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HomeMy WebLinkAboutMiscellaneous - 51 BANNAN DRIVE 4/30/2018 51 BANNAN DRIVE 210/038.0-0114-0000.0 j Location 16f (3ANNOA) -1�>fc-'_ < No. �b 9' Date of N 0RTh TOWN OF NORTH ANDOVER 10. p ' Certificate of Occupancy $ sMus c� Building/Frame Permit Fee $ �a Foundation Permit Fee $ Other Permit Fee $ TOTAL $ /O;L U Check # F �r 1 6 8 1 2 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVAT5 OR DEMOLISH A.ONE OR TWO FAMILY DWELLING -BUILDING PERMIT NUMBER. DATE ISSUED: 0 ® - X ic SIGNATURE: Building Commissioner/Inspector of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors.Map and Parcel Number: Map Number Parcel Number j1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Fronto 11 1.6 BUILDING SETBACKS(ft) Front Yard Side Yard Rear Yard R red Provide R fired Provided Required Provided 1.7 Water Supply M.G.I—C.40. 54) .1.5. Flood Zone Information: 1.8 Sewerage Disposal System: D Public 0 Private ❑ Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System ❑ _J SECTION 2-PROPERTY OWNERSHM/AUTHORIZEDAGENT Historic District: Yes No �"I 2.1 Owner of Record �^ / Name(Print) Address for Service: Signature Telephone Br► Q 2.2 Owner of Record: �} s t t Name-Print Address for Service: z ti M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: 04 �. License Number Address'/ Expiration Date a. Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 -��KC�'l t��1s2�jr��vrTxa C°� Cf�j Company'Name1"A 001 < � Registration Number Address Expiration Date / �^ Signature Telephone G) 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 Pro osed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify 1/ W S ; Brief Description of Proposed Work: 4-/ / r ok h�:e- �Z SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be tIC1ALpUSE ONLY 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+5 GO Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, �Oki A as Owner/Authorized Agent of subject property Hereby au orize / to act on My be ha I n all in rs rela rve to work authorized by this building permit application. /0 iy Si natt e of Owner Date F SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, / � �Q �9 as Owne Aut orized A e f 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 Na Signature of Own /A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB ST SV E OF FLOOR TIMBERS 1 2 3 SPAN DIMENSIONS OF SILLS llIMENSIONS OF POSTS DiMI NSIONS OF GIRDERS I II ioI IT OF FOUNDATION THICKNESS SI/L01. FOOTING X MATERIAL,OF CHIMNEY IS 1itJILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE a k The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations r Boston, Mass. 02 911 i I V Q sv• WorkersI Compensation Insurance Affidavit Name Please Print Name: /�,Wa Location: Z�,. so ST — City e # I am a homeowner performing all work myself. 1 am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. Company name: Address city. Phone Insurance.Co. Policy# Company name: , Address City: Phone#: : Insurance.Co. Poliev# Failure to secure coinage as required ender Section 25A or MGL 152 can leadto-uw imposition of c iminat penamies or a fine urs:to$1,500,06 and/or one yearsImprisonment-as WeelLas_ca44xmaittes m-tbelcrm—dABTQP afioe-ct_(.;icDm)-aid agmen understand that a copy of this statement may be forwarded to the Office of Investigations of the MA for coverage verification. /do hereby certify under the pains and es of perjury that UN irdomra&w proviried above is true and correct Signature // Date Print name ��*CT��fc�rr Pine-# Official use only do not write in this area to be completed by city or town afficiar City or Town Perr itUcensi Building Dept []Check d immediate response is requred [] Licensing Board p S%ctmaWs Office. Contact person: Phone# Health Department Ei Other 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: SSI — 14lCw 71-714V)caet �, (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector .3 't;. S r ei.` �� `4 `}4-.. S:{. ��{ t30:111 of B.M(lifig Regulations a,ld Standar do HOME IMPROVEMENT CONTRACTOR Registration: 104409 Expiration: 7/14/2004 a` Type: Individual 1 IAPICCA CONSTRUCTION Ronald lapicca 257 South Street _ Reading,MA 01867 ~- T Adn.inistrat,�r Jj BOARD OF BUILDING REGULATIONS i License: CONSTRUCTION SUPERVISOR t _ s Number: CS 055501 Birthdate: 12110/1968 Expires: 12110/2004 Tr.no: 5964 Restricted: 00 I RONALD J IAPICCA ffE G 257 SOUTH ST , - ' f READING, MA 01867 Administrator Page No. of Pages IAPICCA CONSTRUCTION REG. LIC, #104403 LIC.#455511 20 Wilson Street READING, MA 01867 (781) 344-1328 Fax (781) 344-1928 PROPOSAL U �Ip TONP ONE 125 Q 2" DATE STREET /f °��• JOB/NAME CITY,STATE and ZIP COPE JOB LOCATION ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates ford r�a�T.S � .�/St�+'/y. �lri4fl3/- E°y✓hjr+$✓// 's f�7 fiR<r�� fA'4 c+odz ��'�aGc. �'�..at�'6� �.r�'cs^-3 �- j�r..h,r��r.t j- �' ,��f`�f ,.