HomeMy WebLinkAboutMiscellaneous - 203 COTUIT STREET 4/30/2018N
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February 21, 2015
TH ENORFOLK(b�DEDHAMG ROUPa
FORM OF NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B
Building Commissioner, or Inspector of Buildings
c/o City or Town Hall
1600 Osgood Street
North Andover, MA 01845
Board of Health or Board of Selectmen
c/o City or Town Hall
1600 Osgood Street
North Andover, MA 01845
Fire Department or Arson Squad
c/o City or Town Hall
1600 Osgood Street
North Andover, MA 01845
RE: Our File No.:
P1587471
Insured:
DENNIS J DESCHAMP
DONNA K DESCHAMP
Address:
203 COTUIT ST, NORTH ANDOVER, MA
Policy No.:
N252046
Loss Date:
02/06/2015
Loss Type:
Building or Other Structure Damage
A 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, Ch. 143, Sec. 6 to be
applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct
it to my attention and include a reference to the captioned insured, location, policy number, loss
date and claim or file number.
If no reply is received from your office within ten days, we will assume you have no liens of any
type against this property, and the claim will be paid in our customary manner.
Sincerely,
;��/ e0pa-'-
Marie J. Landers
Property Claim Examiner
1-800-688-1825 x1136
NORFOLK & DEDHAM MUTUAL FIRE INSURANCE CO. 222 Ames Street, P.O. Box 9109, Dedham, MA 02027-9109
DORCHESTER MUTUAL INSURANCE CO. Telephone: (800) 688-1825
FITCHBURG MUTUAL INSURANCE CO. 0 Fax: (781) 329-1818
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1
44
Office Use Only
LQmmuitwl:�ti of Asa >.�s Permit No. a�
A Bepartmtat of Vub it —AIIfetij Occupancy & Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS 527 CMA 12:00 M0 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
QQK or Town of NORTH ANDOVER To the Inspector of Wires:
The udersigned applies for a permit to perfo
Location (Street & Number) 2 )3
Owner or Tenant
Owner's Address Z.O '� r..
Is this permit in conjunction with a building permit:
Purpose of Buildina
Existing Service Amps �.
New Service Amps _J
Number of Feeders and Ampacity
Volts
Voits
Location and Nature of Proposed Electrical Work
cal work described below.
Yes Y No C
(Check Appropriate Box)
Utility Authorization No.
Overhead Undgrnd
Overhead Undgrnd
No. of Meters
No. of Meters
Total
No. of Lignnnq Outlets i No. of Hot Tubs / No. of Transformers KVA
No.
of Licht�n Fixtures
9
Swimming Pool Above —
grne. —
In
cmc. — I
Generators KVA
No. of Emergency Lighting
No.
of P.eceetacie Outlets I
No. of Oil Burners
I
Battery Units
No.
of Switch Outlets I
No. of Gas Burners
FIRE ALARMS No. of Zones
No. Detection and
Total
No.
of Ranges
No. of Air Cenc' tons
Initiating Devices
No. of Sounding Devices
No.of Heat Total Total
No. of Disposals � Purrs ?ons KW
of Self Contained
No.
of Dishwashers
iNo.
ScaceiArea Heating
KW
Detecron/Souneing Devices
I
— Murncmai
Local _Connec*,on _Other
No. of Dryers Heatmc Devices KW
ry
No. of No. of
Low Voltage
No
of Water Heaters KW
I Signs Sa,lasts
I Wiring
No. of Motors Total
HP
OTHER:
INSURANCE COVERAGE. Pursuant to the requirements of Massac-users general Laws _
I have a current Liability Insurance Policy inciucmg Cam... ,,/eee Coerattons Coverage or its suostantial eeuivaient. YES _ NO _ !
have suomitted valid proof of same to the Office. YES r! NO - if,- nave/Jibe ,�o YES. please indicate the type 7t -overage ey
checKing the appro nate oox. �C �'� y I
INSURANCE OND - OTHER = (Please Scec:fy)
(E .nation Datet
I
I Work 5
Insbectton Date Recuestec: Rough
of perlyrry:I __t...., _ /i 1-/ —
Estimated Value of
Wcrx to Start _.
Signed unser the I
FIRM NAME
Licensee
Final
_ LIC. NO.
/� /U alt/ Sus. T No. CD 6J—CT K I
Address Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee eoes not have the insurance coverage or its suostantial eeurvalent as re-
ouned by Massachusetts General Laws. and that my signature an this hermit application waives this reduirement. Owner Agent
(P!ease checK one)
(Signature of Owner or Agent)
Teiecnone No. PERMIT FEE 5
x+6565
K
2312
,,ORT){
O p
�,SSACMUgEt
i
Date....b........................... i
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
1 r
This certifies that
has permission to perform
wiringin the building of '
8 ....................................................: ..::..r......r.:...........
at........................ :...................................................... . North Andover, Mass.
Fee Lic. No. -
ELECTRICALINSPECTOR
o6%Cu""5 1=x:23 '; - PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File
Location '203 &761
Sd—
No. 2 Date Co
A
Q
TOWN OF NORTH ANDOVEk
N
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fe O6 ! $
Sewer Connection Fee $
Water Connection Fee
TOTAL
4WO
Building Inspector
T-, R I Div. Public Works
IPERMIT NO. '
w
APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS.
