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HomeMy WebLinkAboutMiscellaneous - 38 CHESTNUT COURT 4/30/201876U4 Date. . ThrA ........ r 1-10N, TOWN OF NORTH ANDO ER .fflw&*A .111155 PERMIT FOR GAS INSTgLATION This certifies that ................. has permission for gas installation ... W v :t� � .............. in the buildings of .. ....................... at A4 North Andover, Mass. Fee. Lic. No... G'A'S IN..%!•�lrs. ,:�.. . Check# M CIVIr MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town: '"Yl,��dU f 2 MA. Date: Permit# Building Location: �2 f��.f ,� �// t (ti T Owners Name: 44 ej7o-1,•••- Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential E4— New: ❑ Alteration: ❑ Renovation: ❑ Replacement: [!J— Plans Submitted: Yes ❑ No ❑ CIVIr INSURANCE COVERAGE: I have a current liability,insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes Fej No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy 21— 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner ❑ Agent E] By checking this box ❑; 1 hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and v Illy fV lvVVIVUUV drlu LFId[ au pmmomg wore ana Installations performed under the permit issued for this application will be in --•••I•••'••"" ^•`•• ... • �•��•••���� r�v��A�V �� VI LI IV IVIOA*dGl I UbtMb OLdLB rlumoing Voae ana t;napter 942 of the General Laws By Type of License: ❑ Plumber J." "4 ef Title ❑ Gas Fitter St ature of Lice ed Plumber Gas Fitter z ❑ Master City/Town ❑Journeyman License Number: APPROVED OFFICE USE ONLY El LP Installer IL Q 3: N 0 N LU LU V 0 0 N H = O W F- w LU Z OLU F- Z O W W W O F- � W N U W Z 0 N 0 Q = u. Z I. LU W Z IJZJ O W J uj F- F- 0 Z = Lu -•l U' u- IN.. = W H W IX w 0 o 0 LL 0 0 _ = g >0 ° � °o: � > > > � 0 SUB BSMT. BASEMENT -TsT FLOOR 2 FLOOR --i"FLOOR 4 IH FLOOR 5 FLOOR 6 TH FLOOR 7 FLOOR 8 FLOOR Installing Company Name: ,� 5 ►,%lefiyi of /�p�- �f Check One Only Certificate # Address: SD n7� [� JJD,k 6 2 � �� 9j,J��. ty/Toww "') U " �_ L im► 'y{ate El Corporation Business Tel:% �(d q� Fax: S— ❑ Partnership lrm/Company Name of Licensed Plumber /Gas Fitter: 6 s ,��� INSURANCE COVERAGE: I have a current liability,insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes Fej No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy 21— 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner ❑ Agent E] By checking this box ❑; 1 hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and v Illy fV lvVVIVUUV drlu LFId[ au pmmomg wore ana Installations performed under the permit issued for this application will be in --•••I•••'••"" ^•`•• ... • �•��•••���� r�v��A�V �� VI LI IV IVIOA*dGl I UbtMb OLdLB rlumoing Voae ana t;napter 942 of the General Laws By Type of License: ❑ Plumber J." "4 ef Title ❑ Gas Fitter St ature of Lice ed Plumber Gas Fitter z ❑ Master City/Town ❑Journeyman License Number: APPROVED OFFICE USE ONLY El LP Installer Date. /. /3;/ .0 - � ........ TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION ' 2 y This certifies that ...... has permission for gas installation .... in the buildings of 0 0.1 ............................. at ...... North Andover, Mass. Fee. rP.CJ77� Lic. No. . . 7,77). 3. GAS INSPECTOR X Check# U J 5283 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) i Date NORTH ANDOVER, MASSACHUSETTS , Building Locations 3= Owner's Name New D Renovation Replacement IT Permit # 3 Amount $ L� (r -,- Plans Submitted (Print or type)` Check one: Certificate Installing Company Name �Z �f s,A(��tLrz. e �Y� Corp. Address �� �' �/T El Partner. Business Telephone 131irm/Co. Name of Licensed Plumber'or Gas Fitter lf� I b, INSURANCE COVERAGE Check one: I have a current liability Insurance, policy or it's substantial equivalent. Yes 1" NoO If you have checked yes, please indicate the type coverage by checking the appropriate box, Liability insurance policy 131*� Other type of indemnity 1:1 Bond 13 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 1:3 Agent13 I herehv rPrfiAi *h.+ X11 . F+t. A :I _J :_r_W -- ' ____ ___ _.... _ ..,,,,,,,,,,,,,,u "" , „UVF „,VIII ,«CV kur emerea) In aoove application are true and accurate to the best of my knowledge and that all plumbing work and insta11 t' ns performed under Perini Issued for this application will be in compliance with all pertinent provisions of the Massachus tat asC de jd Chapt 142 of th eneral Laws. !