The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #185 - 14 SARGENT STREET 9/11/2006 TOWN OF NORTH ANDOVER TF/ APPLICATION FOR PLAN EXAMINATION opt NOROR ,61tio Permit NO: ✓ ' Date Received / —11r�� * s coc— Date Issued: a0 4rffC 9SSACHUS�� IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNERIy� (' Print M � AP NO.: ?5 PARCEL: d ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑ ,Addition Two or more family v Industrial Alteration No. of units: Repair, replacement ❑ Assessory Bldg Commercial = Demolition Moving(relocation) ❑ Other C Others: E Foundation only DESCRIPTION OF WORK TO BE PREF RM D s 9 Identification Please Type or Print Clearly) OWNER: Name: d Phone: S Address:-L-�x 4 fa�/—(I 43Z/7 CONTRACTOR Name: Phone: - lf! 3 !o Address: Supervisor's Construction License: -7"��6 � Exp. Date: �� Home Improvement License:,ZD 3��8 EYp. Date:-7—(/1 ARC HITECT;ENGIINEER � Nal11e: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.•$11.00 PER 51000.00 OF THE TOTAL ESTIMATED COST BASED ON 5125.00 PER S.F. Total Project Cost :$ cry FEE:$ Check No.: /�� Receipt No.: �� J TYPE OF SEWERAGE DISPOSAL F-, Swimming Pools r Tanning/Nlassage/Body;art Public Sewer ' Tobacco Sales '11 Food PackagingiSales Well - Permanent Dumpster on Site � Private(septic tank,etc. '^I Electric Meter location to project ;MOTE: Persons contracting with unregistered contractors do not have access to the guarmity fund Signature of Agent/Owner —�t -�' Signature of contractor Plans Submitted ❑ Plans Waived i Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION El COMMENTS DATE REJECTED DATE APPROVED b HEALTH ❑ ❑ �i COMMENTS Zoning Board of,-appeals: Variance, Petition No: Zoning Decision;receipt submitted yes— Planning.; Board Decision: Comments Conservation Decision: _Comments Water&Sewer connection,Si nature& Date Driveway Permit Temp Dumpster on site yes no__ Fire Department signature/date I I i Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use) I'agc± of-I I Doc I�;.SIII C IIONAi_si.izvIC'LSDGPARIMH4r13PFOkNW c'1,.jtrd.ICK'.Jan:UUh I 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 ❑ 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 Addition Or Decks I ❑ Building Permit Application ❑ 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) 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 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 0"V:INSPECTIONAL S6:RV1('PS UEPARTNII{N 1AWFORiM05 I i 10/06/2005 12:31 617 796 0110 4 17813444475 NO.533 9002 ACORD CERTIFICATE OF LIABILITY INSURANCE CSR DM DATE(MMUDD/YYYYI FAMHO-1 10106105 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Corkin insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 180 Wells Avenue HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Suite 301a ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Newton Center MA 02459 Phone: 617-796-0111 £ax:617-796-0110 INSURERS AFFORDING COVERAGE NAIC0 INSURED INSURER A. LIBERTY htfTAL INSVtVwCE CO, 15628 Family Homes Inc. INSURER B; Todd Finestone INSURER C: 247 Washington S7. INSURER D: Stoughton HA D INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWrfHGTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY Be ISSUED.OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITION3 OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INS TYPE OF INSURANCE POLICY NUMBER DATE(MMID DATE MIA DDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE 3 COMMERCIAL GENERAL LIABILITY PREMISES knee) B CLAIMS MADE D OCCUR MED EXP(Any one person) S PERSONAL A ADV INJURY I GENERAL AGGREGATE f GEML AGGREGATE LINT APPLIES PER; PRODUCTS-COMPIOP AGG S POLICY %coi LOC 1 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT f ANY AUTO (Ea atcidonl) ALL OWNED AUTOS I BODILY INJURY I SCHEDULED AUTOS (Pa.person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Pe(accident) f PROPERTY DAMAGE 1 IPcr Axlderu) rAG ELIABILITYAUTO ONLY-EA ACCIDENT I NY AUTO OTHER THAN EAACC I AUTO ONLY: AGO S ( EXCESSNMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE I i i DEDUCTIBLE f RETENTION f 1 WORKERS COMPENSATION AND TORY l!M S X ER A EMP LOYERS•L1AelUTY ANY PROPRIETORIPARTNERlEXECUTNE WC-5319-31211.9-014 09/22/05 09/22/06 E,L.EACH ACCIDENT 1500000 Has. s.dRMIEMBEREXCLUDEOT HEL.DISEASE-EAEMPLOYEE 1500000 I Ir ree,tivxribe undo. $TECTAL PROVISION$below OTHER E.L.DISEASE-POLICY LIMIT 5 500000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS i I j CERTIFICATE HOLDER CANCELLATION ASSURED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN TODD FINELSTONE NOTICE TO THE CERTIFICATE HOLDER NAMEO TO THE LEFT,BUT FAILURE TO DO 50 SHALL IMPOSE NO OBLIGATION OR LIABILITY 0 ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 1 Michael R. Cork' ACORD 25(2001/08) 0 ACORD CORPOftATION 1988 (603)432-0530 i i i i I Mark Little I Proprietor l/We the owner($)_of the premises mentioned below, hereby contract with and authorize-: ML installation, (hereinafter referred:to,-a :s'the`Contractor") to fumish all necessary materials, labor and workmanship,to install,oonstruat and place the Fmprovemerits acx;Ording to the following specifications,terms and