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HomeMy WebLinkAboutMiscellaneous - 56 SUGARCANE LANE 4/30/2018 56 SUGARCANE LANE 210/106.A-0237-0000.0 Phone: 978-632-2660 Fax: 978-632-2662 JAMES A. TRUDEAU Adjustment Service Inc. P.O.Box 7 Gardner,MA 01440 claims(&trudeauad i.com Notice of Casualty Loss of Buildine Under Massachusetts General Laws, Chapter 139, Section 3B June 18,2015 J Building Inspector 120 Main Street North Andover,MA 01845 Board of Health 120 Main Street North Andover,MA 01845 Fire Department Dept.of Records 124 Main Street North Andover,MA 01845 Insured: C.Michael&Lisa Staff Loss Location: 56 Sugarcane Lane,North Andover,MA 01845 Insurance Company: Preferred Mutual Insurance Co. Policy No.: PROO100589567 Date of Loss: June 12,2015 File Number: 15-13605 Claim Number: 15116704 Type of Loss: Water Damage 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 writer and include a reference to the captioned insured, location,policy number,date of loss,and file or claim number. Claim has been made involving loss, damage or destruction of the above-captionedproperty, which may exceed $5000. If any notice under Massachusetts General Laws Chapter 175 Section 97A is appropriate, please direct it to the attention of this writer and include a reference to the above-captioned insured, location,policy number,date of loss and claim number. On this date, I cause copies of this notice to be sent to the person(s) named above at the address indicated by first class mail. Sincerely, Joshua M.Trudeau Claims Adjuster i I Phone: 978-632-2660 Fax: 978-632-2662 JAMES A. TRUDEAU Adjustment Service Inc. P.O.Box 7 Gardner,MA 01440 claims(a,trudeauad i.com Notice of Casualty Loss of Building Under Massachusetts General Laws, Chapter 139, Section 313 F ruary 1.1,2015 Building Inspector 120 Main Street North Andover,MA 01845 Board of Health 120 Main Street North Andover,MA 01845 Fire Department Dept. of Records 1.24'Main Street North Andover,MA 01845 Insured: C.Michael Staff and Lisa Staff Loss Location: 56 Sugarcane Lane,North Andover,MA 01845 Insurance Company: ,,Preferred Mutual Insurance Co. Policy No.: PHO0100589567 Date of Loss: February 8,2015 File Number: 15-12664 Claim Number: 15103019 Type of Loss: Ice Dam 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 1.39, Section 3B" is appropriate, please direct it to the writer and include a reference to the captioned insured,location,policy number, date of loss,and file or claim number. Claim has been made involving loss, damage or destruction of the above-captioned property, which may exceed $5000. If any notice under Massachusetts General Laws, Chapter 175, Section 97A is appropriate, please direct it to the attention of this writer and include a reference to the above-captioned insured, location,policy number,date of loss and claim number. On this date, I cause copies of this notice to be sent to the person(s) named above at the address indicated by first class mail., ' Sincerely, Joshua M. Trudeau Claims Adjuster � I Date. 31. . . . ... .. I ' .' O ..`` °.4O o? TOWN OF NORTH ANDOVER 49 p PERMIT FOR GAS INSTALLATION" �J �9SSACMUSE�t This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . f7' - has permission for gas installation . . . . . . . . . . . . . . . . . . . . in the buildings of . . . . 