Loading...
HomeMy WebLinkAboutMiscellaneous - 34 Camden StreetForm of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings City Hall N Andover, MA 01845 To: Board of Health or Board of Selectmen City Hall N Andover, MA 01845 RE: Insured: Alfred Charest Property Address: 34 Camden St N Andover, MA 01845 Policy Number: F0114091 Cause/Date of Loss: Water Damage Loss of 10/24/2005 File or Claim Number: BOSO43406 RECEIVED DEC 0 2 2005 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 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. Don Winslow 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. 2,a 6 6) Signature Date New England Claims Service, Inc 100 Conifer Hill Drive Suite 308 Danvers, MA 01923 (978) 777-9900 (978) 774-9296 �l Date ..... �-...:...:f 1 °f o= °� TOWN OF NORTH ANDOVER 9 49 o PERMIT FOR GAS INSTALLATION 1 This certifies that ................. has peri ission for gas installation ....... in `the buildings of ... ......................... at '' . ' . � :�. �. r .............. , North Andover, Mass, Fee.,.! . f .. Lic. No.... ��' .. ��- � -7. .......... GAS INSPECTOR Check # �% C 36 '2 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING � (Print or Type) ,�-`Veeoe� , Mass. Dat Permit # �0 2 Building Location 1 Owner's Name r,-4, Alhw"v f Type of Occupanry New ❑ .Gi.- SUB—BSMT. BASEMENT 1ST FLOOR 2NDFLOOR _ 3RD FLOOR 4TH FLOOR STH FLOOR 67H���. FLOOR 7TH FLOOR STH FLOOR Renovation ❑ Replacement Plans Submitted: Yes❑,iNo ❑ Installing Company Name �j j �, r (ZzT `,AN) M A T wl 120 Check one: Certificate Address 30 0QA (H iv%A. nJ i-Kf . ❑ Corporation y 111 E z H U E fJ ri1 r� D( ?q y ❑ Partnership Business Telephone /z, 2 — 9 9 "7 f 2-Firm/Co. Name of Licensed Plumber or Gas Fitter -f' c?mr--r A `�AMrrt �Tr�i�r� -- INSURANCE COVERAGE: I have a current f bility insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes [ No ❑ If you have checked Les, please indicate the type coverage by checking the appropriate box A liability insurance policy 0--- ' 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 ❑ Sig ature 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 pe ' i ed for this application i be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of ne Laws. AiBy T of Ucense: C� Plumber n ure of licensedu or atter Title Wtter 9333 er Ucense Number City/Town Journeyman N N C7 Y< ¢ N WW z ¢ ¢ F- '= Z W O W J d Vf ¢ c m = }- 4 2 W V Z C U. u< < W S F„ N ¢ y ¢ W H N W >• c N ¢ O ¢¢ W y=j O N d Y V O 0 < O m J = O c ¢ > Z U¢> N z FO- 1L OZ¢ ¢ S c W }- !- i- W O S J O b #A H1 ¢ S O Installing Company Name �j j �, r (ZzT `,AN) M A T wl 120 Check one: Certificate Address 30 0QA (H iv%A. nJ i-Kf . ❑ Corporation y 111 E z H U E fJ ri1 r� D( ?q y ❑ Partnership Business Telephone /z, 2 — 9 9 "7 f 2-Firm/Co. Name of Licensed Plumber or Gas Fitter -f' c?mr--r A `�AMrrt �Tr�i�r� -- INSURANCE COVERAGE: I have a current f bility insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes [ No ❑ If you have checked Les, please indicate the type coverage by checking the appropriate box A liability insurance policy 0--- ' 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 ❑ Sig ature 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 pe ' i ed for this application i be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of ne Laws. AiBy T of Ucense: C� Plumber n ure of licensedu or atter Title Wtter 9333 er Ucense Number City/Town Journeyman IF r. V r a � > 2 � � O a z = to o a o O v 0 O ,n i O 2977 Date/�>/? 