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HomeMy WebLinkAboutBuilding Permit #006 - 1092 GREAT POND ROAD 7/6/2006 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION o 32 a , oL o Permit NO: C Date Received ! ` SSACH Date Issued: Us���h'l� IMPORTANT': Applicant must complete all items on this page TLOCATION c �( ..�� PROPERTY OWNER S� CVe Print Print MAP NO.: (?3 PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building P(One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ,ICRepair, replacement,.4 ❑ Assessory Bldg ❑ Commercial ❑ Demolition 5 ❑Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION.QF WO TO BE PREFORMED 1-Identification Please Type or Print Clearly) OWNER: Name: S �c �"�� Phone: Address: e CONTRACTOR Name: Q�el� � Pn r Phone: �) 11111-161r' � ilk Address: iGC�C �G1� /����'�C Supervisor's Construction License: Exp. Date: Home Improvement License: //el-�2 Exp. Date: '2— ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BUILDING PERMIT.•$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ G 1 74, b xD@@`=FEE:$ (� Check No.: Recei t No.: p Page 1 of 4 TYPE OF SEWARGE DISPOSAL Swimming Pools ❑ Public Sewer F1Tanning/Massage/Body Art E] g Well F1Tobacco Sales ❑ Food Packaging/Sales El ❑ Permanent Dumpster on Site El ' Private(septic tank,etc. Electric Meter location to project r NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor j Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ . Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING &,DEVELOPMENT ❑ ❑ []Water Shed Special Permit ❑ Site Plan Special Permit Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ i COMMENTS I DATE REJECTED DATE APPROVED IIEALTH ❑ ❑ 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 es Fi Temp Dumpster on site yesre Department signature/date Building Setback(ft.) Front Yard Side Yard Rear Yard Required EProvided Required Provides Required Provided DIM ENSION 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 Building Department artment The following is a list of the required forms to be filled out for the appropriate permit to be obtained. 4 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 DEPARTMENTMITORM05 Pace 4 of 4 Locationl ! Z �s f��+r► No. 006 Date G "� �oRTh TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Z '� s•►CHU Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 1 9 4 ) 3 Building Inspector V40RTH Town of Andover No. g)Cp 77 497- L A over, Mass., 07* k 404 C OCHICHEWICK V I ORATED P' C BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT......S4.�..v44.........F.4.cn.4.4.................................................................................... BUILDING INSPECTOR Foundation has permission to erect........................................ buildings on ...... ...0..1.1..........&O........ I .... 44#0 Rough to be occupied as....... ...�..... ......f0wV141-00c.-W........................................................ Chimney provided that the person accepting t 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 O PERMIT EXPIRES IN 6 MONTHS Final 2. ELECTRICAL INSPECTOR UNLESS -CONSTRU ON STARTS 40P Rough _..................... .......................... ...... BUILDING..INSPECTOR Service 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. QOO o E Q4 1 Licenced & Fully Insured May 3, 2006 Steve French 1092 Great Pond Road N.Andover, Massachusetts 1) Remove and dispose of existing cedar shingles and strapping. 2) Install 3/4 inch CDX plywood to entire roof deck secured with 8D ring nails. 