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Home My WebLink AboutBuilding Permit #161 - 135 BOSTON STREET 8/29/2007 ,AOR 3 `"r.0 q L BUILDING PERMIT ° <��E "o TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received �9s RATEV•P��4`� SACH�1`� Date Issued: IMPORTANT Applicant must complete all items on this page ONU LOCATION MA 1"NO .. PA E'L� ZO I NG DI 'CR 1 l� fo�i flistrlct eyes rao k Tle Shop Vill: TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: o Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other SepttJVell 4 �" � �x �l�fladdpl�m ` f W�etlaads I ateshked District 'r t f DESCRIPTION OF WORK TO BE PREFORMED: 5 , Mt a � Identification Please Type or Print Clearly) OWNER: Name: Phone: Address CQNTCTOR :lar :� r hole 4' ib- FW M- y Super�ulsor CQbst1-u-, I � 7 1s� Y d sXatlwvx ARCHITECT/ENGINEER Phone: 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: $, 60C--) FEE: $ Is Y Moe rcY Check No.: lS�.� O Receipt No.: )e) , NOTE: Persons contracting with unregistered contractors do not have access to the ar Signature of Agent/ wner ,Signature of contractor . Locationl -> - No. r Date � - n HOR*M TOWN OF NORTH ANDOVER 0� ...a � 9 • ; : Certificate of Occupancy $ E4�' BuildinglFrame Permit Fee $ � s�cHus — e Foundation Permit Fee $ Other Permit Fee $ A" TOTAL $ Check # 205 : 7 Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swinvning 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 F1 ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ . ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ y COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer C91ineption/Signature & Date Driveway Permit Located at 384 Osgo S rebt FIDE DEPARTMENT Temp Dempster ren slte yeas s no Locate&b 124 Mam Street -------- ) �reDepartmen:fi s>I nature/date K OMIVIENS = , 411 s a 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 ❑ 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 ConstructionSin le and Two Family) � 9 ❑ 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 Revised 2.2007 NORTH Town of dover, Mass.,-6 T Q 5=-- LAKE COCHICHEWICK X1,95 RATEDuP�,��`� BOARD OF HEALTH Food/Kitchen PERMIT T D 0 Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... .... ...j�!G..............S ..�.'.(�....� V � .......................... .................................,.............. Foundation has permission to erect........................................ buildings on ...la ....... .r .............. ...................... Rough to be occupied as............F..��AI.....C. r.............. u�....... .�......� Chimney e provided that the person accepting this permit shat n every respect co rm to the�tethe 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 PERMff EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI ARTS Rough Service ............................................ SPECTOR 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. 1 :7-�ie i�ay�yrea�tiuea�e p�✓�2�aaaac�uce ` t3gartl of ButlUing llegulatio,ns and StantLhrc��F ' '• HOME IMPROVEMENT CONTRAd-TOR Registration x,151818 ' ExR irattorF J 7/5/2008 . 3 T i Type Private Corpgration CPQ i=L A LUifASiHOME IMPROVEMENT COIF [WITRIOCS KARAGIORGOS t 01841' ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 s� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Indio ual): �r? C,( ��( ".4 C(�f Address: City/State/Zip: I'tiJC C pAA,kA-- 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. + E) 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 I0.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 1.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ 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: C"y//-f c- S i'll 1.res Policy#or Self-ins. Lic. #. -- Expiration Date: Job Site Address: p 0 .*Ll& I '-�1 City/State/Zip: IKAJ hot Ir Attach a copy of the workerscompensation 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 tip 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 andpenalties ofperjury that the information provided above is true and correct. Sip-nature: Date: Phone#: 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#: Samuel 4 Lukas Home Improvement Corp. 91 High Street Lawrence,MA,01841 (978)618-8083 (978)683-7573 MA Contractor Registration ID: 151818 August 17, 2007 To: For work performed at: Joe Sergi Same 135 Boston, Street North Andover, MA (978) 688-0368 We hereby propose to furnish materials and labor for the completion of the following work: Specifications 1. Existing siding and trims of windows and doors will be removed. 2. These areas will be prepared for new vinyl siding. 3. House will be prepared with Tyvek. 4. Cedar Impression siding will be installed. Customer will choose color of siding. 5. Asiac trimboard will be used for all windows and doors. 6. All trims around eves of house, rakes, and window sills will be completed with new aluminum and necessary soft-fit panels. 7. Gutters will be removed and replaced with new gutters after completion of siding installation. 8. Replace existing shutters with vinyl shutters. Customer will choose style and color.�r�� C-;pw,47 Joe Sergi Siding Page 1 of 2 Samuel*Linea#Rome lmpmvement Corp. 91 High Street Lawrence,MA 01841 (978)618-8085 (978)683-7373 All material is guaranteed to be as specified: first five years material and labor. All workmanship is guaranteed to be for a period of 1 year from date of completion. All work areas are to be kept clean by contractor. All insurances are to be carried by contractor. Contractor is responsible for obtaining necessary permits. Total cost of all labor and materials is $13,000. $1,000 is due upon signed contract. $3,000 is due upon starting and remaining payments will be made as job progresses and any balance is due upon completion. i p Respectfully Submitted, Dimitrios Karagiorgos Acceptance of Proposal The above prices, specifications, and conditions are satisfactory and are accepted. Samuel and Lukas Home Improvement Corp. is authorized to do work as specified. Payment terms are accepted and will be made as outlined above. Signature Date �4�/1) Customer Signature Date Z President of Corp., Mnitnos kiragiofgos Joe Sergi Siding Page 2 of 2