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HomeMy WebLinkAboutMiscellaneous - 825 JOHNSON STREET 4/30/2018wo Safety Insurance P.O. Box 55098 Boston, MA 02205-5098 1-617-951-0600 July 7, 2016 Building Commissioner or Inspector of Buildings Fire Department or Arson Squad Board of Health or Board of Selectmen City Hall NORTH ANDOVER, MA 01845 Insured: EDWARD CAIN and GRACE CAIN Property Address: 825 JOHNSON STREET, NORTH ANDOVER, MA Policy Number: HMA 0101271 Claim Number: BOS00070414 Date of Loss: 7/5/2016 Notice of Loss Under M.G.L. c. 139, � 3B This communication shall serve as written notice pursuant to M.G.L. c. 139, § 313 that [Safety Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a building or other structure at the above -referenced address which may either: (1) meet or exceed $1,000; or (2) cause the condition or the building or other structure to render M.G.L. c. 143, § 6 applicable. In accordance with M.G.L. c. 139, § 313, if the city or town intends to initiate proceedings designed to perfect a lien under Section 313, M.G.L. c. 143, § 9 or M.G.L. c. 111, § 127B, please notify Safety of the same by certified mail. Kindly forward such notice to my attention, at the address indicated below, and include with such notice a reference to the above-described insured, property address, policy number and claim number. If you have any questions regarding this notice, please feel free to contact me directly at (617) 951-0600 EXT 3324. Sincerely, Maria Rivas Claim Examiner Location 'f-"- .-- J , " I I ) :� -) cC7 No. Date -7� Th TOWN OF NORTH ANDOVER ziillillll�� Certificate of Occupancy $ 0 Building/Frame Permit Fee $ s Foundation Permit Fee $ ACI Other Permit Fee $ Sewer Connection Fee $ Pater Connection Fee $ . 4 . I TOT�L-' - 196, C Buildind"ihspect& Div. Public Works PER;Afl ' NO. SSI I APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP d-40. LOT NO. I 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE ZONE { SUB DIV. LOT NO. -I LOCATION �j h J- -To An s o h � PURPOSE OF BUILDING A O OWNER'S NAME - „/ /�' 2146 � % /�i; �� Cl�S� i•� NO. OF STORIES SE�� OWNER'S ADDRESS;. Q6, —, Cl BASEMENT OR SLAB `yJ2NNYD - ARCHITECT'S NAME /1/,o lil SIZE OF FLOOR TIMBERS IST 3RD BUILDER'S NAME *w L. �4uartt�' ca �� `/ SPAN DISTANCE TO NEAREST BUILDING aaL.� �J DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES - SIDES REAR 75 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 '66ARD OF APPEALS ACTION. IF ANY i 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 METERS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS Z S MUST BE FILED AND APPROVED BY BUILDING INSPECTOR FILED SIGNATURE OF OWNEIt OR AUTHORIZED AGENT FEF_ O �"- L PERMIT GRANTED CONTR. TEL. # CONTR. LIC. # 3 PROPERTY INFORMATION LAND COST -T