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Home My WebLink AboutMiscellaneous - 19 FURBER AVENUE 4/30/2018 19 FURBER AVENUE 2101067.0-0062-0000.0 G ` ( MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108.1904 (617)723-3800 Ma Only(800)392-6108, FAX(800)851-8424 5/22/2013 Form of Notice of Casualty Loss to Building Under Mass.Gen. Laws,Ch.139,Sec.3B �v RECEVE® NORTH ANDOVER HEALTH DEPT. (SIA`( 2 8 2013 NORTH ANDOVER TOWN HALL NORTH ANDOVER MA 01845 TOWN T NORTH ANDOVER HEALTH DEPARTMENT Re: Insured: E2116 PH J IRA A&&JENNIFER L SCHRAFFA Property Address: FURBER AVE, NORTHAND OVER, MA 0184 Policy Number: 140 Type Loss: Water Damage:All Other Water Damage Date of Loss: 0511812013 Claim Number: 314255 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 5/14/2015 Form of Notice of Casualty Loss to Building Under Mass.Gen. Laws,Ch.139,Sec.3B NORTH ANDOVER BUILDING COMMOSSIONER NORTH ANDOVER TOWN HALL NORTH ANDOVER MA 01845 Re: Insured: JOSEPH J SCHRAFFA&JENNIFER L SCHRAFFA Property Address: 19-21 FURBER AVE, NORTH ANDOVER, MA 01845 Policy Number: 1216140 Type Loss: Ice Dams Date of Loss: 02/28/2015 Claim Number: 339091 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 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108.1904 (617)723.3800 Ma Only(800)392.6108, FAX(800)851-8424 5122/2013 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: JOSEPH J SCHRAFFA&JENNIFER L SCHRAFFA Property Address: 19-21 FURBER AVE,NORTH ANDOVER, MA 01845 Policy Number: 1216140 Type Loss: Water Damage:All Other Water Damage Date of Loss: 05118/2013 Claim Number: 314255 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 Location ff- -< �r - r� NIP. �? 9 Date f 40*Th TOWN OF NORTH ANDOVER f Op 4L Certificate of Occupancy $ sACNUSE�� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee l// $ Cz' r TOTAL Check # -�- ' .7 .Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED: rn 3 -� -� SIGNATURE: A � � Building Commissioner for of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 17Map Number Parcel Number ( � 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Dis4rid Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: n Public ❑ Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Owner of Record r��/ /1 dw&r� T Ff/reefLZT �� FU/ �2r Amss✓ �J / 0(/e/ Name(Print) Address for Service: 7F G J Signature 0 Telephone �N 2.2 Owner of Record: v ;Tlame Print Address for Service: O Z _ M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O License Number M Address _0 Expiration Date ic Signature Telephone r 1 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name M Registration Number r Address r s Z Expiration Date ^ Signature Telephone V w 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 a h'cable New Construction ❑X Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. 8 Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: / ^� T SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USEONLY Completed by permit applicant 1. Building (a) Building Permit Fee /, 006 , 66 Multi lier 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 I, V- 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, 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 r and belief Print Name Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB ST «, RD SIZE OF FLOOR TIMBERS 1 2 3 SPAN DIMENSIONS OF SILLS ' DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHI VMY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE . 4 . FORM U - LOT RELEASE FORM r INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *******APPLICANT FILLS OUT THIS SECTION* APPLICANT LGf�GG l�C/ Y! e S PHONE(I � U (V U LOCATION: Assessors Map..Number PARCEL _O� II SUBDIVISION` LOT (S) V� STREET 0 ` : C,sr b"-"_ AV ST. NUMBER � *** ******* OFFICIAL USE ONLY*******' REC MMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED `fid DATE,REJECTED COMMENTS � �� W TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS -SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE w w r 2_G•9�E'• ..one. C r � 4 � _ r rj �ouG. SLC. q I hereby certify theme the building shown,ca ;NOTE: I HEfiEBY CERTIFY.TO THE BEST OF MY KNOW, this plan conforrR td the zoning laws j ��LEDGE THAT THE PREMI" SHOWN ON THIS PLAN rhe town of ARE NOT LOCATED VVITFIIN THE FLOOD HAZARD ZONE �(�o�-r-Hq,�je when builE AS DELINEATED ON THE MAP OF COMMUNITY NOTE! THIS IS A TAPE SURVEY. •• ..... ..l.. ,{ NOT TO BE USED FOR ESTABLISHING PROPERTY LINES, NE DOES,Oq tNY MASS. EFFECTIVE ......TUB!