2 �S,f ....... HORTM , TOWN OF NORTH ANDOVER (Aya..ao ,a�00L p PERMIT FOR GAS INSTALLATION i This certifies that ............................ • has permission for gas installation ...................... in the buildings of ........................... at ...) t :. �' a. �. :.:.............. . North Andover, Mass. Fee.. ?... Lic. No.. �.'. ... ......................... . GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GA. FITTING (Print or Type) c�a v d Ve-Y' Mass. Date &419 /d Permit # Building Locati n Owner's Name r<e&-re6l-1 c Type of Occupancy 17tr" N T i r� New p Renovation ❑ Replacement 2 Plans Submitted: Yes❑ No p Installing Company Name r) t;e (2 TA .: Affi Al A T ir1 �Q Check one: Certificate Address 3 0 Cn A C H m A rV i - II " ❑ Corporation f11 r= 7 H U E fJ ri'i r� L t k� ❑ Partnership Business Telephone /L, 2?2 - 9 9 "7 f 2-'rm/Co. Name of Ucensed Plumber or Gas Fitter --R a a E e.'T A- '5 A M M H i r4 CC INSURANCE COVERAGE: I have a current f bility 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 yid Other type of indemnity ❑ Bond ❑ QH/NER'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: Signature of Owner or Owner's Agent Owner❑ 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 pe ' i ed for this application be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of mer Laws. By T of License:4C Plumber t-WhAture of Licensed PlumftrorGaqsltv�R Title tter er License Number City/Town Journeyman } i ENE Installing Company Name r) t;e (2 TA .: Affi Al A T ir1 �Q Check one: Certificate Address 3 0 Cn A C H m A rV i - II " ❑ Corporation f11 r= 7 H U E fJ ri'i r� L t k� ❑ Partnership Business Telephone /L, 2?2 - 9 9 "7 f 2-'rm/Co. Name of Ucensed Plumber or Gas Fitter --R a a E e.'T A- '5 A M M H i r4 CC INSURANCE COVERAGE: I have a current f bility 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 yid Other type of indemnity ❑ Bond ❑ QH/NER'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: Signature of Owner or Owner's Agent Owner❑ 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 pe ' i ed for this application be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of mer Laws. By T of License:4C Plumber t-WhAture of Licensed PlumftrorGaqsltv�R Title tter er License Number City/Town Journeyman } Z O P 0 W ' a N Z N N W Q d O IL v z• r N } J � = O O p W O V• � O O J } m O V } O W IL 0 � v � L Z J d NI W S V F- I W Y N ro =I N22257 0 Ss HUS Date`' -'o(-70 .... :................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that............. ................................................................................ has permission to perform ................................................................... I , C/ —a- 10, wiringin the building of ........ ......................................................................... . .............. . at.. 2-/..( .................................................. North Andover, Mass. .-j I I / — Fee�� ............. Lic. No . ............. .... / :�p K�' , ............................................... