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Home My WebLink AboutBuilding Permit #732 - 133 PLEASANT STREET 5/7/2007 t&ORTH BUILDING PERMIT 0 'LSD 06�~o TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION e Permit NO: Date Received '1)9.0 ^r,p'Pa`��y SSACHUS� Date Issu�F d ✓✓✓✓✓✓ IMPORTANT: Applicant must complete all items on this page �I a -&' : G` �; k y yi p 3' , y �I_ �C INS a OF z � Via. &-- r rag 0-01, ex— TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial y r ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other a zn �� " { t� Ut(�IFloodp] icy sUU taEids y Ulratersh Y Y,c. �i,:/tear trli, 7 Y a ,a t" s ✓fir'`', .5. : , y DESCRIPTION OF WORK TO BE PREFORMED: r Identification Please Type or Print Clearly) OWNER: Name: GRID, Phone: Address: �-eatk/, Y V\ a 111 10 � 1,NN 1" 1 .� a�� s � r ,e r WAIR rr e P j f ' ' VNA n y n s it Slt ?t' (5 ill1{ :1GeI�S#;' �! 1X7� lr ✓ i � y �E P li ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMI'T:/$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $a0�a041 Check No.: `� - Receipt No.: c2yl�� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund AllE S grtrtue�ofAgen /twne :' a$ S�gr�atureofontctar ry i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL = ` ❑ Tanning/Massage/Body Art ❑ Swimming Pools Public Sewer ❑ 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 HEATH ❑ ❑ COM# ENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes I Planning Board Decision: Comments t I Conservation Decision: Comments - Water & Sewer Connection/Si nature& Date Driveway Permit Located at 384 Osgood Street 'FIRE'DF ARTMEIp-TIN, Aster on S yes PYX nom , LoCtci at�2 aln Street's xOak �/' �' �i w Fire,�Qepartxnent sllgnat�ureldate 4 � a. ,'- :�: -"'.�� '; •..: �,.•,.. - • ' =�:' 'F� �•�'`- �,�, .ate r�r 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 4 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 Permit 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 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 o 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 L3 Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o 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) a Building Permit Application a 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 Revised.2.2007 Location _ No. ��'"- Date MORTq TOWN OF NORTH ANDOVER + Certificate of Occupancy $ 'l'�s'•••° '< ildin Bu /Frame Permit Fee $ scMusE� 9 Foundation Permit Fee $ Other Permit Fee $ Ht TOTAL $ k- f Check 20"► 94 v Building Inspector NORTFI Town of 0 No. �- - LAKE o , dover, Mass., 3 COC NICHE S WICK y�. 7� RATED P'P�,��S BOARD OF HEALTH PERM -IT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... ... ........�a.h. Q........Af ..... ................. Foundation has permission to erect..................................... b 'dings on I.? .......00.404 1ftT.••....4 it......a............ Rough to be occupied as s y Chimney ........ ...... .... ..................... ..... . .. ... . ................................................................................ provided that the person accepti this permit shall m every r ct conform to 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 MONS ELECTRICAL INSPECTOR UNLESS CONS`_RU ' ' S�' Rough ......... ..... ................................................................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done I FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. ' C.\ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/individual): —7Z-0 6\, F 0'(L('`jt c-,A _z-o C r Address: rza oyA, Wct_ City/State/Zip: Phone#: ')8-( - 6 b 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. 0 New construction employees(full and/or part-time).* have hired the sub-contractors 2.E3 I am a sole proprietor or partner- listed on the attached sheet.x 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. workers'comp.insurance. 9, ❑Building addition [No workers' comp. insurance 5• UV We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers'comp. c. 152,01(4),and we have no 12.0 Roof repairs insurance required.]t employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#I 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: Policy#or Self-ins. Lic.#: (r)Q0 -S-<o !