HomeMy WebLinkAboutBuilding Permit # 12/1/2016 BUILDING PERMIT of `�0 D
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION "
Permit Nod: Date Received 1 -
Rrsn I
9�SRCHus
Date Issued:
IMPORTANT:Applicant mwt complete all items on this page
LOCATION ',�. NNE. PPl�DPERTY ®MINER .
Pnnf
E rio
900 YearS-iructr�re` yes r
MAP PARCEL _ ZONING' DISTRICT _ Histartc Dsfr�cf yes. no
Maehlne Shop Urllage Yep no.
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement 0 Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ septic n wei ❑ Flaadplam ❑W tlancls Watersheel`District
D.Wa#erlSewer
DES IPTI® F RK TO E PERFORMED:
Identification-- PIease T e or Print Clearly
OWNER: Name: mac_ � c� - Phone: 7 ? /
Address: ''
LLAd
me! . �G�.. .. �Phorne .lr /-�� - c'
_...,.. _�' -
Supervisor, orisfirue tron Licerse ._ Cs ° .. Exp. Date
ment License _ _ Exp: Date
ARCHITECTIENGINEER -`___ Phone.-
Address:
hone:
Address: Reg. Iia.
FEE SCHEDULE:BULDING PERMIT;$92A0 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F.
Total Project Cost: $ tl�l �e � _ FEE: $ �
Check No.: -7 S'S` Receipt Na.;
NOTE: Persons contracting with unregistered contractors do not heave:ca e s the guara �
5i rt,aiare_o .AgerilOiter Signature of conte
t%O R TB-�
Town of = . � ndover
o � - T
No. 5%4
h ver, Mass, 1 D1
'Q Co[.�t[np wr[w 1' ••
' .9S°RArE D
U BOARD OF HEALTH
PERMIT T Food/Kitchen
LD Septic System
r
THIS CERTIFIES THAT .. .�: .�v,..... OI V�,1.[ ..! ' BUILDING INSPECTOR
has permission to erect.......................... buildings on I�...... f.A� A ® ... Foundation
..
� �� �► Rough
tobe occupied as ........................ .............................................,...........................................
... Chimney
provided that the person accepting this permit shall in every respect con form to the terms of the application
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Final
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 CONSTRUCTION TS Rough
.... . ^. . .. - Service
............ ....
BUILDING INSPECTOR Final
GAS INSPECTOR
Occupancy Permit Required to Occup-r Buildin 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.
44 Marian Dr, North Andover Ma,
November 29, 2016
OVERVIEW
1, Project Background ,and D�-�-Scription
Strip and Replace roof
. Project, Scope
I will strip and re-roof entire roof including garage&side porch with 25 year CertainTeed three tab Black roofing
shingles. I will install 9'of ice and water shield on the upper roof(because it has small pitch)also will ice&water all
valleys, and 3' on garage area. I will strip siding over the small kitchen window and ice&water over that area to
prevent any leaks that may come from water behind the siding. I will also remove and install new lead around the
chimney.
3. Deliverables
John Brouillette will obtain all state and local building permits for job. I will also supply dumpster for removal of all
roofing materials.
4. Affected Parties
We will put the dumpster in the driveway on the left side of the garage so not to block your car.All materials will be
delivered to job on the day of start.
Tlte:fa tai rxrr�ta e fps f 1 job viii b6e $10,5l�t3 00 w fig 50%paid icy r r� tial , rrci #r
ba1anc.epaid.ag tete tirtle of o��apis�t carp
S. SPOGific Exclusions from Scope
There will be an extra charge if the plywood under the singles is rotted and needs to be replaced @$100.00 per
sheet installed.To my professional opinion, it does not look like any plywood is rotted at this time. In the event we do
find any wood needing replacement I will take pictures to show the home owner and discuss all materials immediately
as to not slow down or stop the job.
1
6. Implornentation Plan
Providing weather permitting and any unforeseen circumstances-This job will start on Monday the 51h, Of
December 2016,the job should only take one day. All roofing materials will be picked up and cleaned and put in
dumpster on the same day.We will remove the dumpster the following day.
All work and workmanship will be done in a professional manner.
APPROVAL AND AUTHORITY TO PROCEED
We approve the project as described above, and authorize the team to proceed.
— ---- -----
Name Title Date
1 _
6
3
9{f
�
,
?Tp
oved By Dae Api o Date
6 2
I
ne Commonwealth of Massachusetts
7e,PaafiEntofinatustrialAcelde is
r 1 Co g 'ess 5`t eet,SU� 100
Boston,MA 02114-2017
I1'7Y JY.m
ass.govfdza
vq� '..
