HomeMy WebLinkAboutBuilding Permit #473-2011 - 127 Main Street 12/9/2010TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: �� �-5 Date Received
Date Issued: / `` � �
ORTANT: Applicant must com lete all items on this page
LOCATION �A"'
Print
PROPERTY OWNER'S AA)A
Print
MAP NO: PARCEL: ZONING DISTRICT: Historic
scene hop Village yes no
TYPE OF IMPROVEMENT
❑ New Building
❑ A-50tion
Rl�lteration
❑ Repair, replacement
❑ Demolition
PROPOSED USE
Residential
❑ One family
❑ Two or more family
No. of units:
❑ Assessory Bldg —
❑ Other
®'°gyp (Well
_ l0�wat_er/brewer __-- -- r—=r•---�_'�' .--.. t.,.- t-- - _--- _ry
DESCRIPTION OF WORK TO BE PER
Non- Residential
❑ In�dustrial
Commercial
❑ Others:
'®Watershed District,
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MED.:
Identification Please Type or Print CIearly)
OWNER: Name: ^% ���Ij � 4 - n Phone:
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Address: /Z % 41.E ,�
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CONTRACTOR Name: 51,0 oar e7l �� ,IGS ��
Address: / l t _ �`� ���
Supervisor's Construction License: 4&63 Exp. Date:
Home Improv2ent License:. Exp. Date: � w.
.i�aJ�� Phone: �1i�
ARCHITECT/ENGINEER36ro -3
Address:ff«���'l� - f Reg. No.
FEE SCHEDUL . BULD/NG PERMIT: $92.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F.
Total Project Cost: FEE: $ �y
Check No.:
�(S'� Receipt No.:7
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
-_ - - - ___-__— _ _ - -____-____ ___ _�.x_'::.c._--_—_�:-yeti �v:.'.+�„_::..-.-y--_ _-___— ___— .:�.1• `l
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Plans Submitted k 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
CONSERVATION
COMMENTS
HEALTH
COMMENTS
Reviewed on Signature
Reviewed on Signature
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:
FIRE DEPARTMENT - Temp Dumpster on site yes Locatedno384 Osgood Street
Located at 124 Main Street
Fire Department signature/date
COMMENTS
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:.Buildiag Permit Revised 2008
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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
(VOTE: 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
d®TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
1 all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
la t the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
list be submitted with the building application
Doe: Doc.Building permit Revised 2008mi
kan1l3,n1
Location J.T ,7_Oa/%U .20&,o
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No. % `.;2v// Date 12 °
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TOWN OF NORTH ANDOVER
O: t.•o ,• 11.0
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Certificate of Occupancy
$
JcMustt�
Building/Frame Permit Fee
$
Foundation Permit Fee
$
Other Permit Fee
$
TOTAL
$
Check # �/rS7/
23712
6
Buif ing Inspector
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CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number 473-2011 Date: JANUARY 28, 2011
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 107-127 MAIN STREET, North Andover, MA
01845
MAY BE OCCUPIED AS BLDG. G1 AND G2 IN ACCORDANCE WITH THE
PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER
REGULATIONS AS MAY APPLY.
Certificate Issued to:
Fee: 100.00 previously paid
Receipt: 23772
TINA MESSINA
SAN-LAU REALTY TRUST
127 MAIN STREET
NORTH ANDOVER, MA 01845
Building Inspector
404 Middlesex Road — Suite #1
MA
�" "' Tyngsboro, MA 01879
Phone: 978-649-8570
BUILDINGDESIGN,Fax: 978-649-8572
www.marlowedesign.com
AGREEMENT
The following is hereb &ntered by and betw en MARLOWE BUILDING & DESIGN, INC. hereinafter called
"company"and J located
at: ��1 City/State: > Zip:
Ph: Bus. Fax Ph:
hereinafter called "buyer," this _day of , which is the date the transaction, it being the day which
this agreement is signed by the buyer and the company.
1. That the
wit:
Item 1
agrees to furnish and install and the buyer agrees to purchase the products and serv' s hereinafter described, to -
42:z $ a�? i
Item 2 $
Item 3 $
3.
4.
6.
8.
9.
10.
11.
12.
Total Purchase Price
Less Deposit
Total Due:
The company shall not be responsible or damage or delay to strikes, fires, accidents or other causes beyond its reasonable control. The
company carries Workmen's Compensation and Public Liability Insurance, but does not assume risks of any other character under this
contract.
The buyer upon signing this contract represents and warrants that he/she is the lawful owner of the premises. The buyer further
represents that there is no restriction of record, easement or covenant prohibiting or restricting or requiring the consent of any other
party to the work to be performed pursuant to this agreement.
If the buyer shall be in default under the terms of this Agreement, then the company shall have the right, it its sole and absolute
discretion, to suspend any and all efforts set forth herein. Failure to exercise this option shall not constitute a waiver of the right to
exercise the same in the event of any subsequent default. The buyer shall be responsible for all reasonable attorney's fees and collection
costs incurred by the company in enforcing the terms, conditions and/or collection of this Agreement after default. The buyer agrees in
advance this agreement was deemed to have been entered into at Tyngsboro, MA.
Company agrees to perform all work in a workmanlike manner. However, in the event of disagreement as to manner, method of work,
meaning of specifications or material, the customary practice in the industry shall control.
Buyer agrees to give company access to the premises at all normal working hours for work; and failure to do so shall constitute a
substantial breach of said contract.
In the event that upon start of construction it is discovered there is any latent defect and/or rotting or decay or damage caused by
termites, or other infestation, due to any other cause necessitating replacement or reconstruction, or if changes to specifications are
made necessary due to local building code requirements, then in that event, there shall be no obligation or responsibility on the part of
the company to supply any labor or material nor to reconstruct the damage. The buyer shall pay any additional sums required for the
labor, materials or supplies to replace or rebuild said area or to meet local code requirements. The sum shall be in addition to the price
set forth in this agreement.
Company is not experienced or equipped to neither recognize nor handle hazardous material including but not limited to Radon, nuclear
waste (UFF1) or Asbestos. Buyer certifies that no such materials are known to be located upon or in any structure, which is the subject
of this contract.
If more than one person signs this Agreement, each person is fully and personally obligated to keep all of the promises made in this
Agreement, including the promise to pay the full amount owed. The company may enforce its rights under this Agreement against each
person individually or against all together. This means that any one of the signers may be required to pay all of the amounts owed under
this agreement.
The company assumes no responsibility whatsoever for the care, custody and/or control of any and all pets or animals.
Every change order shall carry a $25.00 administrative fee, together with payment in full prior to the start of work.
Attached hereto and incorporated herein by reference is the company's LIMITED WARRANTY.
BUYERS RIGHT TO CANCEL. If this Agreement was solicited at a residence and you do of wan the goods or services, you ,
the buyer may cancel this transaction at any time prior to midnight of the third busine day aft the date of this transaction.
See the attached notice of cancellation form for an explanation of this right.
MA O . I IN DESIGN, INC.
By
3 u y uthorize
Buyer
Buyer (tear on dotted line)
................................................................................................................................................... .
NOTICE OF CANCELLATION
DATE OF TRANSACTION
To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice
or any other written notice or send a telegram to MARLOWE BUILDING & DESIGN, INC., 404 Middlesex Rd.,
Tyngsboro, MA 01879 not later than midnight of
I hereby cancel this transaction.
Date
Buyer's Signature.