PAGE 1
MAP i-40.
LOT NO.
2 RECORD OF OWNERSHIP jDATE
ale," /i
BOOK 'PAGE
13 3 S- -3 30
ZONE
SUB DIV. LOT NO.rI
LOCATION Q 3 i0 i --t1 S'7L
PURPOSE OF BUILDING (%
/ r
ho v t i rd ct /Ia
OWNER'S NAME -
NO. OF STORIES SIZE
OWNER'S ADDRESS '21 3 o G _/ _GL / J ,51 ,
v 7�T T
BASEMENT OR SLAB
ARCHITECT'S NAME
SIZE OF FLOOR TIMBERS IST 2ND
3RD
BUILDER'S NAME �0 /s
SPAN
DISTANCE TO NEAREST BUILDING
--
DIMENSIONS OF SILLS
DISTANCE FROM STREET
POSTS
DISTANCE FROM LOT LINES - SIDES 20'- 30' REAR
GIRDERS
AREA OF LOT FRONTAGE
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW
SIZE OF FOOTING X
IS BUILDING ADDITION
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE
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
INSTRUCTION
�r
SEE BOTH BIDES
70 A
PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILE�D/ AND APPROVED BY BUILDING INSPECTOR
DATE FILED
SIGNAT RE OF OWNER OR AUTHORIZF AGENT
F E/E 1z�
PERMIT GRANTED Q f
19 '` J
3 PROPERTY INFORMATION
LAND COST
100,
EST. BLDG. COST % / L
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
OWNERTEL.#
CONTR. TEL. #
CONTR. LIC. #
H.I.C. if
8 -gzg :Ess tA:.- -i-oG3
r
BUILDING RECORD
i OCCUPANCY 12
SINGLE FAMILY
S ORIES
MULTI. FAMILY
OFFICES
APARTMENTS
_
CONSTRUCTION
2 FOUNDATION
8 INTERIOR FINISH
B 1 2 13
PINE
HARDWD
PLASTER
CONCRETE
CONCRETE BL'K.
BRICK OR STONE
PIERS
DRY WALL
_
UNFIN.
3 BASEMENT
AREA FULL
FIN. B M'T' AREA
1/. 1/7 1/
FIN. ATTIC AREA
_
N_O B M T
FIRE PLACES
_
_
HEAD ROOM
MODERN KITCHEN
4 WALLS I 9 FLOORS
CLAPBOARDS
DROP SIDING
WOOD SHINGLES
ASPHALT SIDING
ASBESTOS SIDING
B
1
2
�_
3
_
CONCRETE
EARTH
HARDW D
COMMON
ASPH. TILE
VERT. SIDING
STUCCO ON MASONRY
_
STUCCO ON FRAME
_
BRICK ON MASONRY
BRICK ON FRAME
ATTIC STRS. 8 FLOOR I_
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR I� POOR _
ADEQUATE NONE
5 ROOF
10 PLUMBING
GABLE
GAMBREL
I
I HIP
BATH Q FIX.)
MANSARD
TOILET RM. )2 FIX.)
FLAT
SHED
WATER CLOSET
ASPHALT SHINGLES
LAVATORY
_
WOOD SHINGES
KITCHEN SINK
_
SLATE
NO PLUMBING
TAR & GRAVEL
STALL SHOWER
_
ROLL ROOFING
MODERN FIXTURES
_
TILE FLOOR
_
TILE DADO
6 FRAMING
I 11 HEATING
WOOD JOIST
PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. & COLS.
STEAM
STEEL BMS. & COLS.
HOT W'T'R OR VAPOR
WOOD RAFTERS
_
AIR CONDITIONING
_
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS
GAS
OIL
B'M'T 2nd _
10 13rd
ELECTRIC
NO HEATING
THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM •
LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA-
RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
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FORDS U IAT RET -EA E FORK
INSTRUCTIONS: This foii 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 local or state law,
regulations or
**************** plicant =fills cut.this section*****************
P::o n e - 62 _s�---
LOCATION: Assessor's :baa Number Parcel
Subdivision �1 Lot(s)
treet o��% 3 ( _ St. Number
RiCOMME-NDATIONS OF Z"JW-N AG=S :
(nn pn WIC
Data- Approved
Oa _e 3pprovec
''_':.w% Planner Data Rejected
^- =enr-
Food Inspector-=eslt_'.
Szpt�c Inspector- =eat=-
C --=e: its
Public Works - sewer/water ccnrections
- driveway permit
Date Approved
Date Rejected
Data Approved
Date Rejected
F i_ a Department
Received by Building Inspec Date
3U�
// t
'amm- w7�wwvffo a.
,Oman,
U
A
NORTH ANDOVER CONSERVATION COMMISSION
SITE INSPECTION SHEET
File* 2-
DEP F e* 4 Date -
Does
ateDoes not have permit with the NACC Weather:
Site Addre
Inspector:
Agent / Representative / Owner:
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