Loading...
HomeMy WebLinkAboutMiscellaneous - 202 FOSTER STREET 4/30/2018WAAF Location � D ;o S No. /5--- Date NORTH TOWN OF NORTH ANDOVER Certificate Occupancy $ of �'�s ••"°' Eta JACMUS Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ,� A(W-__ { 5 6 9 6 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING _�5 !« 5-7 . 1,' Lzrn 317 $,. BUILDING PERMIT NUMBER DATE ISSUED: � � O SIGNATURE: Building Commissionerfl for of Buildings Date JL`1. LiVl\ L—OLLL` L1�r Vz%aT11, 1 LW11% { 1.1 Property Address: 6,2,-FoS7T2 ST 1.2 Assessors Map and Parcel Number: 0 Map umber Parcel Number 2.1 Owner of Record IWAT14 Y CA l 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area Frontage ft 1.6 BUILDING SETBACKS n Front Yard Side Yard Rear Yard Required Provide Reqtlired Provided aired Provided Name Print Address for Service: 1.7 Water Supply M.G.L.C.40. 54) Public ❑ Private ❑ 1.5. Flood Zone Information: Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System ❑ �r,a. LLv1� � - rnvrr.Lci x V VY1\l�,l(JrilY/AU 1riVi(il4LJ) A(:Lr1V1 2.1 Owner of Record IWAT14 Y CA l Name (Print) 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: Not Applicable ❑ Licensed Construction Supervisor: N M� �� f_ �J License Number Address I 'a t Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ nAV 1 �f}S r 1C-.bIOJ,E ikF(-,. * 9L)6 / 0 Company Name - J, 6 b _S: LL 7-T8 IJ S T r A�� E40 Registration Number J s ia 43 CL�v �f1 /0� Expiration Date Signature Telephone z M 90 0 wn ic G) SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 & 2506) 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. Signed affidavit Attached Yes .......0 No ....... ❑ SECTION 5 Description of Proposed Work check al! a livable New Construction 0 Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other 0 Specify Brief Description of Proposed Work: 1116LY1 �LD ? A] -- SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be ( / Com leted b pe it applicant Y&� y$.. 1 se AaQ�t{aV 1 ..rt3uYi �?CY.a.F�I��+ NE Q�jx 4��w 'i i1 s , P- z l{> 1. Building a (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total.Cost of Construction 3 Plumbing Building Permit fee (a) 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 pennit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, LAV 1P CA-5,T)k I ' OAZE ,as Owner utho1IzedAgen 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 1, SiNature of 2 Owrler/A ent Date l/ F NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 ST 2 ND 3 RD 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 ��.• h r.air1i111111"'. Bnurd of Building f2c9uhli0ns 81111 Standards HOME IMPROVEMENT CONTRACTOR Registration: 104569 Expirz;ion: 7/14/02 Type: PRIVATE CORPORATION DAVID CASTRICONE ROOFING, S n* �,astricone 7 Hillside Road Boxford, MA 0192' Admin:sinruur ArevR—D-- CERTIFICATE OF LIABILITY INSURANCE 1 1-0"i29E2-001 1 , L INTERNET-TNlti}!jr$tC$ Ar.ZNCY 522 CHICKIRTNG ROAD , 14OATH ANDOVER, MA D1845 INSUR@D DAVID CASTRICONE R40FING AND SIDING INC. 200 SUTTON STREET, SUITE 226 NORTH AMOVER MA 01845– C:A\/i'r R A r ICC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. T1418 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BGLOV INSURERS AFFORDING COVERAGE INSORERA: AMLLA INSURER B: ARBELLA, PROTECTION INSURER C: RO= SUN ALLIANC1E INSURER D: INSURER E: THE POLICIES OF INSURANCE LI$TED BELOW HAVE BEEN ISSUED TC THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OP. CONOITION OF ANY CONTRACT OR OT14PA t)OCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS CIF SUCH POLICIES. AGGREGATE LIMITS SHOWN WAY HAVE BEEN REDUCED BY PAID CLAIMS, 1NLTYU SR TYPE OF INSURANCE POLICY NUMBERDATE POLICY EFFECnYE POLICY [XPI N LIMITS GENERALLIABILITV I EACH OCCURRENCE 3 1 000 000 A COMMERCIAL GENERAL LIABILITY CLAIMS MACE �OCCURI 8500012710 06/06/2001 1 06/DIS/2002FIREDAMAGE(An Dodi. f 50y000 MED EXP (Any onopemon) S. 51000 © PERSONAL &ADV INJURY 1, 000, 000 II GENERALAGOREOATE f 1,000,000 GERL AGGREGATE LIMIT APPLIES PER: PRO- PRODUCTS - COMPIpP AflG f 1,000,000 POLICY JECTI LDC . AUTOMOUIL.E LIABILITYCOMBINED ANY AUTO i 108/01/2001 SINGLE LIMIT (Ea swidenl) i H In "^`' ALL OWhiEUAU 144506400001 08/01/2002 BODILY INJURY SCNGDULfiD AUTOS (Pot porton) a 250,000 HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Pat grpdtm) Y 500,000 PROPERTY DAMAGE Motattidertl �$ 100,000 - " GAU49LIABILITY AUTO ONLY - EA ACCIDENT Is ANY AUTO ENTHAN EA ACC S AUTO ONLY: AGG 3 EXCEBs LIArdture I EACH OCCURRENCE f AGGREGATE ; OCCUR CLAIMS MADE I a OEOUCTIBLE Is RETENTION S i - s WORKER11COMPENSATION AND EMPLOYERS' LIABILITY - TORY LfUrri C 791X978AO1 09/23/2001 09/23/2002 E.L. EACH ACCIDENT s 300 000 E.L. DISEASE -EA EMPLOYEE S 500 000 El. DISEASE-FOLICYLIMIT $ 100,00'0 " OTHER rI I DESORPTION OF OPERATIONS!LOCA'IIOItsIVEMCLESIEXCLUSIONS ADDED BY 9Fi0ORBEMENTISPECIAL PROWLIONS /�C�T{r1A LTC Lsri, r�rr� if—If 6HOULD ANY OF THD ABOVE b0c)RIDfi@ POLICIES BE CANCELL90 DCFORLd THE EXPI=N DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 010 PAYS WRITTEN NOTIC9 TO THE: OERTIPiCATP Hoom NAMED TO THE LlPT, BUT FAILURE TO DO SO SHALL IMPOSE NO ONLIOATION OR LIABILITY OF ANY KIND Uy" TN! INSURER, ITS AOENTS OR AUTHOARED MACORD CORPORA z E, . c o v O w Ego ,��, v cn o w U CG co G p w O w v E ..0 U itt G x 0 w U O w id q w" GG o � W W O w v U) � w x z C7 O c� C w z a w H � cn zco �i � cn Q O cn . c o m c o � C h O C ' y'n O �% ; C.2 C3 ' O. C O ea m C do::opo � C IL: _ +�+ : H � S ... O _ m N W 1 O .v Em o.C� cm aCD Cf cm O Q :v _ d C m O O V y O O CL C ~ C= N m C •O =cap mO o� 3 N CO3Z 12 W �.�t w O •ty/f � C.t C .E O t+ m • VN Z O UA L3 v m v 0 y = CL ®. O A ` y O .-a-41m� cm CO3 0 Q% .� y O O 03 CL CD CO O O _O O d C CL Cc C.2 J .� O C Z CD V CLy R C C C _cc d CO2 u 0 CO LLI w W crw LLJ U)