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HomeMy WebLinkAboutBuilding Permit #397-13 - 126 HIGH STREET 11/13/2012 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page .LOCATION—. Print PROPERTY OWNER ,QJ1Lt Print J-66 Year Old Structure yes no MAP NO: PARCEL: ZONING DISTRICT: Historic District yes o 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 J�,Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other El Septic El-Well ❑ Floodplain ❑Wetlands ❑ Watershed District 0 Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: 37 vb PE d90AeQr Identification Please Type or Print Clearly) OWNER: Name: IAN DDUryc Phone: 978 114 7y'T� Address: 611 �5�= CONTRACTOR Name: j-AI—Ve . _.. _ _. Phone: '/7Z X870.242 Address: LU gwz&4 --__ Supervisor's Construction License: / ;2V0. Exp. Date: //he 1 Z4_01:4 Home Improvement License: /,SO571 Exp. Date: a ARCHITECT/ENGINEER Phone: a 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: $ 1�12,2 ' FEE: $ 70, vV Check No.: " 9 I !� Receipt No.: NOTE: Persons contracting with unrelaistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor i Plans Submitted ❑ PI ns Waived ❑ Certified Plot Plan ❑ t mped Plans 11 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 o 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 o 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: Doc.Building Permit Revised 2012 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 i 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 b n 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 Departmerit-signature/date '° .COMMENTS 1 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 t ` Doc.Building Permit Revised 2010 Location '2- No. 1� —!� Date -�- • - TOWN OF NORTH ANDOVER 0 9ti 'LI b'111�,,, . Certificate of Occupancy $ "7 Building/Frame Permit Fee . Foundation Permit Fee $ Other Permit Fee $ TOTAL $ oZ Check# 2-02-1 25942 Building 11 ctor NORT1y Town of t E : ., Andover No. t ,� * o h ver, Mass, COC K.c Klw.CK �d A04ATED vp S U BOARD OF HEALTH Food/Kitchen PER 1. T LD Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ......... ....... . ..... .............. P.................................... ........................ ....... Foundation has permission to erect .......................... buildings on ...V—(0. 44 . Rough to be occupied as ............... ... .. �............ ..0- .� ......................................................... Chimney provided that the person accepting his permit shall in every resp conform to the terms of the application Final on file in 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 CONSTRUC 0 T Rough ' - Service ............ ........ ....................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. SEE REVERSE SIDE r CONTRACT# 42-10064 'ITEMIZ � �NS'f _L.1.90 $ALES 0 NTRACT INSTLLED SALES SPECIALIST NUMBER � <: CUSTOMER $I4 "T_%r H � y Sac7nCD 5T6iEETAL7GRESS 1 STREET Ar7©RI:SS f r L11 4 STATE ��1P CITY - - ,•••.,_...,."...,.r........_...r„ ..�, _ STATE IP rv- ELEPHt7NE .. / .TELEPHONE Z�4 TC LOLLE'SCONTRACTORiICENSENu=xm y BANKr (cc tcit,;t�tD Sian l s$oss 'Nutnbecz Ail C7itaer States Lomra's Em tc ee N€�mtier � ..' . . AL,CT,FL N1k'RJi?, 3V,l+ SA ftun tn? srTN'#1 3 ronig. A Y Ttfils Is,a contractbelvreei Lowe's{as defined in theTerm and Condlttons the -he,tnslalfation of"Bonds at rhe, { CustornVi,sesideniial Premises(the,"premises),ai the fq �wnn�iris�alta3l�sn-�drfrsss -�i 7� ctxrr fEETS ZIP - Mt, .... Additional Specifications: The Environmental Protection Agency (EPA) has requested that 'h° U4l Lowe's notify installation customers that,a lead based paint hazard may exist in dwellings built rilor to 1978. See pamphlet EPA fi4T-K-39-QQ1 #or details. able k•locat.tax re trictions;,i ; Work I's fo cornmencs u' on reasonable availability of" P Contractor which is an#icipated to#e � r�, e �^d Estirnatedcomptetfon date is�,�,�,;v,,;; � � (illi in daie�. � [fill tri date]. NOTICE TO CUSTOMER t All items