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HomeMy WebLinkAboutMiscellaneous - 32 CABOT ROAD 4/30/2018 32 CABOT ROAD 210/015.0-0066-0000.0 I M q ate.. . /`..� '.U. . .. TIy Of HOR1H o� ° TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION h SACMUSEtt l This certifies that J. - - r - - +'. . . . . . . . . . has permission for gas . . . . . . .in the buildings of . . . . . .-s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . North Andover, Mass. Fee 5?. . . Lic. No.. . . . �. . . . . . . . . GAS INSPEC,Tj6R Check# ��2� 6267 MASSACHUSETTS UNIFORM APPLIt;ATION FOR,PERMIT TO DO GASFITTING -' (Print or ype) �. 1 ass. Date 20 Q Permit/ a3 Building l tion owners me ` U ype of occupancy New❑ Renovation❑ Replacements Plans Submitted; Yes❑ No❑ LU 0 0 m � o0 SUB- _i > a _� � va�r o'Z . _ W ch � ZOO aBSMT p. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR t 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR y 8TH FLOOR nstalling CompanyName Check one: Certificate 4ddress 17 ❑ Corporation r luslness Telephone _-v ❑ Partnership lame cif Licensed Plumber.or Gas Fitter 1rnuC o. INSUKANCE COVERAGE: 1 have a current 11 blilty Insurance policy or its substantial equivalent, which meets the requirements of MCL Ch 142. Yes pNo ❑ If you have checked yes,please indicate the type of coverage by checking the appropriate box. A liability Insurance policy O/ Other type of indemnity ❑ Bond 0 OWNER'S INSURNACE 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 s per application valves this requirement p Signatu, o Owner or Owner's Agen Check one: Owner ❑ Agent ❑ tereby certify that all of the details and Information I have submitted(or entered)In above application are true and accurate to the best of y knowledge and that all plumbing work and Installations performed under the permit Is mzz;;p tiance with pertinent provisions of the Massachusetts S tate Cas Code and Chapter 142 of the Ce Type of License: By ❑Plumber Tide Signer Ciry/Town ❑C as Fitter ter APPROVED(OFFICE USE ONLY) &MMter License Number g� [i Journeyman :s BELOW"H OFFICE USE ONLY I FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS FEE N0. APPLICATION FOR PERMIT TO DO PLUMBING I NAME A TYPE OF DUILOINO LOCATION OF BUILIVING FLUMES PERMIT GRANTED DATE 1• i PLUmme INs►ECTOR Location 3 co t No. Date �oRTN TOWN OF NORTH ANDOVER 0�� `ac 'a,ti0 3? ' 0L 10- 9 ' Certificate of Occupancy $ �'�s'•" Eta' Building/Frame Permit Fee $ J�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �' y i Check # / o 16810 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING MV,� 4t6r ..: BUILDING PERMIT NUMBER: DATE ISSUED: ic SIGNATURE: Building Commissioner/Ins ctor of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: .3A CA606— R5� � 61s' ®v c � !V D 97-41 AA) 0 0 0 9-� Map Number Parcel Number t 1.3 Zoning Information: V 1.4 Property Dimensions: �e V Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R red Provided Required Provided v 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private 0 -zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record Name(Print) � � 3 A�" r Dr C � ) Address for Service-- Signature Telephone ) 2.2 Owner of Record: y��•l p Name Print Address for Service: M Si nature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ v O V 0 (!,I STR) c p/y F- g o o>,i�'G Company Name rn b O S uT-To� Sq—/ . g a d Registration Number r ss g 3 3 Q Expiration Date ^� Si nature Telephone Y/ SECTION 4-WORKERS COMPENSATION(ML 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. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check applicable) New Construction ❑ Existing Building Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OMCIAL U •Q ,y Co leted b ermit applicant 1. Building r g (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 Ntunber 2 ce S'"' 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 t D Ay ID CA S TR 0 /y,E as Owner/Authorized Agent of subject 1 property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief CAS7jQ1cz1JjE Prin J- --m-2 - 6 W15 SignVature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS I 2 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X t MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-954 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in properly licensed solid waste disposal facility as defined by MGL Chapter 111, S 150 A. The debris will be disposed of in: CAA)Z IV" (Location of Facility) Signature of Permit Applicant hV _ Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector C 1 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration:". 