The URL can be used to link to this page

Home My WebLink AboutBuilding Permit # 11/16/2016 0ORTIJ 4`J� .wcd eg'�a BUILDING PERMIT T F THA x r APPLICATION FOR PLAN EXAMINATIONa4 Permit iU 7: ,� Date Received Date lssued:JL/ CH IMPORTANT: Applicant rntist complete all items on.this page LOCATION t03 int PROPER OWN 0 Prit , MAP NO: PARCEL, I �BONING Q1$,T ICT„;�l�i toric District yes no M ci iine Shoff Village yep ' 'no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential I] New Building ❑ One family Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑Commercial ❑ Repair, replacement ❑Assessory Bldg 0 Others: Demolition ❑ Other Sufic FJ Well- ,,- El Floodplain- -[`9Wetlands 0 Watershed District ❑Water/Sewer m _ cz)oJ Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: Ot TRACTOR NaPhone: Addns Supervisor's CohstrOcbon' License: -- �E p. tete: Horne Irnprovernent�Llcens�e� �� ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE BULDING PERMIT,$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASEL?ON$126.00 P .F Total Project.Cost: $ 40 FEE: $ " Check No.: �p�6Receipt No.: ” NOTE: Persons cuntr�txaa itla unre �t�tered contractors do not have access to the guaranty fund f1 Signature of Ag Signature of contra � �10RTy awn of 2 Andover o No. WQ h ver, Mass, _ �� O �yR Coc"Ic"EWICK F,IfSbR�17'EQ P'Q�`��y V BOARD OF HEALTH Food/Kitchen PERMI LD Septic System THIS CERTIFIES THAT ....,,...... Tjiv ,,,, . .,.�., ....................................... BUILDING INSPECTOR has permission to erect�Ta ... .., uildin son .. 0..3 ... !.I !!�„ .� .......,,,,,.,,,, Foundation . Rough tobe occupied as ....... .. ....,. .. .........,,...............,........,.,........................ Chimney provided that the person accepting this ermit shall 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 CONST TIO Rough Service . . .......... ........'.......... Final BUILDING INSPECTOR GAS INSPECTOR ®ccu anc Permit.fie wired to Occum Buildin 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. of Pages Page.Nc� Builders License # 5B443 � Noma C:onstrUction, f egg # '167538 1 IDUVO f 0 10 1 LLC (781)944-1994wow (no" 978)664-2557 rrEar�rrvc r��r�r��wnrc North Reading, M/\t11 f3Cr4 �� ( ��; R0 , Box 637, , Please visit.Yts at www lValro ofinf coni7 su��tirrrt�ro STATE AND ZVE'CODE _.,.._..�..._.,.___m...._..�...___. ..�_ ✓ � r the ite��"�cl�eckect m boxes Y9eit�ud, " by submits aciticat'Opt' and estimates 1c s well as(ab site with our own disposal truck. SSC DRI VEWAY DUMPSTERS roof shingles 3 layers or more of existing root shingles ip&Remove all existing root related debris Pram root a _ �I'1 layer of existing root shingles _L1,2 layers of existing additiana9 at X1.73 per sq teplace any damaged root decking; not to exceed 32sg• ed e/Rake-edge along entire perimeter (Choice of VtlhiteBrown or Milt) nstall 8 Aluminum Drip g flashing and valley areas halt shingle manufacturer chosen by the homeowner nstalV ICE& ATBR C}fyDBRLAYMEfd Ton all horizontal eaves,sside�iafls, skylights,chimney - �� ft�nce with the asp - install a premium base sheet underlayment(felt)that is to corny _ ner°s Choice of the selected Tamko/Ik�C7 or GAF Limited Litetime Architectural Root Shingles install The Homeow y questions See individual manufacturer's warranty for specific details or please call us with an q _ S s with new aluminum flanges - pipe(s) Replace all existing bathroom dlouve ep existing flashinga _ -. l�Chimney(s)-counter-flash an U Cut&Install new lead flashing nstall a aantft7uous low profit Ridge-Vent on all ridge Vines Root Louver Vents Sotfft-Vents utter machine 4J Sea fess Aluminum Gutters Custom fabricated on site with our own `Leaf Guards 4 Downspouts at additional J Attic insulation Increase existing R.value to .__w...._._.R,value with our awn blown fn insulation machine exclusively using GreenFiber cellulos e insulation ( Other r Al f The Commonwealth of Massachusetts : Department of Industrial Accidents 1 Congress Street, Suite.100 Boston,MA 02114-20.17 N*Moi www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Annlicant Information Please Print Legibly Na.1710 (Busitaess/(-7rganization/Indivrcival): Duval Roofing LLC Address: P.O. Box 637 City/Stttte/Zip: North Reading, MA 01864 - 'hone#: 978-664-2557 Are you an employer?Che$the appropriate box: Type of project(required): 1,2 I am a employer with employees(full and/or part-time).* 7. New construction 2.[:]l am a sole proprietor or partnership and have no employees working for me in $. Remodeling any capacity.[No workers'comp,insurance required.] 3.171 am a homeowner doing all work myself.[No workers'comp.insurance required.]1 9. ❑Demolition 10E]Building addition 4.E]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 Ln 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 ORoof repairs 'these sub-contractors have employees and have workers'comp.insurance 6,[:]We tare a corporation and its officers have exercised their right of exemption per M01,a 14.�(Jther 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box 91 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. I ant an employer that is proi,iilingr ivorkers'compensation insurance for my etnployees. Below is the policy and job site information Travelers Insurance Company Name: _- 7PJ U B-023ON91-9-15 Policy#or Self-ins.Lic.#: - Expiration Date:3/9/17 1030 Johnson St No ANdover Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing,the policy number 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$250,00 a day against the violator. A copy of this statement may be forwarded to the Office of Iaavestigations of the DIA for insurance coverage verification. Ido hereby certif t der the pains and penalties of perjury that the infornuttion pros f e a a i true and correct --,, Si rnat r C "` Date: Plin #:978-664-2557 Of ficial use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector .5.Plumbing Inspector 6.Other Contact Person: Phone#: I , 3 Office of Consumer Affairs and BII/usmess Regulation ' 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 i Home Improvement Cflntractor Registration ------------ Registration: 187338 Type: LLC Expiration: 9/10/2018 TrJI 419291 DUVAL ROOFING LLC. KENNETH DUVAL P.O. BOX 637 NO. READING, MA 01864 - _ Update Address and return card.Mark reason for change. ❑ Address ❑ Renewal [] Employment Lost Card SCA 1 r;, 20M•05/11 'U0Z/0t/Zt -U04elydx3 Jauorssruau� sarfl VW sNrab 32!1.11UpN 0a x0a } .»: IbMQ d 14Z3NN-431 u^paart>ds�oW 'Ta eSp'fepuptS pue suo; 8So-53 :asuaar� S 311cgnd 1n;uautn daQ Srpa$S 10 Pjeoe � �I�esseW 4