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HomeMy WebLinkAboutMiscellaneous - 233 MIDDLESEX STREET 4/30/2018 T 233 MIDDLESEX STREET 2101914.0-0040-0000.0 / 1 PO Box 55098 Boston,MA 02205-5098 617-951-0600 - — Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall N ANDOVER, MA 01845 N ANDOVER, MA 0 1845 RE: Insured: FRANK C CACCIOLA- Property Address: 233-235 MIDDLESEX ST,N ANDOVER, MA Policy Number: HMA 0082311 Claim Number: BOS00062913 Date of Loss: 6/22/2015 Company: Safety Insurance Company Claim has been made involving loss damage or destruction of the above-captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate,please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim number. Allan Leavitt Claim Examiner 7/16/2015 Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3213 Fax: (617) 531-8891 Email: AllanLeavitt@SafetyInsurance.com Date.A—I . __-1ej;'. .��• •• ' a NORTH �? TOWN OF NORTH ANDOVER bo • - PERMIT FOR GAS INSTALLATION . ,� s16 _ s ,S SAC 14USEt This certifies that x . �'. . . . i .. . . . . . has permission for gas installation . .,. .� . . . . . . . . in the buildings of . .�. ... . . . . . . . . . . . . . . . . . . . . . . . . . at .," . - . '�:. . .' - /, North Andover, Mass. Fee.?� . �.� . . Lic. No.. `.?! J GAE I OiCTOR Check# 4493 i MASSACHUSETTS UNIFORM APPLICATON FOR PERmrr TO DO GAS FMING (Type or print) Date `; I j NORTH ANDOVER,MASSACHUSETTS c I � n Building Locations _ — rt`�`� '(Se X )f riN AR � � Permit# Amount� Owner's Name ���� � C New Renovation Replacement D Plans Submitted � w � a a o 0 0 a z o x w � w � a w F" G a� d 3 a O o° oo' o Aa Ua r� � A a E+ O SUB-BASEMENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH . FLOOR 5TH. FLOOR 6TH. FLOOR 7TH . FLOOR STH . FLOOR �e or�) C Q C� Check one: Certificate Installing Company (rye trn ;�h 1 U Corp Address 0. ' ' `eA PvrA 1°y� - �1 �� Partner. r Business Telephone 1� 3� 1" C, �� (� I (1$I���1 SJ (� ©-fi;; /Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Checkone: I have a current liability Insurance policy or it's substantial equivalent. Yes N.0 Ifyou have checked M,please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity Bond Com]' ❑ D Owner's Insurance Waiver: I 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 Owner ❑ Agent ❑ 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 insta aKns performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts S to Gas Code and Chapter 142 ofthe Gen s. By: Sign re of Licensed Plumber Or Gas Fitter Title Plumber I_L 11 � City/Town Gas Fitter License u r Master APPROVED(OFFICE USE ONLY) journeyman ..:�ur�-..r`�.._�.+....•.-.�.+-�- -.._ w-t.: -...!"'".Yre•V""'.":+'-..-}..,,�.f'".r.rsr�rs�,�_�a'�...-�... r Lordtlon 2, No. 'S Date "ORT q TOWN OF NORTH ANDOVER O? •� 'a O0 Certificate of Occupancy $ Building/Frame Permit Fee $ �~ si CMU ..Foundation Permit Fee $ 3� SE Other Permit Fee $ 6 �2 Sewer Connection Fee $ W connection Fee $ TOTAL $ � Buildirig Inspector �'�� - - 6525 Div. Public Works PE&JiIT•�40. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. f PAGE 1 MAP d-40. LOT NO. 2 RECORD OF OWNERSHIP iDATE BOOK 'PAGE ZONE I SUB DIV. LOT NO. - I LOCATION PURPOSE OF BUILDING 3 OWNER'S NAME NO. OF STORIES llsizk OWNER'S ADDRESS c�: /1 BASEMENT OR SLAB ARCHITECT'S NAME C�-Y•vi�� SIZE OF FLOOR TIMBERS IST 2ND 3RD t BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES—SIDES 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 INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EBT. BLDG. COST "y�j�0 � 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. t, �f 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 /�•4 / a BOARD OF HEALTH *�GNATURE 'OWNE AUT ORIZED AGENT r PLANNING BOARD PERMIT GRANTED OWNER TEL.# CONTR.TEL.#ATi 19 --YL CONTR.LIC.#6,&Yjd 4(9 BOARD OF SELECTMEN 9 del�d BUILDING INSPECTOR 1 � J � f BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY _ OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW'D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ lh '/t '/, FIN. ATTIC AREA _ N_O 8.M"T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARDW D ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR Ij POOR ADEQUATE NONE 5 ROOF 10 PLUMBING ly GABLE HIP BATH 13 FIX.) _ GAMBREL 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 I 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE 1!I 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 _ ELECTRIC 1st 13rd NO HEATING r f� i AORTFI � 9 Town of over 0 No. 391 � -u;`� ��N�ti�� >�. o - t _ r: Czec 19 'ort dower, Mass. COCHICHEWICK �tG, AERA T E D P'? if, BOARD OF HEALTH s PERMIT T D Food/Kitchen Septic System y BUILDING INSPECTOR rn THIS CERTIFIES THAT..... �'�S'......480 40ex ...... Foundation oun ation has permission to erect. buildings on ... -S p � �� � .... .�� �....�...' ..... .... Rough to be occupied as.449.0.0co.ju1�..�Ife .. � .a�!.�. .�• � � o 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION START ELECTRICAL INSPECTOR � r,h , � 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 Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. RR/FR /WATFR FINAL DRIVEWAY ENTRY PERMIT