0. . . . . . . . . . . . . . . . . . . . . . . . . . . at . .� l . . 5�. �.A c�?fi �. . . . . . . . . . . . . North Andover, Mass. Fee. . . . Lic. No. U.(. . . . . . GAS INSPECTO Check# 5945 i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING _ (Pri to Type) —57 Mass. Date 19 Permit# Y •" , - Building LOCa�lnn D t Owner's Name rlc Z e (k Type of Occupancy New ❑ Renovation ❑ Replacement pd� Plans Submitted: Yes❑ No N Q N UJ N Y = 6 (n N V N x t- � Q N ¢ O W W N D O V m r < '' = Z O F u¢r 2 O rt C cc ¢. W o p p F• s m N F- W N > cc N C! V W y' W < rt H G F x W W j Z S S p ¢ W W V J N F s A w ¢ A W !x- z era 2- rt 'x o a x W 3 c o c > n n F o SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR * 3RD FLOOR 4TH FLOOR I STHFLOOR ' 6TKFLOOR 7TK FLOOR STH FLOOR Installing Company Name Ahl �l©ISS "t SIG" Check one: Certificate Address OZ t; C'100 96R Y l RG if T Corporation WN 4 0605 Ct 5 ❑. Partnership Business Telephone 339 , W 4Q . 1!0 ❑ Firm/Co. Name of licensed Plumber or.Gas Fitter INSURANCE COVERAGE: I have a curren liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked Yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity❑ Bond ❑ 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: owner[--] Agent ❑ Signature of Owner or Owner's 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 installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General laws. gy. Tof license: Plumber Signature sed Title Gasfitter i t, Master License Number 4 City/Town 9Joumeyman ( 1 NL w BELOW FOR OFFICE USE ONLY PROGRESS INSPECTION FINAL INSPECTION SKETCHES FEE -- -- N0. APPLICATION FOR PERMIT TO DO GASFITTING NAME# TYPE OF BUILDING �.�..� LOCATION OF BUILDING ._...,_.. PLUMBER OR GASFITTER LIQ NO, PERMIT GRANTED DATE,..�.�......�..i 9. GAS INSPECTOR MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMdIINU (Print or Type) v DI NORTH ANDOVER, Mass. Oate ' Building Permit 9 M4 ��l Location Sy 5 /O,/L O Owner's Name -)V4,1 New p Renovation p Replacement p Plans Su ed: Yes Q No p FIXTURES aI « = ( cam « i W s ►- « «, 0 u° Is x rd « s K s t ~ » O O « I « _ „Oil M il Is se�~ F- $ « M st M r` • f K ar s • a V i i t i « r o' yM .s. O • 1L .116 a uy o a s o $ w s ; F 0 U « � 1�t 1 r M o O � j sua—�aaT. eAe�a1�NT IST FLOOR SHO FLOOR SRO FLOOR 1TH FLOOR aTH FLOOR STH FLOOR. 1TH FLOOR =THLOOM - Check one: Certificate Installing Company Name le- -I _ / J ❑Corp. Address �� 1 V P70yz S fi ❑Partnership �7 d Business Telephone X-(, CF _Name of Licensed Plumbery INSURANCE COVERAGE:COVERAGE: ec one 1 have a current liability Insurance policy or No substantial equivalent. Yes E& No O If you have checked yq}, please Indicate the type coverage by checking the appropriate box A liability Insurance policy Other type of Indemnity O Bond ❑ OWNER'S INSURANCE WAIVER: 1 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: Owner p Agent p Nii;stufe of Owner or Owners Aqeni I hereby certify that all of the details and information 1 have submitted for entered)In above application are true and aocuate to the best of my know{edge and that all plumbing work and Instailailone performed under the permit Issued Im this applica wlil in Ban"with all pertinent provisions of the Massachusetts Slate Plumbing Code and Chapter 1�7Zn&9ttxa DY cense Plumber TNN License Number 3 CNynown Type of Plumbing Ucense: Masier APPnOVED(OFFICE USE ONLY) Journeyman O 1 a Date. . .J 1 s- 19"67 r �'<<"•��T:��o TOWN OF NORTH ANDOVER 0 F PERMIT FOR PLUMBING �'•D'�AT.D��"� ,SSACMUS� This certifies that . . . !.