HomeMy WebLinkAboutMiscellaneous - 99 COACHMANS LANE 4/30/2018 (2)Owl
Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
To: Building Commissioner or
Inspector of Buildings
1600 Osgood Street
North Andover, MA 01845
RE: Insured:
Property Address
Policy Number:
Date/Cause of Loss:
File or Claim Number:
Michael & Theresa Buonopane
99 Coachmans Lane
H P2482498
2/27/2015, Water/Ice Dams
31924-R
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 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 and claim or
file number.
Ryan Werner
On this date, I caused copies of this Notice to be sent to the perso s named above at the
addresses indicated above by First Class Mail.
Sign?tuo and Date
ANDERSON ADJUSTMENT CO., INC.
50 Nashua Road, Suite 303
PO Box 1098
Londonderry, NH 03053
li�
NO*T"
,•'` Zoning Bylaw Denial
Nr Town Of North Andover Building Department
. ' 400 Osgood St North Andover, MA. 01845
Phone 9784884M Fax 873483-M2
Street
37.
Request: I Famil Suite
Date 1 ti n hlication is
Please be advised that after review of your Application and plans that your APP
DENIED for the following Zoning Bylaw reasons:
Zoning . R-1 &
item Notes
A Lot Area
1 Lot area Insufficient
2 Lot Area Preexistingyes
F
1
2
herr Notes
Frontage
Frontage Insufficient
Frontage Complies
3
Lot Area Complies
3
Preexists frontage
4
Insufficient Information
4
Insufficient Information
B
Use
5
No access over Frontage
I
Allowed
G
Contiguous Building Area
2
Not Allowed
1
Insufficient Area
3
Use Preexists
2
Complies
4
Special Permit Required Ves
3
Preexisting CBA
5
Insufficient Information
4
Insufficient Information
C
Setback
H
Building Height
1
All setbacks comply
1
Height Exceeds Maximum
2
Front Insufficient
2
Complies
3
Left Side Insufficient
3
PreeYisfing Height
4
Right Side Insufficient
4
Insufficient Information
5
Rear Insufficient
I
Building Coverage
6
Preexists setbacks
1
Coverage exceeds maximum
7
Insufficient Information
2
Coverage Com iss
D
Watershed
3
Coverage Preexisting yes
1
Not in Watershed
4
Insufficient Information
2
In Watershed yes
j
sign _L1 A
3
Lot prior to 10/24/94
1
Sign not allowed
4
Zone to be Determined
2 J
Sign Complies
5
Insufficient Information
3
Insufficient Information
E
Historic District
K
Parking
i
In District review required
1
More Parking Required
2
Not in district yes
I2
Parking Complies
3
Insufficient Information
13
Insufficient Information
4
Pre-existingParking I
Rented for the above is checked below
Item S S ial Permits Planning Board Item #
Variance
Site Plan Review Special Permit
Setback Variance
Access other than Frontage Special Permit
Parldng Variance
Frontage Exception Lot Special Permit
Lot Area Variance
Common Driveway Special Permit
Hei ht Variance
Congregate Housing Special Permit
Variance for Sign
Continuing Care Retirement Special Permit
Special Permits Zoning Board
Ind dent Elderly Housing Special Permit
Special Permit Non -Conforming Use ZBA
Large Estate Condo Special Permit
Earth Removal Special Permit ZBA
Planned Development District Special Permit
Special Permit Use not Listed but Similar
Planned Residential Special Permit B-4
Special Permit for fFamil Suite
R-6 Density Special Permit
special Permit preexisting nonconforming
Watershed Special Permit
The above review and at! r,' m i mplanetion of such is based on the plans and intarrnation subrnimsd. No definitive review and
or advice shall be bsasd on vubd eiphnalions by the applicant nor shay such wrbsl se9larnMOm by the Whcent aw" to
provide de k*m answers IDV* above ramine for DENIAL. Any inaccuraces, mialsadMhg ihbrrrnatiorh, or other subsequent
changes to the informdion sub It' ' by the applcant shallbe grounds for this revMw to be vddad at tt» di@crM n of the
BulMig Depwbrhsit. The Anchad doctamnt titled 14m Raviaw Nwadve' shill be sMachad haralo and incorporated herein
by reference. The buil ft d"sibi ud will retain all phos and doaanentstion for the above file. You must fle a naw building
permit appiiatim form and begin the pu,.Mh process.
zLits.�.
