The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #162 - 125 BOSTON STREET 8/29/2007 pORTH BUILDING PERMIT 0.*t.TUF0 A TOWN OF NORTH ANDOVER F APPLICATION FOR PLAN EXAMINATION A ^ H O44 to[wtwt r.cw y1V Permit NO: ll Date Received 1.Argo Date Issued: -C' 5 " d IMPORTANT Applicant must complete all items on this page 11 Do, 15 Ilk g1 '1PER +e-I O W N IR ,� y ,,. 'S Svc` � "£ .'u k L �� GA, � � � �$ �`1 ��achineShop �I��g�y£Ni"' '•�yce�•Y.".: ..z44aS y TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family 0 Industrial El Alteration No. of units: 0 Commercial ❑ Repair, replacement ❑ Assessory Bldg 0 Others: ❑ Demolition ❑ Other k fl Septra Ci�Ve1fi$ . F oc lin WWe ands; zt �11Itatersned DE RIPTION OF WORK TO BE PREFORMED: 1 A0 fr!f�e ta e L4-op t,-� t"4=, L Cep av WA-Pue-- k Identification PlysifType or Print Clearly) -- OWNER: Name: Phone: ' Address '{ ase N r .a� F k ,+. c Yt f CCaN d' fJ0' ` aellore � F rX Adtl` 5s ' ' ' Su�p�rvlsor'scnstr , t� srt LAcnseJL u a Hotnelrrrpro�eent; .lel% e .:° . . .;° pD h, �, 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: $ 5-2 , 20D FEE: $ Check No.: ` �S O Receipt No.:A o NOTE: Persons contracting with unregistered contractors do not have ccess to the gua an f2wid Signature of Agn %C)wne`r SI nature of contractor. 9. Location-lx- No. ocation x-No. Date MaRT� TOWN OF NORTH ANDOVER 3? ' 0 p h 9 1 s ; : Certificate of Occupancy $ 'Ss�cHusEt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #1� 205 . 6 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 ❑ �i 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 r HEALTH ❑ 11 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 Located at 384 Osgood Street FIRE DE,PM 'Ddm,pst�r an site es j - k :Coca#ecl at 124 Y � _ 77-Fare Department signature%dafie ' GOMMENS: 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 - Date ........_...._...................................................................................................................._........................................................... Doc.Building Pen-nit Revised 2007 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. i 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) o 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 i that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording j must be submitted with the building application I f Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 t r — Town NORTH of - 6!;L Z __ odover, Mass. ' -- LAKE ' COC NIC ME WICK V 7�ADRATED 0`? �y BOARD OF HEALTH Food/Kitchen PERMIT D Septic System JBUILDING INSPECTOR THIS CERTIFIES THAT ......... .............................................................................. Foundation Iff lingo has permission to erect........................................ build' gs onAr......... �..........• ................. Rough to be occupied as...... "r Chimney provided that the person accep fig this permit shall in every respect conform 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 CONSTRU STARTS 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. NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: 2is 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. Also, note Permits are required under Fire Prevention laws Chapter 148 Section I 0A. The debris will be disposed of in: �- S Lc tom..... , �- (Location of Facility) i' 79' ignature bf Permit Applicant Fire Department Sign off: Dumpster Permit O P !/ Date guiJding Regulations and n j� fiq'daFdsz { iiOME IMPROVEMENT CONTRAGOR 'Registration X15181$ E matren 7/5/2008 - p Y- f 6E Pnuate Corporation LUK/�hlQMI�f91� OEMENT CORP t' MITRI s KARA�I(�R0�5 The Commonwealth of Massachusetts ^; Department of Industrial Accidents 1Office of Investigations ale , 600 Washington Street ' Boston, MA 02111 www.mass.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individ 1): 1 Address: City/State/Zip: J one #: Are you-an employer?Check the appropriate box: Type of project(required): 1.9 I 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 2. I am a sole proprietor ro rietor or partner- listed on the attached sheet. $ ? Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp, insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself.[No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks boz#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. / Insurance Company Name: T-c— Policy#or Self-ins. Lic.#: Expiration Date: ' Job Site Address: 12- City/State/Zip: ' Z-6&A 0, uc- 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 u to$1 500.00 and/or one-year imprisonment,as well el as civil penalties in P Y P � p 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. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Si ertature: Date• Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#• i Samuel Ilukm Home Improvement Corp. 91 High Street Lawrence,AU 01841 (97S)s1S-SO85 (97S)685-7573 All material is guaranteed to be as specified: first five years material and labor. All workmanship is guaranteed to be for a period of 1 year from date of completion. All work areas are to be kept clean by contractor. All insurances are to be carried by contractor. Contractor is responsible for obtaining necessary permits. Total cost of all labor and materials is $12,200. $1,000 is due upon signed contract. $3,000 is due upon starting and remaining payments will be made as job progresses and any balance is due upon completion. Respectfully Submitted, Dimitrios Karagiorgos Acceptance of Proposal The above prices, specifications, and conditions are satisfactory and are accepted. Samuel and Lukas Home Improvement Corp, is authorized to do work as specified. Payment terms are accepted and will be made as outlined above. Signature ZR� Date 17'"4 '- Customer Signature Date President of orp., Wn os Karagiorgos h Bob DeAdder Siding Page 2 of 2 Samuel 4 Luka#BomeImprovement Corp. 91 High Street Lawrence,MA 01841 (978)618-8083 (978)685-7373 MA Contractor Registration ID: 151818 August 17, 2007 To: For work performed at: Bob DeAdder Same 125 Boston, Street North Andover, MA Home (978)686-5286 We hereby propose to furnish materials and labor for the completion of the following work: Specifications 1. Existing siding and trims of windows and doors will be removed. 2. These areas will be prepared for new vinyl siding. 3. House will be prepared with Tyvek. 4. Cedar Impression siding will be installed. Customer will choose color of siding. 5. Asiac trimboard will be used for all windows and doors. 6. All trims around eves of house, rakes, and window sills will be completed with new aluminum and necessary soft-fit panels. 7. Bathroom window will be replaced with an Anderson pop out window. 8. One window near patio room in sun room will be replaced with a new construction vinyl window. 9. Side door will be replaced. Customer will provide door. i / �- - Bob DeAdder Siding Page 1 of 2 i