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HomeMy WebLinkAboutMiscellaneous - 41 WENTWORTH AVENUE 4/30/2018N LaMarche Associates 5 North Road, P.O. Box 250 Chelmsford, MA 01824 800-349-1525 Fax: 978-256-8590 February 17, 2016 Building Commissioner/Inspector of Buildings NORTH ANDOVER, MA 01845-1723 Board of Health/Board of Selectmen NORTH ANDOVER, MA 01845-1723 NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B Claim has been made involving loss, damage or destruction of the property captioned below, 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, cause of loss and LA file number. Insured: MANDA SERGE KASHAMBALA Loss Location: 41 WENTWORTH AVE NORTH ANDOVER, MA 01845-1723 Policy Number: PHOO100863422 Date of Loss: 02/14/2016 Cause of Loss: Water LA File Number: MA -2-31077 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. John Anderson Adjuster LaMarche Associates, Inc. - 800-349-1525 Page 1 of 1 LaMarche Associates 5 North Road, P.O. Box 250 Chelmsford, MA 01824 800-349-1525 Fax: 978-256-8590 March 18, 2015 Building Commissioner/Inspector of Buildings NORTH ANDOVER, MA 01845-1723 Board of Health/Board of Selectmen NORTH ANDOVER, MA 01845-1723 NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B Claim has been made involving loss, damage or destruction of the property captioned below, 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, cause of loss and LA file number. Insured: MANDA SERGE KASHAMBALA Loss Location: 41 WENTWORTH AVE NORTH ANDOVER, MA 01845-1723 Policy Number: PHOO100863422 Date of Loss: 02/23/2015 Cause of Loss: Collapse LA File Number: MA -2-27962 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. Kevin Charlton Adjuster LaMarche Associates, Inc. - 800-349-1525 Page 1 of 1 i r`I � , Location No. Date /a -d-1 aj NORT1y TOWN OF NORTH ANDOVER ' Certificate of Occupancy $ C14U Building/Frame Permit Fee $ �A�MUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $�' Check #�•_' 106344 Building Inspector •� .� ' r , TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ;': T6is;Sectidiit for-0ffieiaE-Use ©ii<I" BUILDING PERMIT NUMBER: DATE ISSUED: Y --- o.I SIGNATURE: 16� Building Commissionerfi for of Buildings Date SECTION I- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: I ie Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area (so Frontage (ft) 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 1.7 Water Supply M.G.L.C.40. 5 34) 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 /2A Owner of Record Address for Service: i / 1/ 11 ✓I Y Al 1 1 / _ Cl Telephone 2.2 Owner of Name Print Address for Service: mnature lege none SECTION 3 - CONSTRUCTION SERVICES 3.;! icensed Co ction Supervisor. S )* iceAsed onstruction Supervisor: t3-7 6d-5-1 Address Signature Telephone 3.2 Registered Home Improvement Contractor Company Name Address Signature Telephone Not Applicable ❑ License Number Expiration Date Not Applicable ❑ Registration Number Expiration Date 't SECTION 4 - WORKERS COMPENSATION (NLG.L C 152 § 25c(6) Y� 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 .......0 No ....... 0 SECTION 5 Description of Proposed Work check su applicable) New Construction 0 Existing Building ❑ Repair(s) 0 Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other 0 Specify Brief Description of Proposed Work: baY VL VC SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant � O. CJSEONLY T 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (,1 x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total (1+2+3+4+5) Check Number S CTIO 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN O AGENT OR CON CTOR APPLIES FOR BUILDING PERMIT I, / as Owner/Authorized Agent of subject property Jeby . tho t^l� t act o, ers re ti a to work authorized by 's building permit application. M ehin alJ*171 Al 6 'Q r s igUatuMWAJALDate SE N 7 WNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Herebv 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 Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR. SLAB SIZE OF FLOOR TIMBERS 1 2 3RD SPAN DIMENSIONS OF SILLS DIlvIENSIONS OF POSTS DIIAENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CFDNINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE L'i3 ui CL !