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Home My WebLink AboutBuilding Permit #321-14 - 110 FOREST STREET 9/29/2014 BUILDING PERMIT o�"°D "qti TOWN OF NORTH ANDOVER �r y "J `° o APPLICATION FOR PLAN EXAMINATION * - Permit No#: Date Received P • R 1• / �gSSACHus��y Date Issued: ` PORTANT: Applicant must complete all items on this page LOCATION / Qf �'S r /6L2.e ( /UO• t�} N ld tl � - 61 Print PROPERTY OWNER D J 1K. t Sia L L / Print 100 Year Structure yes no MAP , ,r PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes 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 ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: fAIf /N7� .9 uI GX�1S 7,; Identification- Please Type or Print Clearly OWNER: Name: m. _"b&1&c.c c_ Phone Q 1 8s— 7 /_J Address: Contractor Name: Phone: qQ L-ls Address: + ?,epce— ]'' Supervisor's Construction License: C5L 161Z,(� Exp. Date: t /I Z f '� Home Improvement License: �L 7NIExp. Date: to b ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING RMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: FEE: $ }� Check No.: 2 � Receipt No.: vA0 d �f1� NOTE: Persons contracting with unregistered contractors do not have access to the gugpdW67yund Signature of Ovvner t Signature of contracto + r Location f� Q No.� � Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee '$3 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#-j- 3 r � Ul Building Inspector 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 ❑ I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS I "4TjAjQ1'=-RV,ATION Reviewed on Signature w i + Ymans StOVe services : 978-868-0435 Signature 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 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS L 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) ❑ Notified for pickup Call Email ' Date Time Contact Name I Doc.Building Pennit Revised 2014 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 o Workers Comp Affidavit ✓ o Photo Copy Of H.I.C. And/Or C.S.L. Licenses ✓ ■ Copy of Contract -1 o F4eef Plan Or Proposed Interior Work �: F rfr►oor�r�y "ff;Wu�;�� `;,; 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 o Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) Li 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) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract Ll Mass check Energy Compliance Report Li 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 Doe:Building Permit Revised 2014 Printed:8/12/2014 3:41:54 PM Sales Order#6085 Store: NRE Ordered: 8/16/2014 Cashier: Michael Associate: Michael HEARTH WORKS FIREPLACE CENTER,INC. 250 MAIN STREET NORTH READING, MA 01864 Phone:978-664-0100 Fax 978-0648007 Email:HEARTHWORKS1 @COMCAST.NET John Driscoll 110 Forest St N.Andover,Ma 01845 978-685-9402 978-97393W Order Lookup Description Price Ext Price 1 VE625SS (316016) 6"X25' SS $499.00 $499.00 1 VE6CONN (316056) 6" CONNECTOR SLEEV $34.19 $34.19 1 VCMONTPCB MONTPELIER WOOD INSERT Cl $2,379.00 $2;379.00 1 VCMEAD3CB MEAD CAST SURROUND CL BLP $522.00 $522.00 Total Qty Ordered: 4 0 4 Subtotal: $3,434.19 10%Disc: -$343.42 Exempt 0%Tax: +$0.00 TOTAL: $3,090.77 Deposit Balance: $0.00 Balance Due: $3,090.77 INSTRUCTIONS: 25.75h 35.25w 21.5d 23rw Install When In $599 +PO4Ir 4388540029959888 X9/15 i Signature ALL SALES FINAL PLEASE SEE REVERSE Office ot`Oo m�airs u"sin abon�. HOME IMPROVEMENT CONTRACTOR f Registration: ,A6129 Type: Expiration: 1U/7I2014 Individual M EW WYMAN. MATTHEW`WYMAN 232 PIERCE S7 LEOMINSTER,MA 01453 Undersecretary ane Certified SP ecialist MHP JXv J r - NA, IONAL CertifiPirition k Gas i 30/2016 Woodburning�4/3012016 Pellet - 04/3072016 Matthew Wyman ID Number:135838 i Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Specialty License_ CSSL-101215 MATTHEW J W'"tAN. 232 PIERCE STREET I LEOMINSTER MA 014 t Expiration 10/12/2015 Commissioner k License or registration valid for iridividul use only before the Office o Consumer Affairs and Business Regulation 10 Park Plaza-Suite Sip" Boston,MA 02116 F valiout signature s: The hearer of this card has demonstrated - his/her knowledge of the trade through nationally recognized testing. To verify the credentials of this card bearer: www.nficertified.org Restricted To: CSSL-SF-Solid Fuel Burning Device r Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS � i 4lrsr\�1�`s�tl�!\ri\,slt�ri\t.Ijlsi .t�. '. + .3�;@3+b• Cj7TT,ytjio-'}Lgfre-4v rFL h. ,.\\.1\.A\"5t.�.t\.\,4r.11.\` \\.41.i1.'�,�\4 r.144.1�t .'.. 5'.Opt �S4tt+r�t�r: r+i i . .�•u 4 s . : r i s:4 _ 4,; 1e 23 21 . i CUSTOMER'S ORDER N0. DEPARTMENT NAME 4 _a ADDRESS ; CITY,STATE, SOLD 6Y CASH c.oO: . CffAR6 dtJ.�IGCT MDSE RETU_` .PAb OOY. 011AN EITY; OESCRtPTIQN PRIGE —14 AM00iff 2 3 Y. [r 4 5 }` x 6 r , 7 10 11 ` } 12 FFF 13 ri 14 t 15 16 17 ti= 18 fsE1;ENED B _. kadanu aocsaos KEEP THIS SLIP FOR REFERENCE01-11 Sales Order Alternative Energy Hearth and Patio Shoppe 114 Lafayette Road Hampton Falls, NH 03844 ph. 1-603-926-0388 fax: 1-603-926-0399 DATE: • Phone DEPT. ORDER NO. WHEN SHIPPED HOW SHIPPED TERMS BUYER SALESMAN QUANTITY DESCRIPTION PRICE AMOUNT Q�1 8'Y :�?a Cancellation of this sales order will be subject to a 25% non refundable, re-stocking fee/service charge. Custom and special orders are non-refundable and non-cancelable. Payment Terms: 60%deposit at time of purchase,custom orders must be paid in fdl/, balance of order must be pre-paid in full prior to pick up,delivery or installation of product. Our installation fee does not include any gas,electrical,or carpentry work, unless otherwise stated. I Have Read And Agree To The Above Terms. Signed: Date: SPECIAL INSTRUCTIONS: We Can Not Accent Any Returns or Refunds on Purchases. All Sales Are Final. t%O R Ttl Town o Andover 0 115 � o h ver, Mass, CO[NICKIWICM '►' �s.4s q^reg) P-PA��S d1 u BOARD OF I fEALTH PERMI T Food/Kitchen L D Septic System THIS CERTIFIES THAT ....... . J2 • ••••••• a�.. .... BUILDING INSPECTOR .. has permission to erect ............ buildings on .�, � fao&%.r � Foundation to be occupied as ... Rough uh .. .. ... ......... Cr. ,�. . .V.{....... K •• •• Chimney provided that the person accepting this permit shall in every respect conform to the terms the applicatio 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 Ficial PERMIT EXPIRES IN.. MO S ELECTRICAL INSPECTOR UNLESS CONSTRUqTM S TS Rough Service ........... ........................................................ BUILDING INSPECTOR. Final GAS INSPECTOR Occupancy Permit Required to Occupy Buildine - 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.