HomeMy WebLinkAboutMiscellaneous - 24 PHILLIPS COURT 4/30/2018r_--
Claim #
Advantage Claim Services Adjuster Assigned: Glenn Guarente
522 Chickering Road #B RECEIVED
North Andover, MA 01845
Form of Notice of Casualty Loss to Building SEE 18 2014
Under Mass. Gen. Laws, Ch. 139, Sec. 3B
TOWN 01- NuK I H ANUUVER
H ALTH DEPARTMENT
To: Building Commissioner or Board of Health
Inspector of Buildings Board of Selectmen
Town Hall Town Hall
North Andover, MA 01845 North Andover, MA
Re: Insured: Carl M. Reppucci
Property address:
North Andover, MA 01845
Policy #: 2616485
Loss of: 2014/09/06
File or Claim No. AD 1550
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.
"09-10-14
ignature and date
Print - Maps
7/-3//0,7
Maps
X22 Phillips Ct, No Andover, MA 01845
My Notes
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7/3/2012
Town of North Andover
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Owner 'Prop_ID !Address Lot
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Location
No. Date
TOWN OF NORTH ANDOVER
^o Certificate of Occupancy $
�sscHustBuilding/Frame Permit Fee $ t
Foundation Permit Fee $
Other Permit Fee $
TOTAL $_
Check #4548 !� f f
Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
WERE
BUILDING PERMIT NUMBER: DATE ISSUED:
SIGNATURE:
Buildin Commissioner/I for of Buildin2 Date
SECTION 1- SITE INFORMATION {
1.1 Property Address:
1.2 Assessors Map and Parcel Number:
Map Number Parcel Number
1.3 Zoning Information:
Zoning District Proposed Use
1.4 Property Dimensions:
Lot Area (sf) Fronta e ft
1.6 BUILDING SETBACKS ft
Front Yard
Side Yard Rear Yard
Required Provide
RegWred Provided Required
Provided
1.7 Water Supply M.G.L.C.40. 54)
Public ❑ Private ❑
1.5. Flood Zone Information: 1.8 Sewerage Disposal System:
Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of R,n,ecord Q
Name (Print) Address for Service':
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
i
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor: Not Applicable ❑
Licensed Construction Supervisor: V 130
License Number .
Address ,Z q
Expiration Date
Signature Telephone
3.2 Registered Home Improvement Contractor Not Applicable ❑
Company Name
3j v 1 �i )� n Registration Number
Addd-res\s V ry /`; �-Plj�
ci> Expiration Date
Signature Telephone
1P
SECTION 4 - WORKERS COMPENSATION (XG.L C 152 § 25c(6) w:
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.
Si ned affidavit Attached Yes .......❑ No ....... ❑
SECTION 5 Description of Proposed Work check all applicable)
New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
r
I SECTION 6 - ESTIMATED CONS'T'RUCTION COSTS I
Item Estimated Cost (Dollar) to be��
permit a licant
Completed bNAIVE
Ok�FICIATS
OPv'L�'r�3>
=` I€ . ........::.
1. Building
�ZooMultiplier
(a) Building Permit Fee
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, 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 Ov;,rier 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 _
Si a ure of Owner/A en Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS 1 ST 2 ND 3 P
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DE�ENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CIII VINEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
J
v
The Contntonivealth of Massachusetts
Department of Industrial Accidents
Mce nllflvestlgatlnns
600 Washington Street
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
0 I am a sole proprietor, general contractor, or homeowner (circle one) and have hired the contractors listed below who
the following workers' compensation polices:
Eanc� co _
pion! b
Fd
noliry !i
Failure to secure coverage as required fonder Section 25A of MGL 152 can lend to the Imposition of criminal penalties of a ii
fine up to 51,500.00 and/or
one years' imprisonment as well as civil penalties in the form ora STOP WORK ORDER and a tine of sI0o.0o a day against me. I understand theta
copy or this statement maybe forwnrded to the Office of Investigations of the DIA for coverage verification.
I do hereby eerr/jy under the pains and penaitles of perjury Ihaf the Information provided above is trite and orrecf.
Signature-
i Date E
Print name
Phone # _
official use only do not write in this area to be completed by city or town ofnelal
city or town:
permit/license # _ nBuilding Department
❑ check if immediate response is required pLicensing Board
pselectmen's Office
contact person: pllealth Department
phone #; Other
('"iuce 3195 rtA)
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• Castricone hoofing & Siding
REPAIRS FREE ESTIMATES
Telephone (978) 682-4266`:
MARIO CASTRICONE
31 Court Street, North Andover, Mass. 01845
I/we, the owner (s) of the premises mentioned below, hereby contract with and authorize you as contractor; to furnish all necessary
materials, labor and workmanship, to, install, construct and place the improvements according to the following specifications, terms and
conditions, on premises below described:
Owner's Name..Jit� �C
`� rr.........i...................�............................................ ti.... .........................
