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HomeMy WebLinkAboutBuilding Permit #741 - 143 Farnum Street 5/31/2006tulic of Id Permit NO:Ji / Date Issued: 5 LOCATION PROPERTY MAP NO.: TOWN OF NORTH ANDOVER ,APPLICATION FOR PLAN EXAM NATION IMPORTANT: Applicant must Date Received:�/ 06 all items on this /(974 PARCEL: 7-) ZONING DISTRICT: w 1 TYPE AND USE OF BUILDING TYPE OF IMPROVEMENT New Building Addition Alteration Repair eplacemen = Demo Moving (relocation Foundation only HISTORIC DISTRICT YES 0 PROPOSED US- Residenti Non- Residential e family = Two or more family =Industrial No. of units: Assessory Bldg =Commercial Other I Others: DESCRIPTIONS)F WORK TO BE PREFORMED OW'NER address: CONTR. Address: Identification Please Type or Print Clearly) f Supery isor's Construction License:_ Exp. Date: 710 [[ome Improvement License: _�('� L��C/ Exp. Date: ,4, D% \RCCI-II-I'LCT ELC[NLER \itnc:: I'hcnc:: Address: Reg. No. FEE SCHEDL LE: BL LDI.NG PERMIT: 510.30 PER Si 900.60 OF THE' TUT IL ESTVI, I TED C)ST S ISED (),N S125.00 PER _5-1' Total Project Cost :$_.,_. In 5—Q CJ x 10.00- FEE:$ C:hcek'�n.: Recc:ipt'�o.: 9 70— Location 13� Y--Xl -*I t7vjiii No. Date 5 6 �oRTM TOWN OF NORTH ANDOVER 3?0....o o f - w ' •'4 Certificate of Occupancy $ s�CHU Building/Frame Permit Fee $ CS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ^� 9 L Z " Building Inspector TYPE OF SEW'ARGE DISPOSAL Public Seller _ Well _ PriNate (septic tank, etc. TanningAlassage Body .art _ Tobacco Sales Permanent Dumpster on Site _ S" immin7 Pools Food Packaein2 Sales Electric deter location to project NOTE: Persons contracting istered contractors do not have access to the i, �uaranty�.J'und Signature of Agent Owner Signature of Contractor Plans Submitted Pl ns 'ai��ed ' Certified Plot Plan _ amped Plans _ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORA PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS _a HEALTH CONINIENTS Zoning Board ofAppeals: %ariance. Petition No: DATE REJECTED �i ❑Water Shed Special Permit � i Site Plan Special Permit ] Other 7_oning Decision; receipt submitted �-es Plannim,y Board Peci,Aoll: l munr C-.,,oscrxaticn Decision: 'V,,tcr ,:z `,:vo-r ccr,nectioni naturc & jatc DATE REJECTED DATE REJECTED comnuunts urnp DUmpster r_n site es_ no _ 'Fire Deparh7ent J- nature gate Building Permit Approsed and Issued by: DATE APPROVED DATE APPROVED J DATE APPROVED Building Setback (ft.) Front Yard Side Yard Rear Yard Required ProN ided Required Provides Required Provided r ' DIMENSION Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. p-oofing, Siding, Interior Rehabilitation Permits Building Permit Application %%Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses j Copy of Contract zi Floor Plan Or Proposed Interior )Fork Addition Or Decks 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 Hydr,. 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) I ❑ Copy of Contract Mass check Energy Compliance Report i In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board %ppeals that the appeal period is o%er. The applicant must then get this recorded at the Registry of Deeds. One cop) ai proof of recording must be submitted with the building application N'(: I\sVNC 1'14)\.1L SNR\ 1('4::i DNP `.R] `IE`,'!':UPP')R`!1!S 1,yc4rf I .I GQ ii n m cn.ml, I'll., z ;Z' Z.Ad C04 z Z la -�5 < 'Woo 0 fi �MK 0, �-r m UJ — of IL Z, �o `, W -.q LU M w CIA Ln ;a C=.C' 0O C' OL (3) Z -G) Q lc--Tn .I m cn.ml, I'll., ;Z' Z.Ad M. A Z la c, ch z lo ;s `, W -.q ;a C=.C' C' OL (3) Z -G) lc--Tn c m -0 G) < 7i (a .I l 1-wff Y %.