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HomeMy WebLinkAboutMiscellaneous - 70 GREEN HILL AVENUE 4/30/2018 70 GREEN HILL AVENUE ` 210/022.0- f E- Location No. .2x-) Date j MGIITol TOWN OF NORTH ANDOVER ' • i Certificate of Occupancy $ ; i • ^off ti s �' b •' � Building/Frame Permit Fee $ �Ss�cMustt Foundation Permit Fee $ Other Permit Fee $ TOTAL $ '' Check # 17798 ( ' -a v—��Building Inspe6tor3 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING fr S s, BUILDING PERMIT NUMBER DATE ISSUED: m aaa� SIGNATURE:---/) �^- Building Commissionerff for of Buildings Date —eV z SECTION 1-SITE INFORMATION O 1.1 Property Address: P 1.2 Assessors Map and Parcel Number: Z�- /f Map Number Parcel Number 1.3 Zoning"Information: /F!f/ 1.4 Propedy Dimensions: Zoning District Proposed Use Lot Area(so Frontage ft 1.6 BUR DING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReTured Provided Reqwred Provided v 1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private 0 Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSIDWAUTHORIZEDAGENT Historic District: Yes No m 2.1 Owner of Record Name(P'nt) Address for Serike Signature Telephone r 2.2 Owner of Record: p4jL O Name Print Address for Service: Signature Tele one 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ t Licensed Construction Supervisor: �i s License Number Add s 311S > OF Exptratt n Date ic ignature Telephone 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name M /4n6/�5/Ap a kAr Registration Number ro Add re /l� Z Expiration45ate ^ St nature Telephone 61/ 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 an applicable) New Construction ❑ Existing Building ❑ Repair(s) Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of yPr zoposed Work: ,,) SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be M,CICI AI.,USE Ol ,y Completed by permit applicanKu t 1. Building (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 44 6 Total 1+2+3+4+5 ° Check Number SECTION 7a OWNER AUTHOR TION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, ��GC.� >as Owner/Authorized Agent of subject property Hereby auth ' e IV �R M"f to act on My behalf,in all matters relative to work authorized by this building permit application. d -Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, /" �ti Z- 13�/Q&.1 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 knedge and belief 13 Print Name o/ Si ature of Owner/Agent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIIvMERS 1ST 2ND3 SPAN DEVIENSIONS OF SILLS DEVIENSIONS OF POSTS DEMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE . ro0��t Page#_�—of •-� pages p Norman L. Blad Construction -978.687.6263 40 Fernview Ave. #10, N. Andover MA 01845 MA Lic. 016141 MA Reg. 131950 Y Proposal Submitted To: Job Name Job# Address Job Location Date Date of Plans Phone# ©O Fax# _—� Archilect r hereby Submit sp Icificatloon.-s a�n_d_estimates for ..... __ J .. _.. 01 . el�e. i_ _T. 4. .......... .... ............. .... _ ... )f��__ '-.-._... ....... a a. �'�1!`'l .Gtr td .....jti it �?lT t, ' ._. 7 r 7 We propose hereby to furnish material and labor—complete in accordance with the above specifications for the sura of: jL �� Dollars with payments to be made as Poll ws: ' ~ ' fit Any alteration or deviation from above specific tions inv Iving extra costs will be I Respectfully f" executed only upon written order, and will become an extra charge over andv;' above the estimate.All agreements contingent upon strikes,accidents,or delays submitted beyond our control. Note—this proposal may be withdrawn b,,us if riot accepted within 5 d _days. i gcceptance of ipropogar The above prices,specifications and conditions are satisfactory and areSlgnatute ' `���1 �` ��_'`�'i ---- hereby accepted.You are authorized to do the work as specified. Payments will be made as outlined above. ;,t Date of Acceptance Signature kJA r_` a. N03819 rn::oe rN.us.n . . ----- - ie �ammxrntJ«,al/� o���aaactr,�ucaelta BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 016141 Birthdate 03/.15/1947 f:xpires: 03/15/2006 Tr.no: "2169.0 Restricted: 00 NORMAN L BLAD _ 40 FERNVIEW AVE#10 N ANDOVER, MA 01845 Commissioner _ � ✓!tl' (JJdIYL7Jt6Itllen(Lllft" / /G717dJCL�UGP,�6 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 131950 Expiration: 10/13/2006 Type: Individual NORMAN L.BLAD NORMAN BLAD 40 FERNVIEW AVE #10 L.G_' � N.ANDOVER,MA 01845 Administrator i I f :10RFOLK AND DEDHAM MUTUAL FIRE INSURANCE COMPANY SMALL CONTRACTORS POLICY NEW BUSINESS DECLARATIONS Policy # R0412920 Named BLAD, NORMAN & ,DAVID N Agent INTERNET INSURANCE AGENCY Ii 1C Insured . 