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer ThEC0] 0JVff .4LTH0F1�,4SS Q7L j Office Use only DEPAR7AIDVI0FPUBLICS4FM Permit No. e7_11R,577_ BOARD OFMEPREVEAWONREGJMTIOAN-WO 812-0 Occupancy & Fees Checked UVPPLICATIONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date M a,r Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street &Number)r^ qM ele✓J �'� . A) O , Y�, O� © V,, --,,— Owner or Tenant e a/ g—h a rP r �- Owner's Address 3 ell- Cam !It/ e-,4. Is this permit in conjunction with a building permit: Yes M No Q-- (Check Appropriate Box) Purpose of Building evi-Utili ty Authorisation No.00 2AL t' Existing Service 7 o 0 Amps �i Li, dvolts Overhead 7711inderground � No. of Meters 2 New Service _ 7_9 Amps e / Q_ olts Overhead [23 --'Underground Q No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets 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 Taal Pumps ' Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW El Connections No. of Water Heaters KW No. of No. of Signs Ballasts No. Hydro Massage Tubs No. of Motors Total HP 117 htsu'arceCo�e R�svanttDthetecllmena>LsafMa�It�GatealLaws IbawaanartLmbtkyhnlm=PbbymduLfzrtgCaro to tritssdluim tat YES E3-0 NO E] Iha%e%hngmdvalidprcdbfsameiDtheOlire YES 0 r7 IfjcuhmedwdmdYES, P=aserdc*,theNx fcae'aebyd=kingthe IlVSURANCE BOND r7 OTHR M ft eeSpx y) E*ffatmD* WC&IDStalt /- f. ?-.7 hgwionD*Recl xswd signeauttdas%W, FIRM NAME rrl Q r�J a lea fir, c Estcttated VahtedEleeati Wade S Rotlglt Fid �Z',Ll L+owseNa /V% Z Licensee '�;et 1; m A i a C r i, a Sigmw 0 u% —LC:a: �(I L;oa1seNo n �— Bts¢>fssTd.Na Adim %D Z f /5�12 n .gin i� • ��Vtk 1.2,& sx _ JA R, C,4 AIL Tei Na 6 S 2" f SG OWNER'SINSURANMWAIVER;iamawat dwlheLmwdmntt�ethemann awnW"se#Wff1asm#WbyNtsat=MCrrealLm&s andthatmysigrotxecnthispmrmappfi=mwainthism*M = (Please check one) Owner M Agent Telephone No. PERMIT FEE $ I-ocation 7 No. .3c� t Date rl` -Sl - °"T" TOWN OF NORTH ANDOVER A Certificate of Occupancy $ �. Building/Frame Permit Fee $ ,'SIACMUSEt Foundation PermitFee $ Oth r Permit l2ee $ 9,r' U 1 Sewer Connection Fee $ -- Water Connection Fee $ --"'-- 1 5 — — Building Inspector 639 Div. Public Works PPR\IIT NJO. / APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. L,4'IAGE 1 MAP 440. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE ZONE SUB DIV. LOT NO.I LOCATION _[ PURPOSE OF BUILDING /C J lvSIZE 6• �:JTY. OWNER'S NAME) /+� fA -.� NO. OF STORIES OWNER'S ADDRESS l� BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME ` L 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 t 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 I FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 �Y 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 FILED 193 .eC- _ ! 3 - l`_'c_ ice/ �"�✓ L SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE _ I PERMIT GRANTED AUG2 i E �I nvvv 19�/JV L OWNER, TEL. CONTR. TEL. # Scll ? CONTR. LIC. # fie 3 PROPERTY INFORMATION LAND COST EST. 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 WwlL BAY IMO 6GTTVR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY I I SFORIES 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 I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE B 1 2 ('- CONCRETE BL'K.PINE BRICK OR STONE � PINE D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN, B'M'T' AREA _ '/. 1/1 FIN. ATTIC AREA _ N_O B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARD1!J'D ASBESTOS SIDING _ COMIACN VERT. SIDING ASPH. TILE STUCCO ON FRAME WIRING POOR NONE Y� 5 ROOF I) 10 PLUMBING D MINGLESI�IINGES ACHENRSIONKT 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 3 COLS. STEAM STEEL BMS. 3 COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS 011 B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING t KAREN H.P. NELSON, DIRECTOR In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number is that the dcbris resulting from this work shall be disposed of in a property liccnscd solid waste disposal facility as dcfincd by MGL c 111, S 150A. The debris will be disposed of in: (Location of .Facility) I kSignature of Pc it Applicant 3Z 9 D e NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. TOw '- " . 