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HomeMy WebLinkAboutBuilding Permit # 8/26/2016 BUILDING PERMIT ONorrN �,zLE� rb'4'LD TOWN OF NORTH ANDOVER o - APPLICATION FOR PLAN EXAMINATION " ._ � z e ( Date Received q Permit No#:� "'" .,rEP i �`SSRCHU �� Date Issued: C2 IMPORTANT: Applicant must complete all items on this page LOCATION " �"tfA _ _ Print PROPERTY OWNER � Print 100 Year Structure yes � no MAP PARCEL: _ ZONING DISTRICT: Historic District yes no Machine Shop Village yey, n i� TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building V One family ❑Addition ❑ Two or more family ❑ Industrial CVAlteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ SeptEc ❑Well © Floodplain ❑Wetlands , C i111atersled Dfstrrct ' BterlS£yUEC.: DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name:`` Phone Address:g3 `' Contractor Name-�TkVA421)�� Email. ?LA . t - � Address: 0 V�'1 `3v t C3 Supervisor's Construction LicenseC.6-03-1 �( ._Exp. Date: f L ax ' Home Improvement License: Q�- , 8 Exp. Date: 7 t 24 1 ,:�Lo 1 ARCH ITECTIENGINEER Phone: Address: Reg. No. FEE SCHEDULE.,BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Perso s contracting with unregistered contractors do not have access to the uaranty fun F OO R'�F '� own of _ a.. 6 ndover 0 ' 0% No. �-- doll V. h ver Mass LAKG LOGH�C nE w1Cn U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ......, ..�..� :.�e ..... f..�r�,. ,p ..................................... BUILDING INSPECTOR 1...... - .., e ..... Foundation has permission to erect .......................... buildings an ...,... .. .'.`. ..., Rough to be occupied as �J/ l .r��... .. p� f*r�*=war•... .. ................................... Chimney provided that the person accepting this permits In every respect conform to the terms of the application Final on file in 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CS I ST S Rough rvice ... .. .........,. ............ Final BUILDING INSPE R GAS INSPECTOR OccugancV Permit Required to Occugy RuildinRough Display in a Conspicuous Place on the Premises — Do Not Remove Final VN No Lathing or Dry all To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Munroe Builders Estimate 131 washington Street Methueri, MA 01844 Date Estimate# 8/25/2016 2016-27 Name/Address Stuart Miller 93 MARTIN AVL-;. NORTH ANDOVER MA Project Description Amount Total REMOVE BACK WALL OF HALL CLOSET AND ADD ONE FOOT POUR 1,800.00 1,800.00 INCHES OF FLOOR FRAME TO ALLOW FOR WASHER AND DRYER T 0 FIT INSIDEYRAME WALL TO CEILING AND INSTALL 518 FIRECODE WALL BOARD TO GARAGE SIDE AND CLOSET SIDE OF WALL. INSTALL INSULATION IN FLOOR AND WALLS.ALL WALL BOARD WILL BE TAPED AND PRIMED READY FOR PAINT A]LE I-LOOR WILL BE FILLED IN WITH TILE BY OWNERSTO MAT"CH EXISTING. PLUMBING,ELECTIUCAL AND DRYER VIEN1"INCL 13Y OT)IER.S.ALL 0.00 0.00 WORK WILL BE INSPECTED PRIOR TO CLOSING UP INSIDE WALLS AND CEILING.GARAGF SIDE 518 FIRE CODE WILL BE INSTALLED AFTER FRAME TO PROTECT OCCUPANTS. q1,U-1Q(dTota1 $1,800.00 a / i Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-037698 Construction Saaperoor IAMBS G MUNROE,JR 131 WASHINGTON STREE°C.. METHUEN MA 01844 r,,"/ZC Expiration: Commissioner 11/08/2017 C,ITa^`Y a(WIMur(011(111 rx/. 