T. BLDG. COST 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 BUILDING INSPECTOR 'NV-ld 101d S30b-ld3EI SIHl 'a3SOdWlH3df1S '013 'S39VU -VE) 'S3H0LIOd HIM 'S9N1a-une d0 SNOISN3W1a LOVX3 aNV S3N11 10'1 WOM4 3ONV1S1a ONV 101 JOSNOISN3WI0 LOVX3 MOHS.LSf1W N01103S SIHl Zt I AONVdf1000 L aaOD31 JNIa11n9 VNllV3H ON _I PJC I +'1 P"L 1.W.9 J181J313 110 SWOON 10 SVJ Sa31V3H llNn 0.1.H 1NVIOV8 JNINO1110NOJ a1V _ Sa311Va DOOM dOdVA 80 8.1.M IOH slOJ B 'SW9 13315 WV31S Nana aIV lOH 03J801 3:)VN8n1 SS313did _ 'S10J V 'SW9 839W11 1SIOf 000M 9NIIV3H Il I ONIWVUd 9 OOVO 3111 a0o13 3111 _ S38n1X11 N8300W ONIJOOa 1108 83MOHS 11VIS 13AVaO 8 8V1 ON19Wnld ON 31y1S ANIS N3HJ11X S30NIHS DOOM A8O1VAV1 S910NIHS 11VHdSV 13SO1J 131VM 1V11 1'X11 LI W8 131101 08VSNVWNVW �f-36—SWIVO — X11 EI HlV9 dlH 319y0 ONiownld 0 dooa 5 �I a00d 3a011J3dns ONI81M _I 80011 F 'sats J111V 3WV81 NO 3NO1S kdNOSVW NO 3NO1S 'X19 a30NIJ a0 ':)NO:) 3WV81 NO XJIa9 kdNOSVW NO XJI89 —� E 9 3111'HdSV NOWWOJ 3WVa1 No oJJn1s ABNOSVW NO 655n1S ONIOIS '183A `JN101S SO1S39S7y O.MOaVH ON101S 11VHdSV HldV3 S310NIHS 000M 08 1O9d0 313aJNOJ S08V VlD SM0013 6 II S17VM b N3HJlIX N8300W S3JVld 32113 V3SV JI11V V36V .1.W.9 NI1 W008 OV3H 1.W 9 ON ilnl V3ay — — E L HSINId _— 1 N13Nn llVfA Ad(] a31SVld — O MOaVH 3NId E 801831NI 8 1N3W3SV9 £ S831d 3NOls 80 XJla9 'X.19 31DDNOJ 313aJNOJ NOIIVONnOd Z N 0 i.L::) n H IS N 00 S1N3WAVdV s3JI13o_— Allwvl I11nw S31N0!SI AlJWVJ 316N SS Zt I AONVdf1000 L aaOD31 JNIa11n9 L.. 4 02 = oc of oe , H H o Lm 0 ._ � 0 a a� Q W 0 C cc ow 'fl C W o y.r L o a H c a h Z O z P o •wn C z �ZD._ z W C W O 0 m J G .0 z ? ma �. _z to Qown u of J m W u z m L C E .d a. L Ql W O) N U m {.- llJ Y 7 cS3 3 > cd _ O C fhW O Q u ii a: ii Q iL ¢ U. m N vEj A U.e r"-, 164Q w 0 e 0 v h e 0 V c Ix Q au, a h C 60 r 0 00 c 40v H 3 as ..a m C ci y I .0 w 0 c O a d •; _o c cc 4 C.4 0 Z Nil , H H o Lm ._ a E a a� Q L CL 0 C ow 'fl C W o y.r L o a W c a CL o •wn C C �ZD._ .wn — C � 0 m m .0 �. to Qown J Location No. Date 140*Tpf TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee CHU $ Other Permit Fee 1 006, $ el L-.> Sewer Connection Fee $ 1 � C-1 W@Ier, ion Fee $ OTAL $ Buildindlhspedtor �cf Div. Public Works Location No. Date ,&ORTN TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewir, Connection Fee $ `WAM-F'06nnection Fee $ L $ !Icdow Building Inspector Div. Public Works PER11IT NO. J J APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 m7kia KJO. LOT NO.y 2 RECORD OF OWNERSHIP iDATE BOOK 'PAGE ZONE SUB DIV. LOT NO. LOCATION r-- P�{ uo �'Q N S� PURPOSE OF BUILDING �� N i 1—C L e r y(3 „ / ^ OWNER'S NA!!R t4" nc ,��y NO. OF STORIES SIZE OWNER'S ADDRESF n AY j-O� BASEMENT OR SLAB ARCHITECT'S NAME - SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME' 6 t? i Pao /L &.?,&%"O r ,/ SPAN --- DIMENSIONS OF SILLS DISTANCE TO NEAREST BUILDING 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 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 PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BYY%BUILDING INSPECTOR v//DAFILED Cpl („ S 3 PROPERTY INFORMATION LAND COST V EST. BLDG. COST EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM ,IV iMIRC PERMIT NO. 1n2_ 4 APPROVED BY BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED AGENT OWNER TEL. N. t? ' �%q 9� F e t (v jcr CONTR. TEL. # VCONTR. LIC. # PLANNING BOARD PERMIT GRANTED M 19_ BOARD OF SELECTMEN i BUILDING INSPECTOR 'NV1d 101d S3aV1d3u SIHl 'a3SOdWIM3dnS 'a13 'S3ovu -V0 'S3HO210d HIM 'S°9Nia-line d0 SNOISN3Wia 17VX3 aNY S3N11 101 WOLId 30NVJ-SIa aNV 101-40SNO1SN3Wla 17VX3 MOHSiSnW N01133S SIHI z1 I AaNVdnaOo I aV033b JNiciin9 `JNIIV3H ON I P'6 I +s 1 1 PUZ 1.W.9 JI8IJ313 110 SWOON dO SV J SM31V3H.IINn J.1.H 1NVIOVM JNINOI110NOJ 81V _ S831dV8 DOOM MOdVA 80 8.1.M IOH S10J 8 'SW9 1331S WV31S 'NMnd MIV lOH 03JMOd 3JVNMn3 SS313d1d SlOJ 8 'SW9 8H9WIl 1SIOf OOOM ONIMH II II ONIWVMi 9 OOVO 3111 80013 3111 _ S3Mn1Xlj NM300W `JN1300M 1108 _ 63MOHS IIV1S 13AVdO 8 MVI `JN19Wnld ON 31v1S ANIS N3HJ11A S30NIHS DOOM AMOIVAVI S319NIHS 11VHdSV 13SO1J M31VM 03HS lyld I'Xld ZIW8 -T3-1 10-1 08VSNVW 13M9WV0 'X13 EI H1V9 dIH 319V0 ONIHWnld O( 1 i008LNON 5 I 3801Od 11 MOOd I S ONINIM 3WVM4 NO 3NOIS ABNOSVW NO 3NOIS 'A19 830NIJ MO 'JNOJ _I 80014 8 'S81S JI11V 3WV8d NO AJI89 ABNOSVW NO AJi89 — _ _E e _ _ 9 3lI1 'HdSV NOl°IWOJ 3WV4d NO OJJn1S AMNOSVW NO OJJn1S ONIOIS '183A `JNIOIS SOIS31SV G ti\(]BVH ONMIS 11VHdSV H18V3 S310NIHS 0008 3138JNOJ S08V1O9dVlo SHOOK 6 S11vM v N3HJ11A Nd300W S3JVld 3813 W008 0V3H 1.W 9 ON % t/, %, llndy38V V38V JIIIV NIj V38V .1.W.9 'N13 1N3W3SV9 £ NI1Nn 11VM A80 •y 831SV1d S831d O. M08VH 3NOIS 80 AJIM9 3NId 'A.19 3138JNOJ 3138JNOJ HSINIi 110IN31NI 9 NOliVdNnOi z N0uonHlSN00 S1N3W18VdV S3J13d0 —_ A11wvd 111nw 53180!S AIIWVJ 310NIS z1 I AaNVdnaOo I aV033b JNiciin9 FORM U TOWN OF NORTH ANDOVER LOT RELEASE FORM SUBDIVISION ASSESSORS MAP SUBDIVISION LOT(S) S PERMANENT ADDRESS (ASSIGIB BY D.P.W. STREET 1).r 0114n_Q'n AZ S APPLICA PHONE } i 7 DATE OF APPLICATION TOWN USE BELOW THIS LINE PLANNING BOARD DATE APPROVED TOWN PLANNER DATE REJECTED CONSERVATION COMMISSION DATE APPROVED CONSERVATION ADMIN. DATE REJECTED BOARD OF HEALTH DATE APPROVED j HEALT S IT I DATE REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT SEWER/WATER CONNECTIONS FIRE DEPT. RECEIVED BY BUILDING INSPECTION DATE This form shall be signed by the agents of the Planning and Health Boards, ` the Conservation Commission prior to the issuance of any building, permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. A S 0 O 1t. 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