.
Job.1> CC~\ \ W '� . State�.1.
i�,J. �......... .... ( ty........ ......
I,
SPECIFICATIONS
}..... ...�`............ ... 1,iJ� ..................................... ' ................ :...........................
V.
............. .... .............. ....... ..
� �.... .....� . c. :...C: k�, . ... V .C.i .. �.� ..:...................,................................
... ......... .. ... ................... ...............................................................
,....ti:.. �.'.... �...�..................................................... ...............
.............. .. ...\.�,...............................................................................................................
............. .... ...... ,...................................................................
.. �'...i r.....1 ....................................... '....1........ .../.........
r.,............................................................................ -....
.......... —Q—Q :., Q ✓fit �1.1�.SQ........................................................................................... ...........................
........................................
..................
Materials and labor to cost $..
....... . ..................... Payable4�"'`........ ... ...............................and balance in............
monthly installments of $ .........................................each, payable on .........................................day of each and every month thereafter until paid
in full (..............% charge per year is to be added to above cost of labor and materials and is included in monthly payments.)
Contractor will do all of said work in a good workmanlike manner.
Upon completion of above work, all undersigned agree to execute and deliver to contractor, their joint note in accordance with his (their) above obligation and a
completion as requested by the contractor. Upon refusal to do so, contractor may at its option declare the entire contract price or so much as then remains unpaid
immediately due and payable. It is agreed that if permitted by law contractor shall be paid by the owner(s), all reasonable costs, attorney fees and expenses, in
addition to the amount due and unpaid, that shall be incurred in enforcing the terms and conditions of this contract and/or any lien in connection therewith.
It is further agreed that this contract may be assigned by contractor; and also that the obligations hereof shall bind and apply to their heirs, successors or estates
of the parties.
The undersigned warrant(s) that he is ,(they are) the owner(s) of the above mentioned premises and that legal title thereto stands of record in his (their) name(s).
PROVISO: This contract shall be void and of no effort if credit approved of owner(s) is refused.
There are no representations, guaranties or warranties, except such as may be herein incorporated, if any, nor any agreements collateral hereto, nor is this
contract dependent upon or subject to any conditions not herein stated. Any subsequent agreement in reference hereto shall be binding only if in writing and signed
by all parties.
Cover attic storage cleaning not included.
Receipt of a copy of this contract is hereby acknowledged, and it is further acknowledged by the undersigned that the foregoing provisions have been read and
the contents thereof understood and that no representation or agreement not herein contained shall be binding upon the parties and that all of the agreements and
understandings of said parties are.contained herein.
Owner or Owners are not responsible for Property Damage or Liability while job is in operation..
IN WITNESS WHEREOF, the parties have hereunto signed their names this .................... `��
.... day of..::.....
Accepted:
Signed-:. .......... :..............................
(OWNER HAS 3 DAYS IN WHICH TO CANCEL CONTRACT) Owner
Per ..........:i :�
Representative
Signed.........................................................................:............
Owner
Signed......................................................................................
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO 00 GASFITTtN[;
(Print or Type)
f NORTH ANDOVER ,Mass.Date �,� �j 4j,Buildina Location—at/ pij /Ap S C Permit a~i
`Owners Name
Y
• New '^ Renovation Replacement p Plans Submitted
S
FIXT(h - D
(Print or Type)
Installing Company Name
Address 7 t Af?i) A 7—)
i
. -1,AL R t, &r k /`AS 5 010 3
Business Telephone: Q_21
Check one: Certificate
Q Corp.
Partner.
[T:J'Firm/Co.
Name of Licensed Plumber or Gas Fitter PP- 147',/1,
Insurance Coverage: Indicate the type of insurance coverage"by checking the
appropriate box:
Liability insurance policy her type of indemnity F__j Bond Ej
Insurance Waiver: 1, 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 17 Agent El
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 aU plumbing worst and installations performed under Permit iueed for this application will -be In compliance with all pettineat
provisions of the hiarsachusetts State Gas Code and Chapter 142 of tho General Laws.
