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HomeMy WebLinkAboutMiscellaneous - 56 Milk Street 56 MILK STREET 2101060.A-0002-0000.0 - _____ Location S /3)1 l S � No. i% C, Date MORTH TOWN OF NORTH ANDOVER � A 9 Certificate of Occupancy $ 4 s � < �'�s'•••°';<�' Building/Frame Permit Fee $ AC NUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Cy Check # /!y Building Inspector t TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING „. #1 BUILDING PERMIT NUMBER: 17 �y DATE ISSUED: M / `/- SIGNATURE: Building Commissionerff for of Buildings Date SECTION 1-SITE INFORMATION z 1.1 Property Address: 1.2 Assessors Map and Parcel Number: " MILI S7" (,,C) A- a V o, n L' D 0 Q Ek Map Number Parcel Number 11.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(so Fr.-a . ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Rapired 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 2.1 Owner of Record ' T)4A] C©-�—LM S SSG 61Z 1--1/ S'T; , APO, MD o VF—A Name(Print) Address forService: / T 4v Signature Telephone 2.2 Owner of Record: Name Print Address for Service: z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensedfonstruction Supervisor: License Number Address f Expiration Date ic Signature Telephone rM 3.2 Registered Home Improvement Contractor Not Applicable ❑ DAV D CAs rkl Ga/JF=� JQFG. Company Name 16M /V A S7—, J/T O v) M n Registration Number A a® /5f b 3 b Expiration Date e — Signa Telephone 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 applicable) New Construction ❑ Existing Building V Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SVL�J' /- R E o o F SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY CorApleted by permit applicant I. 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 relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, � AI/ D 0— ASIR Z [A A) 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 N e Si ature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 ST 2ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BtJIL,DING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Town o SORTH North Andover O� �ED , Citi Building Department o 27 Charles Street * _ North Andover Massachusetts 01845 x (978) 688-9545 Fax (978) 688-9542o RgreD �SSACNUSt DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c.l 1, sl 50a. The debris will be disposed of in/at: Facility location Y a, ,, r q- r- 6" ±ain�s-e-/ Signature of Applicant /Z Y�o Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. ' .� .��r• G r.:rrrun.itrv,,:rt�/� r� /�.....,r,vr,,..r.(( linurd of Building Regulations Hud Slalld111'd1 HOME IMPROVEMENT CONTRACTOR Registration: 104569 Exair2iion: 7/14/02 Tvge: PRIVATE CORPORATION DAVID CASTRICONE ROOFING, S WC? &astficone 7 Hillside Road _ Boxford,MA 0192' Admintslr:�lur Commonwea(.th of wassachusetts Department Of Industria accidents Office ofInvestigations 600 Washington Street (Boston, 5M 02111 Workers'Compensation Insurance Affidavit APPLICANT INFORMATION r �+ Please PRINT Legibly ' Name: DAA1 tC_Q LL1 A)S Location: y (n /"�'�I 1 L S T, City:_ AQ , A/V D U V Telephone#: I am a homeowner performing all work myself. I am sole proprietor and have no one working in my capacity 1 am an employer providing workers'compensation for my employees working on this job Company Name: nn 1 T) l TI� C Q f1 E_LlZ)OFP�LT -P Address: 1A.7710 ArS T7 City: ;\�� TIT /1i'I�� �' q -�Telephone#: g� �o •� uZ,C7 Insurance Company: A6Y/41, S7 ajo A1-Lit?�Cji_ Policy#: p 1 am(circle one) sole proprietor,general contractor or homeowner and have hired the contractors listed below who have the following workers' compensation policies: Company Name: Address: City: Telephone#: Insurance Company: Policy#: Company Name: Address: City: Telephone M Insurance Company: Policy#: Attach additional sheet if necessary Failure to secure coverage as required under Section 25A of MGL 15B can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties 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. I do hereby certify under' e pains a penalties of perjury that the information above is true and correct" Signamr j Date: T l Print Name:__ DAVID- CASZX1ro1jE Phone#9 �'[ Q_� — 2 4,z D Official Use ONLY-Do not write in this area o City or Town: Permit/License#: Building Department o Licensing Board o Selectmen's Office o Check If Immediate response is required o Health Department 13 Other TONNM Of over 0 No. 0 c C o ".;& ' dower, Mass., IT 0'�ATED P?VL C3 H BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT..........PA�......10!�M*A....................................................................................... BUILDING INSPECTOR la Foundation has permission to erect......US-4.AAA....... buildings on ...4r....... ......... ........................ Rough to be occupied as.... Aj C. Chimney . . .................................................... 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-Laws relating to the Inspe tion, Alteration and Construction of Buildings in the Town of North Andover. 64044/62 R PLUMBING INSPECTOR VIOLATION of the Zoning -or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR Rough 44 ............../...if j.. .....a............................................— Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough 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. ,v ✓;C�y t ut b ..�2 a I will Install this system in ince with all- CommoneieuJth of 1;assachus t e is arld re�,ulati,ons of the Hoard of Health of the Ieovin of siorth i.ndover. Further, I cAll construct the house seus er. of bell and spigot pipe, tha � minimum diameter being 4 inches, and will maintain a minlinami rL ae of 1i0 u.n 14 feet preceding the cesspool or septic tank, rihere the graao shall not exceed c/o 1 will install a-ee$eptro - or septic tank of s0-0 iri sizee k manhole (s) permitting easy cleaning will be Provideil MEreuovablu cover (s) of iron or concrete within 12 inches of the ground surface, 1 will provide subsurface disposal field with open jointed bell unct spigot PiPe at ler st 4 inches in diameter and laid in a. series Of trenches, the bottom of vhioh will provide J iA%1.Lvxn os':' ,.1.� Ijinoel �) f,ict of effective abaorpt<.on �a��: , :�`'.a,� �6 . la�for of i•t'T .. •.1t�'_ '�.' �l�„L,':.1. / �,.yt ' 377 })..ftt.3 .. �� (� .� :ttt' LJ:�.. ,. .. ,- •; _ . .. t., ..�•.(;•�•,., L.U('' 'i3 !+*.Z� �::'w/'.T7a 1 i bb .7�. i 1'.E? _ -, Lz � 1 �. .. 1... `•} ..:(. i,.. .'��:.. u-� .L..�.'*... C,;:3 11(ply L .ti.. .. r .. 1 ... .� � 4r ... ....�}� •�i .. .. . 1.'. l.• rte „+ •, •, _r�,_ y ' E1•y'� .-f,� ii' .. �.". r,+1+r .-.'i!y:L....,i1:.•" C ."•t.- N n � - _ y t. o'Z ;..'.l 4.. �/ _ 1Yt:a' .''.1,1.:.1't;,Z l'r:. �.1 •C..,_ _ .. '�`..._ • ... .;�'-..�a _15.5 ...._ .._ _ .._--- - r a G September 311555 Miss Mary Sheridan Health Agent Board of Health North AndoverpPlassachusetts Dear Miss Sheridan: An examination has been made relative to the suitability of the soil for sub-surface disposal of sewage on the Milk Street premises of Mr. Dewey Dyer. The soil in the vicinity consisted of clay. A four minute percolation test was conducted. It is recommended that 144 lineal feet of drainage pipe be installed. Sincerely yours, Ernest F. Romano Master of Science in Public Health