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HomeMy WebLinkAboutBuilding Permit #242-14 - 145 OLD CART WAY 9/18/2013 I TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION I ® L C� �V,4/ Print PROPERTY OWNER ! G �A d�O 0 W Unit# Print MAP NO: �ARCEL: _ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 100 year-old structure yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building &bne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition [IOther v_. a._.4-.�- .. -• - ©;ptic, �0}Well' ❑Floodplam� t��Wetlandsr pa Wa ershedIDi stric,t DESCRIPTION OF WORK TO BE PERFORMED: '�,2c r5 Fri sIJ 6/C 4,V(f- S 41/v �C.t� �`' I�✓6 , .D i/vtL P9 S U oy o L%/t m h 7 Y- )c FF,0' hvra-u A/0 cllf, VICM7; I e-/d S 0 (Identification Please Type or Print Clearly) OWNER: Name:M I &21-- 7'14 AQ rz Al Phone: 7 3 z/3 Address: )q5' 6L0 CAnT CONTRACTOR Name N16", Phone: Address: Z 1-6w111CL 3.T V✓1 L. 1Nd - Supervisor's Construction License: 99 Exp. Date: Home Improvement License: 16 a 4 G 7 Exp. Date: ARCH ITECTIENGINEER_ G - Phone: Address: " Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ /a. op FEE: $ I j��g Check No.: ✓? Receipt No.: .NOTE: Per ns contra 11 'th u e red contr ctors do not havP,Ja` to earanty fund vvne Signature of:confactor t Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL I I 1 Public Sewer ❑ Tanning/Massage/BodyArt ❑ 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 CONSERVATION Reviewed on Signature I ` I COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit ]DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dempster on site yes no Located at 124 Main Street Fire Department signature/date. COMMENTS 1 Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. I 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 MG[..Chapter 166 section 21A—F and G min.$100-$1000 fine I i NOTES and DATA—(For department use I 4 i I LI Notified for pickup - Date Doc:.Building Permit:Revised 2011 June/mi F-1 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 k ❑ Photo Copy of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract f ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products ;= ROTE: 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 MOTE: 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) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products MOTE: 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 f I must be submitted with the building application I ' Doc: Doc.Building Permit Revised 2008mi p I � 1 Location . No. �</? Date G . = TOWN OF NORTH ANDOVER I 'i Certificate of Occupancy $ F Building/Frame Permit Fee $ p Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 1 t I Check# � i' 26864 Building Inspector r -INORTH ve' 'o No. �a_ * - b i h ver, Mass g i T O LAKE � COCHICNE WICK SAO� GATED �,P S U BOARD OF HEALTH Food/Kitchen PERMIT T LD` ,,/ Septic System THIS CERTIFIES THAT ......'.�.1'16.... ,?.. G.'Gl�kl••G�y.............................................................. BUILDING INSPECTOR has permission to erect . buildings on Foundation Rough ................................................................ to be occupied as ................X� Gl. .. .`". . .`,.l..d.v. chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO ARTS Rough ................................... Service ............ ..... � ....... