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HomeMy WebLinkAboutBuilding Permit #275 - 1 MEADOW LANE 10/10/2006 L TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION o*No RT s qti N � Perniit NO: Date Received /O"/0- V3{s +� � A � // �y/ 7 �Rrep SPP �y Date Issued: �'G�'l/(/ 9SSACHU`��� IMPORTANT: Applicant must complete all items on this page LOCATION x p a �J[Gy-1 Lis Print PROPERTY OWNER Z a.t,I1 w Crt _/ Print i MAP NO.:d�/5, PARCEL: ZONING DISTRICT: I TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building e One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: Z'kepair,replacement ❑Assessory Bldg ❑ Commercial ❑Demolition ❑Moving(relocation) ❑ Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED S' ? Identification Please Type or Print Clearly) OWNER: Name:__% /� �t 4//j e u, Phone: Address: / t"u G( rices L r.( CONTRACTOR Name: 10v" �, �i�' Phone: /It ?S7Y Address: / ® Supervisor's Construction License:_0 y j / 2 Exp. Date: Home Improvement License: / Exp. Date: I ARCHITECT/ENGINEER Name: Phone: I 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 FEES Check No.: y 7 Receipt No.: 4;� Page l of 4 r TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ ❑ Tanning/Massage/Body Art L]Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guar my fund Signature of Agent/Owner Signature of contracto r U� Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ amped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ j COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Signature&Date Driveway Permit Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA— For department use) Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 r Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DF.PARTMENT:BPFORMOS I Page 4 of 4 Location � � 1•�,-� No. ��� Date /0 A). G NORT1y TOWN OF NORTH ANDOVER O Certificate of Occupancy $ �'�s' Mu9 "•°''t�' Buildin /Frame Permit Fee $ swcst Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 19665 , Building Inspector Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Reglstration; 128612 Explration: 4/28/2007 TYPO: DBA THOMPSON'S ROOFING " THOMAS DOYLE" # 8 WEST ST SALEM,NH 03079 Administrator ` BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 060112 t Birthdate: o8/04/1956 Expires: 08/04/2008 Tr.no: 28784 Restricted: 00 THOMAS T DOYLE 8 WEST ST SALEM, NH 03079 Commissioner Page Of Free Estimates 105 Haverhill Street Fully Insured Methuen, MA 01844 T111l.�.1�1V'.!L!1 1 OlV 9 S 1lw�1OO11' Jll l�`�G (978) 691-1355 Jj Shingles'-Slate- Rubber Roof � Single Ply- Copper Work PROPOSAL SUBMITTED TO PHONE DATE Frank Andrews 9-3-06 STREET JOB NAME 1 Meadow Lane CITY,STATE AND ZIP CODE JOB LOCATION North Andover MA 01845 ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: Strip off dll roof shingles on entire house and garage Renail all loose boards and if any needs to be repalced it will cost $3 . 00 a ft. lx8 Install aluminum drip edge around roof line Apply ice and water shield 6 ft. up all along edge and in valleys Apply 15 lb, felt paper on rest of roof area Reshingle with a GAF Timberline 30 Architect shingle Install new flanges around soil pipes iCut in a ridge vent system Seal and chimney flashing emove 11 work related debris 30 year warranty on material 5 year guarantee on labor construction lic . #060112 improvement #128612 propoOt herebyto furnish material and labor—complete in accordance p c ce with above specifications,for the sum of: Seven thousand eight hundred dollars($ 7 ,800 . 00 Payment to be made as follows: $3,000 . 00 down ba n e [U on ocmpletion Ail material is guaranteed to be its specified.All work to be oomp!=1Cd in a worivnSnlike(YOW according to standard practices.Any etrction or deviation from above tpecifications Involving extra costs will be executed only Upon+mitten orders,and wA become an aft doW over and above the estimate.All agreements oortinpat upon strikes,eccidorts or ddays beyond our control. Owner to carry fire.tornab ext other necessary insurance.our wwkas are fully Note:This proposal may be covered by Ntorkmen's compensation keumme. withdrawn by us If not eccepted within da Ys �r • 2rceptance of pr©psat—The above prices,specifications and Signature �y conditions are satisfactory and are hereby accepted.You are authorized to do the { work as specified.Payment will T madar outlined above. �.10RTIy Town of No. 0 }( over, Mass.,A 060 Y Q LAKE 2COCHI CHEWICK y %ADRATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....�_.�a�i..........�..r......,r !t'................................... Foundation ......................... ........................... has permission to erect........................................ buildings on..../........A.40 ........ ................... Rough to be occupied as........... Irl .. ..,.,.'P,,,,, t, a Chimney provided that the person acceptin this permit shall in ev respect con orm to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Law 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 CONSTRU; - SAT Rough ....... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. DATE(MM/DD/YYYY) ACORD., CERTIFICATE OF LIABILITY INSURANCE 07/26/2006 PRODUCER THIS CERTIFICATE IS .ISSUED AS A MATTER OF INFORMATION Pelham Insurati nce Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 960 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 122 Bridge Street Pelham NH 03076 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Nautilus Thomas Doyle dba INSURER B Associated Industries Thompson's Construction Roofing INSURER C: 8 West St INSURER D: Salem NH 03079 INSURER E. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED-TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD-LI POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MMIDD/YY DATE(MM/DD/YY) A GENERAL LIABILITY NC 532152 04/15/2006 04/15/2007 EACH OCCURRENCE $__ 1,000,000 DAMAGE TO RENTED ` 50,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS MADE D OCCUR MED EXP(Any one person) $ _ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 1,000,000 POLICY JE OCT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY. AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ _ S DEDUCTIBLE $ RETENTION $ $ WC STATU- B WORKERS COMPENSATION AND AWC7012214012006 04/21/2006 04/21/2007 X OTH- TORY LIMITS EP. EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? El DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Various Construction CERTIFICATE HOLDER CANCELLATION i SHOULD ANY OF THE ABOVE DESCRIBED P0111CIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER. WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT