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HomeMy WebLinkAboutMiscellaneous - 77 CHADWICK STREET 4/30/2018N NORTH .ANDOVER BUILDING DEPARTMENT .1600 Osgood Street North Andover Tel: 978-688-9545 Fax: 978-588-9542 .BUSYNESS FORM F01? TOWN CLERK ADDRESS:Ck�-I C K �5L ON NG I)ISTRIO T : Ll TYPE OFBUSINES: i lLZ�P LC t�rG( S BUILDING LAYOUT AVAILABLE PARKING SPAMS: ZONING BYLAW USAGE: rYES ! NO BUSINESS FORM FORMWN CLERK SIGNATURE 2.40 Home Occupation (1989132) An accessory use conducted within a dwelling by a resident who resides in the dwelling as his principal address, which is clearly secondary to the use• of the building for living ptuposes. Home occupations shall 'include,"but not 'limited to the following uses; personal services such as fiunished by an artist or instructor, but not occupation involved witdi motor vehicle repairs, beauty paxlors, animal kennels, or the conduct of retail business, or the manufacturing of goods, which impacts the residential nature of the neighborhood. 4. For use of a dwelling in any residential district or multi family district for a home occupation, the following conditions shall apply. a. Not more than a total of three (3) people may be employed in the home occupation, one of whom shall be the Mier of the home occupation and residing in said diwlling; b. The use is carried on strictly within the, principal building; c. There shall be no ex-terior alterations, accessory buildings, or display which are not customary with residential buildings, . d. Not more than twenty five (25) percent of the existing gross floor area of ;the dwelling unit. so used, not to exceed one thousand (1000) square feet, is devoted to'such use. In connection with such use, there is to be kept no stock in trade, commodities or products which occupy space beyond these limits; e. There will be no display of goods or wares visible from the street; f. The building or premises occupied shall not be rendered objectionable or detrimental to the residential character of the neighborhood due to the exterior appearance, emission of odor, gas, smoke, dust, noise, disturbance, or in any other way become objectionable or detrimental to any residential use within the neighborhood; g. Any such building shalt include no features of design not customary in buildings for residential use. Signature Dale ' Location 22 No.� ` Date " pf "� oT fhO TOWN OF NORTH ANDOVER 4.. • o p Certificate of Occupancy $ i "--- L;�s� �, Building/Frame Permit Fee $ 'r AGMUSEt Foundation Permit Fee $ Other Permit Fee $ �J Sewer Connection Fee Water Connection Fee $ TOTAL $ J Building Inspector r� Div. Public Works PEV\IIT NQ. r /2 / APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. v IVA PAGE 1 MAP h40. LOT NO. 2 RECORD OF OWNERSHIP ;DATE BOOK ;PAGE ZONE SUB DIV. LOT NO. OCATION hAaC(,vt r��„C` PURPOSE OF BUILDING n G -rAI^S ICs, _ I�C iac / -o o�' II OWNER'S NAME W Ll Lb NO. OF STORIES SIZE OWNER'S ADDRESS C+ �� 1 I L�L �W BASEMENT OR SLAB A CHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME QolJCl�l.t7 i_ 0� SPAN _- DIMENSIONS OF SILLS POSTS DISTANCE TO NEAREST BUILDING 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 IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION 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 00 PAGE 1 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 ANDAPPROVED BY BUILDING INSPECTOR DyfE FILED Zs ` /)- SIGNATURE OF OWNER ORA THORIZED AGENT FEE l/ / /' V ,/ v NER TEL. N 6Pd'�090 PERMIT GRANTED NTR. TEL. 3 S8 � F J Is 2 CONTR. LIC.