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. SEE REVERSE SIDE ' a NEW ENGLAND CUSTOM DESIGN, INC. 226 LOWELL STREET WILMINGTON,MA 01887 _ #978-658-0881 Home Improvement Contract Registration No. 102467 ROOFING AND SIDING AGREEMENT This is a legally binding contract.Make sure you read this Agreement and understand it before signing it.Do not sign this contract if there are any blank spaces. NOTICE:All home improvement contractors and subcontractors,unless specifically exempted by Massachusetts law,must be registered with the Commonwealth of Massachusetts.All inquiries about registration should be directed to: DIRECTOR-HOME IMPROVEMENT CONTRACTOR REGISTRATION One Ashburton Place,Room 1301 Boston,Massachusetts 02108 Telephone:#617 727-8598 tis Agreement is 7de on 20/ by and between New England Custom Design,Inc.(hereinafter,"Contractor") .d owner �//� ,\ ty 1V'. ��tJt�VL`� State Ince Zi w rA (hereinafter,""/Owner'),of /Town p ( )ihone �7�' /T T -aa69 b Address("The Premises') �^ !1/ �/�� W61 ( �phone(,/7 73 V,3 w England Custom Design,Inc.Salesperson Roofing will be applied only on slope roof surfaces//below,over present roofing shingles unless specified under REMARKS. WW Z MATERIAL�?;V-0 3C) Color C� n Main Roof I/fs Bay Windows a�r� Extensions a Porches:Front Side Rear Other Roofs d �' NOTE:Roof board replacement cost 1�-�.5� per foot OR oL per 4'x 8'sheet of 8 F in h CDX plywood. LEN ARKS/ TRAS:Missing or defective lumber is not included in any category of work unless sfecified e. ra-Z'i� is e - ASAn r 4 —na to 0 s f / e r 411 Awl— Iry ` S ► .efS yna ! oS� The Conhuctoragreestoperforminagw4 and wmkmanlfkemanneraIlwmkdetailedabow.-f AV7,J CASH PRICE$ zo. y00. OG DOWN PAYMENT$ OG• GL Noce AU R�fistg Cusfiiafterst k," PAYABLE ON START OF WORKS New England Custom Destg> 1ic willllotle`t_ PAYABLE $ heldresponstblefordtisranddebrrsalluiul o ainc areas dutvlgmofitl�vstallatlon}P1eae PAYABLE ON COMPJ,ETION$ DATE: v/ Tr 20 _ RIGHT TO CANCEL to Owner may cancel this agreement if it has been signed by the Owner at a place other than the address of the Contractor,which may be his main office or branch thereof,provided that the Owner ti6es the Contractor in wilting at his main office or branch by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this Agree- ant.See attached Notice of Cancellation.A cancellation fee representing 30%of the contract price will be in effect if cancellation is requested after the legally allotted time has elapsed. ie Owner hereby certifies that he has read this Agreement,that the terns and conditions and the meaning thereof have been explained to him, at he Cully understands them and that there is no derstanding between the patties,verbal or otherwise,than that which is contained in this Agreement,and agrees that or is n ible nor bound by any representations not con- ned in this Agreement,made by any of its agents,unless the same be reduced to writing and signed by the Co ctor. ITENTION H MEO R:DO NO SIGN THISCO IF THERE ARE ANY SPACES. / ? Z� wtter's Nignature Date glana tustJwA1&7rgn,Inc. ate wner's Signature Date ' ,q Ll tLP�O�I77/i7%09N.UPQ�LYL O��%(�1,C74d�L000P.�b:'. \ Office of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR E'egistration -,jt2467 Type xpiration:�-7/212b14 Private Corp#atio J NEW ENGLAND CUj4 I N INC. s µ �. Val Lanza r% f 226 LOWELL ST. 6 � WILMINGTON, MA 01887 Undetsecretary i j Massachusetts -Department of Public Safety Board of Buifding Regulations and Standards• Construction Supen icor' License: CS-008828 a 1 r r.S '] VAL J LANZA 34 BVMY S REVERE 14 021 92...