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HomeMy WebLinkAboutBuilding Permit # 10/3/2016 df�owwmnxmmmmmnNnvwv�fr "�• .. � , BUILDING PERMIT TOWN OF NORTH APPLICATION FOR N E IN T` C � Permit : Date Received Vii' d ai w. N Oate issued: 16 , t IMPORTANTla"cant must C1 Implete all iteias ��tltls 7 77 777777 / 60 A � EK /i/i J / / d r TYPE OF IMPROVEMENT EMENT" P ED USE Residential Dion- Residential F.1 New Building n family []Addition ❑ Two or more family ❑ Industrial 11 t r tion No. of units: ❑ Commercial F+ epair, replacement ❑Assessory Bldg ❑ hers: 1.1 Demolition ❑ Other boda w a ,• J CIL C, n:a 01 '" Identification Please Type or Print Clearly) OWNER: Name: 131' Phone.- 7 bl00 i,', „r„.r / r, ,�, ;r,,,.,, /r•>J Ai, >�;,,! i1db,AG ,i"i+W ', � "{!1 ” ' 77 7-17-7 NW r M "r ,i r r.., ,,. r f „ ARCHITECT/ENGINEER Rhone: Address: �' leg. No. FES'SCHEDULE.'BULDING PERMIT.$1100 PER$1000.00 OF THE TOTAL.ESTIMATED COST BASED ON$125.44 PER S.F. Total Project Cost, f . 7 Y.. � . C C" FEE: Check o.: 1-- Receipt .:_ NOTE: Persons contracting with unre is red contractors do not have access to the guaranlyfund Signature. ; g n r Mgr `ctrctr Dimension Number of Stories; _ Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL. Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— (For department use) 1C 0(7e.&-yj I ALO:Jl b- C'UOA14 -2-cjt t�e )i �k La �A Q-.1j 40 U Notified for pickup Call Email ' Date Time Contact Name Doc.Building Permit Revised 2014 1 Plans Submittee,-D, Plans Waived ❑ Certified Plot Plan ❑ t mped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. ❑ Permanent Dempster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INT'ERDEPART'MENTAL SIGN OFF n U FORM PLANNING & DEVELOPMENT eweOn 0 � ��� Signature^ COMMENTSIF 'CONSERVATION Reviewed on_g S Si natur COMMENTS WEALTH Reviewed on__ Signature COMMENTS -Zoning Board of Appeals: Variance, Petition No: Zoning Decisionlrecelpt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer ConnectionISi nature ©atie C7rivewa Permit DPW Town.Engineer: Signature: Located 384 Osgood Street FIRE:DEPARTMENT Tetjp 17umpsfer or ;s�te ayes LacaEed at 124 inStreet, 777777-7777777777 FirelDeldate COMMENTS- ... .................................................. . NjORTp$ own of .T, ndover O No. h h ver, Mass, /0 io #/ COC�fIC M(WICK V� a� V BOARD OF HEALTH Food/Kitchen PERMIT ' T LD Septic System ♦ r THIS CERTIFIES THAT r ... � .� .� k,. � .�!....a f.!.............. BUILDING INSPECTOR ...... .... RD Foundation has permission to erect .......................... buildings on ....... ..�Q...... .L. .................................I...... Rough to be occupied a5 Chimney p ......... .. �SIL......�,��*.,�.�.. ...��.�........................................................... provided that the person accepting this permit shall in every respect conform to the terms of the application Final on fife 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. LESS C T STARTS Rough Service ....... .... .. ... ....... " Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Fina! No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. COLONIAL RESTORATIONS, LLC ,Specializing in 9ruclural Restoration/Repair of Post&Beam Homes and Barns since 1981 Homeowner Information Name P one um treet Address City/Town Mate p Code Conti-actor Information Company Name/Phone Number Colonial RestorationsLLC 508-735-9900 Street Address 74 Dug Hill Rd City/Town State Zip Code Holland, MA 01521 Business Phone Federal Employer ID or S.S. Number: 042864184 Home Improvement Contractor Reg. Number: 108470 Expiration date: 8118116 (Describe in detail the work to completed.) 61 44e. 67'K CIC, CL pill/'C'.('-c CIA V L pYyek) 43 C),f t - Approximate date when contractor will begin contracted work. CA,!JJ, 1:�_U polk - Approximate date when contracted work will be substantially completed. The nature of our work does not allow exact scheduling. Projects often grow in size once started if additional damage is found when the building is opened up. Weather, etc. can also cause delays. 