#L -lx 1 11 1 G %jF LI11%U1IL1 I ➢ UJ ABCOrd C-1 1 04/27/ PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Popolizio Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 175 Littleton Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Westford MA 01886 Phone:978-692-8667 Faxz978-692-8588 ABCO CONSTRUCTION JOSEPH GYS 51 LONGMEADOW DRIVE LOWELL MA 01852 COVERAGES INSURERS AFFORDING COVERAGE I NAIC # INSURER A: PREFERRED MUTUAL INSURANCE INSURER B: INSURER C: INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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 CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS- lNbK LTR NSR TYPE OF INSURANCE POLICY NUMBERPOLICY E FE E DATE MMIDD PO P RATION DATE MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE S 500, OOO A X COMMERCIALGENERAL LIABWTY CLAIMS MADE Fx-1 OCCUR CPP 0140 56 13 82 04/26/06 04/26/07 PREMISE Ea� ) $50,000 MED EXP (Any one person) S5,000 PERSONAL &ADV INJURY $5110 OOO` , GENERAL AGGREGATE $1,000,000 GEML AGGREGATE LIMIT APPLIES PER POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG S1,000,000 AUTOMOBILE LIABILITY ANY AUTO - COMBINED SINGLE LIMIT (Ea accident) S ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY S (Per person) HIRED AUTOS NON -OWNED AUTOS BODILY INJURY S (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY OCCUR FICLAIMS MADE EACH OCCURRENCE S AGGREGATE $ S DEDUCTIBLE S RETENTION S S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORY LIMITS ER E -L. EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMSER EXCLUDED? E.L.DISEASE - EA EMPLOYEE $ If yes, describe under I SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CARPENTRY - WORKERS COMPENSATION CERTIFICATE TO COME DIRECTLY FROM THE INSURANCE COMPANY r�rr�rrr��wrr -- GANGtLLA I ION MAUREEN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR - REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Richard J. -Po of zld ACORD-25 (2001!08) ! © ACORD CORPORATION 1988 ........ . . ...... .......... . %Adh 1-7 .......... D4_27 PRODUCER THIS CERTIFICATE IS ISSUED AS - A - MATTER OF INFORMUTI"OR ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE POPOLIZIO INS AGENCY 175 LITTLETON ROAD HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW. WESTFORD MA 01886 COMPANY COMPANIES AFFORDING COVERAGE 29H5J A HARTFORD UNDERWRITERS INSURANCE COMPANY INSURED COMPANY GYS, JOSEPH DBA B COMPANY ABCO CONSTRUCTION 51 LONGMEADOW DRIVE LOWELL MA 01852 c COMPANY D K., THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BE LOW' BEEN '� ED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REOUIREMENT, 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 CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OFINSURANCEPOUCYEFFECTIVE POLICY NUMBER DATE (MMDDXYY) POLICY EXPIRATION DATE (MMkDDNYY) LIMITS GENERAL UABIUTY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY CLAIMS OCCUR S MADE r PRODUCTS-COMPIOP AGG. PERSONAL& AOV INJURY EACH OCCURRENCE 'RRE -DAMAGE OWNER'S & CONTRACTORS PROT (Any one fire) $ MED. EXPENSE (Arty one person) $ AUTOMOBILE LIABIUTY ANY AUTO COMBINED SINGLE $ LIMIT ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per Accident) $ PROPERTY DAMAGE $ GARAGE UABIUTY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY - EACH ACCIDENT AGGREGATE EXCESS UABIUTY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM A WORKER'S COMPENSATION AND EMPLOYER'S LIABILITY (UB -746X684-1-06) 05-01-06 05-01-07 STATUTORY LIMITS EACH ACCIDENT THE PROPRIETOR PARTNERS/EXECUTIVER INCL OFFICERS ARE: X EXCL X OTHER DISEASE -POLICY LIMIT $ sim, fin DISEASE—EACH EMPLOYE 100, DESCRIPTION OF OPERATIONWLOCATION94EMOLES/RESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. "CF11TIFICATE:14OLD. UL -ATI W. 