H sys
. -gga�kexs' Couzpeusatio�aXi�suran-ce,A,�davi-t:Bnzldexs/Contxactaxsl��ectxzc3axts/�l�mbers.
TOBBRXED VaTEE M:'MMT'K(4 ATt�gO t "S lease Prz�t Le ' I
lican-i fufo)rm-ation
(--r-, N n 6 r 0L-.,7 I je
Name(Business/(7igauizaiionadividl'
Addxess: .? 1 C
�( Phone#:
i tatelzip:
ecktIie a xo riafehox: hype ogprojeet Oreq&ed);
Areyou art empToyeF.C pp p T Q�'dWI66ng5 fiction
� l ees full andlor part time).
l am a employer wTt}�--- ..-emP nY { g, Reztln d ft
2,Ellam asolapropzietornrpartnershipmdhavenoempinycesvvorl formeerr
any capacity[Towozkers'comp.insurance requircd] �. Demolitioxt
3.E]Iamahomeawnerdoingallworkmyself Noworkers'comp-insurance required ' 1pFIB-ul.dingaddition.
c4.QIamalrnmewv7aerandwillbehiringcorriracfozstoconduotellwculcanmyproperty_ lwill 11i�1BleG ICal:ep,3g or dt tio]1s
ensure tha;,all contractors-,#h-heme workers' antpons a(aan ins�uarrce or are sola !lU11pkW big repast's mr additions
na emp
"
wifh �'lc"y ees. L_t
proprietars
54-11 am.a general contmotp;and ihaYe hiredthesub-eenfzaears listed orrthe attached sheat
13<.[�Kaofrepairs
These sub-ccntzactozs hage employees mcthave workers'comp.$asurenee xti. Other
6,❑We are a cazpnratinn.andrts,nfficersshaYe erercasedtheir right ofexempticn perMGL c.
152,§l{4),aad'we bane no smployees_INo Workers'comp.insurance required-1
sectina
*Auy applicant t3sat cher hbic#1se °gthey are douag ileo k andthenlvre outside m ntrac ars rnoicst s bmzt a neve affidavit indicating suaTi
t homeowners who submitthis affi.,yr the name o£tha sub-cantcactors and statewhether ozpot(hose ntit BE;have
}Contractors fiat checklis 36-i r allst attached an additional sh z-de their workers'camp.policy number;
employees. Tftha sub-conixactors have er�tployees,they'mus p
enz to er that is providirjg'WorkeNs'cornpematiora insurancefor tray ernplbyes
eIselory is t/iepo�rcy arad�ob site
IamMp y
informadon.
j€surance Com-panyName:
�-- ExpirationD,
1'aliey#ox Sel�ht_s.Lic.#:, � �• .
lob Site AI�ress: r
City/state/Zip: j 1-1-4 f y- "
Ej,-itach a copy'o�the�oxlrexs' eamtp ensaician p olzey declaration page(sh.o�zng the p olzey n-amber and e�pix afioxz date).
Failure to aecme coveraga as xequ0-00
i ed a dax MGenalties i the foYm.off'a OP WOFX ORDER.and.a�neelip
f 4 to 25A is $Z to a�-OO a
and/or one-yearJnpT sonrnent,as 11 as etvd P
clay agah�sttheviolator.A coPY Oftbis stateme!af 3nay be fozu�arded to fire Office ofSuvestigatio ofthaD7A brinsurance
coverage e ' on
S do Here y e rte uzx tliepairas and ercaztties of perjury treat the lnfarmcaao provided wave is true and carred
Date:
�1 e.
P1iOno
Of cical use only. Da x2ot sire M t7iis area,to be completed by city o-F tow, official
Bermj License#
City or To-Vvn*
xssuing-A,-txthoAty(circle one): p eetor
.13oarcl o Health 2.�wld�ngDeparttmeut 3.City)Town Clerk 4.BlectxzcalSns ectnr 5.P1r�u�lihtgSnsp
6.Other
Fhone#_
Can-tact Pexsou
s
rnent
Public Safety
..; } Massachusetts eRa u Regulations fand Standards
Board of BuildingReg
License: CS-064081
Construction Supervisor ��
JOHN J BROUILLETTE
2 HARMONY LN
ANDOVER MA 01810
�� tom— Expiration:
Commissioner
06!2812018
C�i�a T(�npjj,u+.)11071111 oI
Off-lee of Consumer Affairs&k3us ness Regulation
-_- HOME 1MPROVI MENT CONTRACTOR
Registration ' 122514
Exp9ratl0n 91.11/2018 DBA
JJB PROPERTY MAINTENANCE
JOHN BROUILLETTE
go Westford Street dersecretary
Lowell,MAGI 851