HomeMy WebLinkAboutMiscellaneous - 39 RICHARDSON AVENUE 4/30/2018Location 3 cy pcksav /) C-,�
No. 3 -:�, �, Date )- /!), 0 �
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #. /,L/) /) �,
5 4'--.69 Building Inspeclor
t
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE ORTWOFAMILY DWELLING
' .Czi`z T' `2 , � & ".,, -�&�ui71ti11 ,�_ wM"-•$a.s.,�. �`` :. 4R',
BUILDING PERMIT NUMBER: f DATE ISSUED: —/12 — ,::�v
v
SIGNATURE:
Building Commissionerfl for of Buildings Date
SECTION 1- SITE INFORMATION
1.1 Property Address:
1.2 Assessors Map
Map Number
and Parcel Number:
Parcel Number
3 9' J1 aOCAS •-4.0/�'��A�
1.3 Zoning Information:
Zoning District Proposed Use
1.4 Property Dimensions:
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.I,4.454) 1.5. Flood Zone brfotmation:
7_�
Public ❑ Private ❑*'o Zone Outside Flood Zone ❑
1.8 Sewerage Disposal System:
Municipal ❑ On Site Disposal System ❑
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
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:
Licensed Construction Supervisor:
Address t/g
9J
Signature Telephone
Not Applicable ❑
License Number
Expiration Date
3.2 Registered Home Improvement Contractor /
Not Applicable ❑
Company Name
Registration Number
Expirati-A Date
Address
Vg—nature Telephone
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SECTION 4 - WORKERS COMPENSATION (ALG.L C 152 § 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit
in the denial of the issuance of the building permit.
Signed affidavit Attached Yes .......0 No ....... 0
SECTION 5 Description of Proposed Work check all a Hcable
New Construction ❑ Existing Building ❑ Repair(s) Aherations(s) ❑ Addition ❑
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
1 SECTION 6 - ESTIMATED CONSTRUCTION COSTS 1
Item Estimated Cost (Dollar) to be
Completed b permit applicant
;.. ....
1. Building
(a) Building Permit Fee
Multiplier
2 Electrical ` oc>
�s
(b) Estimated Total Cost of
Construction
3 Plumbing,5 O
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 permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
I, ��Gv� /,G�UnI '�1 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
Cr-•v✓J -�� o P�
Print Name
Signature of Owner/Agent Date
NO. OF STORIES SIZE '
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS 1 2 ND 3 RD
SPAN
DM ENSIONS OF SILLS
DRvIENSIONS OF POSTS
DEVIENSIONS 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
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Date ...
DEC 0 1991
,AORTH TOWN OF NORTH ANDOVER
0*
4OR GAS INSTALLATION
AndoV0ft&f
This certifies that (h
..........
has permission for gas installation
in the buildings of
I........................
at .7. . 7 r� ;:
North Andover, Mass.
Fee. Lic. No /7
Y-% ..........................
GASINSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File
s� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
—------�� (Print or Type)
top-'--- NORTH ANDOVER Mass. Date 11/27/ 1991 Permit #
3 - I
Building Location 39 Richardson Avenue Owner's Name Douglas
Type of Occupancy RESIDENTIAL
New F-4 Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ No ❑
■����t���Q���■
Installing Company Name BAY STATE GAS COMPANY
Address 55 MARSTON STREET
LAWRENCE, MA 01840
Business Telephone_ 508-687-1105
Name of Licensed Plumber or Gas Fitter
Check one: Certificate #
K7 Corporation 6 4 C
❑ Partnership
❑ Firm/Co.
INSURANCE COVERAGE:
have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes 11 No ❑
If you have checked yes, please indicate the type coverage by checking the appropriate box.
A 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:
Owner❑ Agent ❑
Signature of Owner or Owner's 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 alter u��ybinog wpprk i-nd installations performed under the permit issued for this application will be in compliance with all
pertinent provisions of �RieL JasachlDsetts S{ate Gas Code and Chapter 142 of the G La •
r�
By _ ' s �ii ;e of License:
' I ` ' Plumber Signature of Licensed Plumber or Gas Fitter
Title _ DEC 510 Gasfitter
Master License Number. M-429
City/Town_ _ -- __ Journeyman
Ar'PnOVED (of. I ICF USl. UIJi Y1 �r-� r
NAME
SEMI
it
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• • •
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MEN'
Installing Company Name BAY STATE GAS COMPANY
Address 55 MARSTON STREET
LAWRENCE, MA 01840
Business Telephone_ 508-687-1105
Name of Licensed Plumber or Gas Fitter
Check one: Certificate #
K7 Corporation 6 4 C
❑ Partnership
❑ Firm/Co.