��6 dielz r 3 PROPERTY INFORMATION LAmD COST EST. BLDG. COST Z, �j S'O 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 �41d4 4�4w BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES MULTI. FAMILY OFFICES APARTMENTS __ CONSTRUCTION 2 FOUNDATION CONCRETE —I 8 INTERIOR FINISH PINE HARDW D— B — 2 I_ — CONCRETE BL'K. BRICK OR STONE PIERS PLASTER DRY WALL UNFIN — 3 BASEMENT AREA FULL FIN. B M T AREA 'h 1/1 °/. FIN ATTIC AREA _ NO B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS CONCRETE EARTH B 1 ��_ 2 3 _ _ _ DROP SIDING WOOD SHINGLES ASPHALT SIDING HARDW D COMMON ASPH. TILE ASBESTOS SIDING VERT. SIDING STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR I_ CONC. OR CINDER BLK. _ WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE GAMBRELMANSARD I I HIP BATH (3 FIX.) TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & 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 $ B'M'T 2nd _ tnt 13rd ELECTRIC NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. RAYMOND E. DAMPHOOSSE, JR. AND SONS ROOFING CO., INC. MA. CONSTRUCTION BOX 431 LAWRENCE P.O. S UPERVIS(7il -Ik"N it QF.n(Z1)r, LAWRENCE, MA 01842 HOME IMPROVEMENT REG. It 101862 From: 1 iC/�/✓� V 2-1 TEL: 683-4588 ROOFING — SIDING — INSULATION ,{ Date (Name( ` (Address) To: UTYOND E. DAWBOUSSE, J9. AND SONS HOOFING CO., INC., BOX 431 LAWRENCE P.O., LAWRENCE, MASSACHUSETTS 01842 I (we) hereby authorize the Contractor to furnish all materials and labor necessary to Install, construct and place the Improvements described below in -on building located at No. City �/� © �/✓�0 � 2 State //?'14— J C�� Ci Street, in accordance with the following specifications: C '01 , ,%G�1 C� i �s9it/% i'� At.�z2/J P '% /f/ii2f A14"? t , % �t> �' _ /I, `%� i (: � ->' �/✓� i F� .�-� �',�-,.-� �A. /r Gam.' � c � � .9j'�/'i ..' _<:a n v-iL G/2✓j A �C r C.eir✓J .Al-%irrJ//�.:-� r �t°� , /iI') ,�/���t [� �/✓ / / /%. yf / ��� J / ./ rel/ 7f". 62//9"//�'-`f; �i2 ((' C�G •� i C . Y �3 V . All of the above work to be done in a good and workman -like manner. ow c4=G>rr,-���c',�� All men and equipment insured. Premisiis4cq be left clean upon completion of work. For the total sum of A. ' Entire Sum to be paid immediate upon completion in accordance with pla TOTAL CASH SELLING PRICE .......... S DOWN PAYMENT IN CASH ........../. v DEFERRED BALANCEO . 's UPON COMPLETION ................5�-2,2j dollars. as shown below. The undersigned agrees to keep property mentioned in this agreement properly insured against loss by fire including the Contractor's interest therein. This agreement shall become binding only upon the written acceptance hereof by said Contractor, and upon such acceptance this shall constitute the entire contract and be binding upon the parties hereto, there being no covenants, promises or agreements, written or oral except as herein set forth. It is the intention of the parties hereto that this contract shall be binding upon their respective heirs, executors, administrators, successors and assigns. Customer agrees to pay a reasonable sum as attorney's fees and Court Costs if placed In hands of attorney for collection. The owner further agrees that in event of cancellation of This contract after acceptance by the contractor and before the work is commenced the OWNER agrees to pay 20% of the total consideration herein named as liquidated damages for breach of contract. Said contractor shall not be responsible for damage or delay due to