- Rli , -11 z 0 U O E Q Q Z C. O CO � C I C C C* Q O 'ECDCD m m � L Z O� 3� O G O tj �Q ca o =� CL c �c Q C.0 Z U CL V y O C O. .y LLI LU W W oc W U) v Hca. CV O C • um cL cc or 2 t 1B.", M G M 3. v$ C O ti p� ao ID :gym; ID L Cavi o WIZ o o o :cam � q• G c QCQ �- m s �- w "" vi m �i w o CL c o 2 y� E 92 .0 a� o 0 CLLO CLO. mNip o !- Rli , -11 z 0 U O E Q Q Z C. O CO � C I C C C* Q O 'ECDCD m m � L Z O� 3� O G O tj �Q ca o =� CL c �c Q C.0 Z U CL V y O C O. .y LLI LU W W oc W U) FORM - U - LOT RELEASE FORM INSTRUCTIONS:. This form is used to verify that all -necessary approval/ permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. Known ago 1111111111REAMENE ONE so Eson"WANE ME so wagon ME me am No RENE Sam Oman am Una sow MEMO No APPLICANT f"*(IntPHONE "1 ! 0 ` M-5447 ASSESSORS MAP N ER LOT NUMBER SUBDIVISION NUMBER 094 - 33 _CCW . D STREETJL'1 I hili k....STREET NUMBER Lff OFFICIAL USE ONLY R114COMNENDA ONS OF TOWN AGENTS 7—im 0 0 a 0 0 ----------DATE APPROVED L D'2- C SERVATION ADMINISTRA OR A DATE REJECTED TOWN PLANNER COMMENTS til rl 1 DATE APPROVED FOOD INSPECTOR - HEALTH DATE REJECTED SEPTIC INSPECTOR - HEALTH COMMENTS PUBLIC WORKS — SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTNIENT DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR — �� / DATE Pools USA 37 Lambert Street, Revere MA 02151, (781) 286-3069 Installation agreement between Pools USA herein called the ins ler d Herein called the customer of the real estate located a For the ' s lation of one swimming pool size base installation price i350, f3 purchased from consisting of the following: ence ck ."�""�""'"°"'" walkw y In order to maintain the lowest possible installation price, the following conditionsust be agreed upon. 1. The installer warrants the pool installation against defects in workmanship for I swimming season(s) (season ends Dec 31s') 2. Installation does not include electrical work, stairs, ladders, or solar/heating systems. 3. All empty boxes and pool packaging are to remain at the pool site, at a location chosen by the customer. 4. Installer is not responsible for removing sod, rocks, dirt, etc. remaining from the excavation or for damage to the grounds resulting from the normal use of equipment. 5. Customer is responsible to comply with any local zoning ordinances and to obtain any necessary permits and specifically assumes sole responsibility for the exact location of the pool. 6. Customer is to stake out pool site. 7. Customer is to make sure pool site is not located over any underground services, leaching fields, septic tanks, etc. Any. damage done to the aforementioned will not be the responsibility of the installer. 8. Landscaping is not included in the installation, nor is the installer responsible for any alterations to the landscape. 9. Customer is to supply hoses, water to fill the pool, and accessibility to the pool site for any equipment that is needed. 10. All efforts are made to remove wrinkles from the liner. However, due to the prefab nature of aboveground pools, weather conditions and other factors, WE DO NOT GUARANTEE A WRINKLE FREE LINER. It. The installer is not responsible for any manufacturer's defects including the liner and any results of that defect such as water loss. - 12. Decks, fences, and accessories are not included in the normal base installation price. 13. For your safety, this is a non -diving pool. Customer assumes full responsibility to make all users aware of this fact, and assumes any liability which may result from misuse of this pool. He/She also agrees to make sure signs indicating "NO DIVING" are affixed in a conspicuous place and remain in good condition. 14. The installer is not responsible or liable for any damage to the pool or for a washout of the cove inside the pool due to poor water drainage surrounding the pool area caused by rain, flood, acts of God or any types of storm, emptying the pool of water or failure to winterize the pool. 15. There will be an additional charge if the pool base cannot be delivered to the pool site or if other than normal conditions exist. 