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HomeMy WebLinkAboutBuilding Permit # 11/21/2016 qi 0RT#1 BUILDING PERMIT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#: �s ww row Date Received U Date Issued: I I IMPORTANT Applicant must complete all items on this page LOCATION Prin t v ti PROPERTY,OWNED -P�ht 11 010,Ye/arStr"b'dur"' yes Cno yes I n o MAP G' D'I'S' TRIC' T" Hi-�t ZbNIN br*c District Machine Shop Villaqe yes 0 no TYPE OF IMPROVEMENT PROPOSED USE Residential Residential E New Building 9 One family 11 Addition 0 Two or more family 11 Industrial Cl Alteration No. of units: I.] Commercial ..Repair, replacement Cl Assessory Bldg E Others: 11 Demolition E Other ---—------ 11 Septic 0 Well E Floodplain E Wetlands E Watershed District E Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly' OWNER: Name: Phone: e.17- zor-7-/-9j"V Address:— 3;'l Oe —------------ C Contractor Name: Phone: e-elf o ntra Address: -�?f Supervisor's Construction License: P4�;�'e Exp. Date: [Home Improvement License: Exp, Date.-: 7-/ ARCHITECT/ENGINEER Phone: Address: Rea. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. TotalProject Cost: $ FEE: $ Check No. 7 Receipt No..,: : NOTE: Persons contracting wetly unregistered contractors do not have access to the guaranty fund �g.nature of Agent/Owner Signature of contractoi��,',-O-,, _ t%O R T#1 Town of No. - x - h ver, Mass 0 � LAME 1 coc"tc"t WICK � RRT E D t �• U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .#...... .,.Mw.m.o.o ..... . .. BUILDING INSPECTOR ......... .,....�. . ... .. ....... has permission to erect.......................... building/in .. ,. ,......... ... .....I .�.� �. .. Foundation AN . .. .....�. ... Rough to be occupied as ............. . ...... .,A. ... ..... F...................................... Chimney provided that the person accepting this permit shavery 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 Fina[ PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS C®NSTRUCTI N TART Rough Service ........ .... ...... ......................... ................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Rcquired to ®ccupE Building 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. 77777771 Hi-Tech Indow & Siding, Inc. Roofing 20 Aegean Drive Unit �� � MA Reg. # 118836 Methuen, MA:01844 MA Lic # CS - 106508 1-800851-0000 ry 1 16 . www.hitechcorp.bia �� ®ate. I 1 _1_ t Consultant. 3 Job dame: _ _�_ -. Telepho 5 Job Address: Town: Contractor agrees to start described work on or about weeks after final fittings,and complete described work in about — working days.Contractor shall not be held liable for delays due to cause boyond our control.Hi-Tech shall not be held liable for any dama to lawns or plants-Contractor shalt not be liable for any damage to painting or stain during installation of windows or doors.Hi-Tech does not do any paint- ing or staining, In the event that a punch list should accrue at the and of the job,a maximum of 2%is the all ab a amourit to be held back The following work includes all labor and materials needed to complete your job in a workmanlike manner. p ' dab Irr .led i Iter Si It id"ter V 1 ® Combination Job-Roofing with Qlher work 1st eel Eaves wilding Permit emoving Fx[sting Shingles AE!Va eys and Gh!mnay oinl Guaranlee Program art r wind Shinglos found Vent Pipes ❑Other ❑ Going Over Existing Shiisgles ndedayrnant ❑ New Hug Edge Nr Drip Edge ❑ Venting Crice waker Shieid 01"stall Ridge Vent ❑Install Real Vents ® sealing ®Rid and ❑inslal oltil Vents ❑Install Roof Pan ❑ Gult York u11as Cleaningelall Skylights ❑Other emoving Debris in a Legal Manner Type (] O ocaft t9?f�etat i:4ollo. Location. -"No 5perpemoval em ve cumplele House emover Complete Garage ]Butter W.rk 6"vBq I�Ot1B, _ 1 La or Removal Z ❑2 Layer Removal Locaflons To Have Guile;: apply Dumpslor Eftfo Yar'dar ❑20 Yardnr Dempster Location: a 11 utlor Work To He bone can Gutter After Removal i s !R«f Uniierlayment Tn f lE Areas Roi,,ove<f ❑Gullar Removal eplace Roof Boards As Needed-Extra charge As Noodrd ❑Seamless Ginlet Color cif- s � t3r�lre". - ❑Pipe color . omp,ele House mptets Garaga ..... ❑Fascia wood Cl Other ❑Gutter Guard ❑ Water Fall System ❑Englert System �3fliat;fft)t5, Manufacturer: I" { Slyla: ra 1 8hingle Color: �® ❑ 3 Tab Shingto rchilectural fp ❑ Fiberglass ❑Grgan!c ❑ 25 Year Shingle ❑3U_War Shingle All work Areas To Be Left Broom Clear: ❑ 40 Year Shinglo GO year ahinglo pa.'Jmall k t'talifwy' �5 .' 