strikes, fires, accidents, or other causes beyond his reasonable control. We, the undersigned, certify that we are the sole owners of the property herein described on which said work or repairs are to be performed. IN WITNESS WHEREOF, the undersigned has (have) hereunto set his (their) hand(s) and seal(s) the day and year written above. Accepted By RAYMOND E. DAMPHOUSSE, JR. AND SONS OFINGCO.,IN. (Signature and T' of Official) Husband Wife d Mail Address (If different from above) F11 i E RLIC s. x w O A CG u o w° v U) >1 • ; U u Q CO 0 w z z A •� C cu -Qv w 02 a c U c w U ww z •-+ z � a �" P4 w a O z Z x U W W a o �4 5: v C/5w m C O u CW. z 0-4 na o 0: m w w GG � w w c a co z v C/) Q o U) D J • U co co c c o E m c L o O c o � Z co CL O O CA C Z Ico cm O O CA �V, co A '� w • � L L. LU U) R� ' o c m m z OL d N y �Q i CD 2. C3 R 0 Q QO = 0 C QC 2L— y -a CD �o� C.3 J -0 t GD o Z z_ &S C V h y:+ C ` y d p L L` ca A Q 3 y y cm gg C) y z z •O �•O� CL yC=, C o �C � C y O %! O Q> o zCD Q o m 3 �V•y O Ci•CZ L O Ocm O C LSo C Q L O C O ~ CL 03 ~ N CD co �0+ 47 r0+ cc.* t LL •V! O C •E CL E o CO •y Z o LU LU m om�c g CO) C Ci O .0 C:) • U co co Q z o E m L o O v Z co CL O CA Z Ico cm O O CA �V, co A '� w • � L L. LU U) m m z O i CD 0 0 R 0 Q 2L— CO) y -a CD CIO C.3 J -0 GD CO) Z z_ V h C Q y C� z z qZ J CL 'Ri�RTF�nr�2+nRl'11R: FC1!'�'7.AM: ]•E1R15A!i^ .. _ _ .. ... .. � .... .. :t!'P^ ^'.TaiTr. n�.-�-.-.tin..-.ct_.rT•r..1...r.,,.,•�,�-. �..Tr.. �•v •. " .qP.-.... s OFFICES OF: APPEALS ;t..w = NORTH ANDOVER BUILDING DIVISION OF CONSERVATION PLANNING PL-�NNING PLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON, DIRECTOR 120 Main Street North Andover. Massachusetts 01845 (617) 685.4775 In accordance wit tl the provisions of MGL c 40, S 54, a condition of Building Permit Number 1 E �}- is that the debris resulting from this work shall be disposed of in a prcperly liccnscd solid waste disposal facility as defined by NIGL c 111, S 156A. The debris will be disposed of in: (Location of Faciiity) Sicnature of Fumit Appiicmnt Date N0T_: Demolition permit from the Town of north Andover must be obtained 'or this project through the Office of the Building Inspector. Location 77 No. z 1V Date 9� TOWN OF NORTH ANDOVER o Certificate of Occupancy $ ;a Building/Frame Permit Fee $ ��s'•CHU Foundation Permit Fee $ sACMust -A#her Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ P �r Cilding Inspector C v Div. Public Works PE 011T NQ. / qc APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. V PAGE 1 MAP K -4O. LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE ZONE SUB DIV. LOT NO. -I LOCATION PURPOSE OF BUILDING ,C� , ly ^ f_1� l OWNER'S NAME NO. OF STORIES SAE OWNER'S ADDRESS GV jN&OBASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME Vtidp��l �Jq�/� SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES - SIDES REAR '" GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION ( /�l. F Q i ;1 IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TOO REQUI EMENTS OF COD �O� 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 1 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 DATE FILSD 1 --2-3--9 6 SI� OF E OR/CUIZED AGENT V c FEE PERMIT GRANTED 19 2 3 Ro 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST � 19 EST. BLDG. COST PER SQ. FT. � 1 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY OWNER TEL. # (J ogl%-Ao- - 6090 7a CONTR. TEL. # 9F6 - 2 ! 2�? CONTR. LIC. # 0402612 H.I.C.