�. . . .'. . . . .j r. . . r./i;, . has permission to perform �' ..�? ':'. . .7. . . . . . I. . . . J. f. r plumbing in the buildings of .f.I./j?�: . . . .� : �! at. �'7. . . a t !P.'. :. . !!. . . . . ., North Andover, Mass. Fee. .! Lic. No.. . ... . . . . . . . . . . . . . .f . . . . . . PLUMBING INSPECTOR 11/26/93 14:22 15.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File atlonSaagle- 'qNo. Date JZ) A TOWN OF NORTH-A DOVER p Certificate of Occupancy $ z 5� ° Building/Frame Permit Fee $ • a �ssAcHusEth Foundation Permit Fee $ ` �Other Permit Fee $ -$ewer Connection Fee $ Water Connection Fee TOTAL $ 161071 J U 4 X1993 Building Inspector c 6267 Div. Public Works •1 t Location Date e N0RT1j TOWN OF NORTH ANDOVER Of�t..ao °1ti Certificate of Occupancy $ �•,. # " Building/Frame Permit Fee $ -� 'SSACMust` Foundation Permit Fee $ ,� -OtPermit Fee $ - _ 4 :• 05"Monnection Fee $ Water Connection Fee $ _____----- TOTAL $ Building Inspector z:IQ Div. Public Works IT 3libcation � No. Date 4 Of � AORTh TOWN OF NORTH ANDOVER , Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ ` + - >Water Connection Fee $ •° -'TOTAL $ , !3, 23 3Building Inspectof w 7 ''• Div. Public Works fro•�'`�v ,-7• APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP +40./04¢# I LOT NO. 3.7 "7— ;P40A 2 RECORD OF OWNERSHIP [DJATE BOOK ;PAGE E= — ZONE S D V. OT NO. D,B� ' �J.S�Z" /0 I' y I �� LOCATION PURR SE OF BUILDING I / i OWNER'S NAME OF STORIES �SIZE OWNER'S ADDRESS LfdIX �yC 4/h- !./� �!,dQ/D BASEMENT OR SLAB -fJ�S� tK r �9 ��j/�J- /-./q�i✓�e� ARCHITECT'S NAME .L�i1V uv O'/� O SIZE OF FLOOR TIMBERSJ 1ST.r4.{x!O 2ND a.( X/Q !R BUILDER'S NAME - /1tQ� // P SPAN DISTANCE TO NEAREST BUILDING 'y R%1 DIMENSIONS OF SILLS --- DISTANCE FROM STREET s( - "• POSTS DISTANCE FROM LOT LINES—SIDES �Ys / REAR /00 •' "' GIRDERS J x AREA OF LOT //3 d/® FRONTAGE �c�v/ HEIGHT OF FOUNDATION (� / THICKNESS 1 T J((i a7 O IS BUILDING NEW SIZE OF FOOTING is o 4 X t �,S IS BUILDING ADDITION r MATERIAL OF CHIMNEY �r G IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND S o f; WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 'y IS BUILDING CONNECTED TO TOWN WATER yds. BOARD OF APPEALS ACTION. IF ANY �/p IS BUILDING CONNECTED TO TOWN SEWER lv`� i v �t IS BUILDING CONNECTED TO NATURAL GAS LINE Q 5- INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES B=PER � /ZZ Q•A o EST. BLDG. COST � -2 Y, ��+ s-, v O ' PAGE 1 FILL OUT SECTIONS I - 3 LESS�A rf� [. /19 4), p✓d EST. BLDG. COST PER SQT. FT.(o 1► EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS i - 12 DUE FRAME PERMIT$..0 EL So_ SEPTIC PERMIT NO. ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING ; '06, 00 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS • PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR C-- DATE FILED BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE / / �7. S" y PERMIT GRANTED OWNER TEL.