conditions on premises below described with reference to whioh Vwg warrant.that[�[AVG** areIsrecord holderLL(o)I-of titre;Owner's Owner's Name /y/Mid �� P7.s� "/,79lj91lU� Z1 Tel. Job Addaess`-7 city- 1' i;Jew State SPECIFICATIONS: P die-5 slid 1 �i W� 14_1 9 421:1G!, h / L s IF e Av,, .L b In consideration of the labor and materials fumished by the Contractor,the Owners)agree(s)to pay the Contractor the sum of Depo'lt=to exceed 33 1/3%5-`fir l�DA 1 ) Balance Due$ J��'LS'� Est. Start Est. Comp. Security Interest Yes O No O It shall be the obligation of the Home Improvement Contractor to obtain such permits as the Owner's Agent.The Owners who secure their own construction-related permits.or deal with unregistered Contractors will be excluded from the guaranty flhd provisions of MGLC, 142A. All Home Improvement Contractors and Subcontractor;shall be registered by the Director and that any inquiries about a Contractor or Subcontractor relating to a registration should be directed to: Director Horne irnprovement Contractor Registration One Ashburton Place.Room 1301 Boston.MA 02108 (617)727-8698 THE OWNER SHALL PAY FOR THE WORT{BY THE FOLLOWING METHOD: CASH UPON.COMPLETION( ) BY MODERNIZATION LOAN( ) Notwithstanding acceplanoe of this contract by Contractor,this Contract shall be cancellable by theContractor If the home owner In unable to finance the payment of this Work through an established bank or other financial institution or within fifteen(16)days: All work performed by the Contractor is fully covered by Insurance. NOTICE TO THE OWNER(S):If It will be necessary foryou to obtain a bank Modernization Loan in order to enable you to pay for said improvements. 1.Do=sign this Agreement before you read it. 2.You will be given a Completely filled in copy Of this Agreement. . This Agreement constitutes the entire agreement of the parties and no other agreements, representations and/or warranties, expressed or Implied,shall be binding on either party hereto unless in writing and sigtion red by both parties.Any alteration or deviation on the specifications listed above involving extra costs of materials or labor will be furnished and performed only upon written order tion will be in addition to the cost price of this contract. The Owner(s)hereby certlfY(Ies)that he has(they have)read this Agreement,that the terms and conditbns and the meaning thereof have been explained to him(them)and he(they)fully understand(s)them. The Owners)acknowledge(s)the receipt of an executed copy of this a Agreement A reethe time 9 t me of execution hereof. If any provisions of this agreement are In conflict,with any statute,regulation,ordinance or rule of law,then such provisions shall be deemed null and volt to the extent that they may conflict therewith,but without invalidating the remaining provisions hereof. COMPANY'S GUARANTEE: The Company guarantees Its workmanship for. dyears. It will replace efeclive.materlel within the period of guarantee free'of charge.All requests for services must n writingt This agreement maybe cancelled by en officer of the Contractor,but only within three(3)busin=g day*front the date of execution and In a similar manner of the Owner(s)'right of eancellattom You may cancel this Agreement without any liability to provided the third business q -following fast you send a wr{tten"tics to the Contractor by midnight of ay g your signing pf this A�1grGaemerrt,by ordinary matt, dated.by telegram,or soot by delivery. WITNESS our hands and seals this alb day of 20� (SUBJECT TO VPIVI FFICE PROVAL) r� r By: r/ r epresen rve ner . � C�.D ,�la, '�un2�rtuxtuo.�tGC� u�:�11a,�1ttcludell6 � ! II BOARD OF BUILDING REGULATIONS l License: CONSTRUCTION SUPERVISOR Number: CS 007754 }. ys Birthdate: 06/20/1926 f ` Expires: 06/20/2008 Tr.no: 23 391 t Restricted: 00 i FREDERICK E REID i ! 104 GREEN ST WOBURN. MA 01801 I Commissioner Board of Building Regulations and Standards t r HOME IMPROVEMENT CONTRACTOR % o Registration: 103158 i Expiration: 7/6/2008 Type: Individual FREDERICK E.REID Frederick Reid 104 Green St Wnhurn. MA 01801 "Purity Adminktrntnr FORTH ToVM of Andover No. too nr..a .n� o o f dower, Mass., 06 COC MIC!�E wICH Ao'4q rE D APS\ •t� S BOARD OF HEALTH PER IT �1 Food/Kitchen Septic System THIS CERTIFIES THAT....... ................................................... .................... BUILDING INSPECTOR Foundation has permission to erect........................................ buildings on j!K...... ' .�. .... ...T.... ......P............ Rough to be occupied as. � .... �1A�! !M1..��........4j—t*%..��.�................................................................ Chimney provided that the person ccepting tlTis permit shall in every respect 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 asow PERMIT EXPIRES I1 6 MONTHS ELECTRICAL INSPECTOR UNLESS COII�IISTRI_JC �. 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Location o r No. Date �aRTM TOWN OF NORTH ANDOVER to " Certificate of Occupancy $ bass'„°•E< Building/Frame Permit Fee $ 7 tCMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ r Check # �/ } 19564 Building 95G4Building Inspector