# f0W cl1- 1 OCCUPANCY SINGLE FAMILY I STORIES MULTI. FAMILY PIPELESS FURNACE OFFICES APARTMENTS FIRE PLACES HEAD ROOM CONSTRUCTION 2 FOUNDATION STEAM 8 INTERIOR FINISH CONCRETE _;--WALLS —I 3 I CONCRETE BL'K. B 1 PINE DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ BRICK OR STONE HARD�,4 D COMMON ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME HARDW D GAS _ PIERS B'M'T 2nd _ Ist 13rd PLASTER ATTIC STRS. & FLOOR CONC. OR CINDER K. WIRING STONE ON MASONRY DRY VJALL — 3 BASEMENT II AREA FULL I FIN. 8 M AREA '/. 1/7 1/. PIPELESS FURNACE FIN. ATTIC AREA N_O B MT FIRE PLACES HEAD ROOM TIMBER BMS. & COLS. MODERN KITCHEN STEAM STEEL BMS. & COLS. _;--WALLS I 9 FLOORS CLAPBOARDS WOOD RAFTERS _ B 1 _ DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ CONCRETE EARTH HARD�,4 D COMMON ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME 7 NO. OF ROOMS GAS OI l B'M'T 2nd _ Ist 13rd BRICK ON MASON Y BRICK ON FRAME ATTIC STRS. & FLOOR CONC. OR CINDER K. WIRING STONE ON MASONRY 5 ROOF II 10 PLUMBING TAR & GRAVEL 1-11 STALL SHOWER 1_1 FI BUILDING RECORD 12 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. 11 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 WOOD RAFTERS _ AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OI l B'M'T 2nd _ Ist 13rd ELECTRIC NO HEATING c 'O C `C � d CO) n 10 0 co n Z CO) CD O -c, CL r-. c' O r0 -r O � � C C1 CO) n� -v O CD CCDM O CL rr CD =r CD O CD W CD �' ^CD L O CO) r �Q CD .7 v CO) O 'a Z CD rn„M, .Ot O CD O G CD z I rj C 0 CD 0 CD O _ to O ao S. to CD c 0 N C 0 a: N CO CCD C E" O S. O d 2 co) N Q d O S CD _ 1 CA m n CD tG n a n N C7 T w ='-m .-� = — CD CD CO) N T ='a�a C m _ =rN O O O N p CD O = SDI CD N n O C CD O ZS.CW, N O n O CD CO) C3 ? CD CD N " CD �•: C CD N G ' d N N Q v Q0- C W CL 03 < G " `a CO) CD ` J1 co) _ CD CD w. N (� ( ) CD CO C'J .. C, O O — W of-� CD =r r- O CD I _\1 ac CD do C . CD _ CD C _ cl n O c O o' =W C, . m MEA aE cn 71- °� C/) rn : �n w a 00 w c ro oGOa O w A p °�'� n ro � rocn O cn �^ •n a y 0 0 P=h A' i o., —_ —3 The Commonwealth of Massachusetts Department of Industrial Accidents 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit city /Y0 I n \s l -i ,jam phone # ��1 '" (e�0,?b I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. pang n ell 1vAY``PC, ��C�PA_ 'Y �PD a t;tAn,;: r.,.,_ insurance co r_1AI4 V� —}- �kC oolicv # (A% < 2, I am a sole proprietor, general contractor, or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: address city: phone # 21-✓ —v- Q Id96 address:-71�1/i -7 •S 6-��✓J phone u Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a copy of this statfKent may be forwarded toAe Office of Investigations of the DIA for coverage verification. I do hert' c rt and r yainaallies of perjury that the information provided above is true and correct. Signature t Date Print name Phone # _ —9 0 `•'Raw . 'jam official use only do not write in this area to be completed by city or town official o city or town: permit/license # nliuilding Department ' ❑Licensing Board j ❑ check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone #• nOther )mored 3/1)e PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. :.V'.r[ nl :✓�""r, ry �,.:7.;:i c�' � h.; .L, } :� t - i � c %r ^"` ,f.. y;.�r• fig, ..z�. RP#. ',e�:1�i•. ":.t.'t..i3 a.,: .rr.� .r,:i'5�:�}:..r3:i...,e{°+��. ,1,�.�:h`�lt� _ ?• , �. Va:" Applicants " Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. 77-7`777-77 72777yin5 :tiy s�+ - �^ r �r .,CIG IR "• City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office mf Inllestigallions 600 Washington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 �i1:3'�,�4y��•r'.