„F c THISPPLAN WAS DRAWN FORR THAN SMORTGAGE INTENT. BY THE DEPARTMENT OF HOUSING AND URBAN PURPOSES ONLY. NOT TO RE RECORDED. DEVELOPMENT.FFDERAL INSURANCE ADMINISTRATION MORTGAGE PLAN ENGINE RING , SINCE 1920 ?� -�”oFMT� PLAN OF PROPERTY I N I HEREBY CERTIFY THAT ,` ,`V Dop,4: ' A THE BUILDING 15 aNTHE oN i� TALMADGE ��' /"1 �`�r/q�� THIS FLAN li ON THE McNEELY OWNED BY GROUND AS SHOWN. .. LAND SURVEYOR So SCALE : I = 20 DATE; L.G. BRACKETT CO. INC. WINCHESTER MASS. COON Y': .�I4_ PLAN BY �� Z� S PLAN: -d1Qs�33,�3 — DATE: OF PLAN: _4VCW—Z9` 2(;�_ NORTH 0 0 bAndover No. 33 z _ oo dover, Mass.LA , 3 �O COCMICMEW I- DRATED SPk? Cl 4 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR .Ako*j THIS CERTIFIES THAT......lei . .. ... !vA. ...... ... ................................................... Foundation has permission to erect....Al)Ye........... buildings on ......Q.-I...... v4.1f4......*A 40,4w Rough 1^d 0 0. ........� ....r ........ Chimney to be occupied as..../ ,6.Q. ......(� .......... .......4..... �I�. ... provided that the person accepting this permit shall in every respect conform to the terms of the app li6ation on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and onstruction of Buildings in the Town of North Andover. 46 I'' 6 3SIm PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION T ELECTRICAL INSPECTOR Rough i. ........................................ 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. MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTIN� (Print or Type) t NORTH ANDOVER Mass. Date J- '3 '3 _ 4uilding Location /Cj' Permit ) 0 Owners Name�� New '1 Renovation D Replacement Plans Submitted FIXTURc:(z N W w14 x of a N ¢ .0 j .N = t; t- C -4 o uai a �•• x " o t- oc a to rn t^ w m a a w tw- vt a W s " I- in 0 y 4 LU W w rn z d x tz W a a w t- tu t- x to rL c7 t- 2 F- z 1. W w O > W !- 2 d W t o .• i' }- to z O Z W O m = d ,r:r > W = z 4 ct d Q O O W tr x O c1 Y U. Q O .r V fL ? c2 d 1•- O SUR–aSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR - (Print or Type) Check one: Certificate Installing Company Q Corp. Addresss3,��,�,¢,��O��c f Partner. !c^ F-1 Firm/Co. Business Telephone: TI)R •- 8 Name of Licensed Plumber or Gas Fitter Insurance Covera e: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ®�0ther type of indemnity F--j Bond El Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner LJ Agent Ej i hereby certify that aU of the details and information 1 have submitted (or entered)in above application are true and accurate to the best of my knowledge and that all plumbing worts and installations performed under'Permit iueed lo: this application will-tie-in compliance with all pertinent Provisions of the Massachusetts State Cas Code and Chapter 142 of the Genual Laws. - By TYPE LICENSE: f ` Title Plumber as fitter Signa ure of Licensed City/Town: Master Plumber or Gasfitter APPROVED (OFFICE use ONLY) License 8f ��3 License Number 2210 Date.. . I �. NORTH TOWN OF NORTH ANDOVER E Of4..Eo ,s1ti0 '�� PERMIT FOR GAS INSTALLATION, SS'AC'HUSE��y V y5 t 1 t p This certifies that . ./T C(/? y. . ,V�. . /?. . .1 t.U.�f� CU o a . . ✓ P has permission for gas installation . . . . . . . . . . . t in the buildings of . . .�/�_; n -?.S. . . . . . . . . . . . . . . . . . . . . . . . . . .�. at . . /.�'. .l�u.�./�.1�. .. . . . . ., North Andover, Mass. Fee. . 1.,00 Lic. No..�7. i R5 . . . . . . . . . . . . . . . . . . . . . . . . . . f /^ C'^ GAS INSPECTOR ish E WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD:File