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HomeMy WebLinkAboutBuilding Permit #96-12 - 110 FULLER ROAD 8/3/2011 BUILDING PERMIT "°RT►1 qq, TOWN OF NORTH ANDOVER APPLICATION ` °� APPLICATION FOR PLAN EXAMINATION � eya Permit NO: I�� °4 Date Received z, "°q,T.° 2 �SSACH15�� Date Issued: ✓" IMPORTANT:Applicant must complete all items on this page LOCATION C I PROPERTY OWNER �'��'���' Print Print MAP 210 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 PREFORMED: ,. Identificatio Please Type or Print Clearly) OWNER: Name: &C_ Phone: Address o o L C-Z �Z�- { ,, • CONTRACTOR Name: r1 ,C.!-1Y1 fir'' Phone: Address: r �L Supervisor's Construction License: 069 I -0 Exp. Date: 14UZ /l Home Improvement License: 1"12 Exp. Date l• 23 i r- 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: $ �2• O C� FEE: $ o� 7:V-A Check No.: . *1 Receipt No.: NOTE: Persons contractingwit un gist red contractors do not have access tot guaran fund ignature of Agent/Owner Signature of contractor x _ __ Location - No. 1- Date ' NORTIy TOWN OF NORTH ANDOVER O f Certificate of Occupancy $ CHU t� Building/Frame Permit Fee $ a � Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 3 (,-? 24 �ru5 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature 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 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 924 Main Street' Fire Department signature/date COMMENTS i 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 0 Notified for pickup - Date I ......-.......................................__.... ---- ---.....-......-........................................_...._...............-...........---- ...._......----....------------......._..__..............__. Doc.Building Permit Revised 2010 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified 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) ❑ 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:Building Permit Revised 2008 NORTIy ' Town of _ - Andover .. . No. v �(� - oZp/ . }}(( o , dower, 1Vlass o p Y o {= CAKE COCMICKEWICK 7�S RATED P"P�,`�� BOARD OF HEALTH Food/Kitchen Septic System ..PERMIT T D BUILDING INSPECTOR THIS CERTIFIES THAT..................... ....�.i...�.0*%►............................................... ...................................................... Foundation has permission to erect...........:............................ buildings on 116 !��. .r. g *.................. Rough to las occupied as S. �.�......U-s-#%-%--L �r.�.V. ....... Chimney p ....VJ ......... l............provided that the person acceptin this permit shall in every respect nform to the terms of the plication 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 M S ELECTRICAL INSPECTOR- UNLESS CONSTRUC TS 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. ++f Construction Supervisor L.tcenste License: CS 55120 Restricted to: 00 JOHN W LANZAFAME 30 TEMPLE OR METHUEN.MA 01844 AL Etpiratton. 4f WI;) t nsrttss!.ionrr Trft: 13445 Ae CSM � ed +. Office of Consumer Affairs and ffusiness Regulation s 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Horne Improvement C trg0or Registration A}Nt Retlistmbon: 137057 ,4 Type: DBA Expiration: 1012/2012 Tr* 204021 ALL UNDER ONE ROOF JOHN LANZAFAME a p. 166 A MERRIMACK ST. METHEUN, MA 01844 Update Address and return card.Mark reason for change, Address - Renewal E,`I Employment F ' Lost yard officef .g-11r�i, or c Ucease or registration valid for indiridul use only, HOME IMPIOVEMENT CONTRACTOR before the expiration date. If found return to: RegFatiatiort; 137057 TYPe� office of Consumer Affairs and Business Regulation .. +� Expiration: 1002072 DBA 10 Park Plaza-Snits 5170 Boston,MA 02116 ALL UNDER ONE F10S3� JOHN LANZAFAME 166 A MERRIMACK STI �_.. METHEUN.MA 01644 Underwenetary Not valid vrithout&' t ple Commonwealth of Massachusetts Department of Industrial Accidents Office oflnvestigations 600 fflashington Street Boston, MA 02111 ;vmm?zass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers AAnpficant Information Please Print Legibly Name (Business/Organization/Individual): 1 Address: --- City/State/Zip: kw '0" Phone Are you an employer? Check the appropriate box: Type of project(required): 1.I'21 am a'employer with_ 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors ❑ Remodeling 2.El am a sole proprietor or partner-. listed on the attached sheet. t ship and have no employees These sub-contractors have 8. E] Demolition . workers' comp. insurance. 