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Home My WebLink AboutMiscellaneous - 120 AUTRAN AVENUE 4/30/2018 / •120 AUTRAN AVENUE J 2101045.D-0007-0000.0 l / - I i -120 AUTRAN AVENUE 210/045.D-0007-0000.0 J E A�r4v A Location No. 4`' Date —2- a a-jc u' MaRTM TOWN OF NORTH ANDOVER 3?O•t . o , ,�OL 4 i Certificate of Occupancy $ tt� Building/Frame Permit Fee $ s�ckus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # so// 4535 :f��G,- ' 5 3 ' Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: 1-7DATE ISSUED: C,) 'caa — .cam® SIGNATURE: Building Commissionerfl for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSIIIPIAUTHORIZED AGENT 2.1 Owner ner of Record Name(Print) Address for Service: w I Signature Telephone Q1 2.2 Owner of Record: 4 Name Print Address for Service: z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ p Licensed Construction Supervisor: Z LA Lk<9 5 License Number Addres Expiration Danes—OZ Signa re Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name 2 J ZS g Z\ Registration Number �• -f9 Addres u1 S 2 Expiration Date Si na re Telephone 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 will result in the denial of the issuance of the building permit. Si red affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check au a Ucabte New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS r Item Estimated Cost(Dollar)to be 0F ';'DW: $10' A' Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction ,5 on6. G c� 3 Plumbing Building Permit fee(e)x (b) 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 I> as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, ,as Owne,Authorized Agent of subject property Hereby declare that the statements and infonnation on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name" IX Signature o) caner/A ent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TEVIBERS OT 2 ND 3 PD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS 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 CORNERSTONE FINANCIAL W GROUP —Building Financial Independence Since 1868— Connell J. Tarr, CLU Chartered Financial Consultant 1 O' 0 ti A) 4A Q 200 WHEELER ROAD PENN MUTUAL SECURITIES OFFERED THROUGH BURLINGTON,MA 01 803 INDEPENDENCE SQUARE HORNOR,TOWNSEND&KENT,INC. 617-229-0777 ♦ PHILADELPHIA,PA 19103 a 200 WHEELER ROAD FAx 617-229-5516 215-956-8000 BURLINGTON,MA 01803 617-229-0777 i r Town of North AndoverNORTH OY�SLmD l6�� O Building Department o 27 Charles Street 'D North Andover Massachusetts 01845 4 Z ti 978 688-9545 Fax 978 688-9542 X44` �`y1m �9SSAC�IUS�� DEBRIS DISPOSAL FORM i In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL el 1, s150a. The debris will be disposed of in/at: CCS SOW C�S� Facility location Signature of Applicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. i I ACORD CERTIFICATE OF AL.11TY INSURANCE PRODUCER {603}772-4781 FAX t,a03j772-324- - �F�CATE7515SUED 5 mwrTER--ol ORtVT6Trr'AA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICA.I�. Foy Insurance Group - Exeter HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTENT?t,R 64 Par tsmouth Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BF_L.0%N YG Box 1030 INSURERS AFFORDING COVERAGE Exeter, NH 03833 INSURED Gaylan Schwaraer vSGP.EF.A Peerless 21 Sandown Road NSURERP Guard Insurance Group OanvT ) NH 03819 to<14ER 1"HF POLICsE n:!"