�� By: Title City/Town, APPROVED (OFFICE USE ONLY) 6 - Signature of Licensed Plumber Or Gas Fitter Plumber ❑ Gas Fitter ricense Mumoer Master 0 Joumeyman p a� cc y g �, W oG V = W d C x w w° °r a > d W x a a Q H Qz d > W a d a d Q O O Z x d O x fi 3 Q C7 .a U C > SU B-BASEM ENT BASEM ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR (Print or type)` Check one: Certificate Installing Company Name �Z �f s,A(��tLrz. e �Y� Corp. Address �� �' �/T El Partner. Business Telephone 131irm/Co. Name of Licensed Plumber'or Gas Fitter lf� I b, INSURANCE COVERAGE Check one: I have a current liability Insurance, policy or it's substantial equivalent. Yes 1" NoO If you have checked yes, please indicate the type coverage by checking the appropriate box, Liability insurance policy 131*� Other type of indemnity 1:1 Bond 13 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 1:3 Agent13 I herehv rPrfiAi *h.+ X11 . F+t. A :I _J :_r_W -- ' ____ ___ _.... _ ..,,,,,,,,,,,,,,u "" , „UVF „,VIII ,«CV kur emerea) In aoove application are true and accurate to the best of my knowledge and that all plumbing work and insta11 t' ns performed under Perini Issued for this application will be in compliance with all pertinent provisions of the Massachus tat asC de jd Chapt 142 of th eneral Laws. !�� By: Title City/Town, APPROVED (OFFICE USE ONLY) 6 - Signature of Licensed Plumber Or Gas Fitter Plumber ❑ Gas Fitter ricense Mumoer Master 0 Joumeyman 'e� O TOW OF p PERMI FOR Date ........ NORTH ANDOVER GAS INSTALLATION This certifies that ...P,1 ............ has permission for gas installation ,............. in the buildings of ............................ at ... .6............i North Andover, Mass. Fee. .7.. Lic. No..7 `.) ... .....t,, .. U -^t1, ...... 6AS INSPECTOR 1 Check # 55511 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO (Print or Type) r- DO GASFITTING W k T H A N OV C e— _.Mass. Date_446_ Permit #_�_ Building Location38 CiCSTOI)lX CT Owner's Name C ) P-0 56r,LIJ )Type of Occupancy k SI Dt N 7IAlL New ❑ Renovation ❑ Replacement �] Plans Submitted: Yes❑ No ❑ Installing Company Name BAY STATE GAS COMPANY Check one: Certificate # Address 55 MARSTON STREET U Corporation 1862 LAWRENCE, MA 01840 ❑ Partnership Business Telephone 9 7 S- 6 8,7-"l 10 5 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Francis X. Corkery INSURANCE COVERAGE: I have aYceusrenntt liability insoura❑nce policy or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy K Other type of indemnity O Bond O 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 O I hereby certify that all of the details and information I have submitted (or entered) in abo pplication are true and accupte to the best of my knowledge and that all plumbing work and installations performed under the permit *ZZ=1 pliance with all Pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the GeT e of License: Plumber Signature of Licensed Plumber or Gas Title Gasfitter Master License Number _374-5 City/Town PJourneyman AP PPOVIEff O C—F9S—F--0—NTW— I— ON ■��loiMEMNON MEN OMR mni no on MINK 0 Sol son .. ■OMMMOMMIMEMMEN MEN KNOMMIE■ .. ■OMEMENOINEEMMI monsoons SO0 Installing Company Name BAY STATE GAS COMPANY Check one: Certificate # Address 55 MARSTON STREET U Corporation 1862 LAWRENCE, MA 01840 ❑ Partnership Business Telephone 9 7 S- 6 8,7-"l 10 5 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Francis X. Corkery INSURANCE COVERAGE: I have aYceusrenntt liability insoura❑nce policy or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy K Other type of indemnity O Bond O 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 O I hereby certify that all of the details and information I have submitted (or entered) in abo pplication are true and accupte to the best of my knowledge and that all plumbing work and installations performed under the permit *ZZ=1 pliance with all Pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the GeT e of License: Plumber Signature of Licensed Plumber or Gas Title Gasfitter Master License Number _374-5 City/Town PJourneyman AP PPOVIEff O C—F9S—F--0—NTW— I— ON J z O w N a w 0. w LL. 0 a O U. 3 c ..r w m NI W z U W iI X N z 0 f - V W CL z_ J