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HomeMy WebLinkAboutBuilding Permit #44 - 127 BEVERLY STREET 7/18/2007 BUILDING PERMIT NORTF/ Ottteo °'q.�.O TOWN OF NORTH ANDOVERO o? � APPLICATION FOR PLAN EXAMINATION '' 4141 n Permit NO: Date Received ? 0 1'° ' '� AC US Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION A Print PROPERTY OWNER, Print MAP NO PARCEL: ZONING DISTRICT. Historic District yes no. Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family VAddition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: X Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PR FORMED: y I j l� 5� i- dentification Please Type or Printarlyr,:�i��11 �lu�c� `+P +11 e�" OWNER: Name: Prione: Address: CONTRACTOR Name: e-( Phone- r q-7,fi ;�15�44 Address: ` Supervisor's Construction License: SO Exp. Date:' a Ar�5-10 Home Improvement License: 11 I!g Exp. Date; ARCHITECT/ENGINEER �v iv, \ Phone:—2-22 9-T!!F 7- 5356 Address: q q yi((!xU Or-, Reg. No. �9gL, 4' FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $_'3 61. c, FEE: $ Check No.: - /3'330 Receipt No.: 0 NOTE: Persons contracting with unregistered contractors do not have access the guaranty fund Signature of Agent/Ovmer Signature of con#racto, Location 2, 7 6 No. Date f NORM TOWN OF NORTH ANDOVER + Certificate of Occupancy $ CHus`� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ •r Check # 133-3 20411 14 Building Inspector i i 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 REJECTED DATE APPROVED CONSERVATIO U; COMMENTS �lV ( C I IQ S DATE REJECTED DATE APPROVED HEALTH 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 DEPARTMENT - Temp Dumpster n site yes no Located at 124 Main Street Fire Department signature/date 4+ d COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ��!g O 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 2 1 A–F and G min.$100-$1000 fine NOTES and DATA— For department use d ✓J D � 1 ful VV — ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 I I 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 ❑ 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 eered 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 i Revised 2.2007 =__-�`' ---,�- �.. e. I r� ' i � � � i 1 ��� V -- � ,'� i`�x�• �'' �, a fY ._c �',.� __ f.� .moi i'�i.:�_ Bo t Const ljc"I ngRegulatiou� n Su au ` '�*4e1 L'cehse; pervisor license udards e' t tt-. S ate C, 2115/180582 ! t p�r�hon 974 Restrct�o 2115/2009 MEl ICHq Tri 12298 q ST r, 15G F N S JAN LOWE T ' s r 01852 ' _ CVW,41P, ommissioue Ii y "I t,�}ri .. s R0l NNT: rc #Rerstraf�on x148Tzs X81 - } �c �r rrlotl W200, TYpe .,DBA y ,�0 A 5 :JOHN-IR E rvi.0 i_ 3 E{I.GFt ST M C 852 OnAhu u Rolm,n n n n n rr A& ■ ■ ■ Michael St. Jean Remodeling Quality Home Repair Michael St. Jean workmans comp as well as Liability insurance Ma. Registration numberl32683 Home improvement contractor number 148582 Construction supervisors license number 80582 Phone number 978-479-2154 Contract for Molly Tannatt 127 Beverly St. N Andover Ma.. Phone- (978)-682-0738 Garage Contract We will provide labor and material to complete the following: Tear down and dispose of existing garage, deck, and foundation. Install new foundation. Frame out,trim, side and roof new 14 x 25 single stall garage. Garage will have five windows, one removed from rear of house and installed in rear of garage. A new vinyl garage door with lights in top panel and new motor will be installed. Garage will have attic space with aluminum pull down stairs installed. Garage will be fire proofed to code. Interior of garage will remain unfinished. We will install new concrete floor. We will install new electrical up to code. We will match decorative trim on existing gable end of house. Price includes all permit fees. Price does not include cost of plans. Total Labor and material $35,000.00 Down payment$13,000.00 AziAl,n k-I 1 2"d payment due upon completion of demo and foundation $11,000.00 3rd payment due upon completion of frame$5,500.00 4th payment due upon completion of exterior finishes $2750.00 Final payment due upon completion of job $2750.00 13If,, The Commonwealth of Massachusetts " r Department of Industrial Accidents � , Office of Investigations tr \ u r 600 Washington Street Boston, MA 02111 www.mass.g ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): /YGj`c►1&J Address: City/State/Zip: 'aa o iy! 3L, Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 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 or partner- listed on the attached sheet. # 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. workers' comp. insurance. Y p tY• 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 I l Plumbing repairs or additions 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 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. /am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: -�— w1 •C's Policy#or Self-ins. Lic.#: �� — 0_7 Expiration Date: a Ua @� C�. �j�(� py I ? Job Site Address: g e- City/State/Zip: api�,� Attach a copy of the workers' compensation olicy 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 well 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. Ido hereby certify nder the pains and penalties of perjury that the information provided above is true and correct Si ature: Date: Phone Official use only. Do not write in this area,to be completed by city or town official I i 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 I Contact Person: Phone#: i 10LDLOLO_ 'ON 9NIMVHQ I6 = . i No�1`d���� Cyt c L 0-,I bIla v E - t lsrxa t� FF I • Jo ad :7d1�b W ,%b i I 5 -- - r., . ps a ----- ,1 --j � i 17nfhl��tid'Jv17.� -rn'M SiNI�.p � i I rn o� I I I ;•. I - ,; --- - I , i �• � I� ! 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Foundation /Y has permission to erect................... ................... buildings on .../pn(. ..,�sC. �'. ..J .................................... Rough to be occupied as )P/ �.. . ".. .................................... Chimney .............9!:�: ...�.f.,l .......1.,,r. f.� ......C:3•••�-*L• 11 ney provided that the person accepting this per it shall in every respectMUM form to the termsfif the application on file in Final this office, and to the provisions of the Codes and By-Laws relating 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 CONSTRUCTION ARTS 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.