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Home My WebLink AboutMiscellaneous - 60 CHESTNUT STREET 4/30/2018/ 60 CHESTNUT STREET 210/060.=_0000.0 4 f Location 6C> c/ `S No. ` Date w�D� „oRT„ TOWN OF NORTH ANDOVER OL f 9 Certificate of Occupancy $ 'SscMusttt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ _ a TOTAL $ S Check # 15002 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING US�".,.#t ..��, r '.-��t�p`, f rx �,s�:^ar :�.� :r. � �"x x��°�,...�•i_`�L, " 1 �t,� ,�Y,,. ��` ' ��ti �t�r�.��i3-�'�` �� K ��e - � �� "a BUILDING PERMIT NUMBER: ' / DATE ISSUED. aL SIGNATURE: Building CornmissionevInspector of Buildings Date SECTION 1-SITE INFORMATION 2 1.1 Property Address. 1.2 Assessors Map and Parcel Number: fir, Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Fronta e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide RequireE= Provided Required Provided Flood ood Zone Information:1.7 Water Supply M.G.LC.40. 54) 1. 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System ❑ _ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record � IT" r / Name(Print) {Address for Service: Q Signature Telephone 2.2 Owner of Record: Name Print Address for Service: C 2 Signature Telephone rr SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Constr tion Su isor� Not Applicable ❑ m, CDZ� 33 l/ Lic sed Constru ion Superv' or: //� '� �, License Number Ad s ' �/�/ �' Expiratio Date ign ture ' Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address r Expiration Date Signature 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.......0 SECTION 5 Description of Proposed Work check all applicable) New Construction 0 Existing Building ❑ Repair(s) 0 Alterations(s) ❑ Addition 0 Accessory Bldg. ❑ Demolition ❑ Other 0 Specify 4 Brie Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS ? Item Estimated Cost(Dollar)to be '�ak � Q Completed by permit applicant 1. Building �-7 (a) Building Permit Fee / Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(8)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 C NTRACTOR APPLIES FOR BUILDING PERMIT 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. r' e Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 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 Prin aine g Sie of Owner/A en t Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 s 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIlvINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 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 Name.....1.. ... ....... . .... ................ Job Address....L)(/..... ................ ..........................City. .......... .' ...State..')&.tt............................ SPECIFICATIONS .... �..12..... ......... .......... .................)�_ t�� .... ........ ...............�// . ... ...... �...... � � .......................................... C ........ .................... . .' .... .. f ......................................... /.d. - .. ..- .... ......................... c� ......................... F..... ... .. ..................................... A_, = .................................................................. :. ... . ......................................... ..... 2...... ........... ,,.... ....................................... .................. ...... F....................................... .. .............. ......... \p/ J I J/ � ... ..... .. ............ ...�..... .. .... ..... .... .. ... .......•....•.....i•••R ..•............................................. ..... ......... .. ...............a... ........ •.................. ..K.......... ..................................................................... .. - ............. ...........................................C.. .............,......... ..... ....... .... ...... ......................................................................... .................................................................................. ........ .... .. .................................... Materials and labor to cost$ ....417.......11.......................... Payable .........................................on ..... .............and balance in............ 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, guaranties or warranties, except 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 operatio ........ IN WITNESS WHEREOF,the parties have hereunto signed their names this................ ay of. .. .. . ...... . .. �t� Accepted: a� Signed.... . .....�.............................. .................................. (OWNER HAS 3 DAYS IN WHICH TO CANCEL CONTRACT) Owner Signed...................................................................................... Owner Per ... . . ' ?v ....................... Signed...................................................................................... Representative , 2rie Commomveafth of%=achusetts oepartrn ,of Industnaf.Accidents Sys Ofiice of Inve,-tigations .... 600 Washington Street Boston, W,ZI 02111 Workers'Compensation Insurance Affidavit APPLIC LNFORMATION Please PRINT Legibly Name: Location: City. Telephone#: D I am a homeowner performing all work myself. ❑ I am sole proprietor and have no one working in my capacity ❑ I am an empl9per providing workers' co pensation for my employees working on this job Company Name: C` Address: LJ 17 City: Telephone#: G / �tl Insurance Company: Policy#: W C Q �fl f I, D I 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#: 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$100.00 a day against me. I understand thata copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certrfy under the gins and penalties of perjury that the information above is true and orrecL Signature: Date: Print Name: Phone# Ofucial Use ONLY-Do not write in this area o Building Department City or Town: Permit/License#: o Licensing Board 0 Selectmen's Of ic:e o Health Department o Check if Immediate response is required D Other I NORT►y ,,.own oED /. dover �IA - �` � - - _ A Q dover, Mass., � RATED S H BOARD OF HEALTH PERMIT T Food/Kitchen Septic System L cc BUILDING INSPECTOR THIS CERTIFIES THAT.........� !./.�1,,Si....Iti.{......J.�'!!�. ....................................... . Foundation ........................... .. has permission to erect...-. �O..�........ buildings on ......... ... .,..,..C-. .r ......N. .......s .... ,."......... Rough to be occupied as..........59 c.' Q....��...........1.......... r% O N...�W5 t C;.AN.e_.�............. 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 Inspection, Alteration and Construction of Buildings in the Town of North Andover. � O C// Y o? Y, — 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 ................................................................... 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. Smoke Det. SEE REVERSE SIDE