Building Department Official Signature
Application Received
//W/-16 - 6
Application Denied
Denial Sent: If Faxed Phone Number/Date:
Plan Review Namkdve
The following narrative is provided to further explain the reasons for denial for the application/
permit for the property indicated on the reverse side:
loom IIMMIM 1t[ Do"
B-4 A Special Permit through the Zoning Board of Apppalg J -s
re uired for a family suite in R-1
Zoning )bylaw.
required for a properties
Protection District.
Referred To:
Fire
Health
Police
x Zoning Board
Conservation
Depadment of Public Works
X Planning
Historical Commission
Other
BUILDING DEPT
Location "1 77 620 tS `A U -e-,
No. Date a
MORTH TOWN OF NORTH ANDOVER
O
� 9
Certificate of Occupancy $
�'�s''••°''•t�' 9
uBuilding/Frame /Frame Permit Fee $—
s�cMs�
Foundation Permit Fee $
Other Permit Fee $
TOTAL $ �Q
Check # 399
15334 Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
r
BUILDING PERMIT NUMBER:1-107 DATE ISSUED: :�17^
SIGNATURE: ZLLC
Building Commissionerfl for of Buildings Date
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1.1 Property Address:
99 Cok H mNvs L p-
1.2 Assessors
t> T)
Map Number
Map and Parcel Number:
Parcel Number
1.3 Zoning Information:
Zoning District Proposed Use
1.4 Property Dimensions:
Lot Areas Frontage 11
1.6 BUILDING SETBACKS ft
Front Yard . Side Yard
Rear Yard
Required Provide Required
Required Provided
T-
FProvided
1.7 Water Supply M.GI-C.40. 34) 1.3. Flood Zone Information:
Public ❑ Private 0 Zona Outside Flood Zone 0
1.8 Sewerage Disposal System:
Municipal 0 On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
C RP& 9 (0"
Nam Tint) Address for Service
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone
SECTION 3 -'CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
j� I
Licensed Construction Supervisor:
2322 44�- "e,,1
Address
l00 — l
Signature Telephone
Not Applicable ❑
09 3 p(of
License Number
Expiration Date
3.2 Registered Home Improvement Contractor
2 C� w co
Not Applicable ❑
t ��3z
Company Name
zSZ
Registration Number
l b I (kooz
Address
" - -` A4 l�y 2 " �"' .
Expiration Date
Signature Telephone
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90
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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 wdl
in the denial of the issuance of the buil4trig permit. _
Signed affidavit Attached Yes ....... V No ....... 0
SECTION 5 Desch tion of Proposed Work check ail applicable)
New Construction ❑ Existing Building ❑ Repair(s) Alterations(s) ❑ Addition ❑
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
Axl A,►" )1 ' D(t b 3 Seayoti ( ,
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04.
CVA"rrTnN A _ PCTTMATTTI irnNCT01TfTTnN VnCTC
Item
Estimated Cost Dollar to be
Completed by permit applicant
_
112
1. Building
(a) Building Permit Fee
Multiplier
2 Electrical
t� f
(b) Estimated Total Cost of
Construction
3 Plumbing
Building Permit fee (e) x (b)
Q
4 Mechanical HVAC
5 Fire Protection
6 Total 1+2+3+4+5
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
Q AU A- as Owner/Authorized Agent of subject property
► f�
Hereby authorize ��� to act on
My behalf_, ip all mattersativ to wor authorized by this/building permit application.
Signature of Owner T Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
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 knowledge
and belief
Print Name r�
Signature of Owner/A ent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TBOERS 1 2ND 3
PD
SPAN
DDv ENSIONS OF SILLS
DIN ENSIONS OF POSTS
DIN ENSIONS 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
B-23-1995 8.20PM FROM
v w
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t
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
Please Print
Name: ® / ,�
Location: -/. 9 I.CJWtf "a4A 1___4,J,4A a
l l am a homeowner performing all work myself.
F -1I 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 'ob.