120 Main Street OFFICES OF: " .o .'`' NORTH ANDOVER North Andover. � APPEALS Lt "L' ..N Massachusetts ots45 BUILDING �ye'•u:;Y�d DIVISION OF' (617) 685-4775 CONSERVATION HEALTH PLANNING& COMMUNITY DEVELOPMENT, ' PLANNING KAREN H.P. NELSON, DIRECTOR In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number is that the dcbris resulting from this work shall be disposed of in a property liccnscd solid waste disposal facility as dcfincd by MGL c 111, S 150A. The debris will be disposed of in: (Location of .Facility) I kSignature of Pc it Applicant 3Z 9 D e NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. � uJ 0 N0 CAI (l) O x 4 y sr Ow50 �I m ° fv Z\ t7 >• 3 n (!� r 9{ y s co So m o go z 0 m m � H zoog \pp 2 N m 1 � o z c 4 7�1 n ol x .J i oo c+ en mr ' Z o N .a O �Kzso �+ mz i�r►3ro�o����ms.� �'� A. -w 'S1iR4n�►�i ZVZ fl "nn m00 yop a m O times 10 m a "��T' �c> m O O cm 0, Z O c1 y �Q z -0 C Nmril lH Z m ob ►<-1 N O y O S T z .rt C7 m D D D �r .4_'tA- , .° r'•'t�, �` �� f f e �. a i..4......c :', .} .,+ ro s' r t; dsi imFt t+'yTr S ;. Z } :�✓t h. t ..a u.j+-F '. � .fit T I i'! tt.a{ F 1'w4 Rc 6 1 1-.^i "f. y. -.Neil Kalman\ ; R y, + � , W �� � �#,F err , y � tJorrn day 39 Beltran St. y0 Jefferson :�. z+ a}F Maiden, MA 02148 ,. �, res- a N An"over MA 01845 T ,, 617-322-7352 , j '508-685=6471 Y. sir....`' sv-�c +rt - +1"x c y EASTERN CONSTRUCTION CO.19 _ GUTTERS M CHIMNEYS ROOFS � JACKING PORCHES WINDOWS 'q.. ,, i�•1�� /r /2��s''fd%'/"� - ��'li" �C/G �. �� . j9?f .GDS" Y 14167. _ K ��� . y'-- ,�'�� lIc-� , �'� 1�/c1il%�J' `� /'�f,71•G /�l� lcJ •��'ClJ' `y/ /i�'e. l,.✓� �N _ e •t� /�-f �ifr% .S/,.� tL� t%s�i�'. L.rf�..(' � �''^� i" ' l/y$�C,.� �i'rr.'l7-'t' ;� J`.��' , a � � z z_�r�' :s �� L/..IJ Vii• cf= T �' �""' _ Balance due in full upon completion. r , As a condition precedent to any liability for defective or Improper work- manship, written notice of any claim for damage must be given to the TOTAL TOTAL „� CF•, Contractor within fifteen days of the discovery thereof. Contractor agrees to i repair the some, If there Is any defect in his workmanship of material, and r Contractors sole obligation shall be to repair or replace defective work- DEPOSIT K” manship. Contractor shall not be liable for any consequential damages resulting from of caused by any defective of improper workmanship, whether BALANCE j\ such damage it based upon warranty, contract, negligence, or otherwise.. C') C) z m D C) z z D r CA 0 Z CD O CL r CM Cm V O XqCDv CL Q CD O CO) 10 CD O 7 LTJ Nf d O CO! n� O CO) CD O �F CD CDa Cn. CD CO) 0 0 CCD 0 CCD Ccl= _ z CD -•a,oa N CL o CCD y O O NCDac = ai Z =r -O H _i O .-► CD N T P m Cl. co -Jo O N O .••� O CD CD = CA COQ OCC7 0 O C N D . O W O C =r N'�: a = aco rL Ca 5 0 .+ ' o CD O CD O N co ~ C7 � H"1 O O. R �-y CD � � O N C= 0 CL " ' CO) r CD CO N CAO OCD � CSD pt N ul 0 CD oCD '' ^^ c c�D d► � � f m � y ,' �� icy: �' V J s, o S s CD CL�.� CL od� � C �. c o cl o w o cn �- � r°rD to 7 mIt � 0 ZrD w � z o COD T O p w o o�n C) M 0 °'— rD o o a pa cn o 4 O x y 0 A m •