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HomeMy WebLinkAboutMiscellaneous - 310 PLEASANT STREET 4/30/2018 310 PLEASANT STREET 2101095-.0-0930-0000-0 ` L Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 RE: Insured: Craig Schorer& Christine Bontuso Property Address: 310 Pleasant Street Policy Number: H012299275 Date/Cause of Loss: 9/6/2014, Windstorm/Tree File or Claim Number: 30154-R Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 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. Ryan Werner On this date, I caused copies of this Notice to be sent to the persons named above at the addresses indicated above by First Class Mail. Sign t re and Date ANDERSON ADJUSTMENT CO., INC. 50 Nashua Road, Suite 303 PO Box 1098 Londonderry, NH 03053 'Location/64 No. Date ?, n� ,&CRT" TOWN OF NORTH ANDOVER f 9 i Certificate of Occupancy $ $A 14 9 Buildin /Frame Permit Fee $ $A 14 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 4 I Building Inspector f• TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT•REPAIR,RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING I BUILDING PERMIT NUMBER: DATE ISSUED. X 3-� SIGNATURE: ..� Buil Commissioner/In t Buildin Date S Z SECTION 1-SITE WORMATION 0 1.1 Property Address: 1.2 pAssessors Map and Parcel Number: Map Number Parcel Number SND • ���9-e 'C�.�-_ 1.3 Zoning Information: 1.4 Property Dimensions: Q Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard R red Provide RecItfired Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record 16 )�� v` " r?,l QcL� \1 N e(Print) Address for Service Sig ature Telephone 2.2 Owner of Record: O ,Name Print Address for Service: z rn Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ ` Licensed Construction Supervisor: O License Number M 'Address Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name rn Registration Number r Address r s Expiration Date /) Signature Telephone Y/ 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 au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ DemoliTion '"' ❑ Other ❑ Specify Brief Description of Proposed Work: �4 SECTION 6-ESTIMATED CONSTRUCTION COSTS R Item Estimated Cost(Dollar)to be OF1qCIAL-USE 0NL,Y Completed by permit applicant 1. Building / a (a) Building Permit Fee Multiplier 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 as Owner/Authorized Agent of subject property Hereby authorize V 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 and belief Print Name Signature of 0e/A ent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T ABERS in 2ND3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHNINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE HOME IMPROVEMENT CONTRACTOR E i �. I Registration 103317 Type - DBA Expiration 07/07/00 CASTRICONE ROOFING $ SIDING C Mario T. .Castricone 2 �ourt-St. ADMINISTRATOR N. Andover MA 01845 Castricone Roofing & 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 premis,gstplow des ribed:�, Owner's Name............ ...................... ............ ....... ...................................... ....... .... . ... Job Address.—,d..�....... a&.��: .. ..................................ci t� .... ... State.... .4� SPECIFICATIONS ... ...... . ........ ....... . .....6-1-7......................... ... ..... da.................................................................................................................... . :................... ............ :................................................................................................................................................................................. r :::: .....................................................:::� v7 ....:::::::..: :::.:::.:. . - . ............................................................................................................................... . ...:� '`:..:��J-P.....�..�..�� .................................................................. ................................................................ ZL 47 �. Materials and labor to cost$ ... ..4?..:................................... Payable../.........!..........................on ................................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 oper t' n. v' IN WITNESS WHEREOF, the parties have hereunto signed their names this ........ :.....................day of. . . ..... ..... 11.... Accepted: ��`` Signe . ..G,�;;ne.:... .. .......... .. .... ........ nor (OWNER HAS 3 DAYS IN WHICH TO CANCEL CONTRACT) / Signed............................................................... ................... r , Owner ' /ALX Per..... ........ ... ...................................................... Signed...................................................................................... Representative The Commonwealth of Massachusetts C Department of lndustrial.�ccidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insuranc., Affidavit Name l Please Print (`dome: v • � \�- Location: City Phone T I am a homeowner performing all work myself. j I am a sole proprietor and have no one working in any c4ac:h/ I am an employer providing workers' compensation for my employees working on this job. Comoanv name: CUYU Address C-V-11 "Y CiN: "nQ e 1'K Phone Insurance Co. Y ` t� Pclic/ Ccmcanv name: Address Phone Y Insurance Co. Policy Y Failure to secure coverage as required under Section 29A or iiGL 152 can lead to the imposition of cnmir.al penalties of a rine up to S1,5CO.Co and/or one years'imorscnment as Weil as c:vii penalties in the form of a STCF`NCRK ORCE:R and a rine of(5100.120) a day against me. I understand that a copy of this statement may be for.varded to the Office of Investigations&the CIA for coverage verification. 1 do hereby certiry under the pains and penalties or q.ury that:he information provided accve is.'rue and ccrrec.- 1 ^ ( Signature ��" nate Print name C 1 ���L Phone .r(obi d Offic:ai use only do not write in.this area to be completed by city cr tcvn crfic:ai City or TcNn Permit/Ucensirc ❑ Building Dept [Check,r immediate response is required ❑ Licensing Ecard ❑ Se!ectman's Office Ccnract person: Phcre Health Department Other �ORTti Town of 4Andover No. 9 .­"�_ ­ '�I­;.`-"J^� �' '. - ijC 2.00 e �A o 7� H dower, Mass. ,7wd"COC HIC HE WICK �• SAO� RATE D S E BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT.... BUILDING INSPECTOR ......... ..... ..................................................... Foundation has permission to ere ....... ........ .................. buildings on.... Q .... Rough to be occupied as. ...... Chimney provided that the person accept' g this permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final 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 ST T ELECTRICAL INSPECTOR Rough ........................................................................).... .. ............ Service BUILD INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough No Lathing or Dry Wall To Be Done Final Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. SEE REVERSE SIDE smoke Det.