#.09 475-,8,71j' PLANNING BOARD CONTR. TEL. G a - / 19 CONTR. LIC.#—00-rr 3?_ BOARD OF SELECTMEN JAN 2 9 + ' _. \ + 1��✓� BYILDINO INSPECTOR 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 a I 2 13 CONCRETE BL K. PINE !/ BRICK OR STONE HARDW D PIERS PLASTERy _ _ DRY WALL I L UNFIN. Lr 3 BASEMENT AREA FULL 171, FIN. BMT AREA y '/, 1/1 3/4 FIN. ATTIC AREA L�'1 NO B M T FIRE PLACES _ 4 HEAD ROOM _ MODERN KITCHEN 1}` 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDW'D V _ ASBESTOS SIDING COMMON 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 SUPERIORPOOR ADEQUATE I-i NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) e GAMBREL MANSARD TOILET RM. (2 FIX.) L FLAT SHED WATER CLOSET _ ASPHALT SHINGLES V LAVATORY - WOOD SHINGES KITCHEN SINK tp SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM — STEEL BMS. & COLS. HOT W'T'R OR VAPOR r C' WOOD RAFTERS �_ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 IND. OF ROOMS GAS OIL dJ B'M'T 2nd _ ELECTRIC 1st I\3rd NO HEATING_ n L-. K FORM U - LOT RELEASE FORM INSTRUCTIONS: This form 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 requirements. ****************Applicant fills out this section***************** APPLICANT: PhoneOf �7J�P71J LOCATION: Assessor's Map Number 1614A Parcel Subdivision 2V�te �� Lotks Street ICC)M St. Number ************************Official Use Only************************ /R,ECCOMMENDATIONS OF TOWN AGENTS: /� 7 I/loll Or Date Approved T "1 Conservation Administrator Date Rejected Comments - -PW407lff-P.r��"P� Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved �� Septic Inspector-Health Date Rejected Comments -Public Works - /water connections - driveway permit Ve_w i 'issu ed Lcf- vc'd PC Fire Department r Received by Building Inspector Date f� r JAN 2 9 t � �pRTH Town of t Fr < < Andover 0 No .r � } dower, Mass., 'W 19 O �. COCHICHEWICK � -/ AORATE0 �S 41 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System a r so A BUILDING INSPECTOR THIS CERTIFIES THAT....RQ...A.A. R..r.......#rce-I...vs.11IM1110.................................. Foundation has permission to erect.�,*.$#).O*AW#Wbuildings on .gf&.XIJ..CN.Af-dow. .4r Rough s to be occupied as. .fi, ..,F/�/!�/...,t. .Qj/ .� eto- tteter.n.�� ?s-o�--ft-h--e- -ap`plIcation�� Chimney provided that the person accepting this permit shall in every respect conform on file in Final this office, and to the provisions of the Codes and By-Laws relafing to the Inspection, Alteration and Cc struction of Buildings in the Town of North Andover. PERM ONLY PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. REGULATED BY PAIL U4M. B.C. Rough PERMIT EXPIRES IN 6 MO - � - Final �1� fFE PAID��o. � o UNLESS CONSTRUCTION STARTS �i cS`D ELECTRICAL INSPECTOR PERMIT FOR FRAME/BUILDING Rough ...'� .. ... ....� .. .... ...... ` BUILDING INSPECTOR Service DATE: `7 � 3 FEE PAID'._,.,.7, Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. .247 Smoke Det. SEWER/WATER FINAL ��,1�Y*ib87 DRIVEWAY ENTRY PERMIT ♦ . "-r"" --_,-.,�...-..