74 Dug Hill Rd, Holland, M,4 01521 (508) 735-9900 .41,,,w­1w.cr 1.9-8, o,n,,,1 email- infq ,�qr j.com COL ONIA L RES TORA TIONS, LL C Specializing in Structural Restoration/Repair qfPost&Beam Homes and Barns since 1981 Total Contract Price and Payment Schedule The Contractor agrees to perform the work specified above for the sum ofd� for labor(see estimate for possible additional charges). If any additional work is found, there will be additional charges. Material costs are additional and should be about t e 6o,c0 . .All conditions from estimate apply to this contract. A deposit of a' 7 00,v is required to be scheduled. Payment is to be in I parts with final payment due in full upon completion. Client agrees that deposit signifies their ownership of the property and responsibility for all bills. Property owner also signifies by deposit that property is residential, not commercial or industrial. When the estimate indicates payment to be in installments each installment is due after a proportionate amount of work is complete. Please have funds transferred to checking if necessary so payments can.be made in a timely manner. Any payments significantly overdue will be subject to maximum interest rates allowable. Money for custom ordered materials is due prior to the order being placed. NOTES: (*) Including all finance charges (**)Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(a) one-third of the total contract price or (b)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Subcontractors -The contractor agrees to be solely responsible for completion of the work described. If electricians,plumbers, or other contractors are needed for Colonial Restorations to perform their work, it is the responsibility of the homeowner to hire and pay other contractors. Colonial Restorations does not function as a general contractor. Contract Acceptance - Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. - Don't be pressured into signing the contract. Take time to read and fully understand it.Ask questions if something is unclear. Deposits are not refundable. Two identical copies of the contract must be completed and signed. One copy should go to the homeowner. The of copy should be kept by the contractor. �Homeowi r s MgtVaArem C-6n't�r's Signature/Date 74 Dug Hill Rd,, Holland, MA 01521 (508) 735-9900 1VVV ler 1981.com email- i i - -r 198 Lcoo r 6t \ The Commonwealth of Massachusetts Department oflndustrialAccidents b I Congress Street,Suite 100 Boston,MA 02.1.14-2017 www.mass.gov/dxa Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILE WITH TBE FERNIITTING AUTHORITY. Applicant Infor€nationff Please Print Le lbl Name (Business/Organization/Individual): 1 u i v�+ �eJ _cam °'T^ s Address: 2 City/State/Zip: [-�IQ 414 6 f f-a I Phone 7.?.-- Are you an employer?Check the appropriate box: Type of project(required): IQ I am a employer with employees(full and/or part-time).* 7. ❑New construction 2. am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9, ❑Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 ❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions proprietors with no employees. 12.❑plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet, 13.E]Roof repairs Those sub-contractors have employees and have workers'comp.insurance,x 14.[�-Other 6.E]We area corporation and its officers have exercised their right of exemption per MGL G. 152,§1(4),and we have no employees.[No workers'camp.insurance required.] *Any applicant that checks box fil must also fill out the section below showing their workers'compensation policy information. t/Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have. employees, If the sub-contractors have employees,they must provide their workers'comp.policy number. fain an employer that is providing workers'compensation insurance for my employees. Below is tine policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: ' lob Site Address: City/State/Zip: I Attach a copy of the workers' compensation policy declaration page(slio`ving the policy nufaber and expiration.date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify under the pains and Penalties ofperjuty that file inforrttationprovided above is true and correct, Signature- Date.• $" 3 1 to Phone# © c" 7 `�S'rJ� Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 3 COLONIAL RESTORATIONS, LLC Specializing In Struclural RestorationlRepair ofPose& Beam Moores and Barns since 1981 Massachusetts Departraaent of ta'raMe Safety m m Hoard of Building Recitalations and Standards Colonial License: CS-078132 , Restorations, LLC y �r T BRADFORD GREEN V14Barn OGB Bible 74 DUG HILL RD fru '1 Leaning ag`ging m MOTTO HOLLAND MA 01521 ABri'dGreen 508-%35.9900 lama Greerr wr~,er1981,carn i1f0@cr1981.c01r1 Q -� Expiration: Cornnaissioner 0812212018 Z,�C('<"I7�h1r✓i(fl�Yf//�f�V. Pte.'-'f YIC<F.Sarkl"/'C1Y„bd"*�t�P Office of Consumer Affairs&Rusev9 Regulation MEM1 3 v �ii�� HOME IMPROVEMENT CONTRACTOR k3©M' IMPROV M TWIT CC)1 TRMUM OR Registration: 108470 Type: 6;C}LOtILRBTf}RATIQNS V� Expiration: 8/18/2018 Partnership 74 Dug Hili Rd COLONIAL RESTORATIONS LLC Holland,MA 01521 Thomas Green 74 DUG HILL RD. _t iC:i F3EG rib, Exf�it� s_....._. HIC.O606 817 12/01./2015 11/30/2016 tDnctersecretar HOLLAND,MA 01521 — - �✓y o SIGNED 74 Dug Holl.Rd - Holland, MA 01521 (508) 735-9900 email-in j b a),v��19 8 w oi,i,i