��,WWR�t`F��bm :�` r �. k � �' � � s ��^ t �` �S` t ��e 7oomvmo�zu�eea�ii o�✓�iaaaac�ucaelti i tr — —_ Resiri�ied a' LSC y� .T pi ei Tn { I 0E?ANittEN i:F J� . �nfEI . T • ti ��HSiRI�Ci 1'�N •:•?. ' �:Or, _��, ,NU Numhe;: WiHS: Birth-date:1 1A - USONY ooi> l5 psOS6; '1097 01/11/1953 1G - : & 2 Faoiiy Noses Restricted To: 00 xv CAKIt:. 'r -UK 1�,5 ROCKY HILL rn ?L 0 U T A"?cn • � � �ilealGi c�✓�aaaaaiusella , HOME IMPROVEMENT CONTRACTOR + Registration 100502 Type - 'PRIVATE CORPORATION Expiration 06/18/96 AMERICAN REMODELING INC Charles Cook `�14585 NORTH STEMMONS tS102 ADMINISTRATOR DALLAS TX 75247 r APR -18-y6 '1'HU 'l:ll AM NXTbM A PRA 11U. louuiuoujoi I j vvL..r teas.. Portsmouth. NH 03801 sarJiO at ells Nome ME (800 --21• ��Y (80'01436-6580D� Imp'+avwents (0`761 ) 96 ;8042 Job• No: NH. INE.NY Said, furnished and metalled by —� MA Registration Numbs* AMERICAN UXODEUNG, INC- Ban" — 100502 OUR. W L( fwrue Phone =f �/ NAM I cy - C IY !•Q•- ` p'r�= - 61Pte: . _ ZP: Addrosr %>tJ�LL y,,,e, a■ owners or ate premeea daan'bed be herwrialler reianed to as Turct■sef over b tprnrael with AUERICAN REMODELING, INC.(A CENTURY ¢t AIlT110R1ZED CONTRACTOR). Isr@rylbr n b As PREMISES 19 kMah, b driver and arrange ra IrlsWafim of an m2lerials nseewry b Improve ltle— PREMISES LOCATED AT: (CITY) (STATE) (ZIP) (STREET) aamrding m ant toe0wtng spsdAcaFo� NOT SPECIFICATIONS INCLUDED INCLUDED necessaryFRIEPARAT.KM 1• ❑ Obtain 211 necessary perm is and inwranees Z ❑ arWwd S ARms n awk area - renail woes wood. (111110mmass surface wood wMre rceeassry in work Nal VCfue— raDLddkinp Or rallela. 8. ❑ 4. Q }a' L ❑ affa&=7. �. 7,kr•IL.H SIDING; PORCH EYE= QI FAN M MRI 20. 21. 22. 23. 2A. 25. 26. 27. 29. a 0 LJ Ramous Ejastni db g Typo: — Area: fir out was N break big* w aklcop areas• LaaUarK Caulk and sell eloww sit vk ftw i doors in work area u ready I.WI RU apPn W 9-11sitarist ss'IL Marl tre wron on pawl areas b be sided wtlh 314' eabud" Pott';yrens brrPk and gr m Imulalfan to aws a sat wen sudam Ior krsWalidn of ikfup Color— �, Viro Clad awritin rn laade sri� Location: Remove and raabatll PAtarng Location, - _ — Color — Cudom Cal V'wo sills tjferom: Crclonr Cut Vogt Pertlad wird systam: Location:..---- mor. Custom YuI)A Clad aluminum ldeaa boards: Localise — Com — -- — — Jump widow - L=50n: Color. —. — Cuabm wrvp wi.juwa wnh virryldadaluminum: locelam Color.--- Remove and rokWd sbrme windows Color: — Custom wrap door hoinge w%h viyd dad alwWnum; Locanpn; -- tel./ remove and rthe+at Morris doors {ovation `— Cola • W. — fiakme c0PWP=l Farmatab loddt9m1efM Leetllan: —'— 0a1ar:. G� Install loadvkrfie/b�krJ� {p DOLOR— TYPE: STYLE-. lit — Poichcerrarpe: LOMI[Orrc �— —' Porch poste: COLOR Pumh bearrg�---^- COLOR _ - Glean up andwta+wf of an job re40.ed debris: ' Each job is am sivipped In mold delays• Remove roneess matsdets and re-ttoh issuers r.MW warranty subsequent b inatalla IML lratrc57�se"e warranty oomntenang Iran the we of Cumprel WL SPECIALJ�� --. •--�- �—'— - is iir�/�yulMr.'