HomeMy WebLinkAboutMiscellaneous - 184 WAVERLY ROAD 4/30/2018 (2)L
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MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617)723-3800 Ma Only (8001392-6108, FAX (800)851-8424
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139, Sec.36
NORTH ANDOVER BUILDING COMMOSSIONER
NORTH ANDOVER TOWN HALL
NORTH ANDOVER MA 01845
Re: Insured: ANTONIO CASTILLO
Property Address: 184-186 WAVERLEY RD, NORTH ANDOVER, MA 01845
Policy Number: 1334313
Type Loss:
Windstorm Other than Hurricane or Tornad
Date of Loss:
02/06/2016
Claim Number:
403300
Claim has been made involving loss, damage or destruction of the above captioned property, 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
2/10/2016
Date. . ..................
TOWN OF NORTH ANDOVER
1 4wo PERMIT FOR GAS INSTALLATION
ThisNcertifies that . . tt-. /.-/. . . .,. / ..............
has permission for gas installation .... .................
in the buildings of ... -/�" '1 14 1--
.....................................
at J" North Andover, Mass.
Fee. Lic. No.. ..... .........
....... / ..........
GASINSPECTOR
Check# ? )-(-(,
3 6"' 9
MASSACHUSETTS UNIFORM APPLICATIO FO
(Print T )�%
Gt 1�� . Mass. Date
G
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It
Building
ERMIT TO DO GASFITTING
1 0/ Permit #
Owner's Name 1
Type of Occupancy
New p Renovation p Replacement Plans Submitted: Yesp No p
Installing Company Name - �T`�S INSTALLERS It,C• �one: Certificate
af
Address_
1 a u,`.. , b go i„ 0230 C3'�Cor}�ration
0 Partnership
Business Telephone n -2 % p Firm/Co.
Name of Ucensed Plumber or Gas Fdter
INSURANCE COVERAGE:
I have a current ' ility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes No 0
If you have checked yes, pleaseIndicatethe type coverage by checking the appropriate box
A liability Insurance policy Other type of indemnity ❑ Bond O
OWNER'S INSURANCE WAIVER: 1 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 Ownerp Agent p
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 the permit issued for this application will be in compliance with all
pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General laws.
Tpu!T of U n
BY ce se.
Title
Plumbyrer S+gnature of UceOted Flurffber or GaeFOtter
X �
ter License Number
Gty/Town Journeyman
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Location,
No. Date ;_�A' 2—
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
CHU
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PAIUNBY
ater Connection Fee $
A TOTAL $
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No. Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
'I foundation Permit Fee $
CHUS /6/4 Cr Ire r A � �tF 76'ey a- — $
Sewer Connection Fee $
Fee
19,9,TOTAL
Building ln�pector
Div. Public Works
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OFFICES OF:
APPEALS
BUILDING
CONSERVATION
HEALTH
PLANNING
04 NORTH 1
Town of
L
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NORTH ANDOVER
SSACHU DIVISION OF
PLANNING & COMMUNITY DEVELOPMENT
KAREN I-I.P. NFI.SON, DIRECTOR
120 Main Street
North Andover,
Massachusetts 01.t{45
(61 7) 685-4775
In accordance with the provisions 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 c 111, S
150A.
The debris will be disposed of in:
(Location of Facility)
S' ature 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.
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Location 6/ P- 6/
7 Date
N o.
TOWN OF NORTH ANDOVER
Certificate of Occupancy
Building/Frame Permit Fee
$
Foundation Permit Fee
$
CHU
Other Permit Fee
$
Sewer Connection Fee
Water Connection Fee
$
$
199, Building Inspector
off'or
C0,11
14, Odor Div. Public Works
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Town of North Andover
BUILDING DEPARTMENT
Homeowner License Exemption
(Please print)
d,
DATE /flz�l
JOB LOCATION Ila mer
Number Str
"HOMEOWNER" Chrisn Z
,.N,. iVame H
.:',-.!.,:PRESENT MAILING ADDRESS
40"et Address
�-3 3 2Z -L%2
ome Phone
Section of town
623 32 � 5/ z2
Work Phone
City Own S
State Zip code
The current exemption for "homeowners" was extended to include owner
occupied dwellings of six units or less and to allow such hde owr
engage an individual for hire who does not possess a license ride to
.that the owner acts as supervisor. (State Building Code Section 109.
'?,'..DEFINITION OF HOMEOWNER: Ion 109.1.1)
'` Person(s) who owns a parcel of land on which he/she r
, reside, on which there is, or is Intended to be resides or intends to
.:ing, attached or detached structures accessory be,
usee ts and/or l farawell-
,''''structures. A person who constructs more than one home
period shall not be In a two-year
ch o ear
ere
to the Building Official, on a form jornacceptable uto the 'T�Buldinr' shall submit
that he/she shall be responsible for all such work performed under
buildingpermit. P (Section 109.1.1)
The undersigned "homeowner" assumes responsibility for compliance
.':State Building Code and other applicable codes, by-laws, rules1lan with the
regulations. d
The undersigned "homeowner" certifies that he/she understands the l'
North Andover Building Department minimum inspection procedures and
Town of
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 cu
,.required � cubic feet or
q red to Comply � larger, wbe
ply with State Building Code g 111 uc
.Control.g Section
127.0
Construction
It
"'ER"OFICATEw O%F USE OCCUPANCY
Building Permit Number
067 (1991)
Date JUNE 41 1991
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 184-186 WAVERLY ROAD
MAYBE OCCUPIED AS REPAIR & RENOVATE EXISTING 2 -FAMILY IN ACCORDANCE
DWELLING
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH
OTHER REGULATIONS AS MAY APPLY.
' CERTIFICATE ISSUED TO Chris &Mike McMahon
j S A
. ; * ADDRESS
139 Stage Road
�SSQruliE� E .�
Building Inspector
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