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HomeMy WebLinkAboutBuilding Permit #151 - 102 HILLSIDE ROAD 8/28/2008 BUILDING PERMIT o*"°pT bgti TOWN OF NORTH ANDOVER or "=A.'° o° APPLICATION FOR PLAN EXAMINATION 7D Permit NO: Date Received �4°�q,T.o,.PP`.� gsSACHUs�� Date Issued: IMPORTANT: Applicant must complete all items on this page -nn 'PROPERTY OWNER -tJ4ckY�•+c , ' v ynhA, e4a Print WAP NO: ? PARCEL: ZONINGISI"RICT His`foric District yes no 1 a Machine Shap Village fres . no _ TYPE OF IMPROVEMENT PROPOSED USE Resiqagal Non- Residential New Building ne family Addition Two or more family Industrial Alteration:, Roof No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic ilVell ° Floadplsn' Wetlsnds Natershed District° . ° Water/Sewer- DESCF IPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) _ OWNER: Name:_ Tac( v„z/ ^i Ann 7-�e,--i4v l Phone: Address: /0; llill5i-/' A".". a -CONTe RACTtJR Marn '11ameS o tphone... z � .. Y 9 ia 17 Addrof ess: YIn o c>� ri -'Supervisor's Construction,License � ..Exp°. 'Date " f� �a Home•`Irraprovanent License:— ARCHITECT/ENGINEER Phone: Address: `.Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ � � � FEE: $ A/ Check No.: P3 3�Z Receipt No.: j NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund — FLi ignaturesof,}Age-it/Owner�.°�� �;�'Signature`.o#contractor: �'�y.�. Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH - Reviewed on _ -Signature COMMENTS t Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes l Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Os ood Street 'FIRE DEPARTMENT =3Tem*-Dum t, on site. .yes: :no. w. , L" ated at 124 MainStreet'--I .Fire,DepartMent"signature/date$ 4• 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.$100-$1000 fine NOTES and DATA— (For department use) rl ❑ Notified for pickup - Date i Doc.Building Permit Revised 2008 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 o Building Permit Application L3 Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy'of Contract ❑ Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit o 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) D Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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 DEPARTMENT:BPFORM07 Revised 2.2008 i Location No: S Date a?� � I N°RTS TOWN OF NORTH ANDOVER _ o 41 Certificate of Occupancy $ � 07 <.<�iice. 4 • y� �'�s',^�•Eta Building/Frame Permit Fee $ �— /1CMUs - Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 4 58 f Building Inspector AORTH TO" Of Andover No. ' o dower, Mass.,- LAK �. COCKICHEWICK ORATED 7 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...................C ....... ................ ............... ............... Foundation .. ............................. has permission to erect........................................ buildings on ..../ �. ... 1� ............................ Rough to be occupied as.............:........� �/. ! .. .. .Pp.. . ... .. Chimney ,e.. f.. ,�. i .................................................. ............................. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 CONSTRUCTION TS Rough Service BUILDINECTOR 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.. IFSE7E REVERSE SIDE smoke Det. DOUCET REMODELING LTD . 8 ARLINGTON ROAD MA. Reg. 4l 122690 WOBURN , MA. 01801 933-4816 1/we, the owner(s) of the premises mentioned below, hereby agree and authorize you as contractor, to furnish all necessary materials, labor and workmanship, to install, construct and place the improvements.according to the following specifications, terms and conditions, on premises below oescribed, which we warrant and represent that we have good record title as to owners lIin our own name. //11 Owner's Name ..T nL K....7. �.' r j. . .......v .......................................... ................................................... Job Address .../©. .....!:!.!fl S.►. �.../`Gf:............................................ CityState .......:/44............ ,41///J PECIFICATION [ re"f n w� S" t-1 e d r /iie �kt\�/inn YYLq/� /YbC9� eze � arm d -W�t` a•�c�h,; R�r� ' ...... d'n ra, _�"ba Cc/ L°S. �c� �.-. ��.-1 �r $h �e� t•� �� � �� _l�/a� �• l . alU � 0We r00 e ey ice e� Rrr b.4,d er i,,—l` / ea ver- 4e 1--eS d &e r e,'a;;�7 0.e • t-l< Ul7Fi`.