HomeMy WebLinkAboutMiscellaneous - 63 HIGH WOOD WAY 4/30/2018 (2) 63 HIGH WOOD WAY
210/103.0-0087-0000.0 �
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NORTH TOWN OR NORTH ANDOVER
400 F R
Certificate of Occupancy $
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tMUBuilding/Frame Permit Fee $ 40
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Foundation Permit Fee $
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Other Permit Fee $
TOTAL $
Check #
5597 // `Building Inspec
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TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATIONTOCONSTRUCT REPAIg,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
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BUILDING PERMIT NUNMER. DATE ISSUED:
SIGNATURE:
Buildin Commissioner/12sfor of Buildings Date
SECTION 1-SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map and Parcel Number:
6,� 141 "Waa WAY ���
Map Number Parcel
MT71 i1-MoVF-R
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Areas Frontage it
1.6 BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard
Required Provide Required Providedaired Provided
1.7 Water Supply M.GJ,' 40.° „*) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System:
Public ❑ Private""❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System 0
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SECTION 2-PROPER 'VOWNERSH1PIAUTHORIZED AGENT -
2.1 Owner of Record
Name(Print) Address for Service
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
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Signature Telephone
SECTION 3-CONSTRUCTION SERVICES 90
3.1 Licensed Construction Supervisor: Not Applicable ❑
I)Ay ? C hSTA I C 1>4E REG, SDG- ,
Licensed Construction Supervisor:
i License Number
t,a.? b A� ST: Af ib, /Q V J?o V E.)e Mh wn
Ad s1
.ae� ` �Q
Expiration Date
Signature Telephone
3.2 Registered Home Improvement ContractorNot Applicable ❑
Company Name n y� p
U-�T&AI 'ST r /V 6 410 1) E/9. MA Registrition T—Number
A s
Expiration Date
Signature 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. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Si ned affidavit Attached Yes.......❑ No..:....❑
SECTION 5 Description of Proposed Work check applicable)
New Construction ❑ Existing Building Repair(s) ❑ Alterations(s) ❑ Addition ❑
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify *•
Brief Description of Proposed Work:
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be 0 L C�.77��
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C mleted b permit a licant
tF y.,sT$Fkf3rd x.1 ." :;'b �'a'4•'a'" yaz b a".aS�'.
]. Building
L/ ,1 (a) Building Permit Fee
Z v'1. Multi lier
2 Electrical (b) Estimated Total.Cost of
Construction
3 Plumbing
4 Mechanical(HVAC)
Building Permit fee(H) X (b)
5 Fire Protection
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6 Total 1+2+3+4+5 q 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.
Si nature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
I'--. 1/AV 1 C A—S T—i t eW E as Owner uthorized Agen 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 '7
V C
Print -e
Si ature of Owner/A ent Date
NO.OF STORIES SIZE
BASEMENT'OR SLAB
SIZE OF FLOOR TIMBERS 1 2ND 3
SPAN
DIMENSIONS OF'SILLS
DIMENSIONS OF POSTS
DIMENSIONS 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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`_ Board of Building liegulations and Standards License or reuiatration valid for. individul use only
�- — " HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
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t Registration: 104569 Board of Building Regulations and Standards
One Ashburton Place Rm 1301
Expiration: 7/14/02
Boston, 11x.02108
Type: PRIVATE CORPORATION
DAVID CASTRICONE ROOFING, S
POP S;astricone
7 Hillside Road
Boxford, MA 0192'. Administrator Not valid without signature
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Town of North Andover o� No oTH qti
ZS 6y 0
Building Department o
27 Charles Street
North Andover, Massachusetts 01845 �
(978) 688-9545 Fax (978) 688-9542 °�4 0
COCMI[�jwKM
��SSACHUS����
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 cl 1, sl 50a.
The debris will be disposed of in/at:
Facility location
Signature of Applicant
Date
NOTE: A demolition permit from the Town of North Andover must be obtained for this
project through the Office of the Building Inspector.
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T dover
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No.
� CO, •�i Z. �z= ��A o � over, Mass.,
I� COCHICHEWICK
7 AORATEO PP�� 5
'9S � BOARD OF HEALTH
Food/Kitchen
' PER Septic System
THIS CERTIFIES THAT.........: BUILDING INSPECTOR
.
.... ....................... ..... ................. .. ....�........................................... ...... Foundation
has permission to erect. ... .. ..... .......... build! s on 43 ............... Rough
to be occupied as.`, .�. Chimney
.... ... . ... . ............................................................ .
provided that the person accepting this p it shall in every respect conform to the terms of the application on file in Final
this office, and to the provisions of the des and By-Laws relating to the Inspection, Alteration and Construction of
Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Kermit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS
UNLESS CONSTRUCTION S4R S ELECTRICAL INSPECTOR
�w?"-...........................: 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.
Smoke Det.
SEE REVERSE SIDE