1
`t3 &Y)133
Company name:
Address
City: Phone #
Failure to secure coverage as required under Section 25A or MCL 152 can lead to the Iroposition of criminal penalties.of a fine up to $1,500.00
and/or one years' imprisonment as well as civic penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I
understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
I do herby certify under the pains and penafies of perjury that the information provided above is true and correct
Signature �V���j, Date 2119 Wce
Print name `y�� lit Phone #_7 r
Official use only. do not write in this area to be completed by city or town official'
❑Check if immediate response is required Building Dept
Contact person:
RM WORKMAN'S COMPENSATION
❑
Building Dept
❑
Licensing Board
❑
Selectman's Office
❑
Health Department
❑
Other
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NORTI{
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�,SSACMUS�
Date ..; ..//.. o
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ........!�1.a(.ti..�n.i. s ..........Ll F.4...... 5
has permission to perform .......�...... ......... A ..............
wiring in the building of ...... �1 /f..:...��.............................................
..... , North Andove Mass'
at ....... ...�.�C�..�-��G%C??.4.f1...S.....�.�...... �
�ee. ....�(1.. Lic. Nq4........... ...... ........ .r,f./ER
...Y/.. ....
LECr IC AL IN
Check It —1---T—
,
TW OOMMONWE4UHOFMASSCHUSEM Office Use only
NPARTMENTOFPUBLICS4MY Permit No.
BOAM OFMEPREVEM7ONRWUL MOAN5270M IMO �—
Occupancy & Fees Checked
1" PLICATION FOR PST TO PERFORM ELECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00
kr r�L'r%aLo r RINT IN INK OR TYPE ALL INFORMATION)
Town of North Andover
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number) tr O t -C �4 N A I�J S
Owner or Tenant b A-eA-Z—i A-
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Owner's Address
Date .� f t 10 2__
To the Inspector of Wires:
Is this permit in conjunction with a building permit: YesONo a (Check Appropriate Box)
Purpose of Building L( --S t , s Utility Authorization No.
■ 1�1���1 ISI■■1� -�
Existing Service Amps / Volts Overhead Underground rl No. of Meters
New Service Amps �/� Volts Overhead Underground No. of Meters
Number c}f Feeders and Ampacity
Location and Nature of Proposed Electrical Work i 2- , I S 6A So u 190
No. of Luting Outlets�Zl
No. of Hot Tubs
No. of Transformers
Total
KVA
No. of Lighting Fixtures���
Swimming Pool Above
Below
Generators
KVA
and
ground
No. of Receptacle Outlets Si
No. of 0il Burners
No. of Emergency Lighting Battery Units
No. of Switch Outlets
13
No. of Gas Burners
FIRE ALARMS
No. of Zones
No. of Ranges
No. of Air Cond. Total
Tons
No. of Detection and
No. of Disposals
No. of Heat Total Total
Pumps
Toffs
KW
Initiating Devices
No. of Sounding Devices
No. of Dishwashers
Space Area Heating KW
No. of Self Contained
Detection/Sounding Devices
Local a Municipala
Connections
Other
No. of Dryers
Heating Devices KW
N of Water Heaters KW
No. of No. of
Signs
Bailasis
No. Hydro Massage Tubs
No. of Motors
Total HP
Y
OTHER
lr ranoeCaaagz Pustrantbthera ana�afMassachst Ga�aallaws
Ihawa=utLiabt*his r&=Pc ymdAgC vide. �
ComaWcristt�a}eva" YES LJ NO
Iha�eabrutbdNddptoofofsmlDlt eOffim YES U NO � F)cuhmechWWYES,plemm&WthetAeafwmaWbydw"gthe
lNKJR CE BOND (PI mspetify)
E#EtlonDtale
E fim*dVakxcfEkChical Work $
WorktoStst , O Z -''' hgieWmD*Rque*d Rough _ 3��.��� Final
SuedtnderTrPtMkksofpeijttty.
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OWNER'SMURA?4MWANER;I.amawatetlnttbeI duespot &irs raneorreoritss&stK le#wimtaste#WbyNb=hB&Cme iLam
aadthatnTys�*uernthispm*appbc bmwai. sthismw'wy ent.
(Please check one) Owner Agent
Telephone No. PERMIT FEE (/CJ