��.1's.'ucry�• ,I-J�%'I�_f_�,�-- - wwk not to be dares Ttw CASH PRICE Isr sill Labgr a Motional C",tludlnn any "Iabw d"$) °: Ccmmpeca S— - Terms: Caul ❑ Cneal (Subject b the approval d Its Credit ad" 011palt"Ong Bales raft II thte b a earl, ktnaaulo•r the Pvm1wa pAeo ch" be Paid as MOO= // D _ "wowe S B! _ Total Prim Cash Duron rarncnl11— n Yris is a credit credit uanaacrien. M agree rnent la CmL l is cantaated b a separate doeumeN which IN nnowPn credit record wits relevance _ an independent edit repufGno yore ria urrdcreVed are I,_Gby a dWaing AMERICAN REMODELM INC. to ve* and review my laur ayrnY and Mks" them ham an Ilabiity incurred k_(, inadvorteraamfssions or er=L Verbal undersWor gs and rrmcmenls Wlth aposippWfives etlet not be binding All widwstorian0s and agnewanta must be sal twin In Writing in th�eisyContrail• ADDRIONAL PROVISIONS ARE STATED ON REVERSE SIDE AND ARE PART OF THIS CONTRACT NTRACT• 1S.[w IN WITNESS WHEREOF PerdnaseKs) have herounro signed alernenrets)dlt=�!dayof ¢ppyLS{pNSMESTAt>UUNNEtIfAM Mid edaa sledges receipt 01 a WE copy of d"s Contract OVE UNLESS ERW 0 rHISE SPECIFIED, IT IS WIDE O THAT THE OWNM IS READY FOR TI nS WORKTO BEGIN' THE pURCHA'E PRICE 0 WTEC AB WaLgEHCrpRCpOIILVUNRL DA E 7tSlS USAGE ApPUI'sS TO DOOR TO.000R SALES ONLY. You 1ha Purchaser(9) may caecal this transaction at sny linins prior to mi�tight of the thud UES busiTO day o:r the date or O is transaction. See accompanying notice W cancellation form (or an explanation m thisig t of t sirwas asked tieiow also aapWraaas rocewl tool H M;I4sQ s) recew- gpparala Unwoorron Nanta. effterd is IP al niq:<r dAabta fspa 19 'be or kranbyMe orwro (MY.) d the W�sew Pnm ea ; corllred0o4 ' 7� 6136WOM P lmt In accordance with the provisions 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 111, S 150A. The debris will be disposed of in which City or Town ', % �'e Q he • STREET D`RES f` G'1 p TYPE OF CONTAINER FOR TRANSPORTATION §ignatd,re of Permit A1plicant 1�-Z-3-� Date Sugg"t,ad Affidavit for Home Improventent Contractor Permit Application For 0111ce uae Only NAME OF CITnYfroWN Ycrn►!t Nu. /1%a t " O VPy Date AfTIDAVIT Husne Impruvctucrtt C:utttructor Luw Supplement to Permit Applie:ation JAG Lc. 142Arequirmthat the'remnslruclinn nhervlirnl renovitoinn reMlir m(Kterniryinn ennvenion,l0hnwemrnr,rcmnvul,demolilir,n • ,-cnnalr'l-^1i4111 nr nn 11ddili4111 IU 1111V pleT1N1111e 41W11CI'-1NY•114,lle,1 Imili1111e comil1111111• oil 1 •uil nue Out 01411 mule 0111111 /41uf dW1111111. 111 au u.1u'rn v11101 h b/e adjnl'e11l 041SUL-11 IM111f11re 411 buddme" tic aluuC UY ICE13IeIQ1 W4611bblauI1, W►II► a.el►am cAb ctlllulia, •luuJ: wuh u111cl Icyalrcu►cuu. Type of Wor Sr Address of Work , % 7 C���>��+t J ` Owner Name: t/t � I, . M I ll t t. Cost Dace of Permit Application: I hereby certify that: p^� Registration is not required for the: following rcason(s): _Work c:xcludW by law - Job under SI,LM 13ulldint, not owner -occupied (:owner pulling own permit _Other (il)ecify) 4 Notice is hereby given that: OWNrRS PULLING TIiEIR OWN PERMIT Olt DEALING WITH UNRECISTLRCD CON'I'RAL—MRS 1:011APPLICABLE OME:INUIROVL'1v11:N'1' WURiC UO NOTHAVE IAVL-: ACCESS TO TI --11 n1t111't'1:..�'I'lON PROGRAM OR GUARANTY 1-*UlvU UNDI' R MC L Signed under penalties of perjury: / /L%•,��t/ti�'�, t�'(� I hereby apply for a permit as the agent of the owner: - A -w--6 00V I No. o arae J 1tc� i,trauun ll.tte CUnlrall r Olt: Notwithstanding the above notice, I hereby apply for a permit Ws the owner of the above Property: Date Uwncr Name Location I c 1c, <Z --i No. /_ `4 Date N°"TM TOWN OF NORTH ANDOVER F � Certificate of Occupancy $ > ; ' Building/Frame Permit Fee $ EE Foundation Permit Fee $ Other Permit Feesllri(,� $—� Sewer Connection Fee $ N Water Connection Fee $ TOTAL $ ` Building Inspector Div. Public Works PERMIT NO.y G►� APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. 