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Home My WebLink AboutBuilding Permit #534 - 158 MAIN STREET 2/13/2006 NORT1f 3r e..,r. ..,.•• OL ~ TOWN OF NORTH ANDOVER o! ,s"•' APPLICATION FOR PLAN EXAMINATION aA �9SSACHUSEt Permit NO: J� 3 Date Received: /J e4 Date Issued: /S C IMPORTANT: Applicant must complete all items on this page LOCATION / MIA+) 7 10 Oq 0 S J�91 Print PROPERTY OWNER �' �12�' �2y 5 (-4 Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building 0 One family 0 Addition ❑Two or more family 0 Industrial ❑Alteration No. of units: ' epair, replacement ❑ Assessory Bldg Commercial 0 Demolition 0 Moving(relocation) ❑ Other 0 Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED STn3,_1,0P,l R-,,P(),,LS 4 (3 c-rte .5 Identification Please Tyne or Print Clearly) OWNER: Name: �r�� yUy C� �G Phone: Signature Address: AK /'q- � 5 ! , /U 191"", u(FY( .. CONTRACTOR Name: T vhy\ a,A h ZA rArm&' Phone: Address: T� �L� d2i Uc� �=rtl ue-')') ow As S Supervisor's Construction License: O6`� 12 D Exp. Date: Home Improvement License: / 13 .9 O s Exp. Date: ARCHITECT/ENGINEERJ0/1n14 U�'c-_`JC�,s�lr��•- Name: Phone: Address: 01 / °�j" QT/1R /J (-4 Reg. No. 3!2 7 0 FEE SCHEDULE:BULDING PERMIT:$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. 1 640�' Total Project Cost :$ �j �Oo , u o x10.00=FEE:$ Check No.: Receipt No.: /�2 0 9 / 7 TYPE OF SEWARGE DISPOSAL Tanning/Massage/Body Art ❑ Swimming Pools Public Sewer LJ Well ❑ Tobacco Sales Food Packaging/Sales b Permanent Dumpster on Site Private(septic tank, etc. NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fired Signature of Agent/Owner Signature of Contractor Plans Submitted Rr Plans Waived ❑ 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 ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ 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/ _ Temp Dumpster on site yes_no t/ Fire Department signature/date Building Permit Approved and Issued by: 6 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.: NOTFS and DATA—(For department use) Doc:INSPLC"I'lDNAL.SLRVIC'L-S DEPARTMI::N'I':13PPC)RMO? (7eated JMC Jan._G!Ib 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 ❑ Debris Removal Fon-n u 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 ❑ Building Permit Application ❑ Form U ❑ Surveyed Plot Plan ❑ Debris Removal Form ❑ 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 ❑ Form U ❑ 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 ors special permit was required the Town Clerks office must stamp the decision from the Board of P P 9 P 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 DEPARTMENTMFORNI05 Location No. Date ? 9r. NORTq TOWN OF NORTH ANDOVER } ° Certificate of Occupancy $ , ... ;. � D �'7S'••O•'<� Building/Frame/Frame Permit Fee $ �6 s,aNust 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ?6- D a Check # /�'2 q 8977 Building Inspector 't NORTH 0 of RAndover ::. ;.. No. - o dover, Mass., Z OCMICKEWICK Ids RATED 7 4 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ........... ....�� ...�. ..... .............................................. Foundation has permission to erect........................................ buildings on Q� . .. .�� .... ................ Rough to be occupied as .... Chimney provided that the person accepting this permit shall in every respect con of rm to the terms of a application o e 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 ✓ l PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI ARTS Rough .......... .. .. .... . Service ... ......... . . ..... ... ....... BUILDING 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. Burnet Street No. SEE REVERSE SIDE Smoke Det. I �'lie �o�nimo�uaea�C o��a°acluiaelta ' -• BOARD OF BUILDING REGULATIONS i License: .CONSTRUCTION SUPERVISOR Number 5� ' 069120 I ��+ �' j Birthdate::•�04�103/1959 � k 3�c .EX t s 04.103%2407 Tr.no: 10500 Res JOHN.W LANZAF ,�'A 1 . • 30 TEMPIE:DR METHUEN; MA 01844~ comniissioaerpj�jj •� a✓die �am�y,wnurcP,all,�,o�n,au Sta�:ir�c� \1" HOME IMPROVEMENT CONTRACTOR, f Registration:• 137057 ? -- Yp DBA I ALL UNDER CNERI200F OHN LANZA.F. l' JOB oe-w"s 4NOV.