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HomeMy WebLinkAboutMiscellaneous - 32 MAGNOLIA DRIVE 4/30/2018 32 MAGNOLIA DRIVE 210/056.0-0049-0000.0 I II I i } Location No. � U Date N NORTh TOWN OF NORTH ANDOVER 0 ,Go , o s Certificate of Occupancy $ cMBuilding/Frame Permit Fee $ s� us Foundation Permit Fee $ Other Permit Feed Ut $ TOTAL $ Check # U Z J 14397 w ' Building InsWctor TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: / U DATE ISSUED: SIGNATURE: Building Commissioner/Ifor o i din 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 Fronta e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided keqwred 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 ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT I 2.1 Owne of Record O�\ISI \r . � Name(Print Address for Service Signature Telephone 2.j Owner of Record: � Name Print Address for Service: Signature Tele hone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: T3 License Number Address Expiration Date Signature Telephone rM 3.2 Registered Home Improvement Contractor _ Not Applicable ❑ Company Name c Registration Number Address Expiration Date gna Siture Telephone I 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. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work(check alD a Beable New Construction 0 Existing Building ❑ Repair(s) 0 Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition 0' Other 0 Specify ., Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be 3 &F'FICIA;L USE(INIS Completed by permit applicant s _ tJF s I. Building 2L (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 vU 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 1 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 Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are tnie and accurate,to the best of my knowledge and belief V'J�C 0 C C QA&- Print Name r'a'h—ire—of Owner/A-ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TEVIBERS 1sT 2ND 3 PID SPAN DINIENSIONS OF SILLS DIMENSIONS OF POSTS DtINIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CI AINENEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE . J/e Pa,�nton..�eal!/o�✓�aooa�iaeetta HOME •IMPROVEMENT CONTRACTOR x Registration 103317 Type - DBA Expiration 07/07/00 CASTRICONE ROOFING 8 SIDING C Mar--bo T. Castricone ��3 urt-St. ADMINISTRATOR N. Andover MA 01845 ,�f�f°^__-�. �, -~✓lce �o�rurr�o�.uveall�v-a�'�-i�a�uaeCta� BOARD OF BUILDING REGULATIONS '. License: CONSTRUCTION SUPERVISOR Number: CS 034049 P ' Birthdate: 12/08/1923 Expires: 12/08/2001 Tr.no: 10391 Restricted To: 00 MARIO T CASTRICONE 31 COURT ST G•f•�« N ANDOVER, MA 01845 Administrator r. i -- - The Commonwealth of A7nssnclirrsettc Dq)artnfent ojIndiistrial it ccidents - Mee offtlyesfiy2tion.v ` 600 [Vashinoto' n Street Boston, Alas. 0211.1 Workers' Compensation Insurance Affidavit ❑ I am a homeovmer performing all work rnysclf. --- ❑ I am a sole proprietor and have no one working in any capacity ❑ I am an emp.1%er providing workers' compensation for my employees working on this job, corn an naive. ` :. tic th 1. e . A wren • U nC# '� ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired thecontractors listed below who have the following workers' compensation polices: 92n_pany name: address. ' gty, phOng# insurance co. q hey# t como�►ny name address ; city: i phone# q. insurAnce co p9Zl K Failure to secure coverage as required under Section 25A of GL 152 can lead to the Imposition of criminal pennities of a fine up to S 1,500.00 and/or one years'imprisonment as well as civil penattics in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify under the paints arty!penally jperjxry that the information provided above is true and orre / Signature Date C�7�y�`� Print name Phone# official use only do not write In this arca to be completed by city or town official city or town: permit/license# -Building Department []Licensing Board []check if immediate response is rtquired []Selectmen's Office []Ilealth Department contact person: phone#; -Other (re,iged 3/05 PIA) ... .� � k Information and Instructions , Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees.. .As quoted from the."law", an entployee..is,defined as every person in the service of another under any contract of hire,,express or implied, oral or_written =: : An employer is defined as an individual;.parttl�F.51 ip,iastocjatipp, �arporf}tic;n,pr,other legal entity, or any rivo or mote of the foregoing engaged in a joint enterprise, end;�t}eS�diu�ltta J1ega�representatives of a deceased employer, or the receiver or trustee of an individual , partne�ship,•association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants i Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. j t '`I City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents ' Office of investigations 600 Washington Street Boston,Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727.4900 ext. 406,409 or 375 Castricone hooting & Siding REPAIRS FREE ESTIMATES Aj� Telephone (978) 682-4266 Cl� ur , tl �d MARIO CASTRICONE 31 Court Street,North Andover,Mass. 01845 1eiI I/we, the owner(s)of the premises mentioned below, hereby contract with and authorize you as contractor,to furnish all necessary materials, labor and workmanship, to install,construct and place the improvements according to the following specifications,terms and conditions, on premises below des abed: Owner's Name................................... ....... ... 1 > �--- ........................................................................... ..................... ...................... Job Address... ............ � i... � .......................................CityVZ. V ......State �z........................ SPECIFICATIONS �t�......................... .