Q Z n r 0 z• F- N q O Q O F- t- a a w z a cc 0 W z 0 a U CL CL a w w LL. 0 a w m M O z d J a w F' z a a c I- 2 2 a LU a 0 a I Location `,�� r� r�`'`""�'� `� * No. U Date 0 0 TOWN OF NORTH ANDOVER 3 ., a Certificate of Occupancy $ CNUS C Et� Building/Frame Permit Fee $ � Foundation Permit Fee $ Other Permit Fee TOTAL Check # '18633 $ f1 �� Building Inspecfc(r i/ APPLICATION TO CON! BUILDING PERMIT SIGNATURE: TOWN OF NORTH ANDOVER BUILDING DEPARTMENT ,TRUCP REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY I oulltun t-oMMlSStoner/1 ctor of B SECTION 1- SITE INFORMATION 1.1 Property Address: 1.3 Zoning Wormatiou: Zoning District Proposed Use 1.6 WELDING SETBACKS ft Front Yard Side Y; Required Provide Rerntired TE ISSUED: Igs Date 1.2 Assessors Map and Parcel 6 616 Map Number 1.4 Property Dimensions: Area (st) Fr( l Provided Keaton 00sq Parcel Number Rear Yard Provided 1.7 Water Supply M.G.L.C.40. $ 34 1.3. Flood Zone Information:aG ISP 1.8 Sewerage oral System: Public 0 Private ❑ ZOIIe Outside Flood Zone 0 Municipal 0 On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record ea sa,�,son OU UVIJ�n-AAJ Name (Print) Address for Service _� Z3 A00, figZ)o V`�� Signature Telephone 2.2 Owner of Record: a Name Print Address for Service: SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: Address Signature 3.2 Registered Home Improvement Contractor Company Name Address cam. , o-- Telephone - L p.3 -9 License Number Expiration Date Not Applicable ❑ Registration Number Expiration Date ou M X rsS Z O D rn 0 z M 90 O D ic r p� V r" r Z SECTION 4 - WORKERS COMPENSATION (MG.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- all applicable) New Construction ❑ Existing Building Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: Vinvi �s l(AIYA SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building Is 880 (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee.(e) X (b) / d 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 1, 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. / 17_ 1 (,p los Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, 124 v 1 S YX e Lv A2 E as Owner/Authorized Agent 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 c, s Prim an Y r — --11r /-�' A Si atire of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TRVIBERS Isr2 No3 RD SPAN Dl v1ENSIONS 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 O z N rA N I CC O•— m p-0 i mm H= �3 O m p � cc0a cma O � c ec CL o CD C CD V y O C C•— •— C c y 0 LU 0 LLI cc oe W w 99 SS a o H a W LLJh a H x W w 9:1M C*) CL C N /a O Q 0 L w • ) c9i Q O w rs: UC Xr- cG w" o CL w w c►: w" c4 O cn E v� N I CC O•— m p-0 i mm H= �3 O m p � cc0a cma O � c ec CL o CD C CD V y O C C•— •— C c y 0 LU 0 LLI cc oe W w 99 SS _ o H W LLJh H x W w 9:1M C*) CL C N I CC O•— m p-0 i mm H= �3 O m p � cc0a cma O � c ec CL o CD C CD V y O C C•— •— C c y 0 LU 0 LLI cc oe W w 99 SS o o � C3 _ CL C N /a O Q o.o o CL N E� c N N y o►Ce 03 C m _s N N o N • • o CD a� N O O ~ 0 C i� Q 0 m N2 0 CL a . • C m � O QE Q ate. CLS ~ coos • .L' d� C 'o E A io, c C ems MI13 t g o N I CC O•— m p-0 i mm H= �3 O m p � cc0a cma O � c ec CL o CD C CD V y O C C•— •— C c y 0 LU 0 LLI cc oe W w 99 Board of Building Regulations and Standards mom ` HOME IMPROVEMENT CONTRACTOR ` Registration: 104569 Expirai%on 7114/2006 Type Private Corporation j DAVID CASTRICONE ROOFING,!SIDING & David Castricone 7 Hillside Road.. r. —i✓ Boxford, MA 01921 Administrator i NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. Also,.note Permits are required under Fire Prevention laws Chapter 148 Section 10A. The debris will be disposed of in: V4. � . 4&0-, ill — — LL a,r,J <,,- l rir_. , <c-nlern . 6NJR Fire Department Sign off: Dumpster Permit (Location of Facility) Signature of Permit Applicant Z'2 -Z6 /A Date DAVID CASTRICONE ROOFING, SIDING & REMODELING REPLACEMENT WINDOWS HOME IMPROVEMENT CONTRACTOR REGISTRATION NUMBER 104569 200 SUTTON STREET, SUITE 226, NO. ANDOVER, MA 01845 7 HILLSIDE ROAD, BOXFORD, MA 01921 In North Andover 978-683-3420 In Boxford 978-887-6147 In Haverhill 978-374-7314 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 b\elow escribed-,) Owner's Name..... 1 �1 u.. ........ ....................... Telephone #.....6.. 16........ .. .. .:1�...... Job Address............ %. ;. ......CV0.................. City...... .4 .......... State......�14 ........ Specifications: ....u..�..x.. ,. ........................................................................... ............... , VApply vinyl siding and corners. Type: .r4� ..-.�—�.:1 Cover fascia boards and rake boards. LksF ll vinyl soffit - soli orate „'z. d' ! l G c,..................... K �� _ ........................................................................................................................-.-_.........:�............................................................ . ,,,Cover wood casings around windows. /place any gable vents and dryer vents with vinyl. .......................................... Areas to be covered:........... ....5.i.. ..1.. ........eL .......... ..... 0..t�.t ..y:. -.r................................................................ .�....�.. n. ��., ....... r..�. ,�................... .............. �.:�.�.1. -..� ...... l .. ............ .�.3.+t,.. .:..�=;i. e...........y!ja... ............. .Q;�..� ..... ..ii.S..tZ,.,c......(�.. .......... �,.Si�.............. .............. .............. ............................ ..... . . . . % . ..... .. .. .r2.. x..4,4.. j ...... �.,;7.. ....... ...... d! _:. ............ :... -3 .....: 4N.,1V ........ PT .. ....... G. ...... I. ..,.... ...... ...................................................................................................................................................................................................................... One Year Workmanship Warranty (Not Transferable) Manufacturer's Warranty as specified b manufacturer Materials and Labor to cost $..../..g...7.0............ Payable.....0...... on .....� .... . ....... Payable ............................. on .................................. Balance payable on completion of job Owner or Owners are not responsible for Property Damage or Liability while job is in operation. Contractor is not responsible for any damage to the interior of property, including pre-existing conditions (i.e. water stains, crumbling plaster, exposed nails) or conditions resulting from application of materials specified above (i.e. objects coming loose from walls, crumbling plaster, exposed nails, dust in attic or other living spaces, water stains when roofing shingles have not had adequate time to cure). Upon completion of above work, all undersigned agree to execute and deliver to contractor, their joint note in accordance with his (their) above obligation as requested by 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 the contract and/or any lien in connection herewith. 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. The undersigned warrant(s) that he is (they are) the owners(s) of the above mentioned premises and that legal title thereto stands of record in his (their) names(s). There are no representations, guaranties or warranties, except such as may be herein incorporated, if any, nor any agreements collateral hereto, nor is the 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. All Home Improvement Contractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Director, Home Improvement Contractor Registration One Ashburton Place Room 1301, Boston, MA 02108 Tel: 617-727-8598 Any and all necessary construction -related permits shall be obtained by the Contractor. Any Owner who secures his own construction -related permit or deals with unregistered contractors shall be excluded from access to the Guarantee Fund. Approximate starting date of work..................................................................... Completion date .............................................................. 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. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Owner has three business days to cancel this contract and incur no penalty. IN WITNESS WHEREOF, the parties have hereunto signed their names this .......... day of .. a G.�-c .fi., 20....r?? Accepted: dtcPer........ ... a.4,...... � . hd..�ri?Y.hrC✓ Representative Signed % :�: Fs�::� �c...;�:: .....`.::!::F :'�........ Owner Signed......................................................................................... Owner