40 FERNVIIPW AVE #10 Phone 978 685-7690 N ANDOVER MA 01845 Agent # 2 015 5 Y °y FORM OF BUSINESS: 77777771 Policy PerioA: ONE Y1,AR from 02/04/04. to 02/04/05 This do claral ions page t )gelher with the policy jacket, the policy'form and any endorsenients, coniplet<,s this polif,y. Covera;;e bel ins at 12,U 1 A.M. Standard Time at (he covered premises. PLIY pRIVIIUIViS As Basic Al nual Endorsements State Taxes Total Annual AddnllReturn rEm3 �Le.Lri111CiL_ $1 566 $1 , 566 a Different1 i— -- - Bld ll_ocon Address ; . ... .. ": .< Mortgagee Informatic n Business Description -___-- CARPENTRY r_eni iuni— NO } POLICY DEDUCTIBLE $250 BUSINESS PERSONAL. PROPERTY Limit $10,000 Included t TOTAL ' REMI UM PER BU I LDING $1,56(1.00 I X. Y A 'N `fD ;M F EXCEPT FOR FIRE LEG/L LIABILITY, EACH PAID CLAIM FOR THE THE FOLLOWING COVERAGES REDUCES TILE AlAOUNT OF INSURANCE WE PROVII E DURING THE APPLICABLE ANNUAL PERIOD. PLEASE REFER TO PARAGRAPH D.4 OF THE BUSINESS LIABILITY COVERAGE F )RM. Fi LIMITS'.i]F..IN5�6AdLGEl1IaY11uM_ LIABILITY AND MEDICA. EXPENSES : $300,000 IncJiaded MEDICAL EXPENSES $!i,000 Incl �dEd `TENANT FIRE LEGAL.LI ABILITY $50,000 Inc ,ided L—PE -777777777777 iemiu Pr-el Aum— BP 00 06 01-97 Included BP 00 02 ; 12-99 Incl,3ded CFI 00 01 07-90 . Included BP 00 09 ? 01-97 Incl+ided BF 01 08 03-98 Included BP 04 19 06-139 Incl+ided SP 04 96 10-01 Included CTF-91 07-00 $5,000 PER OCC Incl,!ded `;'IMS-99 07-00 $5;000 PER OCC Included NDCL-2 11-02 Included :NOTEi .`THF: POLICY::PRCVISIONS REC;UIRE THAT :A $ 4on COUNTEFi51aNED Y';: AUTHORiiE�;,R6F'F1E 'ENTATIVE MINIMUM PREMIUM CNA 1GE;.NOFIMALLY::;APP.LIE5;': IF Y_OU GA.N CEL PRIOR TO 'EXPIRATI )N DATE, WE SHALL FiE'CAIN4 AT L, AST �r } $300 REGAFIDLESS O.F T RM; , AMISi_t BOP-2' (REv..0111)41 Type of Payment: DIRECT, AS PAY North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work,shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. The debris will be disposed of in: (Location of acility) Signature of Permit Applicant ay Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector NORT#q own of 0 No. 330 LA. E - dover, Mass., COC MIC MEWICK y�. �iQ ADRA TED `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT` yy............... ..................................................... ... ..................... . �............A j ...... " ... Foundation has permission to erect....................................... buildings on ....7 ..................... ... ..... ............................... Rough to be occupied as Chimney ......... ........ . . .................................................................................................................... provided that t e person accepting this p it shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the des 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCT104S TSRough ......................:1! .....................�c ............................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR DRoughisplay in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings North Andover, MA 01845 RE: Insured: Paul and Mary Rock Property Address: 70 Green Hill Avenue, North Andover, MA 01845 Policy Number: HP2180922 Date/Cause of Loss: 9/14/2004, Water Damage File or Claim Number: 14053-W 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 313 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. Wade Anderson 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. atur and Date ANDERSON ADJUSTMENT CO., INC. 54 Stiles Road, C-106 Salem, NH 03079 RECEIVED NOV 2 9 2004 WILDING DEPT.