� (} ........e.... :............................. ...................... �..AL'! .. ............................................... ... ....... .. GL. ..... r���' ...... .. .............. .......b................ .�..- - ..?....` l `.... ......... . ....... .y.. ............................................ .... ................................ ... A......st-A-- . . . .................................................... ...... ........................................................ :.....0 .. ... ..... .... . 0. ....... .................... .......................................................................................................................... : a ......••• �uu.WSJ...... ...... M ............... il ... .................................................f ...................... .. ... I .. .... ...... ..... ....(..1 .......`:.... 2. ........... . . . ..`!. ............................ .................................................................................................0.......................... ....................................................... ............................................................... .................... Materials and labor to cost$ .... .......f...................................... Payable o.At n and balance in............ monthly installments of$.........................................each payable able on .......day of'each and every month thereafter until paid in full(..............%charge per year is to be added to above cost of labor and materials and is included in monthly payments.) Contractor will do all of said work in a good workmanlike manner. Upon completion of above work,all undersigned agree to execute and deliver to contractor,their joint note in accordance with his(their)above obligation and a completion as requested by the contractor. Upon refusal to do so,contractor may at its option declare the entire contract price or so much as then remains unpaid immediately due and payable. It is agreed that if permitted by law contractor shall be paid by the owner(s), all reasonable costs, attorney fees and expenses, in addition to the amount due and unpaid,that shall be incurred in enforcing the terms and conditions of this contract and/or any lien in connection therewith. It is further agreed that this contract may be assigned by contractor;and also that the obligations hereof shall bind and apply to their heirs,successors or estates of the parties. The undersigned warrant(s)that he is(they are)the owner(s)of the above mentioned premises and that legal title the stands of record in his(their)name(s). PROVISO:This contract shall be void and of no effort if credit approved of owner(s)is refused. There are no representations, guaranties or warranties, except such as may be herein incorporated, if any, nor any agreements collateral hereto, nor is this contract dependent upon or subject to any conditions not herein stated.Any subsequent agreement in reference hereto shall be binding only if in writing and signed by all parties. Cover attic storage cleaning not included. Receipt of a copy of this contract is hereby acknowledged,and it is further acknowledged by the undersigned that the foregoing provisions have been read and the contents thereof understood and that no representation or agreement not herein contained shall be binding upon the parties and that all of the agreements and understandings of said parties are contained herein. Owner or Owners are not responsible for Property Damage or Liability while job is in operation IN WITNESS WHEREOF,the parties have hereunto signed their names this 9 ................�,n...........day Accepted: Signed...0( t-- .f�U.1....... �� �... ,� (OWNER HAS 3 DAYS IN WHICH TO CANCEL CONTRACT) Owner Signed...................................................................................... �Y Owner .t......c.................... .-&4 ............... Signed...................................................................................... Representative AORTH ovM 0 R over No. ~ 70 d � D - __ � r LA Q C�OVer, Mass., IUM I�lb COCMICKEWICK V 7,9 RATED APa,��y S H BOARD OF HEALTH PERM D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.... ....... .... .......................................... ...............................................�.................... ...�..... Foundation has permission to er buildings on .!j ................ .444 ....... Rough V . .... to be occupied a ............................... chimney ........ ........."to�des ..............................................................................provided that the person accermit shall in every respect conform to the terms of the application on file in Final this office, and to the provisioand 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 t UNLESS CONSTRUCTION ST S 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. Bumer O Street No. SEE REVERSE SIDE Smoke Det. NoRTiy ONM o fAndover No. 4 10 00 4 A ori dover, Mass., ti A ZO+r� COC MICMEWICK V ADRATED P' BOARD OF HEALTH T T Food/Kitchen Septic System BUILDING INSPECTOR PERMI D THIS CERTIFIES THAT-ZO ........ .... .........................................................................................�.................... .......... Foundation has permission to or .. ..... . buildings on .� ....................... ........................... ..... . ........ Rough to be occupied a ........ ........................................................ Chimney ......... ....................................................................... provided that the person acce ing t ' ermit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of t odes 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 CONSTRUCTION ST S 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 4 Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.