The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #302 - 134 BERKELEY ROAD 10/18/2007 pORTN BUILDING PERMIT qti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received /�• �SSACNUSE� Date Issued: 7 IMPORTANT:Applicant must complete all items on this page OCITION _11 J , _"'"_6 +s a ap �x z�'OPERTY OWNER N ,a h r ; .,nnt ,ia- x '� x tF:xt. 6iz r xr•{r .. 1 t r 'rz. �7IAP10'" YAELA x �N NG 1�1T�ICT �' 1-1isonc District deco „ Machine>Sh"--------------- flage ,des rao F TYPE OF IMPROVEMENT PROPOSED USE T. Residential Non- Residential New Building One family Addition Two or more family industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other r Septic Well a1FJoDtlplalnletiarads W 4 , atershed`Distract . 17afier/ ererr DESCRIPTION OF WORK TO BE PREFORMED: K"�tc�tfu tbcpfvl�3 9K 0.466-e ewfl—i ` L 114Pel' A 'E Oft Identi kation Please Type or Print Clearly) ! ~ OWNER: Name: W0\JA e, 9d0Jdf&)V Phone: Address: Aerkicydl .,t Y F -� a r IQ �+,"_Y ,xhs- CONTRACTOR Name k aphoe .. ' dtle. ss r T"Jprne`Improvernerat��cense ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unreg1*01red contractors do not have access o t e guars fun Signature of Agent/Owner - Signature of contractor _ _ . i f �/ Location/.3Y •C f / � No. 0 �- Date �oR,M TOWN OF NORTH ANDOVER F. S t Certificate of Occupancy $ sACMUs t� Building/Frame Permit Fee $ 7 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # !� 20708 `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 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 \Q DATE REJECTED DATE APPROVED HEALTH' COMMENTS i Zoning Board of Appeals:Variance, Petition No: Zonin Decision/receipt t su �, p omitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connectionlsignature&Date Driveway Permit Located at 384 Osgood Street , t=1RE DEPARTMENT Temp Durnpster on site yes' no Located at'124Main Street F�re4 epartment s�gr ature/date r 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-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. 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 a 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) o Copy of Contract ❑ Mass check Energy Compliance Report o 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 lite 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): A G Yt-SCX aeAt_�oWt. Address: � ,Edoelfiwt:51- A--rf A oe6,3� City/State/Zip: /`/'T � Q3 3� Phone #: Are you an employer?Check the appropriate box: Type of project(required): 1.U?"'lam 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 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 10.0 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 12.0 Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#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: k55 ,N_5 Policy#or Self-ins. Lic. #: Expiration Date: �S Job Site Address: City/State/Zip: 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 under the ains enalties of perjury that the information provided above is true and correct. Signature:' Date: Yb11 716 Phone#: LCO R� 61 DZ 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#: NORTH 0 of 6Andover 0 No. 0 LAK odower, Mass., COC HIC HEWICK Vot Ao �d ADRATED 7`S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System &%* ^r, .... BUILDING INSPECTOR THIS CERTIFIES THAT..... ............. . /�i�.............................. .... X ............................. Foundation has permission to erect................ ...................... uildings on ...`3..q........ ....t...... ... .... ..0. Rough to be occupied as.........,�� I.. ...... ... r.�.