INSURANCE COVERAGE:
have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes 11 No ❑
If you have checked yes, please indicate the type coverage by checking the appropriate box.
A 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:
Owner❑ Agent ❑
Signature of Owner or Owner's 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 alter u��ybinog wpprk i-nd installations performed under the permit issued for this application will be in compliance with all
pertinent provisions of �RieL JasachlDsetts S{ate Gas Code and Chapter 142 of the G La •
r�
By _ ' s �ii ;e of License:
' I ` ' Plumber Signature of Licensed Plumber or Gas Fitter
Title _ DEC 510 Gasfitter
Master License Number. M-429
City/Town_ _ -- __ Journeyman
Ar'PnOVED (of. I ICF USl. UIJi Y1 �r-� r
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Date............. ...................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that .................... . .........................................................................
I - I - - 71 � _Ie -1
has permission to perform ...............................................................................
wiring in the building of ....... ...........................................
at ...................
........................................................... . North Andover, Mass.
- a- 11 ZP/- \1 �- -
FeeJ�� ........... Lic. No/I I I /?�' �" I
..... .... .......
CAL i NSP ECTOR
ell
Check # I , '-;- 2.�
Official Use Only
Permit No. 3J` JV
% f$ CO l�ll0�2Zf/� l'7 05 7 7& 4SS4e,7MS577S -0i
Vo -&--t od pine Salty Occupancy & Fee Checked3b
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code 5277 CMR 12:00
(Please Print in ink or type all information) Date / Z 0 Z -
To the Inspector of Wires:
Town of North Andover
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number 39
Owner or Tenant
Owner's Address �/
Is this permit in conjunction with a building permit Yes I�f No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No. a5-1 611,
Existing Service 6D Amps �Zv Vats Overhead 0Undgmd ❑ No. of Meters
New Service 200 Amps —/ -z D Bits Overhead E f/ Undgmd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO =
have submitted valid proof of same to the Office YES = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box
INSURANCE = BOND = OTHER = (Please Specify)
?? (Expiration Date)
Estimated Value of Electrical Work$ J0-00
Work to Start /-2 3 —c' 2 Inspection Date Resquested—
Signed under the Penalties of perjury:D�U/�
FIRM NAME___
LIC. NO. I7 / 63 4
NO.
Bus. Tel No. r/ `y 77 6� 2 B 2 (, 'L
Address si Alt Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one)
Telephone No. PERMITTEE $
(Signature of Owner or Agent)
Total
No. of Lighting Outlets
No. of Hot fuse
No. of Transformers KVA
Above ❑ In ❑
No. of Lighting Fixtures
Swimming Pool
grnd ❑ gmd ❑
Generators KVA
No. of Emergency Lighting
No. of Receptacles Outlets
No. of Oil Burners
Battery Units
i
No. of Switch Outlets
No of Gas Burners
FIRE ALARMS No. of Zone
No. of Detection and
Total
No. of Ranges
No of Air Cond
Tons
Initiating Devices
Heat Total Total
No. of Di sal
No.
Pumps Tons
KW
No. of Sounding Devices
No./ of Self Contained
No. of Dishwashers
Space/Area Heating
KW
Detection/Sounding Devices
❑ Municipal ❑ Other
No. of Dryers
Heating Devices
KW
Local Connection
No. of
No. of
Low Voltage
No. of Water Heaters KW
Signs
Bailases
Wiring
No.. Hydro Massage Tuds_
No. of Motors
Total HP
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO =
have submitted valid proof of same to the Office YES = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box
INSURANCE = BOND = OTHER = (Please Specify)
?? (Expiration Date)
Estimated Value of Electrical Work$ J0-00
Work to Start /-2 3 —c' 2 Inspection Date Resquested—
Signed under the Penalties of perjury:D�U/�
FIRM NAME___
LIC. NO. I7 / 63 4
NO.
