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HomeMy WebLinkAboutMiscellaneous - 450 Forest Street / 450 FOSTER STREET 210/104.B-0016-0000.0 Cunningham Lindsey U.S.,Inc. P.O.Box 703689 CUnnin am Dallas, 75370-3689 Lindsey ey Telephonene j.�(888)738-8714 Facsimile(214)488-6766 CLCAT@CL-NA.COM March 24, 2015 TOWN BUILDING COMMISSIONER 120 Main Street North Andover, MA 01845 Claim Number: A033566337 Policy Number: 65794400003 Company Name: ARBELLA INSURANCE GROUP Date of Loss: 03/02/2015 Insured: THOMAS LANG Property Location: 450 FOSTER ST, NORTH ANDOVER, MA 01845 To Whom It May Concern: Claim has been made involving 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. ;Location 1-4v No. D Date ,d V40RTM TOWN OF NORTH ANDOVER Ota,.•° , ,'b0 I ; p Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ � � r•0. Other Permit Fee $ Sewer Connection Fee $ gg&Mater Connection Fee $ • 6 �' TOTAL $ S' . S l� Building Inspector Div. Public Works PRWMIT a,O./D/ APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. /PAGE 1 MAP 4-40. LOT NO. 12 RECORD OF OWNERSHIP IDATE BOOK :PAGE ,ZONE SUB DIV. LOT NO. F I / LOCA OS PURPOSE ✓li't �/ ���� ��T !1„/d /a 6� "NN OWNE ' AME � L ��' NO. OF STORIES /'-` /7 SIZE • /'Y`w WNER!Z,ADX&S BASEMENT OR SLAB _ ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD 11 BUILDER'S NAME ` 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 1�eBUILDING ADDITION MATERIAL OF CHIMNEY BUILDING AMTION IS BUILDING ON SOLID OR FILLED LAND ILL BUILDINCfCO FORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APP ALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER _ 4a IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION L= COST SEE BOTH SIDES EST. BLDG,XT,,,-- ., PAGE 1 FILL OUT SECTIONS 1 - 9 ECT. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS /PLANS MUST B-E/FILED AND APPROVED BY BUILDING INSPECTOR V/ ATE FILED BOARD OF HEALTH SIGNATU=zric4lo- WNER O AUT ORIZED AGENT F E E .3 PLANNING BOARD PERMIT GRANTED OWNER TEL.# 3 `3 CONTR.TEL.# CONTR. LIC.# BOARD OF SELECTMEN ' BUILDING INSPKCTOR � � ao � i BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES 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 RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH !! ,�/(it CONCRETE 3 I 2 I3 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. B M TAREA _ 1/1 1/1 l/ FIN. ATTIC AREA NO B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDW'D ` ASBESTOS SIDING _ COMtACN VERT. SIDING ASPH.TILE STUCCO ON MASONRY �— STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE iON FRAME t SUPERIOR POOR I-] ADEQUATE NONE _- 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) GAMBRELMANSARD TOILET RM. (2 FIX.) FLAT A 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 11 HEATING ri WOOD JOIST PIPELESS FURNACE C FORCED HOT AIR FURN. TIMBER BMS. 6 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 IL O B'M'T 2nd _ ELECTRIC 1st 13rd I NO HEATING J z S FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** �/Io APPLICANT: 72,r.5 l J 'K .y.ee T Glt)6' Phone ifs r5 LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) Street . 10 AsTcx- .JT St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit `Fire Department 6� Received by Building Inspector Date y Suggested Affidavit for Home Improvement Contractor Permit Application For Office Use Only NAME OF CITY/TOWN Permit No. A7 11-117 CIO(/e.__ Date AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c.142A requires that the"reconstruction,alteration,renovation,repair,modernization,conversion,inprovement,removal,demolition. or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: �.a1s/—S4 4A.rQ'We.v ?� Est. Costff3'a'77) Address of Work_'Ao rS Tc� f1, Owner Name: _4_, ,V&S Ge..) 7- 9%,tz� L,q Al!G= Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law Job under 51,000 ::X7- tlding not owner-occupied wner pulling own permit _Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: '1a 4 �� Date Owner am C Scat¢.. P,� ^ Eli ► LA u �I f � � c Fr QCs � � � liu*L7- Tnl 'd —�-4---- � - % �1 PQ I i I 1 ' v � ORTH ovm Of 0 � over No.10 s .:.z � oC,.;,-CIpdower, Mass., &,eA/L at 4 19 Ai A0RATE0 PPa��,�cJ BOARD.OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT. � f ow'.."�".l..�./�.�C��J..�.. ..�................................... Foundation has permission to erectA)AU14................ buildings on... � r C. ... .. Rough to be occupied as.gI.�V�.� .. .; A.*Vr*.# ....Af#V!-J'0 r C e.................... himn y provided that the person accepting this permit shall in every respect conforrif to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. s�l�/� /f w /*�C •��I rMi1 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough .... W . .. . ....... .. ..... ........ Service . BUILDING INS ECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. cnn►en MIATED PIKI0PRivr\A/AY FNTRY PERMIT _ _