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Home My WebLink AboutBuilding Permit #726 - 1135 GREAT POND ROAD 5/7/2007 BUILDING PERMIT p°RTIC q it`eD '6. 1'p TOWN OF NORTH ANDOVER o? °0 APPLICATION FOR PLAN EXAMINATION °° Permit NO: ` Date Received` C� ��SSAC HU`�� Date Issued: 7- 7 IMPORTANT: Applicant must complete all items on this page I_OCA1�I0 Hwy � j 11INAl r -N � N TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ne family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ` Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic 9 11V i 4 1=iso plan U1 e (gradsft Ave"t� fib Dis rt t DESCRIPTION OF WORK TO BE PREFORMED: t iZ n�� fix!v�'"r'�JCj W i N(-L6 ISCOIE � K&f �� UJ f i 4 SAW&- &' -AJ O s Tfux,TOpp/-- Identification RALIdentification Please Type or Print Clearly) OWNER: Name: a i ):�-s <3e--lrv4- Phone: r7'9- 77-r 6 � Address: 11 (oO 6-74CA5- -PUX-47 s' - s ' air 2 .e � ,,r�cc• if t 4OR mm' A` .. w' t 6flNTACTt ; Nt � �� 1 � o r M 5per�r�sr' r� ctio� � erlse o- M ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDINC,PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. l Total Project Cost: $ f/� ` �� `' FEE: $ Check No.: Receipt No.: r�� NOTE: Persons contracting with unregistered contractors do not have access to e r ty u Si natureof A ent/Owner Signture o c�rtacto`r j . x. i ; NORTH BUILDING PERMIT Olt f TOWN OF NORTH ANDOVER 02 APPLICATION FOR PLAN EXAMINATION Permit NO: Z96 Date Received SSACHUS� Date Issued: Q�"7 7 IMPORTANT: Applicant must complete all items on this page s s ; 4r� a 51, 19 I TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building k1bne family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Sept ell; ❑� rdpalrens � laters�d Drcr 1�later:°/5ewe k � DESCRIPTION OF WORK TO BE PREFORMED: -yu o 3T f-(J0-FbP A,- 4 . Identification Please Type or Print Clearly) OWNER: Name: Phone: 97!R' 77-r &5C6 Address: 11 60 Ce-6?45- ?e)X)17 .".'z�.: '� � � ar 39 � , ✓ "SMI 511 MIX « z 2 4 ARCHITECT/ENGINEER Phone: 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: $ 15/6 FEE: $ Check No.:- A Receipt No.: �� NOTE: Persons contracting with unregistered contractors do not have access to e r ty u Signature of 8 6t, wner�� ; �.. Signature of corl�r cto ` . w _ 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 DATE REJECTED DATE APPROVED ~. CONSERVATION ❑ ❑ COMMENTS DATE REJECTED , ,DATE APPROVED HEALTH HE - - ❑ COMMENTS s Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Si nature& Date Driveway Permit Located at 384 Osgood Street N FIREDtART1IN TmADtam�serons�t� y " no ' ��re lie a:tmertt s�gnature`,date � s NPR 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 P MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date r Doc.Building Permit Revised 2007 J 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 y aulic 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 I Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM ce with the provision of MGL c 40 S 54 a condition of Building Permit In accordance p g Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. The debris will be disposed of in: (Location o Facili ) Signature of Permit Applicant Date i NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector "`� ✓fie v�anvnworsuea� o�✓�a�ra��ir�.i�a BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR ''�,• etc ��' Number: CS e 035313 Birthdate 05/02/1962 Expires 05/02/2008 Tr.no: 25616 4 Restricted ;00 r DONALD G RONDEAU .f PO BOX 522 r DRACUT, MA 01826 . k s Commissioner ' k� Board of Building Regulations and Staiida- _ HOME IMPROVEMENT CONTRACTOR Registration 137434 Explratlon 11/12/2008. Tr# -124494?.t Type Private Corporation RONDEAU CONSTRUCTION INC.. DAVID RONDEAU :� 182 ARLINGTON ST-, '-)RACUT, MA 01826 _ Administrator _ The Commonwealth of Massachusetts d Department of Industrial Accidents Office of Investigations 0�< Boston, Mass. 02911 Workers'Compensation Insurance Afdavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity �I am an employer providing workers' compensation for my employees working on this job. Company name: R01J 06-1.0 t OMP.-IRUC T1D W Address �.U. ��SC ;Z 2 City: Phon4q nB ? Is- 3 ,'?? ' Insurance.Co. A46VO-00 Zue(c� Policy# Clg `Z2 VBBZVr Company name: Address City: Phone#• Insurance Co. Policv# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to$1,500.00 and/or one years'imprisonment_as.well_as_civil:penattiesintheform jofa_STOP WORK ORDER_and..a.fine.of.(.$1.DO.DD)_aday against-me. 1 understand that a copy of this stgerAnt may be forwarded to the Office of Investigations of the DIA for coverage verification. t do hereby certify under f in d plti perj that the information provided above is true and correct. Signature �--�/ 9 Date Print name 1"5<3 A0,L® o ru p F. J Phone.# R �' $!s' -777 Official use only do not write in this areato be completed by city or Town official' City or Town_ Permit/Licensing Building Dept ❑Check if immediate response is required C Licensing Board r-1 Selectman's Office Contact persona Phone#: E] Health Department Other 05/04/2007 08:34 9787256295 BROOKS FACILITIES PAGE 03/03 603MM080 p.2 07 10:28a Cindy Rondeau OU031AZIGIN Phone(848)4W2684 Fax(609)535.9080 RondeaulnoCod.00m &m&au CowtruCUM, INC. R 0. Box 522 Dracut;MA 01826 Gar8e11l ldin8 Brooks Sdtoal 1160 Grset Pond Road Quilts Number. 234 N.Andover,MA 01846 Quote DAV. May 3,207 Page: t Brooks 6/2107 C.O.D. Existing shingles will be removed b decking. Roof decking wiN be reeeauted as needed. Aluminum drip edge will be installed on all perimeter edges. 6' of ice and wafer barrier shield will be Inst sled at @&VW. 3' of barrier shield will be Installe4 in all valleys. 18' of barrier shield wW be Installed against all waUs and around penetrations. A seli`sealing aspttah shingle wilts a 25 year warranty will be applied over under-Iaymenft. All walls will be milabshed as required. ; All pipes will receive new cailar fleshings. Valleys will be shingle waren. Cap-over vents WIN be installed at all ridges. All required pemita will be obtained. All roof related debris will be removed to an onshe dumpster. Roaf will carry a 26 year malerid and 6 year labor warranty. TOTAL 10,150.00 A Subtotal 10.150.00 Sales Tax