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HomeMy WebLinkAboutMiscellaneous - 50 PHILLIPS COURT 4/30/2018 -50 PHILLIPS COURT 210/095.0 0034-0000.0 i Location �--" No. e?o Date '9- G-407? MaRTM TOWN OF NORTH ANDOVER H?.•� • Oe 9 + s • Certificate of Occupancy $ cMusE< Building/Frame Permit Fee. $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # a 6586 Building Inspector r TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING >g l Z l 0 , BUILDING PERMIT NUMBER DATE ISSUED. SIGNATURE: Building Comrriissioner/12#ctor of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 3 Map Number Parcel Number IV 1.3 Zoning Information: 1.4 Property Dimensions: Zonin District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide RegLured Provided Required Provided ® i 1.7 Water Supply M.GL.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 Historic District: Yes No m 2.1 Owner of Record �y ,p / YVl ) Z 1 C" U,,S.1 PA ' d, 1 Name(Print) Address for Service: Signature Telephone © / 2.2 Owner of Record: are Print O Address for Service: z M Si ature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensedy Construction pervisor: Not Applicable ❑ VK Licensed Construction Supervisor: License Number mn —31 ddress !�' �7 �s>� / �1� Expiration Dateic ignature Telephone Pr 3.2 Registered Home Improvement Contractor Not Applicable ❑ Coiltpany Name Registration Number r Address r Expiration Date /� Signature Telephone r , 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 all licable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: _ 1 i SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIALUSE ONLY 6- Completed by permit applicant 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+9 ► . ,1 a•.• + JF iv►-,i' Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BU.LDING.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, as Owner/Authorized Agent of subject property N Hereby declare that the statements and information on the foregoing application are true and accurate;to the best of my knowledge E and belief Print Name i Si ature of Owner/A en Date `. NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS 1 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS ; DE\,ENSIONS OF GIRDERS DIGHT OF FOUNDATION THICKNESS t� SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE ez&C MC4"of f�{�Sacfiusatts ,�' c >�p ►et of Inls�srriat�te�dents 9'. of 600 Wasknown Stn ®osto�, 1[02111 We*=.Compeo"non laattra ce AffW11 it Please l[tINT Legibly A.!'f'+ Yr �'}TQ82MAT7OA1 i v br:Ze' Location: d � Telerhone M: City: pe all work myself- G I am a homeowner ❑ i arc sole ro etor and have no one won ism rA aoity ❑I am an empioyer providing work=%'cotnapetuation for ray employees aorl�g an this yob Company Name: Address: 9 7 L City: Telephone M Insurance compaiay: Policy ff:_ •� ❑ and have hared the contractors listed below who have the following 1 am(circle one) sole proprietor,general contmetor or homeowner workers' corsmperssatioa polieiea! Compazy Name: Address: Telephone 0: Ciry: - Insureace Company: Policy 0: -.---�— Company Name: — -- Address: City. __ Telephone : insurance Company: Policy Attach additional sheet if necessary min Failure to secure coverage as required under Section 25A of MGL 15B can lead to the imposition of criminal penalties of a fine ul,to$1,500.OG and/or one years' impriSO=Cnt aS well IS ClVl penalties in the forth a:a STOP WORK ORDER and a fixe of 1100.00 a day agaios me. 1 understand that a copy of this statement may be forwarded to the office of Investigations of the AIA for coverage verification. I do hereby ctrrito under the pains andpen4gies of perjury than the information above is true and c rrem. Si nue: ft. Date: L �� f� Print?Maine!�l�h� 14 � �Q S ��' �,�,��$.�/ Phone# Of ficial Use ONLY-Do not unite in this area r � a®ui!ding vep®nasent ^tty or' .wn_ PermltlLicense 0: c Licensing Boaro I —-- 0 Selectmen's Office Health Dezertmant 0 Check if immediate response is required 0 Other a- i jeo'NORTN Town of over ON•` t. �` .� * 4 No. o dover, Mass. o ) f CoC MICM WICK ORATED S H � BOARD OF HEALTH PERMIT T Food/Kitchen Septic System V ` i mew INSPECTOR THIS CERTIFIES THAT 5 ..50; ...............................................�........................................ .................................. Foundation V '1 So -s� I 1 rs c� has permission to erect...... ...�N.......�............. buildings on ......................................... ....�........�.. .......................... Rough to be occupied as s �� �O d V r L A Chimney p ...... ............ ...................... ....................................................... 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 -La s r I tin to the Inspect'on, Alteration and Construction of Buildings in the Town of North Andover. I /®0 am- PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST so 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 BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. CaStricone Roofing & Siding REPAIRS FREE ESTIMATES Telephone (978) 682-4266 MARIO CASTRICONE 31 Court Street,North Andover,Mass. 01845 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 described- Owner's escribed:Owner s Name. ... / ..................................... ......... ........... ................................................. ............................ ..... . .. ........... ........State ..............................Job Address............................ . . SPECIFICATIONS ........... '. , � . . .......................... ........... . ,2 3 ............... ... ........................ ....... .............. ..... ... ...... ......... . -3 ... ..... .... .... .......:... .ti............................. ...................................... ...... ........ ............................ ....... .. ..................................... �, ........... .�..: .. .. ... ...... ............... .................. .... . .............( .A...... .......... .......... ................ ....�' ........................................................ ..... .... .... ............... ..' :� � {........................... ... .............................................::::::::::::::::::::::::::::::: ... .....G �a.� ........... .G , .......................... ...::- mac........... ... ............................................. ...... ...... .r. ..... ......... J............ ....... ................. ................... .................................................... .`i.. .. ..�.... '. .. ............. i......�.. ........................................................................ ................................................. Materials and labor to cost ................................. Payable� $ ................... y .........................................on ................................and balance m............ monthly installments of$.........................................each payable 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 thereto 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, uaranties or warranties except cept 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................,j/d '�...day of.. j� ....., 9............ Accepted: Er_ Signed. ,. .....:� �,;:..... .. .............c ................. (OWNER HAS 3 DAYS IN WHICH TO CANCEL CONTRACT) Owner / Signed...................................................................................... Owner Per. .... 1✓` . . r ..... �............................. Signed...................................................................................... Representative