..SURANCE LISTED BELOV4 HAVE BEEN ISSUED TOTHE INSURED NAPaE ABOVE FOR THE POLICY PERIOD IND'CATED N^T) i'NS'A' ANY REG ?F,,- :RDA OR CONDITICN OF ANY CONTRACT OR 0 r HER DOCUMENT v711TH RESPECT TO WHICH THIS CERTIFICATE PJ1A'i NE ISSI F" ? MAY PF;--' T-'`- 'vSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TFWAS EXCLUSIONS AN POLICE TE LItv11TS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS Nsrrr"'_�....—_.. u 7Exarr�CrroVr--- —---------- -- LTR 1 _— TYPE OF lNSUR.4NCE--- — ——POLICY NUMBER — ^ ONE(A'ii,vDOr'rYI DATE{MMIDDIYY) i GENERAL LIABILITY CCP9293305 -� 03 '21/200003/21/2001 1 EACH C--CURRcNCr X COONIERCIAL GENERAL OABS LiTv ! �I FIRE DAL:4GF CLA'`-AS MADE LL( OCCUR I !.'ED E`tP J4n,`n=p?rs_n___._....� __. A �— -- -`-•-' PFRSONA.I.u ACV_IN --_------� � GENFkr+l.AG(,RE'.;At'F . . . GFN'L AGGREGATE Lit,111 APPLIES PEP. PRODUCTS-C.Oh1F1C o - - n AUTOMOBILE LIABILITY r;NYAL'T.) r I lFea 7dani} ALL O'. nL,•;S '.NEO I I UUDIL'�IN 11,-YUTOS SCH=DULED Aj i Fer ce�:on—- -- t-1RED AUTOS BODILY It NON-Olo,NFD Al TOS i Fer a_ar:er:j -- j I PROPFRTY 7A%-1ACE I ,Pe acclaer, ; I I GARAGE LIABILITY r.-----_----�---- AUT;IXi V FAw;C4'cN- I I ;�+\ AUTO Y ! I C -- ----- ! rHA`1 ALA U ONLY r4E� rC\.._ ._.._ t EXCESS! c6,LITYt— -- -'-- I .0 - r I -I I I CLAIMS NIAC'E I :+G FCC-A iL vc .._ -----_.--_ 7 WORhF 'r .2,'0-EN5A710NAND 4WC202185 Ol,rl$/2001 01/1$/2002 OR.y m'ITSI EMP,,i'- -� _... f E L EACH AC;_IDCNT -- F 1. LL ^ISEA.SE I � i I -1------ - -1 --------- DESCRIPTION OF OpFRA77C,'vS,'L.:-iC4T UNSr)IEHICLES%EXCLUSIONS ADDED BY ENDORSEM.ENrlSPECfAL PROVISIONS �- Interior Carpentry CERTIFICATE HOLDER I ADpITIONAL INSURED;INSURER L FTTFR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEf•t'uF I,IF EXPIRATION DATE THEREOF,THE ISSUING C0.14PANY WIf.L ENDEAVOR"D t+c,tt �Q-DAYS WRITTEN NOTICE 70 THE CERTIFICATE HOLDER.NA1..1E.0 TO'H°.t- Town of North Andover j BUT FAILURE TO MAIL SUCH NOT'CE.SHALL IM POSE N003LIGATk,)N0RL�aR�. _ Charles Street OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESEN-A T North Andover, MA 0 1 8 4 5 AUTHORIZED REPRESENTATIVE --' - Gary Rohr CIC -- RPORA`I"ilt;, , t � t { f; t j .., i � � i { ;F �� - - -- -� f /` r -� O ✓fie �arr�nw�zurealC/ �/�aaaclu�aelta ,, BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Y Number: CS 024485 Birthdate: 03/20/1955 Expires: 03/20/2002 Tr.no: 22354 Restricted To: 00 GAYLAN P SCHWARZER 21 SANDOWN RDS. %� DANVILLE, NH 03819 Administrator Q ✓lzP. �OI%YI)LOI%LUP,(L� o��;li'aa�ac�i+.coP,Cla �\ Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 123258 " Expiration: 01/15/2003 O Type: INDIVIDUAL GAYLAN SCHWARZER CAYLAN SCHWARZER 21 SANDOWN R7 DANVILLE,NH 03819 Administrator ,tAORTH Town of Andover No. it 0% 0 L A dover, Mass., %2-off COCHICHI W19 ORATED PX BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System 111 BUILDING INSPECTOR ..... ...... .. .. ... ...... THIS CERTIFIES THAT........ ...... . A............................ Foundation has permission to erect .. ...... buildings ....A .....AvAp. Rough Chimney to be occupied as...............Z& ......... ..L��.r.... .... provided that the person accepting this permit shall in every respect conform to the terms of the application a Ile 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUC N TS ELECTRICAL INSPECTOR .......... C Rough .......... ................ ................................................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display inn-a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.