�,°�§i /9�..a�r� 1'•"�.o�r�rf` . '�J'. P Frapagg hereby to furnish material and labopcomplete in accordance with above specifications, for the sum of: dollars($ � ). Payment to be made as follows: / All material is guaranteed to be as specified. All work to be completed,in a workmanlike manner according to standard practices.Any alteration or deviation from above specifications Authorized, involving extra costs will be executed only upon written orders, and will become an extra Signature charge over and above the estimate. All agreements contingent upon strikes, accidents � r or delays beyond our control.Owner to carry fire,tornado and other necessary insurance. Note:This proposal may be Our workers are.fully covered by Workman's Compensation Insurance. withdrawn by us if not accepted within days. Aruptaurr ®1 Proposal —The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature '�� �-�" to do the work as specified. Payment will be made as outlined above. Date of Acceptance: -c,: Signature NORTIy Town of 4 Andover •• No. O� roc ICLA O dower, Mass., HEWICK 7� AD'QATED S H E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System - BUILDING INSPECTOR THISCERTIFIES THAT..........,D.�� ............. ........ ..v..`................................................................................ Foundation has permission to erect.... �..'V. 5..�... 3ANNoN......��?�. .�.. Rough p �bflddlngs on ............ g to be occupied as I N ` It v �� Chimney p ............................... ......................................:.C............................... .................................................... 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 Lating to the Inspection, Alteration and Construction of Je Buildings in the Town of North. Andover. '� PLUMBING INSPECTOR e * 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. SEE REVERSE SIDE Smoke Det. —c7z Date.. . .... ..19. .. ...... .. NORTH TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION ISS CHO This certifies that ... . . . . . . . . . . ...�. . . . . . . . . . . . . . . . . . . . . . . has permission for gas Inst . . . . . . . . . . . . . . . . . . . . 2, Illation in the buildings of . . . la-:-el . . . . . . . . . . . . . . . . . . . . . . . . at North Andover, Mass. Fee:- t. . . '? Lic. No..Ie)11� . . . . . . . . . . . . G EC ASINSP TOR V Check4 4682 i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) ��1-2 \ ,• _ Mass. Date!"�rA,'� 1 � � Permit # Building Location MA ype of Occupancy QST Replacem rd Plans Submitted: Yesp No(New p Renovation p 2 N W N 7-7 Y Z W. 4n N 0 rt N z !- Z O H W rt O V m �_ S 0 v Jt =Z d aW h Zorn rOHs oaW o ¢W s s m 0 r- W W o aA z Z YI 2 C I- Z o tm 2 0 •>1G- W<W_O tl aC O O drtW Y 010 S SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR ~ SO STH FLOOR 1 A 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name c5`d,�-� E Check one: Certificate Address ^L$ �v`�e O Corporation WO{ �Y10oV�.� ©`��� O• Partnership Business Telephone °1 b— Cn$k_-v—+b(o D Firm/Co. Name of licensed Plumber or.Gas Fitter INSURANCE COVERAGE: I have a curren lability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No O If you have checked yL, please indicate the type coverage by checking the appropriate box. A liability insurance policy S Other type of indemnity❑ Bond 0 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: OwnerO Agent O a 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 all plumbing work and installations performed under the permit issued for this application wilt be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General taws. �,. T of license: PlumberSig—nature of Licensed Plumber or Gas rmer Title stlicense Number M /•Y -����d sten en City/Town Joumeyman APPfiONED 1 N r 7 Date.. . . .. .. . .. . . ...... .. `4r NORTp Of 6 t o= p TOWN OF NORTH ANDOVER t - PERMIT FOR GAS INSTALLATION SACMUSEtS This certifies that . . . . .. . . . . . . `''fid . ... . . . . . . . . . . . . . . ...1 has permission for gas installation .2.'et, ...4 in the buildings of . . . . . . . . . . . .. . . . . . . . . . . . . . . . at - . . . a.�-. - . . . , North Andover, Mass. Fee. 7Lic. �f GA�SPE 7.K Check# c::-)9n 5048 MASSACHUSETTS UNIFORM AP ICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date — f Building Location Owners N e 2! Permit# �3 C1 y Amounts 7, Type of Oqp anc New Renovation Replacement Plans Submitted Yes No ❑ FIXTURES V. In 3 s�agv>� >ASEMM M Rfm MHJDM >ifm a>H>LOM 5MHfM 6MfLOOR 7MH-CM gm H-0m 1 i(Print or type) Check one: Certificate Installing Company Name , ❑ Corp. Address R4 V Partner. um sess Telephone II/Firm/Co. Name of Licensed Plumber: I 11-4)r pt , w-Aea Insurance Coverage: Indicate fie type of insurance c verage by checking the appropriate box: Liability insurance policy IT Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature 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 i11 ions performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus Ss Stale P in ode and Chapter 142 of the General Laws. By: 'Signature ol LicengSKjriumt)Title er Type of Plum ng Licen ,��� City/Town icense RumDer Master ❑ Journeyman APPROVED(OFFICE USE ONLY 04/06/1997 15:02 5083736611 STEWART/ANDOVER PAGE 01 JUBr41 Aivl.)6ver 1JD �n St, �$ �� SffitSRCL N�rtl A I1aa/�r 47 RkURMD gzRW Mh 01835 578-372-7472 MM ADORM QkUcw loo S Svc � �hhgr'i �►'-- 1 f.SoO 0?3-7 Cor/ kn !a n e lSoo . g� 5" GJi reef le. vm - . rd0 K t-r um lgrt f I 0-0 J/ba /e S,v (� 1 G ,Qin�g•�,�r r� . J v �a, ! r ?a vc-n Jan 158 15 Cen , 7� �e,n enc. 1,