By TYPE LICENSE:
lumber
Title Gasfitter rj&ature of Licensed
City/Town:
Master PlUmber or Gasfitter
APPROVED (OFFICE use ONLY) r Journeyman )_ r ire)
License Number
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.S 11Fi—$$i.1T•
BASEMENT
IST FLOOR
2ND FLOOR
I
3RD FLOOR
4TH FLOOR
5TH FLOOR
6TH FLOOR
7TH FLOOR
8TH FLOOR
-
(Print or Type)
Installing Company Name
Address 7 t Af?i) A 7—)
i
. -1,AL R t, &r k /`AS 5 010 3
Business Telephone: Q_21
Check one: Certificate
Q Corp.
Partner.
[T:J'Firm/Co.
Name of Licensed Plumber or Gas Fitter PP- 147',/1,
Insurance Coverage: Indicate the type of insurance coverage"by checking the
appropriate box:
Liability insurance policy her type of indemnity F__j Bond Ej
Insurance Waiver: 1, 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 17 Agent El
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 aU plumbing worst and installations performed under Permit iueed for this application will -be In compliance with all pettineat
provisions of the hiarsachusetts State Gas Code and Chapter 142 of tho General Laws.
By TYPE LICENSE:
lumber
Title Gasfitter rj&ature of Licensed
City/Town:
Master PlUmber or Gasfitter
APPROVED (OFFICE use ONLY) r Journeyman )_ r ire)
License Number
%TO
Date.
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that
has permission for gas installation . f., ..� ... , ,
in the buildings of ...r . !, a c r f :.......................... .
at . ."f . %/, /�,.? -.f.. ( ........ , . , North Andover, Mass.
Fee. eA~ .... Lic. No.?. � A � .. ..................
........
07105/ 08:47 jg,r Gry�INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File
P' RJtIT NO.
r
APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS.
MAF i-40.
LOT NO.
I
2 RECORD OF OWNERSHIP IDATE
BOOK ;PAGE
ZONE
SUB DIV. LOT
NO.
I
PURPOSE OF BUILDING
- _e-11
LOCATION.j
OWNER'S NAME e
NO. OF STORIES SIZE
OWNER'S ADDRESS
BASEMENT OR SLAB '
ARCHITECT'S NAME
SIZE OF FLOOR TIMBERS IST 2ND - 3RD
BUILDER'S NAME
Pr tc..V.(i
SPAN "
DISTANCE TO NEAREST BUILDING
DIMENSIONS OF SILLS
POSTS
DISTANCE FROM STREET
DISTANCE FROM LOT LINES - SIDES
REAR
GIRDERS
AREA OF LOT
FRONTAGE
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW
SIZE OF FOOTING x
AS BUILDING ADDITION
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION
f�c Com(
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
SEE BOTH SIDES
PAGE I 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 FILED AND APPROVED BY BUILDING INSPECTOR
PTIX, FILED-,
SIGNATURE OF OWNER Off -AUTHORIZED AGENT
FEE V v
PERMIT GRANTED
19
M
7J66
OWNER TEL. 04-t_ air, U
CONTR. TEL. # -3 q &(
CONTR. LIC. #
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST
EST. BLDG. COST PER/SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
BUILDING INSPECTOR
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY STORIES
THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
MULTI. FAMILY
LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA-
RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
N 3, Il - +I
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1st 3 R4.,
OFFICES
APARTMENTS
__
CONSTRUCTION
2 FOUNDATION
CONCRETE
—I
8 INTERIOR
FINISH
PINE
HARDW D
3
2 13
_
CONCRETE BL'K.
BRICK OR STONE
PIERS
PLASTER
DRY WALL
UNFIN.
_
3 BASEMENT
AREA FULL
FIN. B M AREA
_
'/ 1/2 '/,
FIN. ATTIC AREA
_
N_O B M
FIRE PLACES
HEAD ROOM
MODERN KITCHEN
_
4 WALLS I 9 FLOORS
CLAPBOARDS
B
_
1
2 3
�_
_
_
_
DROP SIDING
WOOD SHINGLES
CONCRETE
EARTH
ASPHALT SIDING
ASBESTOS SIDING
HARDW D
COMMCN
ASPH. TILE
VERT. SIDING
_
STUCCO ON MASONRY
STUCCO ON FRAME
_
BRICK ON MASONRY
ATTIC STRS. 8 FLOOR _
BRICK ON FRAME
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR I� POOR
ADEQUATE NONE
5 ROOF
10 PLUMBING
GABLE
GAMBRELMANSARD
I
HIP
BATH Q FIX.)
TOILET RM. 12 FIX.)
FLAT
SHED
WATER CLOSET
—
_
ASPHALT SHINGLES
LAVATORY
WOOD SHINGES
KITCHEN SINK
SLATE
NO PLUMBING
TAR 8 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 _
rd
ELECTRIC
NO HEATING
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