- .. r Expi.rat+on Commissioner 04/20/2014 i � 1 Fl 03/15/2013 14 ; 12 9785319442 #3292 P. 001/001 AC CERTIFICATE �7E(MM/DDYYW) .-.-- TE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS 13I CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVE[ AMEND, EXTEND QR ALTER THE COVERAGE AFFORDED BY THE POUCIFS BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT; it the certificate holder.is ari:, pIT10NAL INSURED, the policy(ies) must be endorsed. if SUSROQATION IS WAIVER, subject to the terms and conditions of the policy;certain policies may require an endorsement..A statement on this certificate does not confer rights to the certificate holder in lieu of Such endoisementfs), PRODUCER CONTACT Kilgore Insurance Agency PHONE' 5 Centennial Drive 978) 531,-6550 A!X No: (9�8> 531-5442 E•MAl L Peabady, MA 01966 ADDRESS: INSURERiBf AFFORDING CQV•FRA,�i•E �^NAIC 0 INSURE•• INSURER AIWestern World Insurance INSURED --•-- _�__ --...... INSURER B:Safety ,.TnsuXarice Comna.,, New England Custom Resign INSURERc:TraV�1 Oro Pro t. E Casualty Ron Weinberg '• - _ ,_,.•, 226 Lowell Street / Unit B4-A lNSUft•�R.D;. _Wilmington, MA 01887 - INSURER E,: -*--- I N$URER F: COVERAGES CERTIFICATE NUMFt=R- REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN I$ SUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOb INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TE kM OR COND1710N OF ANY CpNTRACT OR OTHER DOOUMENT WfTH RESPECT T I CERTIFICATE 0 WHICH THIS H 5 E MAY 8E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED<3Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANOCONgTIONS OFSUCJI POLICIES.LIMITS 5HbVdN MAY HAVE BEEN REDpUCEp Spy rPAID CLAIMS, �ADDLTSUBR( - -POaaCYN MBE MM DDIYEYYY I MM OG EYYY LIMITS LTR II TYPE OP INSVRANCE I '^ GENERALLIABIUTY NPP1340227 3/14/13 3/14/l4 A '- EACH OCCURRENCE $ 11 n/�n/�n/� (/�'� (� _._... .«....___YJ00 0OQ.. j•,X COMMERCIAL GENE RALLIAl�ILITY DANLr ETOREN7ED l �.., �REMI F ..{Eat_...$ .504000 _ CIA IMSiv1ADE �{I OCCUR ' : MED EXP(Arty.ora erson $ " -- PERSONALE ADVINJURY _ $ 1,OOt7 ,OQD GENERALAGGREGA TE $ 2 00. 000.--- REN'IAGGRFGATE LIMITAPPLIES PER PRODUCTS•COMPIOP ACG $ 2 0 CT LOC POLICY. PRO- r , --• _.__ _�,. O,O••r Q O S A4TOLIABILITY Y 5054921 4/5/13 4/5/14 �6 JINt D IfJ LE LIMIT ANYAUTO AUTO ALLOWNEO BODILY INJURY(Per Pemon) $ _..,_ ?�Q,Q•QQ , AUTOS x SCHEDULED AUTOS BODILY INJURY{Porxcidcnt) $ 500 4QQ NUTOSON-OJ6p PROPERTY pMnA0E,,,,_. HIRCpAVTOS �•AUTOS er5ocident) __ $_10 0 000 UMBRELLA LIAR $ CES S UAB O CC•VR TACH OCCURRENCE.—... $ F7- EX _.••„ CLAIMS•MADE AGGREGATE I DED RETENTION$ -"" C 1h�?RKER$COMPENSATION 7p�NI3_0239N23-2-13 3/14/13 3/14/14 WC STATU• 0TH• $ AND EMPLOYERS'LIAa1WrY Y r N X ORY.LIMI.T8_,_. ANY,17RMEMB RlPARTNERIEXECUTNE E.L,EACHACCIDEPfr S _100,000_ OFFIC,F.WMEMBER EXCLUDED? _N N/A _ (Mnndatory beund Fll DISEASE-E MPL,YEF.,e6..•,_ 100 QQ_Q H yos.q��salbe untler A E �. .. OESCRIP710N OF OPERATIONS below E.I..DISEASE-POLICY LIMIT 500-1000 1 - I DESCRIPTION OF OPERATIONS I LOCATION6 I VE HICLES (A4210ACORD101,AddivanalRorrarksSehedule,ifmorespaceisreelimd) CERTIFICATE HOLDER CANCELLATION SHOUi.P ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL 55 DELIVERED IN ACCQRDANCE WITH THE POLICY PROVISIONS. ar° AU1110RIZED REPRESENTATIV CVrus A. Y<a.lq-or Q)4092_')A4A A RROn r'nonnnAT,nu k11_!_-_ -_-..'_ 1.