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TOMAIL . 10 DAYS WRITTEN NOTICE To THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR UABIUTY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESENTATIVE .... . .... ....... . ..... ........ . .......... m m X C m y m y m CA o � y C'7 n z y O. O �� C :z a� o C.) o ® CD CD O r� CL C� d Co CD CD C CD y� CO O co) O co CD S- CO) y O 10 CD O CD O CD 7 er. ■ O S. C0 • cn 0 .2 o , �OaO m 1 CM")O C N m aN�• = a ..►C ' =r= H -� CL ,, ... O ��; -+ a C C O m C� d N N O 0 O H � � C0 ® _, m � 0: O S. C0 • cn 0 .2 o , �m :`am C 0 �0 aN�• CD a 1 co00 =r CL ,, ... O ��; CD C C O m O C� d N ,......: ,00 C% N n � m N CL m 1a cr cn 0 �m :`am C 0 �0 "�7 CD a 1 co00 =r 1 J j. ID o cn M'�l7 �a C 0 0 "�7 CD i w 1 co00 x w 1 J j. CD C C O C� d N ,......: x dm: n � 0: 1 ' • � O z Cl) O cn M'�l7 �N C f "�7 i� C) i w 1 co00 x w 1 J j. /" F C C O C� d N "p O x � � z E\ M M oni 0 0 c Page No. of Pages' ABCO ROOFING & CONSTRUCTION CO. CONTRACT LOWELL, MA 01852 HIC # 108424 a Super Contractor License # 092469 978-937-5840 or 978-475-7544 PROPOSAL SUBM}TTED TO%l; ., YA PHONE ) ` �q %) ( DATE % STREET ��'� / JOB NAME / CITY, STATE AND ZIP';CODE 1 JOB LOCATION ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: 1 � � -� 7 ,7 t , { -ir� �ii",1•,t ��� �"r! 1.� -� � r ;�i �/•'� f/'1i �• le V r.' }n�i� ((I I '[t' /�` y,( i �,/v .:,r..J-YUX! j f,qj .. -" .•��E.`f SSC ILI •'{TAY � �J/�� 1 /U1 fTj A (/' V✓ yo- 'allE i /1 + 'rt of 3 •G.%it (1 `' /� ; ': jf ejjJ� "a� fir. � it tisk>?tQ h {% L, 'J_ t r: 1 C? "t-`��1 c `E t. t,'' { ` moi.'✓.t '� l r ti '� CK" yv/tl I ;�1; (�,L--�,[r't,^. t�j,� !� ,�.�-'x-f'%�� � �i;1 �'�� L�-✓ C� -�:f-t"_`..�' j ! r ,',fjC�ru ti ,�� 1 �-2 O •�i1 ;�. G '`/"` �1..t� ���,:�,/. We Pro Se hereby toyl?urnish material and labor — complete in accordance with above specifications, for the sum of: i.'t:,/ (Af) V ; f i � (% % _ 11,1. 1L?✓� / dollars ($ t 0 }. Paym rifrt be made as .follows: r ' � :y� , +cvf�•!. I � -/ l „t �:� �i _ t �;f� � Vin, � v(,:� � "t.� 24 -�_ Z: f.�:✓, .f/ , F _. -" .�_ � - � ;, �' � i. r (. :l �/ ? `"1 ,'',� ' .' `,.`� `• _.yam, r i All .material is guaranteed to be as specified. All work to be completed in a workman like manner according to standard practices. Any alteration or deviation from .above Authorized f specifications involving extra costs will be executed only. upon written orders, and Signature will become an extra charge over and above the estimate. All agreements contingent i f upon strikes, accidents or delay$ , beyond. our control. Owner to carry . fire, tornado Note:, This proposal mdy be and other necessary insurance. Our workers are fully covered by Workmen's Com• withdrawn by us if not accepted within days. oensotion Insurance. / Acceptance of 1. Proposal -The above prices, specifications and conditions are satisfactory and are: hereby. accepted. You are authorized to do the work.es specified. Payment will be mode as outlined above. Signature t/ ' Sig Date of Acceptance -i ('�'