74rQarr�r�r✓�,rrr✓ 7 Office of Consumer Affairs&Bubiness Regulation d tf�' HOME IMPROVEMENT CONTRACTOR ✓ Registrati0m ' 106656 Type: wExpiration: -7/2412016 DBA a r MUNROE BUILDERS James Munroe 131 Washington St Methuen,MA 01844 ' Undersecretary T-we Commonwealth Of'_ glsyt eh.usetts . z Department offfidustrralAceldlents .l Cone less Steeet,,Smite.100 Boston,.A 0.21.14 2017 ©&ex's,Compima-do)llmuurarice.AfAda-dt:BuUclers/C!Onfractors/BIectKlcian�s/Pl bexs. TO BE FMXD WXM`im pEgNHYING AUTHOR'. Alicanf 7nfaxmataion )?Iease P rint Le 'bl &TL1a,(BusinesslOr9auizai3on11ndividu01): M� CjtylState%Zip: 1(V� � iU W Phone#; :Z?�� Areyau an employer? Cheekt&ap�xolar3ata anx: Type of project(�eqtatirM): 1.p 1 am a amployer-Wth employees(fall andlor part thve). 1. Q New oozistruction 2.XIamasolo proprietoxorpartuershipaudhavenaemployeesWodl ng formein 8. �Remoa�elirig any capacity.JITo�a adcers'comp.insurance required j �. Q Demolition '-❑Iamahomeownerdoingallworkmyseli pbworkers'eorZtp.i�stzra�tcerequizerl. t 10❑Bufl(YA9 actclition 4.E]I am a homeowner and will be hiring contractors to conduct all-WD&on my property. I wi11 J. lel ectrical xepairs or dditioxrs enswo that all corrtractors either have WQ3:k0r8'compensation insu€anee orare sole = pr6:w-tors w ihno employees. 12, plumbing repairs or additions 5-Q I am ageneral copta.ctor and I have hire the scab-contractors listed on the attaohed sheet. '�Racrfxep alrS These sub-contracbrslia p einplayees andhavoworkers'comp-insumnce 14 Otho 6.Q'We are a aorpomtiga end ifs of�c,ers have exercised their right of exemption Par MGL c. 152,§1(4),=4 W-9 bane ck.e�nplciyeF,wpworkers'omnp.insiuuaneercquiredj •. *Away applicant laatchecl�sbox�l must:alsoM outthe seedonbelowshowingtheirwoi -rs'compensationpolicyin,_ormatian T Homeowners-vho suiiax"a:it{his a0davitiadi'catingthey are doing allwork andthenliire outside contractors must:sit'6mit anew afifidavft indicating such. TContractors thatcheclethis boxmust'4442ed an additional sheet sbowiagthe name ofthe aub-contractors and state Yvhethhcr oanotthose entitieshave employees.Ifthe sub-contraaiors Lave employees,�liey must providatheir workers'comp.policy number. I crm are erriplayer&at xs pr ovidb7g-worlrers'compensation insurance for my employees.' $elo7v is the policy and job szte ir2for�cutio�2. . Insurance Company Name: Policy#01:Self jws lie.#: Expiration Data: lob Site Address- City/Mate/.Zip: Attacha copy of theyvarkers' cbmpepatimpolleydeclarationpage(showingthepolicynnxnberax�dexpixatianr dlate). Failure to secure coverage as xaquired under MGL a. 152, §25A is a eximinal violation pwdshable by a i='in.e up to$1,500.00 vil penalties in.the form o£a STOW WORK ORDER and a fr ,dup to$250-00 a and/or one year vnpri�onment,as yell as ci day against the violator.A,copy of this statement may bo forwarded to&0 Offiae ofluvastigatians of the DIA for insuraxace coverage vorif catim- Ydo Hereby cerlify urzdrer tree rains anapen 'es Ofpeijury tlaatthe informationpravideclalrove is Lrue arLcl correct i5i a�6�— iYi'L�� � Phone#: Official arse orzry. pa not Write in this area,to lie completed by city or tort off�ciar City or Town: Y errxtitlJ(licen�se# Issuing Authoxity-(circle one). E 1.Uoaxdo�JL[ealtb2.Builc gDepaxtment 3. 6. 4.�ilettxicallnspector 5.Pluxnb:ingInspector 6.Other Caxttact1'exsou: )?hone 4.-