-_` •._ -. _`fix �:;- Location 5� n No. Date U 3 3:0.H°"r" TOWN OF NORTH ANDOVER x«.0 , 16 Midi& A Certificate of Occupancy $ 41 • Building/Frame Permit Fee $ �ss�c,"u;SEt r-__ 'F.o ndation Permit Fee _ $ ajW -Permit Fee $ Sewer Connection Fee $ \_ 1%Oer Connection Fee $ kv TOTAL $ Building Inspector MI6 3 7 � { Div. Public Works MI c)t t tca:SOl . rCI OW11 t)1 .3�::�'�: Nta��'l'><I �1,IyI�UtiIL'lt r•:,, II� . ,I,,,, . . lillll.l)IN(� %: r.t:i�c�cii lii•, fl:►►IR){•t c:()NtiI:I(VAT1ON It�'t:cl►►tv�►1' Uil �l►cr{;t•t?,'c. i I l l a\I:I'I I ) I�i.��NNltvc; 1'l,ANN1NG. KA :1 I I.P. N1:1 tic )N. 141 tl:(:I( )I t ' CHIAINL'Y APPLICAI-ION ANO IT-1311 I* PERM1.1'. # )CATION -30 i'+ s,cy il2(f 4N(--- L/� UNER'S NAME: 6d L �N-,Jdl/ /h C Ool ✓�n/�Sv 1ILDER'S NAME: �� /�1�1% � ��Gp��S //✓G, ISON'S NAME: SON'S ADDRESS: A4 dC-w ISON'S TELEPHONE: JERIAL OF CHIMNEY: _�nlls oxitv, IFERIOR CHIMNEY: C9 _ LXI LRIOR CIIIMNL"Y: ll�WER AND SIZE OF FLUES: II CKNESS OF HEARTH: ,,U cfv, nney an OvAepence colt In to e. le.qu"ilicillell-C6 u() the curie and flt(ve atice.5 and :gutati.u)vs been kece-Zved: _- .TE: .GNATURE OF MASON: .RMIT GRANTED: F LL 'BERT NICETTA v 'ILDING INSPECTOR SPECTEO: MARKS: _ SULLU BLOCK (t[ --QUIItED THIS PERMIT MUST• GE OISPLAYLO 014 111E PRUII SLS S CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number �`'-�' 2 Date THIS CERTIFIES THAT THE BUILDING LOCATED ON MAY BE OCCUPIED AS IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO f•` ! 'a ADDRESS '� = Building Inspector 0 o ori , over No.0 Ado� dover, Mass., 19 C(ICHICHEWICK PP TBOARD OF HEALTH Food/Kitchen PERMIT 0 D Septic System d f V d A BUILDING INSPECTOR THIS CERTIFIESTHAT....Ra...+/Vekr....... .. .................................. Foundation �. �. t� �.. . has permission to erect.�i�.r�� /.�buildingson . Rough to be occupied as.4.1�.�i..A.S..�/.�1.!�/...4.�..4040���.1-I*C. ... .... .. � Chimn // � /dy� ,5 provided that the person accepting this permit shall in every respect conform to the ter s of the application on file in Fi 101111, this office; and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of C; 6 Aft Buildings in the Town of North Andover. PERM ONLY LUM TG;,VPCT�)R REGULATED BY PARA. 114.8-S. B.C. hti VIOLATION of the Zoning or Building Regulations Voids this Permit. g j t/ ` al PERMIT EXPIRES IN 6 1v40 6ATEt �. :�� �PAID��0, � o n [, ����-�: �, � ELECTRICAL INSPECTOR �_JNJ...ESS CON"' I��.1C.��ICON STARTS Rough! PERMIT FOR FRAME/BUILDING Service � LDING INSPECTOR BUI � Final Q� DATE ' �3 FEE PAID•/ � Ocatpwicy I'crmit Regttirecl to Occupy l;i•tildirlg GAS INSPEc�To Rough /r S' Display in a Conspicuous Place on the Premises -- Do Not Remove 1 q� t L7-1— No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT/ Burner II�Ci' CONSERVATIO Street No,;) 1 `� PLANNING MAL ��?3� Smoke Det. 11 SEWER/WATER,�u' �11A NAL ��� ib�3J DRIVEWAY ENTRY PERMITS �� r LOT fl }' AV 3,4 1 Fi ' 0� � � I I f ►Z f)/' � �\ AN r \ / ` i 1 LAJ .. UJ . .� ... v • ��� tib. ��.` �' 51, ` ;��� " -,.,,� c , ,, �� � �►+�� =`` `S C�S �� ` � Z-'moo- 130 \ �t • cV \ \ SEPTIC ` til \\ , 1 0. !2� v \ 41 to ci G r^�� ♦� . \ ♦ �\S REQutR MEAlT i. w '''� 1! 4iii �Z� 9 O 135r yr SLE♦/. P`♦ \ j / �. Lij Lj �Z3 JAN 2 9 SHAL_t_Ow L 14AC-H�CHAMBER � i � \ � � . \ �, SYSTEM w/!pp'14 ►Z,Z , _AND OR WATERCOURSE y s `�j � / FL-T ]RE REs t 2v FROM THE LEACHING Q ./� :SERVE AREA. w O 1 . r