16. The installer will not guarantee an appropriate fit between an existing deck and a new pool 17. The pool base may arrive without notice. Please leave driveway clear if no one is to be at home. 18. Dates of installation are subject to change at the discretion of the installer due to weather conditions or installation delays. 19. There will be an additional charge of $25.00 if your bank returns your check unpaid. 20. The installer is not responsible for missing pool parts. Definition of a normal installation is as follows: Pool site within 6" of level, soil condition normal, no large rocks, tree stumps, etc. If heavy equipment is needed, there will be an additional charge. If due to ground conditions the machine is unable to bring pool site to grade then customer is to pay for services rendered and installer will discuss further options with customer. The owner a rees with Pools USA in consideration of the performanc of the above specifications o a ontractor the total sum of $ , of which $ has been paid this date ;o O i5 and a $ Y x FINAL CASH PAYMENT is to be paid upon completion. This agreement constitutes the entire agreement between the parties, and no other representations, agreements, or commitments are binding . upon the parties unless specified in writing in this contract. In witness whereof, we hereunto set our hands and seats. COMMENTS: CUSTOMER CONTRACT Submitted To:: Ray & Maryann Cahoon .;1 TRIPLE C CONSTRUCTION 117 GOODHUE'ROAD DERRY, NH x::03038 (603)890-3922 ,':- + cl Job Loention: 41 Wentworth Ave. North Andover, MA 01845 Description of work performed' Deck — 481 square feet with 1. stairwell `x ' 4 ;`' Concrete to consist of 8 piers, 12" sonar tubes/up to code Pressure treated frame throughout up to code Composite decking throughout including landing and stairs, color to be determined by homeowner Installation of decking, face nailed 2 1/2. finish nails Rail system Endurance product line, white m color only?turned ballast, PVC 1 - 36 gate at top of stairwell/deck PVC lattice around lower deck only; not gate or access pariel,,white in colors Composite trim over lattice joints/seams throughout r DEPOSIT $10,000:00 ?4,-�, UPON COMPLETION OF FRAME ^ -5,000.00 r ` UPON COMPLETION OF CONTRACT 1 ' 8.. 35:00 TOTAL $16,835.00 b" NOTE: Permit to be provided by homeowner, inspection to be called in by homeowner. r � w Removal of existing deck to be'provided by,contraetorat' Any and all labor or material provided other, than'said`eontract.ikill bean extra and Due payable in full upon completion of extrarh Anis electrical; plumbing, sewer or water Drainage or lines needing removal or replacement will be provi6d by homeowner. ' : k M.v3'-s.J .1^.•:r- P 'w . e • ti'J �' ve � t .. Schedule of Term & Condition r Y *Payment is due upon receipt. All money owed to Triple C Construction will be charged 10% additional monthly on balance due until payment in full has been received. If collection activity is necessary, you will be responsible for any and atl fees tripleC Construction may incur in retrieving all monies owed, including lawyer and court fees. a = ' Work Authorization ' I hereby acknowledge the soodple of terns, conditions, labor and materials] or job rate and Yam the owner or the owner's agent and I have the authority to authorize the above n to do the work as outlined in the work description section and any additional work necessary for the completion of the work as de d section of this customer invoice i The signing of the work authorization on this customer invoice shall constitute a contract. s. {•.. - X (p ze ignature "i 7 xDate, ` 44'��`3./ Authorized sign r V'A', '" S -. � .. r# � �afirn. i r a �`. ash rN'�-, na ••- - I have inspected the described work that was performed, the work authorization and l hereby acknowledge the satisfactory completion of same and acknowledge the receipt of my copy of the contract ufrk ,? t x ts4'M �a Date Authorized signature ,. .y . x .. r` U k Y h 1 Date j Authorized signature , ` a r. . 