/CKq.1 CL-� Expiration Date: IF0 Job Site Address: 1 3 ,2&MZE7`� City/State/Zip: N, 44 JzEe (— 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 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. I'do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si nature: Q Date: <S- Phone#: Official use only. Do not write in this area,to be completed by city or town of iciaL 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#: PROM FAX NO. : 7812721395 May, 02 2037 0a:58P1 P2 Ih 4:c`i•—Ctlf W%k r�"� 4";r_. ;�',, bF ..l UHHt Ur'.W J.EN e104 tC.54 P.L:11 John F. O'Brien INC. Prapnal 3 237 Trapelo Road WuitD,am,Ma.€32452.6: 17 Te'.781-936.4057 1�a*,�:.April 30 t Fam.781.209.0659 k ,lab Dxuion: 133 Fleami;sct. Bill Ta�c:3� N' rth Andom MA. 11 Motalson lyd- M 0184 i EurlinWn MA.. 01903 1 We,Hereby submit Specifications ants,astir.gtes For. s e strip c faro roof r Ir► mU alumisam drip edge on perimeter of hOusC IststLiI sir,frit of ice and writer shield e instdil 30 lbs felt pwr sill ridge.`gent • 1 stall new pipe flanges CE all Pipes • Itstall'13*car Cc-ruLintced for 30 year G.AY,architectum. 1,shingles can antire roof I a pmvide dutnpstcr aacl ren-inve ail debris created by its Total $8400.00 All workrr,-Anship gwara.�tteed for til years a i f terig1s;and lab& ^- tete In accordance with above ipeaificatiobs.for.the sora W rr;:i�w rc se to fUrnish e.,1 rano ,� p e h p� . P ' of $42� ._��dall,ars I i with payment to be made as foilowa:,-mac G9• � i tL 4i1 rasarerlsi icy�ueranteaci to :ai gpeci>-ied-nli work is to lie ccmrpkWd iia a workaMblikc manner according to standard practices.Any elterativn or deviatloe+froom Gpa lflc�titmc involving e.wa assts will be executed up an er it*--u orders,and will bcs4fare m exrra crntxge rarer and aNwo the estimatc-all agrc=ents cpntingOnt upon stKkes,ecci&rits or de`aya beyond oar ` conurnl,Dar workers are all eovemd by wvorker's COrr3pensatiM lame MCC A:rh, tios;;ignaturc: Nola:rMz proposal zw)r be wit1a&3Fn in not acceplal wotlziry 10 days---- — - weput"�-�rbove prices.Spec-1ficatlona anal c mditioni aro herby acccpfod.Yau ace authvo to da the fwork as spwMcd-P r{rx :t wlil lsc+rme'e as oudinod Ahow.. sigt�,t»: ! Ewe o°Ac ceMncc, I MAI`, 4, `,0l1,-/ 8, 3 04 IN 0 (11 8 2112"..------ DATE mill" Easlwn lrs3iirarce,Group I.Lc, THIS CEPTfj;jcATj3 Is ISSUED AS A MATTER OF INFORMATION, GNLY A114D CONFERS NOR1014TS UPON THE CERTIFICA71- T-141S CFRTJFfC�AT AEND.EXM.ND OR ALTER THE COVERAG2 AFroFi)E0 BY E 2-11 DOES NOT AN HUDER. Natick,MA POLICIES BELOW. THE COMPANJES AFFORDIN-(3 r, VF p , -0 AC3E 97 Traplo Rd COMPAtNy A AIM.Mutual T�,Ls-u.,ance Co 'r,rp.� W,0111,I1.11. NIA 074Q OLfC.1a Ell PERIOD INWIA I No ME st)RANCI LISTED 8-LD It ET T!5! ,.,.\!o-WITHS'l ANDING ANY'PEE R: 75 Wj-jjC,H1 7 HISCEklIFICATE MAY RP,j5Sjjj;D Op,- IRWENr,TERM,OR CONDfTION OP ANY CONTRACT Ot', I��f,L AFFO'U.)EE,BY T HE P01,101 1.8 D. CUW'NT WIT14 kIFSPECT MAY?ERTA1,N,THZ,NISURANCr -R DO S,EXCLUSIONS AND CON DiTfi)NS OF S UCR POLICIF-, CR!8ED 14FUI\Is C,D [ I K� S.LIM71S SHOWN MAY;,�AVF laEaIREDUCED 5y DA141D CLAIM& titt, 1,vprl,)F INS OUCYIMPIRATIMN SATE la.NZY)"T nA'I`U(N&fiDb,%-,,i t•FN AG;:Ki;rA'f. `jj-Nt.%A'-I.:AWL.I 7— PSKmc-,1'!AL&ADV.fm%Te., c,)NrR,�C:VD191A11i C)C.*CURR:rNCa '71 VANIASE art FXPIX L A.NVV A 07',5 yQD!L V VIOURV H" 'M, I r 0.A 1,71 C'I S sorjjLy tNrljpv 'V'JA5 (AIIIWTV , IOFHRTY D1 _ACC..M � rORM BACH 1--ti,P R 1, OMFE,"04A-110N,AND 14 -MPI.OVFAS L1,10ILJTY I l Y A LKCIENT'L TW: FICIFPq Ar�z Ll Ee\CI-1 AC'IDE, i600564700120o- 04/19/20 Ci7 04./I9(2008 00.00) DISRASE-K)LICY, Lw—M - m ROULD Op T. YE qS,411 IN(% JH zo RIS agEDPOLiCTES BE CANCrUED REFO,-1�THE EXPBLATJOW 1—)AT�d OLORif SLITNO COMPANY Wit,L LNI)PAVOR TO MAil 'LIrlIN NO i=G TO THE CER771CA:11 �T A� To 'M THE L7FT.BUT FA IWIZE TO MAIL j-Wr OR LIAAIL ITY OF ANYKIND UPON T1 fr.-:C 1�()T'CE SHAU INIPOSF NO OBL!GATION 971 MAIN ST COMPANY.jTS A�-ENTS !A 0TROPIZ0 kLPRF-qENT I 4 i --f a i ;JfLE 'f0047t//)t07t[!/ 40CI.6Cb icense or registration valid for individul use only Board of Building Regulations and Standards L HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration::.141060 One Ashburton Place Rm 1301 Expiration:-1/2/2008 Boston,Ma.02108 Type: Private Corporation JOHN F.O'BRIEN 6NG tee,.. / JOHN G,3RIEN ---aT 257 TRAPELO RD Not valid wi hoot signature WALTHAM,MA 02452 Administrator