listed In this contract and specification sheei{Si are to be Installed under conditions agreed upon et lime of purchase and at the price appearing on this contract form. This assumes sound existing substruclures,superstructure and points of attachrnenis. Extra labor nr material incident to installation necessitated by defective substructures,superstructure,.points of aitachment,or the moving of fixtures,or appliances to be billed at extra Cost to CUSt4tfier. DO NOT SIGN THIS CONTRACT UNTIL COMPLETE AND YOU HAVE READ'f HE TERMS ASI ;CONDITIONS'CONTAINED ON THE REVERSE ZIDE OF THIS CONTRACT. BY SIGNING BEL'OIN,"YOU ARE ACKN6WLEbGING THAT YC9U HAVE READ, UNDER-. I STAND AND AGREE TO THE TERMS AND CONDITIONS,SET FORTH ON THE-REVERSE SIDE OF THIS CONTRACT.YOU ARE ENTITLED TO A COPY,OF THIS CONTRACT AT THE TIt1 E aF SIGNA Tt1RE. WITNESS OUR HAND(S)AND SEAL(S)BELOW:THiS DAY OF (Seal) Specialist or 11 Above :(Seal) , ",..Spouse (Seal) Custo�eXteod r acknowledges receipt of arse copy of ihts tx7r tract which was compl$tety fitieci in prior to.Cctttomer'Is exeitiait hereat tF er °m to you,you the t?uyec'may.cancei this transactian at anytirna pr�sr to midnight of the thlydbsinesscfa See thttached notice of cance!atiortrbrm fox a n:ex lavation. f= yaafter the date agt ihls'trrtnsaction this right•••~ �. �,� ; 2012-10-24 16:51 ISOPRT75 6036814226 >> 5086346780 P 1/5 SSZRI35A LOWE'S HOME CENTERS, INC. SLH 2382 PAGE: 1 DATE: 10/24/12 541 SOUTH BROADWAY ORDERED FOR: DAN DROVER SALEM NH ADDRESS: 126 HlGFT ST PHONE: (603)681-4218 NORTH ANDOVER MA 01845 PHONE: (978)420-7479 VENDOR NAME: MASTER ROOF ADDRESS: PO BOX 83 CONTACT: MILFORD MA 01757PHONE: (888)333-7006 PROJECT: 363770255 PSE DROVER ROOF FAX: (508)634-6780 LOWES P0: 146414477 LOWES INVOICE: 88664 ASSOCIATE: WILLIAM COLE EST DELIVERY: 11/08/12 AR NUMBER: QTY ITEM ITEM DESCRIPTION BIN ----_-- VEND_PART# COST EXT-COST 1 322256 LABOR 18 SQ LABOR ].8 SQ 270000 270000----- -- 1 228231 1250 ABOVE 8 PITCH 12SQ ABOVE 8 240.00 240.00 FREIGHT $ 0.00 TOTAL $ 2940.00 ICU a s, 2012-10-24 16:51 ISOPRT75 6036814226 >> 5086346780 P 2/5 PAGE:4kC: LOWE'S HOME CENTERS, INC. SLH 2382 ro PA3 DATE: 10/24/12 541 SOUTH BROADWAY ORDERED FOR: DAN DROVER SALEM NH ADDRESS: 126 HIGH ST PHONE: (603)681,4218 � NORTH ANDOVER MA 01845 PHONE: (978)420-7479 VENDOR NAME: MASTER ROOF ADDRESS: PO BOX 83 CONTACT: MILFORD Mn, 01757PHONE: (888)333-7006 PROJECT: 363770255 PSE DROVER ROOF FAX: (508)634-6780 LOWES P0: 146414478 .OWES INVOICE: 88665 EST DELIVERY: 11/08/12 ASSOCIATE; WILLIAM COLE AR NUMBER: QTY ITEM ITEM DESCRIPTION 1----154347 --- --- ---_BIN---V�---------- ----COST----EXT-COST PERMIT N. ANDOVER PERMIT N. AN — 100.00 —100.00 FREIGHT $ 0.00 TOTAL $ 100.00 SearchResults Page 1 of 1 r Search Results • Select the licensee name below for more information. 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Name License Number License Type IlLicense Status jAddress VALDEZ WILSON R CS-102403 lConstruction Supervisor ctive IMILFORD MA 01757 1 0 i http://elicense.chs.state.ma.usNerification/SearchResults.aspx 11/13/2012 Office of Consumer Affairs &Business Regulation- Mass.Gov Page 1 of 1 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Consumer Affairs and Business Regulation Home Consumer Home Improvement Contracting Home Improvement Contractor Registration Lookup You can search/filter the registration list by any of the criteria below. Search by Registration Number �ISeearch Search by Registrant Name masterroof __�� Search by City __ Zip Code jSe�arch Reg istra ntsl Click on the registration number to view complaint history. You can also view arbitration and Guaranty Fund history. The list is current as of Monday, November 12, 2012. Search Results REGISTRANT RESPONSIBLE REGISTRATION EXPIRATION NAME INDIVIDUAL NUMBER ADDRESS DATE STATUS MASTERROOF VALDEZ, WILSON 150577 151 MAIN ST 04/11/2014 Current MILFORD, MAO 1757 http://services.oca.state.ma.us/hic/licenseelist.aspx 11/13/2012