0 li PAGE 1 MAP KJO. LOT NO. I 2 RECORD OF OWNERSHIP IDATE BOOK ;PAGE ZONE SUB DIV. LOT NO. 'LOCATION �'1'1 t ^, . ` PURPOSE OF BUILDING (,vepdS J bWNER'S NAME 04 A NO. OF STORIES SIZE OWNER'S ADDRESS C -'i" W le BASEMENT OR SLAB ARCHITECT'S NAME '3UILDER'S NAME 5�. - SIZE OF FLOOR TIMBERS IST 2ND 3RD SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS POSTS DISTANCE FROM STREET r DISTANCE FROM LOT LINES — SIDES REAR .S " " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION 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 SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 INSTRUCTIONS 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 "ATE FILED t Y SIGNATURE OF OWNER OR XVTH-6ibiEO AGE FEE /7/ PERMIT GRANTED 197 3 PROPERTY INFORMATION LAND COST iE`ST. BLDG. COST EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY NUILDING /OWNER TEL. N `42 8 A -60 9 CONTR. TEL. # CONTR. LIC. # H.I.C. # BUILDING RECORD 1 OCCUPANCY 12 V SINGLE FAMILY S ODES MULTI. FAMILY 14 OFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE PINE HARDW D B 1 2 13 CONCRETE BL K. BRICK OR STONE PIERS PLASTER DRY WALL _ _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ '/. 1/2 1/ FIN. ATTIC AREA N_O B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS CONCRETE EARTH B _ 1 2 3 �_ _ _ _ DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ HARDII✓'D COMMCN ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK N MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR _ CONC. OR CINDER BLK. WIRING STONE ON MASONRY _ STONE ON FRAME SUPERIOR POOR ADEOUAATE I- i ONE 5 ROOF 10 PLUMBING GABLE HIP BATH Q FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) — FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & 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. 6 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 _ 1st 13rd ELECTRIC NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. ol W cd w d cxr, O A j o V- a V) w Z Z `° C:_ LL ,,/ Nr U m LL O U w z Z CD r. LL o U w Z U a J W -c CY, u > �, i_r LL R; O W -� °�° gyp/ W m Z w u. i = z L V) .� o V) C Q •� Q O C ` Q a'o :om :CA 1mQ 3 : s N E c c� O O V � r "a CD CD cr mm o ¢ . m 3 N r .i O N B QJ' � B y C O o w IENco U CD CD .mcr m V N O i 30. _CM O V) m c C = m m r=... p N � C/i ev = m r••, C t3J Q rte.. CCD rte• .� V V N o v m o m c g f/� d m M O .a 2 !NO N O H L S CL.=m w C Laq C3 J a O z E CD i O O V Z co Q O 0 y CD cm z o � c0 COD co •O M E O mm LLJ V� z L � = 0 CD O i O O i OC C O Q C,* C = O O v J 'C O� Z = z C V y d y C:3 0 z z z J Crawford & Company 1001 Summit Blvd Atlanta, GA 30319 Phone 877-346-0300 4/26/2015 Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 Re: Insured: Claim Number: Policy Number: Our File: Date of Loss: Type of Loss: Location of Loss: To Whom It May Concern: FARINA -PETER -CHAPTER 139_LETTER_CRAW.PDF Peter Farina 033575747 83104400003 6776-2603825 2/28/2015 Ice Damming 77 Chadwick St North Andover, MA 01845 A claim has been made through Arbella Mutual Insurance Company which involves loss, damage, or destruction of the above captioned property, which may either exceed $1,000 or cause Massachusetts General Laws, Chapter 143, Section 6, to be applicable. If any notice under Massachusetts General Law, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer. Kindly include a reference to the captioned insured, location, date of loss and claim number. Very truly yours, James Warren Crawford & Company CC: City/Town Fire Dept, City/Town Health Dept