruction of the above captioned propert,which may either exceed$1000.00 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. MPIUA Claims Division CMA00021 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108-1904 (617)723-3800 Ma Only(800)392-6108, FAX(800)851-8424 5/20/2006 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch.139, Sec.36 ETOWNOF EIVED NORTH ANDOVER HEALTH DEPT. NORTH ANDOVER TOWN HALL 12006 NORTH ANDOVER MA 01845 . Re: Insured: ROBERT CERCHIONE Property Address: 12 ALCOTT WAY, NORTH ANDOVER, MA 01845 Policy Number: 0898829 Type Loss: Water Damage Date of Loss: 05/15/2006 Claim Number: 230014 Claim has been made involving loss,damage or destruction of the above captioned propert,which may either exceed$1000.00 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. MPIUA Claims Division CMA00021 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING 06P` BUILDING PERMIT NUMBER: DATE ISSUED: r7_ v© SIGNATURE: AIA Building Commissioner/12Tectoyof Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number /1I 1.3 Zoning Information: 1.4 Property Dimensions: /" Zoning District Proposed Use Lot Area(so Froirta e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R aired Provided 1.7 Water Supply M.GL.C.4o. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSEMAUTHORIZED AGENT M 2.1 Owner of Record me Address for Service I Signature Telephone Q 2.2 Owner of Record: Name Print Address for Service: M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable r❑ USS d Q W d jLicsedkonstruction Supervisor: ` License Number Address Expiration Date 'Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑( �ompany Name Registration Number address i Expiration Date ii nature Tele hone r� 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.......0 No.......❑ SECTION 5 Description of Proposed Work checkapplicable) New Construction ❑ Existing Building ❑ Repair(s) R" Alterations(s) 0 Addition B� Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: +k) k MASK {Vbm See ky yk(Ltl SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be cY Completed by permit ap ltcant 1. Building (a) Building Permit Fee 0-0 D O Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing 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 as Owner uthorized Agent f subject property Hereby authorize o ac 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> as Owner/Authorized 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 Print Name r Signature of Owner/A ent Date NO.OF ST�%OR SIZE BASEMENT SLAB SIZE OF FLOOR TIMBERS 1ST 2 ND 3FW SPAN DIMENSIONS OF SILLS ffLIGHT OF POSTS OF GIRDERS OUNDATION THICKNESS ING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE I Location /a AlCv-# a,/I '/ No. Date f o1UU MORTM TOWN OF NORTH ANDOVER 0 ' Certificate of Occupancy $ • i a ��'°'• �•'<�' Building/Frame Permit Fee $ ,S1ACNti'�E Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 5 . Check # ! Building Inspector i Riney Management Corp. November 29,2000 James Antenucci 12 Alcott Way North Andover,MA 01845 Re: Approved patio door roof Dear James: Please be advised that the Board of Trustees met on Tuesday,November 28,2000 and discussed the installation of the small roof over your patio door. This has been approved per the specifications as enclosed. Please forward to the Condominium Trust, c/o Riney Management Corporation,certificates of Insurance and the building permit for this construction. If you have any questions,please feel free to contact me at the number listed below. Sincerely, Kevin R. Riney,AMS Property Manager Cc: Board of Trustees File One Village Square • 14-16 Fletcher Street,Suite 5 Chelmsford, MA 01824 Telephone 978-256-7751 • Fax 978-256-4430 • E-Mail klri.ney«aol.com 1 --- - ���Z?�T7L9n0'JtillPll�Ub o�✓N�tl�NtclutJHl�if f BOARD OF BUILDING REGULATIONS } License: CONSTRUCTION SUPERVISOR f Number: CS 010609 Birthdate: 12/0511950 Expires: 12/0512001 Tr.no: 11293 1� Restricted To: 00 ROBERT L SCHUSTER _ 3 DAPPER DARBY DR STONEHAM, MA 02180 Administrator i (G,\ ✓,€e LJa�e�+eorouea�G{o�.Jt'(.c�,wa�u4s.1�3 HONE INPROVENENT CONTRACTOR ° " Registration 124782 Expiration: 11/3/01 Type: BSA gob Schuster Construction Robert Schuster �ehal Darby Drive ADM ISTRATOR oA@hal NA 02180 a The Commonwealth of Massachusetts dDepartment of Industrial Accidents A' Office of investigations �w Boston, Mass. 02111 workers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # aI am a homeowner performing all work myself. s I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. Company name Bv13 SGl+U s 2'. GONST�yG�I DC/ Address 3 WAQP;i C 1 /9 Y i City: `��u fl,y�vt rn S v ar W Phone#: 71.8 -!097-9-V/4 Insurance.Co. Polices Company name: Address . Cite Phone.#: Lnsuran(ie.Co. Policy# Failure to secure coverage as required under section 25A or MGL i52 can lead io the imposition of criminal penalties of,a fine up to i,tWw andfor one years'imprisonment_8s V ell-as.ciol penalties.in-thelarm cfa;TOP--WO 2KbO ER and_.aline_of�$1DO.OW-a.j ly egainstme. understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for Coverage verification. l do hereby certify under the pains and penalties of-perjury that the information provided above is true and correct. Signature, Date 2 Lb Print name Phone.# official use only do not write in this area to be completed by city or town official' City or Town Permit/Ucensing Building Dept ❑Check if immediate response is required ❑ Licensing Board ❑ Selectman's Office Contact person: Phone A. ❑ Health Department Other Town of North Andover o& NORTH ,�f'• 170 Building Departmento 0 27 Charles Street North Andover, Massachusetts 01845 4i � (978) 688-9545 Fax.(978) 688-9542yy� 4 Oro tOLML1yWKR yM` T �9SSACU DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s156a. The debris will be disposed of in/at: Facility location Signature of Applicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. r • " 1 ovj _ �G ,SrVc �v H d. y � . i ' t ` �.`.: I, � �•Y `��l"^"'fr--..•r.: i�.,,,,•JJ 11 a+ , 1 �• ? •.4: ti�C`it� `��` if ! fr*,ai5 '1`"k"M1f�•°H' - .... .. ... _. .. 1 bt .I` 1•t+M� 1�•t «.nMlz�N��}Ih�l,. 17 • � . . ... .. r. �. '1'�. f •++r� � Nr•1f fly r it .. r ' 1 le I � a� r A� Q'XZ I �: NORTH Town of over No. ® � * - 0 COCH.c dover, Mass., 04ATED Cl BOARD OF HEALTH Food/Kitchen PERMIT T .. D Septic System es A CC, f. BUILDING INSPECTOR THISCERTIFIES THAT . ............I............ ..... .................................................................................... Foundation Al 1( .30' has permission to erect... . ............................. buildings on ...1......A ............................. x.............................. . Rough to be occupied as...?a4tp 7>vor- ";evoP S4o%c., c,4-v.P.'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. a 5-// 6 epl'q C-) PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PER Mrr' EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough Service 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.