9, Buildin addition working for me in any capacity. ❑ g [No workers' comp. insurance 5• ❑ We are a corporation and its 10.0'Electrical repairs or additions required.] officers have exercised their right exemption ht of on p er MGL 11.❑ Plumbing repairs or additions 3.El I am a homeowner doing all work g p myself. [No workers' comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.]t employees. [No workers' 13.�Other comp. insurance required.] 'Any applicant that checks box it 1 must also Fill out the section below showing their workers'compensation policy information: t homeowners who submit this arfidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy iriforzrration. I am an employer that is providing lvorkers'compensation insurance for my employees. Below is the policy and job site information. / Insurance Company Name: Policy#or Self-ins. Lic. #: � C d U o/ (J. 40 obi 1 Expiration Date: i ► I °�a a l � Job Site Address: ��� o i 'A �� City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as W' as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby ceillfy under the pai s and penalties of perjury that the information provided/above is true and correct Si afore: Date: Phone#: — 3 1 -- Oficial use only. Do not write in this area,to be completed by cio?or town official. City or Town: Perrnit/License# Issuing Authority (circle one): LHealth 2.Building Department 3.Cityrrbwn Clerk 4.Electrical Inspector 5..Pluttibing Inspector rson: Phone#: A B s � nti l comm-er a 3 f€r} " tar +ry X411 Type Of ii€tr t t 41 B t � �t tr a E=xpert Miionry WUc r� i o rw .�,- t tcrnst3 a C:14z e woc9 w d" s WO w+f to 'vent [liotilsso Proposal To: Ronn Faigen Date 6/'x/11 Street: 110 Fuller Rd. 978-689-7217 N.Andover, MA 99 Vinyl Siding Proposal Ronn.Faigen@ampg-us-Com I. Remove all existing siding from entire house and 10. Install all new vinyl accessories: light blocks,split garage. blocks, meter block etc. (Removing and re-installing 2. Inspect all wood components of entire hoose. Any electrical meter included in proposal) compromised material will not be left. Any exist- 11. Building permit included ing damage or rot will be discussed, confirmed 12. Removal of all work related debris with homeowner and replaced. Replacement of up 13. Limited Lifetime vinyl siding warranty from to (1)sheet of sheathing is included in total cost. MFG. ,not contractor. Any further compromised material will be re- 14. Contractor workmanship warranty: 10 years placed at an additional cost of time and material. Notes: 3. Install breathable house wrap to entire house,All - install new standard color and style shutters seams will be taped for air infiltration. $60.00 per pair. 4. Install 4" standard vinyl corner posts to all house - Install new composite trim and bands around ga- corners. rage doors.$400.00 additional cost 5. install Quest .046 or Monagram 46 doul-de 4"vi- - Any extras,(rot or structural damage repair,shut- nyl siding to entire house and garage. Standard ters,gutters, cupola,front entry door system, etc. colors only. will result in additional cost of time and material. 6. Soffit area: Drill holes in all rafter bays 1'or added All extras will be quoted and confirmed with jventilation if needed. Install vinyl perfor:,ted soffit homeowner before any work is to be performed. panels. Color same as body color. Total COSI: 22,80,_04 7, Install j-channel to all areas that need to Accept vinyl siding. All j-channel will be self-flashed and Payment schedule: 113 on start date angle cut for clean professional appearance. 1/3 at project halfway point 8. Install custom bent aluminum trim cover,,ige to allFiaal balance includ' g any ext s due upon windows, doors, fascias,and rakes. Standni•d col- completion. ors only. ibilp-__11 9. Front entry and(left)bay window: Will ,Iiscuss Highly rated ber of the Accredited BBB and and confirm with homeowner on whet c tt t he ef- Angies' List. 1 fectively and neatly covered by custom I nt alu- minum trim for best possible finish appe:wmce. Local references available&.po-WZst_ Some painting will be required.(not inch: 'ed in proposal) Thank You! fpteept2nocue of Proposal--The above prices. >; 'cificati 2s and conditions are satisfactory and are herby ac- ed. Yare authorized to do the work as cified. P iyment will be made as outlined above.