3) Install EcoStar Glacier Guard Ice & Watershield barrier to entire roof deck. r 4) Install 16oz. copper drip edge to all eve edges and flashing to all valleys, sidewalls and pipes. a 5) Remove and replace siding at all sidewalls to install Ice & Watershield and flashing. 6) Install EcoStar Majestic Traditional Slate exposed 7 inches to weather, secured with EcoStar stainless steel nails. (Color Midnight Gray) 7) Install Eco Star Ridge Vent to all ridges. 8) Install Eco Star copper snow guards to leading edges as needed. Taal price.............................. .......................... .................................$56,700.00 ....................... � Robert L. Green Customer I 4 Fieldstone Terrace Chelmsford, MA 01824 (781) 861-7900 • (781) 275-2338 • Ph6ne/Fax (978) 250-7300 M20GENA it-iCA i c Or`�if"+S�ILITY INSURANCE rlo. 119 P.1 1/2-4/2006 PRODUCER (781)729-8770 FAX (781)729-0053 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION is John A. Pierce Ynsurarlce Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 934 Main St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. I Winchester, MA 01890'•1994 INSURERS AFFORDING COVERAGE NAIC0 INSURED obert Green Inc INSURERA Atlantic Casualty Ins Co 4 Fieldstone Terrace INSURER B: The Travelers 1003& � Chelmsford, MA -01824 INSURER C, INSURER D. INSURER E: COVERAggS T11E POLICIES OF INSURANCE�_ISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDIN ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR 1VL5Y PERTAIN,THE INSURANQ:.AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR oD' TYPE OF INI3URAA CE POLICY NUMBER POLICY EFF!CTIVE POL C EXPIRATION LIMITS GENFRALLIABILITY L08000231201 06/11/2005 06/11/2006 EACH OCCURRENCE S 1,00o,000I DAMAGE TO RENTED a 50,0001 X COMMERCIAL CENEII►L LIABILITY ; CLAIMS MADE [�OCCUR MED EXP(Amy one Denoq) S 5.0001 PERSONAL 8 ADV INJURY S 1,06-0—.000 A ��•!� GENERALAt3GREGATE S 2,000 OOO 5ENIL AGGREGATE LIMIT IkPPLIE$PER PRODUCTS-COMP/OP AGC t 11000,000 POLICY ECT LOO AUTOMOBILE LIABILTIY COMBINED SINGLE LIMIT $ ; IEe eecldent) ANY AUTO ALLOWNEDAU10S BODILY INJURY S (Per person) SCHEDULED AUTOS MIREOAUTOS BODILY INJURY ; (Per eccldenU NON-OWNED AUTO I r PROPCRTY DAMAGE S • SPer Docidepp GARAGE LIABILITY + AUTO ONLY.EA ACCIDENT S ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG S EXCEBSIUMERELLA UAII LITY EACH OCCURRENCE $ OCCUR D CLAIMS MADE AGGREGATE S S DEDUCTIBLE S RETENTION S WORKERS COMPENSATIONAH') 7P]UB621X751-3-05 04/09/200S 04/08/2006 1 WC STA uT PR EMPLOYERS'LIABILITY E.L.EACH ACCIDENT S 100,000 B AY OFFICERIME BER EXCIT,UDEE,,(ECUTIVE E.L.DISEASE.EA EMPLOYEE S 100,000 pyyee,deralbe uuler EL.DISEASE.POLICY LIMIT S S00100 5P6CIAL PROVISIONS below OTHER DC9CRIPTION OF OPERATIONS I LO.-ATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIEICATE HOLDER, C SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDBAVORTD MAIL - 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Hurley BrothElrs Roofing Corp. BUT FAILURE TO MAIL SUCH IC HALL IMPOSE NO 10 N OR LIABILITY 16 Moreland Sixeet OF ANY KIND UPON THE INeu N 8 AGENTS OR S U%,fi SOmervi l l e, MRI 02145 AUTHORIZED REPRRSENTATIVE 11 Kevin L. Pierce ACORD 25(2001/08) FAX: (617)776-3646 CACORD CORPORATION 1988 I . x &>R . - yffy �yfxy . , . < �« [I ? ~ 71w e� \ \ , y�» Z�x A,m¥Building Regulations and StaWa\ / ] 6 » HOME maRO EME T CON �C oR * . [ � Rgt�n :1,1e2 � . pao<ti;07 \ ) `}\\T p d i a \: [ \ ROBERT G EE+ �. � G.—9�� {< - ROBEtT GREEN FIELDSTONE TEPt,;Z� ' CHELMFORD,MA 0,-34, Administrator © : � . � ) � - ;\ \