�ir.,�........... iIJ ........... . . .. ................. .. .. �►o himn y C e provided that the person accepting this permit shall in every respect form to the terms tithe application on file in Final this office, and to the provisions of the Codes and By-Laws relating o 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 14k PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS.'CONSTRU N STARTS Rough Al ......................... Service BUIL 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. ti A. F. Watson General Contracting Estimate 3 Edgemont Street Derry,NH 03038 DATE ESTIMATE# Tel. 603-437-6134 8/21/2007 1342 NAME/ADDRESS ' Mr.&Mrs.Wayne Gendron 134 Berkley Road North Andover MA 01845 TERMS PROJECT Due on receipt Kitchen ITEM DESCRIPTION QTY COST TOTAL Permit Town of N.Andover building permit fee 19 13.00 247.00 labor Carpenter's labor 148 42.00 6,216.00 Materials Miscellaneous Materials 1,500.00 1,500.00 Windows Pella Window Allowance 3,000.00 3,000.00 Plastering Plastering 1,500.00 1,500.00 Electrical Electrical 1,500.00 1,500.00 Plumbing Plumbing: 2,000.00 2,000.00 Floors Kitchen Flooring 1,200.00 1,200.00 dumpster 15 Yard Dumpster 450.00 450.00 Subtotal labor&Materials 1 17,613.00 Cont.fee Contractors 10%Fee profit+overhead 10.00% 1,761.30 Note The Above prices are estimated and will be adjusted to 0.00 actual costs. THANK-YOU A.F.WATSON TOT w /�1 $19,374.30 OWNERS SIGNATURE SIGNATURE CUSTOMER: DOOR STYLE: SHIP TO: PARTS: PARTS: PARTS: WAKEFIELD WAYNE& ROBIN 134 BERKELEY RD. 6-CCROWN8 2-TEP3093 1 -WAINSCOT D/FF GENDRON WOOD SPECIES: NO. ANDOVER, MA 3-TBP8 CUT TO 84 1/8"X 34 1/2 1-978-794-0945 CHERRY 4-TKS8 29" D. BACK OF WORK SOLID GRANITE 3-SCRIBE8 x AREA PENINSULA CEILING: 90 1/4" STAIN COLOR: COUNTERTOPS: 5-FB8 88 1/2"H. 2-DOOR-N AUTUMN 1 -WF636 4-DEK1236 12"X 30" 1 -DOOR-N END OF WORK 23 3/4"X 30 1/16" AREA PENINSULA 1362" FOR THE DW 1 - 1/4 PL 30"x 30" 3312"— 44" 59" 32" 232"T232" 572" BCW3036L W1 836R W3936BD CABTO -W3D2448BD COUNTER SBLC36R SBLC36R MWRH46" � MBO6W DW MBO6W (2 DRAWERS) M w 39"X 39"X39" MWFDEL MWFDER 2-GPREPA W SB33SFTFWDBD 1 -CUSTOM MBWSP-L OVERLAY b) O MBWSP-R O C W PANEL FOR rn mN CSN THE 00 � 2-PILJ25-34 1/2m m V BEVERAGE m m �u�u w REFRIG. N D co m �W 03W 2-DOOR-N Or.�Ttm m 2-WFO6-36 W 00 12"X 30" o�, H UPPER L END OF O r co O CORNER BAR AREA N 2-SBM8 AREA PENINSULA FACE OF THE 1 -WAINSCOT DIFF m REFR SIDE INSTALLATION 70 1/2"X 34 1/2" PANELS NOTE: BACK OF BAR 2-DOOR-N PENINSULA 11 5/8"X 30" SET UPPER 1 -WAINSCOT D/FF LEFT SIDE CABINETS 18"X 34 1/2" B18FHDR OF B24ROTSBD 88"+/- BACK OF MBESRI 1/2 1 -DOOR-L A.F.F B18LFHD 2ROT18-1 16 11/16"X 16" R/BAR REF 1 -DOOR-R 16 11/16"X 16" RW3618-BD Co OC315-90M-B Co MTWSL7/8" MWESL1/4" _ N MWESRI/4" `'X;t o0 MTWSR7/8" MWSI OWCO—� MTRH88 " 5-TDI N O w Design by: 0 Michael James Design 1-978-689-4724 Xa"od&ad ' R iJC� tT�1'u:. ASH pF �cy� PROFESSIONAL P_o. soot mesq STRUCTURAL ENEERING L~STEAD.NH 038? ` oma' `�� DESIGN SEANGIVICEs ALVATORE J. (603)32MM ,,% CZ�Un 20►.� QES I v�.�.x.E FAX(603)329-64MMRESVENT1AL 4 i`1v. L1�apo�Cdt Mq o FClST[ FSs�CNA TITLE E�G\� . A 1 Sots C-tE1�1EiLAL, Laa(L EST) No. JOB's SUBJECT �A T - SHEET No. -0 DESIGNED 8Y DATE �.�a1...-CRECLED BY DATE..�.� d d' SOL.D Sdc.�D Alog'4 %^c-v- To I Act- To SoUnt SEMkA ria�.w QaEaPI��►!G� . 11�tAt.�.. Q.rc.QL.�AGt MEt�t O PSLAM : ��A 1Jtz l.t-1M d' - 3,1S14xC014'LVL �t=1CLT►InL_Peau-M�t N LEIJ%L SCAVE'. MtQf- .04 WA ZTyk. PROFESSIONAL h4gs��Cy. STRUCTURAL ENGINEEFUNG P.O. BOX 958 E.HAMPSTEAD' 03NH 826 f SALVCAToC qE G� DESIGN SERVICES (603)329-5540 �UdTU�t�I FAX (603)329-6406 RESIDENTIAL•CO IALNI �9fCIS1ER TITLE 4 "i LA �fFSSIONA EST.� J 0 B SiTBJECT �. + C.�- N • SHEET N0. DESIGNED BY DATE-7"167-CHECKED BY DATE... VWJ,i I —, tr_,A�, \Q\wa 1Atk---t L-6 Jew t k.k 61 SQ�fLr- l�t:•1.�1�1 wG t� 4 ° 615`