1 ldi;» affil "I'So t7 TA Bank r#nancing ©ONnarToArrange ❑ Hi-Tech ToAsranga [Viistall t3'Drip Edge ❑Install 5"Drip Edge Color 1.'114/ ❑Cash Or Check ❑ Master Card © install 5"Hug Edge-(Go Overs Only) color ❑ Re-Seal Vent Pipe ❑Replar,v Vent Pipe Flange Total Investment �y ❑ Re-Seal Chimney ease ❑Re-Lead Chimney 113 Deposit 1/`+ ❑ Re-Poinl Chirnnoy"Rant Up ❑Step Flash Ag Needed 113 Payment at Halfway Point 113 Balance Day of Substantial ComprallanIq All You may cancel this agreement if it has been signed by a party thereto at a place other than the address of the seller,which may be his main office or branch thereto,provided you notify the seller in writing at his main office or branch by ordinary mail posted, by telegram sent, or by delivery, not later than midnight of the third business day following the signiniq of this agreement.See the attached notice of cancellation form for an explanation of this right. An interest charge of 1.5%per month(119%peryear)will ba Cate of Acc tan added to any amount unpald after 30 days from invaice dal . in il;=Y ev6111 nl dei at; a4€3a _ of tn!a ofda any liar n ii cxa:eaunl is refenmd Signa ro en ce!tomsy i«ce!E�rt p yes r a 3 a er :y lees- llieme v,-r a I)Wo give 1411 mi o n in s mita. Signat Signature tae commonwealth o.fMassachusetts _ Department of Ind.'astr aiAecidents x _=T 1 Congress Street,,S`utte rao <: d Boston,.MA o.211,4-2017 qa< Www rnass.govIdxa b M 5.u [�3exs' CoUapeationbasuxaxRce Affidavit,Buil�ex�ICox��aetaxslE�ectrzciansC�'Inmbers. TO BE MED WJTH M FRRWrMO AU` ROR1 - _.)?lease print Le 'bl A ' Iicant�Orm.ation �- �aU1e(Busi�.esslOrganizaiaonCCndivzdnal): �' Address: .a�� o/8'/y P�loxi.t;#: Gity/ tatolzip; 1�' ocrr r Type ofproject(required); Are you aXl emplopez?Checktjje appropriate box: 1.M l am aemployert rWith employees(lull and/or pa -time}.' 7. ❑ eVT co5lCtlotlo7� 2.�IamasalepropzietararpaztnershipandhaYenoemplayeesWorkingtorrnein $, �Reanodeliii any capacity.[iTovtorkers'comp.inswaaca required.] 9. ❑Demoli-tion insuraucerequired.] ` 3.E]l am ahoracoWmr doing allworkmysel£lgl)'Norkers'comp. 10❑Building addition. 4E lam a homeowner and Will.be hiring coatraetors to conduct all work on my property_ I will Il.❑E1ecricalepaizs or additions ansurothat all cantM9tozs either have Workers'compensation insurance or are solo IZ is:p�i�m f]3llg TOP=s or&ddTtlo31S proPriotorsvithna ernpXbyee�s. eneralcont-raotprandfhava�edthasub-can#ractorslistadonfiheaifachedsleet. i3•, Roo repairs ImagThese suh-eoatractors Soave employees andhave Workers'comp.insuraneet ��.�O�.ar ' s•❑-We are a corporatioli and its.officers have exercised-their right of bxemption por l rTL U. 152,§1(4),aud'we have no employees.pTo waFker,comp,insmauco rapi red-] *�Y applicant that cheeks bots l zriust also:H out the s mtion below showing their W orkers'compensatlnnpolicy informationsu torsm i Horneawners wha submit dt attached an additional ley are sheet showingihensill 3ame o-the sub contractors and statewheth oxIBtsubTaita=Wnoottthse.Pntih'f zhave h tCvntraatars that checlothzs tProm. de their Walkers'comp.policy number. emplayees. Ifthe suh coniaactors have employees,theyZuus arr2 arx employer that is pr oviding-wor�kers'compensation insurance for°my eMployees Belayv is tlielrolicy andja�site information.. Insutance COMP ULY Name: Expiration Date-' Policy##or sedf im.UC.#:. G✓c��/.s T B:���� -m/.� lob Site Address: ! �i�c° 441p B ledCity/state/Zip: /dam <s<�c'r— Attach a copy of e o exs5 compe?nsatron poliep declaxatio:o page(showing the lrolicyxzumbex aril expiration date}. tO 500.00 Failwe to secure coverage as requir ed.underevil penalties in the form is o£ OP WORK ORDER and a Niue of li to $250.00 a and/or one-yearip�prisonment,as- R p day against the violator.A copy oftbis statement may be fbrvvarded to the Oboe of7uvestigatIoU.s of th.e DIA.for h UXanee coverage varificatiozr.. T do hereby certify under triepairxs arzd�penalties of perjury that tlae information pfovicled abol�e s true arad correct Date: ,/�•?�-�� Si atuxe: official use orzZy. Do notwrite in this area,to e completed by city or town Official • PermitlX=icense# City or Town: fs�ulT9gA.uthaxity(circle one): Z.$oaxd of Health. 2.Building))epaxtno.ent 3.CitylT0Vn CZexlr d.Electrical Inspectax S.Plumbing ZtzsPectox 6.Other Phone##: Contact Person-, Massachusetts department of Public Safety I; Board of Building Regulations and Standards License: GS-096516 Construction Supervisor ' t[ I. TIMOTHY W WICKS 3 ELLIS ST ^ METHUEN MA 01844 r J - P-j l ^^^ Expiration: Commissioner 09/0912018 oali.uraxrrmur'l�a�C�/�1ir16ccr.r�rae� }� '1 uia#ion � ice of COusu-er Affairs&Business Reg i T CONTRACTOR 'E;IMPROVEIVIEN Type: - egistration+ 1t383C� Spt�fementGc� i a -� Expiratit" 4/212017 i Hi TECH WINDOVIf&511�1N0 tNS fa�L INC I TIM WIGKS 29 ARROVWWO00 ST MA 01844 i3ndersecretary MI=THUS, �.