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Home My WebLink AboutMiscellaneous - 66 ROCK ROAD 4/30/2018 (2) IRock Rd,66 Map 47 Parcel • Date..... w ....4:;......... 3ro�t,��.o,+°',1s�OpL TOWN OF NORTH ANDOVER PERMIT' FOR WIRING S CHUS Thiscertifies that ...................... ...................................................................... has permission to perform ..................... ......re..............k...C........... wiring in the building of........... XAIO.14?r................................... at..... Nr.......1) .......................... North Andover,Mass. Fee. .f-0—. Lic.No.'��!�3,,3 .......... ........ .............. ..€.: ' ELECTRICALINSPECTOR Check It 661j7 11M LUIVILYLULvVVE LA113 yr X1tU3L f1L1"VJ1i1IC Z" DF.PAR1I11IIVl0FPUB1lCS4FElY permit No. BOARDOFFIREPREVFNHONROGUTAT ONS5VQKR12:fXl Occupancy&Fees Checked APPLICATIONFOR PERMIT TO PERFORMELECTRMCAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat PJCo Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) (!I Owner or Tenant Owner's Address C ?�! Is this permit in conjunction with a building permit:/ Yes 0 No (Check Appropriate Box) Purpose of Building sl" /e L14n 1 ! T Utility Authorization No/7L/)K6 = Existing Service 2-00 Amps lZ Yavolts Overhead EDUndergroundU� No.of Meters New Service Amps olts Overhead r-1 Underground ®/ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work -G>poA i JJ& 7e i2o/ cY' No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA round 0 itround dVo.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units ,No.of Switch Outlets r No.of Gas Burners o.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER- h,A03roeCoVWdr-Plnsi =tbemWimientscfMassadiusMCaremlLaws Ihneaamatliabkhr=mwR) yirrhrdrrgCornplen " Cora is alag uWfft YES NO " � sutxniwdvalidpuefof OdIeOffi=YESr TIfyoubawdreclodYES,pleaseirldcao degWofawwpby INSURANCE BOND O HER (PfeaseSpac�y) "2 V Efti*dValreofIIecmcal WCdc$ WadctoStatt hispwfimDWeRequr-4Fd Rough Final � Pa]tIy'• LP/ FIRMNAME _ e L,ioameNa —,�T?,yo 4,ep? WU Signahne Lioa>seNo / J l Buri=Td NaAdksV— ��/ �{�/G/ 7°�tit lrl L A6 A C a;- t �� .S� Alt Td Na OWNER'SINSURAN EWANIIt IamawarethattheLioamedoesnothavetheirmtaancecorsageorilssubst iiWepvaiEriasmgmijdbyNtism&vsmGeneralLaws and that rrry agnahae m d us pelrrit appliratiotr wanes d>is regt>irerrralt (Please check one) Owner Agent Telephone No. PERMIT FEES signature of Owner or gen i /�' �° �� r, 1 x 4 Location/6 A::�2 i Na y�/ Date i TOWN OF NORTH ANDOVER a if � 9 Certificate of Occupancy $ i Ss�CHu � Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ € TOTAL $ Check # c 1 4 i 6 7 Building Inspec Y i s. TOWN OF NORTH ANDOVER BUILDING DEPARTMENT T APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: , /�/ DATE ISSUED: �l l�' SIGNATURE: /U&f --I Building Commissioner/IEEQEtor of Buildings Date SECTION 1-SITE INFORMATION e1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number Q! 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUII.DING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Regaired Provided Re red 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 0 Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record ,p Name(Print)} Address for Service: (\ 1� 0 Signature Telephone 2.2 Owner of Record: Na%e Print Address for Service: z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ t Company Name Registration Number �+ Address -� "%aE'G�� ' � �Ly !_t "�L' Ll�G =✓ / �" Com" Expiration Date Si nature Telephone SECTION 4-WORKERS COMPENSATION(MLG.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 rmit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check all a licable 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 pF1FICIAI;USEONLY� r Completed b permit a licant 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 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, 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 l Print Name Si ature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIlVIBERS Isr2 ND 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 _ The Commonwealth ofMassacluusetts _ ( Department of Industrial Accidents Office of/nve 9F.711nns 600 Washington Street Boston,Mass. 02111 ` Workers' Compensation Insurance Affidavit ®R Main eQt am . location: �� \"��• ( Q� # ❑ 1 am a homeowner performing all work myself. ohnnr ❑ f 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. Off +�' I;�celse` address \ ins"rancet o Y.�. +�)' ; ad ILo 1r ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the followingworkers' compensation polices: ::.::.::<:..............p..... comp�ittiamr ; ; .Y. `x. -�lQ i�Y t Y n fr :}:t2 ;: .;% 'f t.c.J^<tr e• e address. Y e . stir._— jihOne u insurancd co; pe�v# Failure to secure coverage as required under Section 15A of MGL 152 can lead to the Imposition of criminal penalties of a fine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of simoo a day against me. l understand that a copy of this statement may be forwarded to the orrice of Investigations of the DIA for coverage verification. I do hereby certify under the pains and pen ties of perjury that the information provided above is true and carr CL Signature � ��? �;� ^�$IzP Date V� v -t Print name ��'\_� i_Z1�— �� r�9 T�{ G� h;P Phone ri Official use only do not write In this area to be completed by city or town official city or town: permit/license# nBuilding Department OLfeensing Board ❑check if immediate response is required pselectmen's Office Oflesith Department contact person: phone fl; nOther (revived 3r95 PIA) F -TT o � ✓fie ioomvrxa�:aea�c o�.,/��aaaac%uaella �. j HOME IMPROVEMENT CONTRACTOR Registration 103317 Type - DBA Expiration 07/07/00 CASTRICONE ROOFING & SIDING C Mario T. .Castricone &0'ffC0urt St. ADMINISTRATOR N. Andover MA 01845 Castric®ne Rooting & Siding REPAIRS FREE ESTIMATES Telephone (978) 682-4266 MARIO CASTRICONE 31 Court Street,North Andover,Mass. 01845 [/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 b I w described: Owner's Name. . ......... .. 