'J, N rr , - a Of j0RTN 1 TOWN OF NORTH ANDOVER "O0 OFFICE OF . Q BUILDING DEPARTMENT # ; + 400 Osgood Street North Andover, Massachusetts 01845 D. Robert Nicetta, Building Commissioner HOMEOWNER LICENSE EXEMPTION Please print DATE:IoS7 JOB LOCATION: Number HOMEOWNER PRESENT MAILING ADDRESS City Town Telephone (978) 688-95454 Fax (978)688-9542 Map/Lot mn QT &0 - Work Phone ��L�[�IV1 ave C& 0l�l�' State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other Applicable codes, by-laws, rules and regulations. _ The undersigned "homeowner" certifies the minimum inspection procedures an requh requirements. 1;' HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL understands the Town of North Andover Building Department and that he/she wi)4ompiy with said procedures and BOARD OF APPEALS 688-9541 CONS E,R.VATION 698-9530 11EAL CN 6999540 PLANNING 6"-9535 MORTGAGE INSPECTION PLAN BOSTON SURVEY, INC. 05-03213 P.O. Box 290220 Charlestown, MA 02129 (617) 242-1313 MAIN (617) 242-1616 FAX APPLICANT. CAHOON LOCATION: 41 WENTWORTH AVENUE CITY, STATE: NORTH ANDOVER, MA DEED/CERTT, 115-125 PLAN REF: 39-69 WENTWORTH AVENUE 1994: (c) Boston Survey Software SCALE: 1 inch = 20 feet CERTIFIED TO: PREPARED: 03-24-2005 'he permanent structures are approximately located on the According to Federal Emergency Management Agency ;round as shown. They either conformed to the setback in ASH OF maps, the major improvements on this propertyfall in an equirements of the local zoning ordinances effect at he time of construction, or are exempt from violation �� O y area designated as Zone. nforcement action under M.G.L. Title VII, Chapter 40 �r� GEORGE�� Community Panel No. SQCJ 9 �� 3 c-- vection 7, and that there are no encroachments of major lines a. 0 CA COLLINS Effective Date: (Za/Gf mprovements either way across property except No 7t34 ;hown and noted hereon. o 9 NOTE: Zone C is areas of minimal flooding (no shading). tONP This designation is not based on an elevation certificate. VOTE: This is not a boundary or title insurance survey. Th' p a pri rdance to procedural and technical standards for Mortgage Loan Inspections as adopted my the Massachusetts Board of Registration of professi al enginee endaaAd rveyors, 250 CMR 6.05, and use for any other purpose is prohibited. This plan is not to be Locatio!No. Date ZL' /� Date �� % �7F `I TOWN OF NORTH ANDOVER Certificate of Occupancy $ f Building/Frame Permit Fee $ Fqund 'on Permit Fee If Lermit Fee Sewer Connection Fee Water Connection Fee $ TOTAL $ 1S o 111-7 1`-7 Building Inspector ! 3 9 0 o o Div. Public Works N C,4 0 I Y 0 0 m W H 0 N_ m IL N W >>0 S0 Z LL Q 0 3 0 m m W O Z cc0 o zW w m W I g 0 w N d z m 3 L O O O W a {O J_ a s 7 O a W ,Z M O LL H LL W `� YJ 0 t W LU C) H W H J f U O Q 0 Z a, F W 7 PI N 0 Z 6 N CL L O O O W a J_ a s 7 a W ,Z M O LL LL W `� YJ 0 0 W LU C) H W H J f U O Q 0 Z F 7 PI N 0 9L z ^ ^ O m m W z z m z O m O � 7 W W f m m m p 0 0 F m m W < W F 4 U W i 0 i < (�f `v N Z < Z O < N f. 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'.tG� _ - r S 3 con icon of- Building Permit Number 2 �_ d s ; ..a •.•_ ...,ris resuitinQ :rem this work shill be disrosed of .., c rrc, e -i- as 0.A - by MGL C il11,1, S ine debris -rill be dispose:'. cf ;-: 1 1..� m ri Q Q, l tom: vt,�' Y S'ct101� cf,:zc�,11*L*;, ie:.atart of Permit Acpiicnt Date NOT=: Demolition permit from the Torn of North Andover must be obtained for this project through the Office of the Building Inspector. t TOWN of NORTH ANDOVER AFFIDAVIT Ebm bpmvmEnt Cht=tcr Lw 5. to PeMdt AppliMHCn n• OLzile •al• ■ • r •• ■• ■ • r .••1 ■ • /• • o• n • ••• •1 0• • 1 • • •• Y.1 1 • • i ••' for - ■ • • 1 •1 s. • 1• ■• • 1 • .� .• .•� 1 .• G• 1 .11' I•. Type of Work: K LS_ Est. Cost/de •Qd Addressof Work _Y/ G(/WrZ&fJf'_ TY �1J� Owner Name: G c!!'/C.e Y-1 111:9&a.61 Xle 114/?6' I_C1'i?C'e4 ,"Cf 7b"� Date of Permit Application: f /(O/q I hereby certify that: Registration is not required for the following reason(s): Work excluded by law -Job under $1,000 Building not owner -occupied _Owner pulling own permit Other (specify) Notice is hereby given that: For of Use a11y Fit No. Date •1*10 01 '14N 4110 a Wen 6:IDI11• • a• •' I• PYOWWO 1• • • 14"WIMOK. • i �• • • D D • • • • • !MD► • �.� • ; �• • 4-t Z' • • • r • •% own URI ) IM U Wks; h Sigrnd u -d-- pa-alties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Whet Name