>,a. ��(ii� lis "VI/ Zi11-S a LLOI^c�(' rn.�n•v r�e✓�"//@/^� 5' e4e('/C���`ts i-t,5' .. ��►`e C�l`br j �v�f"i`� a r. Ne-1.v V.--P )` e i'�lCe., 'e�S Zvi ql., ll/ew /LnQ MG11,/1 n Vse r r�t�- edc6S/%n� fe�-AaSijj�ui S -,1;^.2 IH,,+e ,B r e e z e-wa c, rc n7 Z c r e--vsea% L 7e h e', s f c '�(l��a��i t5, 's rt e-e-al 7 w —el^S/-2 lxewl.. f-ke W S 1.6c-1 A R` c?14A', Le CL/ l l/ FP�� Oar+ S Ci�1 W;ll ke re al I'"e 4/C?I' l'� f'�1<1° T�e �, r �e c v e lq w: e 4 ,.0/re-'ihSA'4MeC/, 4 -Iwo 4 S/ � kA �ri`cse�zq - a . / / wi/ P r�rnoc!ecp/ /12 p psce ,�p4,_ (r;�-I'ne ��u£'C,b/'"/.S. , n-n r r-e, 5]�!"i� e l ,I. - `�... . . v,• f�✓!�! be in r k",Iq }4e a /Xe U v-P/^. In consideration of the said work and services to be done by the contractor, the owner agrees to pay the contractor — �t 4 cam• THE SUM OF �'Lr(ve ��avS�` / rt'� �to.,q��e,/ Dr� /V ie Gtr,uv' ollars(S .!� 7 ................................... ....... ..........................I....... .................. .............. DEPOSIT S...Z�/4:...I..... BALANCES... .3 ....a......�..PAYABLE UPON DELIVERY F• MATERIAL$.........101.............................. ON START OFJOBS..........1I................................. BALANCE ON COMPLETION OF WORK S.....g :....`.......... Contractor will do all of said work in a good workmanlike manner. The owner agrees to notify the contractor in writing, signed by the owner, of any defect in workmanship or material. The contractor shall be liable only if it fails to repair any specified defect, including defective repairs, within thirty days after receipt of notice, but not otherwise and in no event shall the contractor be liable beyond the cost to it of labor and material required for any repair work.You may cancel this agreement if it has been consummated by a party thereto at a place other than an address of the seller, which may be his main.office or branch thereof, by a written notice directed to the seller at his main or branch office by ordinary mail posted, by.telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. No'work to be done on this property other than that specified in this contract without additional charges. Receipt of a copy of this contract is hereby acknowledged. This contract is subject to strikes, accidents, or other delays beyond our control. WITNESS WHEREOF, IN I the parties have hereunto signed thea names this day of _. Accepted: Signed G eh crd( Owner Pert'fnPr - Authorized Representative Signed 1 t EE PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Lynch And Conboy Insurance Agency bm HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 31 Plain St ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW P 0 Box 3489 Brockton,MA 02301 COMPANIES AFFORDING INSURANCE COMPANY A GRANITE STATE INSURANCE COMPANY INSURED Luis Ramiro Quindi 238 Broadway Road Dracut,MA 01826-0000 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT WITHSTANDING 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 THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTNE DATE POLICY OWMTOI DATE . A WpRIO=RS COMPENSATION "— AND EhIPLOY@i8'LUIM ffy THE PROPRIETOR/ : uMITS XMCERS ARI= a Exrx a 8271870 4/17/2008 4117/2009 $TATUTO"Umrm OTHER 'Comm Appiesto MA Opetdom only. FACHACCIDENT ! I lSEASE POLICY LIMIT $ 600,00d .OISEASEfACH EMPL $ 100 000 DESCRIPTION OF O TIO HI ITEMS RE:THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR LUIS RAMIRO QUINDI. CERTIFICATE HOLDER! PMCELLATION DOUCET REMODELING I'-Y- . Strotn.D.aNn OF THE ABOVE DEMBM PottGES sE CANCELLED BEFORE THE ExP RAUM DATE THEREOF,THIE Coli AWL WBIEHDEAVOR TO MILL jg 8ARLINGTON RD DAYS WRME4NOTICETOTIECERTFrA7EH umtNAMEOT0TMUST;e11r WOBURN,MA 01801 FMAIRE TO WL SUCH NOTME SHALL WK*E NO OMMTM Olt UAW Y OF ANY MID UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ✓�ze v�o�v�rio9ueJea��o�✓�aaaa�ux6�u °, Board of l q!t Iding Rcgulatton HOME IMPMOVEMENT CON , • Regisetra�6n�..���•: __ _ Exptra�ion 'li)/412�08.. Type PARTNERSHIP. DOUCET REPJIOL DING tTD PARTNERSHP JAMES M DOUGET MLINGTON RD ` V�t33L:RN,MA 01801 . Oe�#ut�'AdrInstrator { Construction es&=License Limnse: CS 23342 Ett#�irtiea 2/1912010 Tr# 17669 d0 k 3f ' JAMES M DOU�ET 1 8 ARLINGTON Rtes WOBURN,MA 01801~ Commissioner F i i