Bus. Tel No. r/ `y 77 6� 2 B 2 (, 'L
Address si Alt Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one)
Telephone No. PERMITTEE $
(Signature of Owner or Agent)
Location -3 C/ /,-)V-
No. e::�, �� Date — '7
TOWN OF NORTH ANDOVER
0
Certificate of Occupancy $
Building/Frame Permit Fee $
CHU
Foundation Permit Fee $
A,7 Other Permit Fee $
TOTAL $
A
Check #
6567 'A'41
Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PERMIT NUMBER: DATE ISSUED: A;7 3
SIGNATURE: 4t
Building Commissioner/122eector of 131uildings Date
SECTION 1- SITE INFORMATION
1.1 Property Address:
r h rcl s tm /I V`s-
1.2 Assessors Map and Parcel Number:
S j 19
Map Number Parcel Number
-9 ,q),
1.3 Zoning Information:
Zoning District Proposed Use
1.4 Property Dimensions:
Lot Areas Fromm e 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:
Public ❑ Private ❑ Zone Outside Flood Zone ❑
1.8 Sewerage Disposal System:
Municipal ❑ On Site Disposal System ❑
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
Historic District: Yea No
2.1 Owner of Record
�C�r 1l,n u 0,5.3 3i �rGN�r son A9 A) -
Name (Print) Address for Service
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
a
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Licensed Construction Supervisor:
Address
Signature Telephone
Not Applicable ❑
License Number
Expiration Date
3.2 Registered Home Improvement Contractor
/W 459x; 0M
Not Applicable ❑
Company Name
",65- �U r� ��-
Regfstration Number
Expirati Date
Add
AA Af Ar
L( -re Telephone
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SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Fail+
in the denial of the issuance of the building permit.
Signed affidavit Attached Yes .......❑ No ....... ❑
SECTION 5 Description of Proposed Work check au applicable)
New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
I SECTION 6 - ESTIMATED CONSTRUCTION COSTS 1
IP
to provide this affidavit will result
Addition ❑
,I dews
Item
Estimated Cost (Dollar) to be
Completed by permit applicant
O)E<k7CIAL USE, ONLY
1. Building
(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 r ative to work au rized by this bur permit application.
Signature of Owner ate
SECTION 7b OW AUTHO ED AGENT DE TION
I, 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
Print Name
Signature of Owner/A ent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS 1 2 3fw
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CH ANEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
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Joe Guglielmino
33 Booth Rd.
Methuen, MA
Joe's Vinyl Siding
PERSONAL AGREEMENT
Proposal Agreement ---
Proposal Submitted To Phone Date
Street ' Job Name
5Acho df
City, State& Zip Job Location
Date of Plans
,.3
We hereby propose to furnish all materials and labor as necessary for the completion of the following
products in accordance with the specifications and drawings. -Tp U , n�
� � 4�'; �� �..�9nr • �®:�: r� � �t:�tt.li �j � n.� j "�%,c,,k� �-� (� .: � tl E�' Cn� A"�% �>'� � �,�c i t, c3�r�-�.
1U �kalLY <�(Q h'.1M kyihalYlC�til.) i/Jr (ft.4rv�� jC✓��C.. {Tiai.VY'i itl'li.i'rl
Total Contract Price Is: 0:1 i 100 h u r7 fv "& dollars ($
Payments to be made as follows l s 1 2- n, AA4 --? o&0 110 at j f.0- 2.0&0, d Ya \ Z Jo
All material is guaranteed to be as specified. All work to be completed in a workman like manner
according to the specifications submitted per :standard practices. Any alteration or deviation from above
specifications involving extra cost will be executed only upon written orders and will become an extra
charge over and above the estimate. All agreements contingent upon strikes, accidents; or delays beyond
our control. Owner to carry fire, tornado and. other necessary insurances.
Note: This Proposal May be withdrawn by this if
Authorized Signature
not accepted within days.
ACCEPTANCE OF PROPOSAL - The above prices, specifications and conditions are satisfactory
and are hereby accepted. You are authorized to do the work as specified. Payment o be paid as
outlined above.
Signa e
Date of Acceptanc
Signature