9 ........ ................ .. ............................. J. ��.. ....� ..State.. ......................... Job Address. .... ....... ........ ..............Ci SPECIFICATIONS .. . .. Zo .... .......... ............................. ... ... )........................................................................................................... ............................ ... . ......7--�.... 7--4 ....... ......................................................................................;....................................... .... .... :...�...... c ......::: ................2 ....................:........................................................................................................ .. ............................................. ........... .......................... :: :: : ..................... ...... : ... . . . :::::::: ::::::: ........ ................................................. : ...... .. . ................. .......................... . . ............ ................ .. ......................................................... ................................ .... . ... ..... ... :............................................................................................................... .......................................................... ..... .................................................... .................................... •��Y '�+� .. r .. ................ Materials and labor to cost$(=-?L .......................................... Payabl :.. . .. ...... ........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 an agreements c (lateral hereto nor is i contract Y 9 9 this dependent upon or subject to any conditionsnot 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 j understandings of said parties are contained herein. Owner or Owners are not responsible for Property Damage or Liability while job is inop at* � �C IN WITNESS WHEREOF,the parties have hereunto signed their names this ..... ...........day,of. fr�� ........., .............. II Accepted: Signed ............... .... ......... ... .................................. Owner i !I NER HAS 3 DAYS IN WHICH TO CANCEL CONTRACT) Sighed...................................................................................... Owner Per.. ..�.... .......... Representative Town of North Andovero� Na oT"�ti Building Department o 27 Charles Street North Andover Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 C. `°`""K•,y,0 �9SSgc Hu5�� 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 ignature 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. I � I vz�.' %0%"fig14%0111TWUi3tM OTMassachusetts ofAeeuseontoDepara'rrent of Fubdk SeJe(y f+errryt Ivo. BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occ w cv a Ree C7ndn�_3f90 peatyun bk) V APPLICATION FOR PERMIT TO PERFORM ELECTRICAL VII N"n to IN a 6e.�O.we ft Fhear.,ceo. sz,-da Im OR t � (PLEASE PRINT INIINK OR TYPE ALL (INFORMATION Dow Y City or Town of 14, ��YJ o The undersigned applies for a permit to perform 1116 electrical work described below. To the lnspoctor of Wires: Location (Street Owner or Tenant Owneris Address Is this permit in conjunction with a building permit res ❑ no (Cit•:it Appropria[e t3o:} Purpose of Suildinry_ _ _Utitity Authorization No. Existing Service amps r Volts Overhead ❑ Undgrd ❑ No. of Metere New Service --- Amps --�r Von Overhead ❑ UndgW ❑ No. of moors— Location of Feeders and A+rtDaciry Location and Nat-,e of Proposed Etec:ricaf War Pq re- T -/a No. of fIghting outlets No.of Hot Tubs TOTAL No.o/Transformers )(VA No. of Li ht Fixtures Above t swimming Pool rnd.❑ rnd❑ Generators tCVA No. of Recaotacle Outlets No. of 04 Burners No.of Emergency Lighting Barts Unita No. of Switch outlets INo. of Gas Burners MAE ALARMS No.of Zones No.of Ranges TOTAL No. of Detection and No. of Air Conditioners TONS Initiating Devices No. of Disoosals HEAT TOTAL. TOTAL No. of Sounaing Devices No_ of Pumoa TONS KW No.of Self Contained No. of OL"Mashers Soaee/Area Heatinq Kyy Derectiontsounding Devices No.of Dryers Headno Devices Municipal — K4H Local ❑ Connection. No. of No. of ❑Other - -_. NO.Of Water Heaters l�W Ballasts LOw voltage � f� J r Wiring WifL �� LS v Ir j Ka.of Mydro Massaae Tubsr No. of Motors Total HP j t OTHER: ' FEB1996 ; INSURANCE COVERAGE: Pursuant to the r emend of Massac F •(?. Fi��r`, I have a current Uabillty Insurance Pot 1 i nusetts General Laws +rand proof of same to Ni offlge. YES O®ng Complmsd�"bO"a Cotler"°or its substantial equivalent. YES O O 1 heave submitted It You have checked Y please indi to the type of coverage by checking the appropriate box. INSURANCE 80N0 ❑ OTHER ❑ (Please Speafy) Estimated Value of Electrical Worts S (Espitation Oete) Work to Z ,—_c V/ Signed under the penalties of Inspection Requested: Rough Final .jury: FIRM NAM �� — Lieensea LIC. NO. SignatureAddress C. NO Bus. 1st. No.r�,�— WNE 0Massa nu iNs Gen., is WAIVER: 1 am aware that the Licensee doss not have the insurance coverage of its sAlt. Tel. No4 M — I Massachusetts General Laws. ano that my signature on this apoliearion weivss this requirement.Owner q equivalent as required by 176.11 (Please check dna} ,\ (Signature of Owner or Anwnrt Telephone No. may/ w T_ 2855 NOR71{ TOWN OF NORTH ANDOVER PERMIT FOR WIRING AC14US� b �R ' �- This certifies that ..........�..!�!.Q.1�,.!!1:?...��............�::...........-C c:......................... hasp ermissionto perform cif.................. ' wiring in the building of........ C{ ................... ....................................................... F. at......�L .....�<�?. ..t....... .f ............................... .North Andover,Mass. �,��. V.... Lic.No�.1��`f� � Fee. ............................................................... ELECTRICAL INSPECTOR E C 96411:36 15.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File