104569 Expiration 711.4/2004 ',Type Private Corporation DAVID CASTRICONeROOFINGS j Nstricone r 7 Hillside Road Boxford,.MA 01921 Administrator I' Dd CERTIFICATE OF LIABILITY INSURANCETowol-rl-lls/2003 PRODUCER THIS CERTIFICATE IS ISSUE n AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ItiTaRNZT INsMWCE A=NCY HOLDER.THI9 CERTIFICATO DOES NOT AMEND,EXTEND OR 522 cxsc>xER=NG Roan ALTER THE COVERA09 AFFORDED BY THE POLICIE8 BELOW. nORTx At+mMIX, IdA 01845 IN3URER8 Al FORDIN3 COVERAGE INSURED INSURERA: A MLLA LAVID CASTRIcom INSURER 8: JMZL ,% BROTECO2ION ROOFING AND UpYNe =1 INSURERC: ROYAL,AWN J\f.LI pp 200 SUTTON STREET, SUITE 226 NORTE ANDOVER MA 01945— INSURER D: INSURER e; covasuaEs THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIO PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TMLI OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH T I8 CERTIFICATE MAY d5 ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DEGORISED HEREIN 16 SUBJECT TO ALL THE 7ERM8, LUSIONB AND OONDtTIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE, I POLICY EFFECTIVE POLICYNUMBERE RA I LIMITS OEhIlRALLUIBIUTT � ACMOCGURRENCE m i 000 000 A ® COMMERCUU GLN@RALUABIUTY 8500012710 06/06/2003 06/05/3004 'IRE DAMAGE nt oft firs) a 50 Opo CLAIMS MADE I u�OCCUR 190 EXP(Any one mravn) 8 51000 ❑ ERSONALAADVINJURY $ 1,000,000 NERALAGGREGA'IE & - 1 L0004000 GEN'LAGGREGATE LIMIT APPUESPER., PRODUCTS•COMPIOPAGG B 110001•000 TI POLICY Ml PR rM L00 AUTOMOBILE LIAeWTY ,COMEINED SINGLE LIMIT 0 © ANY AUTO kE&acNdenl) R ALL OWNED AUTOS 44506400001 08/01/2003 00/01/2004 'BODILYINJURY SCHEOULEDAUT96 j(Pupanten) S 250,000 HIRED AM$ jB001LYINJURY $ 500,000 NON OWNED AUTOS Per aaaWent) I i 1PROPERTY DAMAGE (Perm=deld) 6 100,000 eARAM LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO ERTHAN EA ACC d OTH ❑ TO ONLr. AGO !Ii EXCESS LIABILITY EACH OCCURRENCE 0 OCCUR CLAIM$MADE WREGATE 0 S DEDUCTIBLE + ❑ RETENTION 0 ( E WORKERS OOMPHMSATION AND 4MPLOYSkB'LUUSUTY c'r 791X978A01 00/23/2003 09/23/2004 IEAL PACHACCIDENT 1 100 000 E.L DISUSE•EA EMPLOYE1 1 500,000 1,6 I I T LIMIT 13 100,000 OTHER I I DPCRIPTION OF OPERAIICNSILCCAflONSNENICLESIEXCLUSMNS ADDED BY ENDORSEMENTISPEOUIL PROVISIONS i I i CERTIRCATE HOLDER ANI AQQi I RI u E CANCELLATION � BHOULDANY OF THE ABOVE DEBCRI POL101E$BE CANCELLED BEFORE THE EXPIRATION DATE,THEREOF,TNri ISSUING INSUREIIi YIALL GNMVOR TO MAIL 030 DAY;WRI7TGN NOTICE TO 711E CERTIFICATE MOLDERNAMED TO THE LEFT.BUT FAILURE 70 DO W 6NALL IMPOSE NOOBLIBATION OR LIABILITY F ANY KIND UPON THE INSURER,ITSAGCNTG OR REPRESSTATIVE6. AUTHORIZED NEPRF',S6NTAMVE ACORG 258(7197) t9 ORD CORPORATION 1,988 , i . NORTH Town ofAndover No. i Y - o3 coca����y dover, Mass., ADRATED S H E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.....46 #4 # A*h ................ ' Foundation has permission to erect......5.0.00 .......... buildings on ....3R......C4. o. ....... ............................ Rough .. .. .. . ��If11Sp ';ew%* Chimney to be occupied as ''�' y ........................................................................................................................................................................ provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating tote Inspection, Alteration and Construction of Buildings in the Town of North Andover. s„ ` � 0 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 .. ....................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. r SEE REVERSE SIDE Smoke Det. 7 ; O Date. .. .: •...._. ..��... 3 �'r � MORTM TOWN OF NORTH ANDOVER 0 '�. pp PERMIT FOR GAS INSTALLATION ,SSACMUSES This certifies that . Z). . . . . ... . . . . . . . .! . . . has permission for gas installation . . ."-A-:,1-- . . . . . . . . . . . . . . . U in the buildings of . . . ? '/. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . �. r�—��. %?"�. . . . . . . . . . . . . , North Andover, Mass. � Fee.ry . . . Lic. No: J'.:�. . . . . k `��x?rt. . . . . .. . . . G GAS INSPEQ-rOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer 1 -- T .h. MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS G Type or print) to �"— 2 19 v J NORTH ANDOVER, MASSACHUSETTS —� Building Locations �O Permit# Amount S Owner's Name c� New❑ Renovation ❑ Replacement � Plans Submitted ❑ 7.I .L ;J ryj Cn z y n L j�j = n z .� La n ? r _ - _ Ji c. L - Z - - Z Z t _ =r _ i m Z C j C Cn - <; t , z SUa -s:► SErI ENT `» BASE .M ENT Is•r. FLOG R 2ND . FLOUR 3RD . FLOOR x: .4'r ii . FLOG R 5 r H F L O G R 6T II F L O O R 7T [I . F L O O R 8T 11 . F1, 00 R Name—12V or type) `�� j /� Check one: Certificate Installing Company Address 52 1-7o V—r'1q rLd S 7 ❑ Partner. Business Telephone / �^ L J Elf-i . 6si 1 l Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ NO vj Ifyou have checked ves,please indicate the type coverage by checking the appropriate box. ^) Liability insurance policy ❑/ 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: 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 Permit Issued fo this application will be in compliance with all pertinent provisions of the Massachusetts St Gas and Chapt 142 of t Gene aws. L a 1 By: ignature of Licensed PI r r�GasR�rt& Tide Plumber City/Town ❑ Gas Fitter ens ivumoer L��vfaster APPROVED wFi—;ct-u<<ONLY) ❑ Journeyman