-C4 PARKVIEW CONSULTING, INC. SHEET NO. OF P�ofessional Engineers P.O.Box 1080,Derry,NH 03038 CALCULATED BY 'ea r DATE D Tel. 603-537-0300 Fax. 603-432-0196 CHECKED BY DATE SCALE ........... ............. ........... ............................. ............ ............................... .............................................................. .......... ........................................ ........................... ............ ......................- .............. .............. .............. .............. ............. .......... ................ ...... ............................................................... .......... ................ ........................ ..... ........... ............ ........... .................................... .............. ............. ............................. ................... ............ ................................ ........... ................................ .... ......... .......... cf� .............. ............. ...... .......... ........... ....... ....... . .... ................. .. ....... ............ ......................... V., ........... .............. ...►..... 7 ry .......... .......................... ......................... ............... ................. ........ ................ 'V2 1-04 .......................... .......................... . ................ ..................- ............. ........................ .............................................. ...... ..................................... . .. ............ .................... .................... ....................... ..... :Away, /307/./a ere VJ# .......... ......... .... .. 01,c c/ .. ......... . ........... ........... .. .. ............. . ........ ... ... . .. . ............. .......... ............. Aew lyn d 04all /Sc "pr Wei .................. Ra Ile,- Se,*�/....eez cir- ........... .. .: . ........... ............. . .......... .................... ... ................ ................ . ..........- .......... .......... ..... .. . .... Q INTO STR UCTURAL 40. 312J ST ...... . ........... MAL PARKVIEW CONSULTING, INC. JOB 1 SHEET NO. 2 OF 7 Pi ofessional Engineers P.O.Box 1080,Derry,NH 03038 CALCULATED BY �,aT DATE J" Tel. 603-537-0300 Fax. 603-432-0196 CHECKED BY • "'/�((J?? OATEN/ /07t SCALE A17-,7 j ...........s ............i.......................i........................ ..... ..... ...... ...... .... .. .... ... ..... ....... ....... ...... ... ...... ..... ... ...... .. . .... ... ..... . .. ... .. . , . ........ .t n...rz�e Gilt d. y4`lref r- ... �a e ,....ars Vis' ..... ..........................:........ ................ 4x ........... ... .... z'e Ar liar vdG ........... Y-j AW.r. _ . . _.. V � ................ Same - NTS . ......... F T .. _ P'Q01N10 p. STRUCTURA ........... .o 'A NO. 3125C(2 �'0 �G►5TE �r PARKVIEW CONSULTING, INC. Jos ��`� �� iy�c.� `' 0 vv , lr�? Professional Engineers SHEET NO. OF ` P.O.Box 1080,Derry,NII 03038 CALCULATED BY Si,?! _ DATE/Z A aS Tel. 603-537-0300 Fax. 603-432-0196 CHECKED BY 7— DATE L)� SCALE W7,r0-d ,6 e. ............ ....................................... ............................ ... ...... ..... ... /" i : ...... ..... ..... ......................... ...................i............. i. .. ...... .... dY . .. . ,. .. .. lz. ..........................;.. .................. .....:. f ............ ..... 1 k f3/ ... . ... . e� .............:..........:...........:.. ..................:..........................;....... . ._ ....may., =: 2�S f' ell ............. I� l e u le 77 /! ... O tiff'.. ............................:...........:.... . ..............:........ . ...... ............' �, !� a G >r , wiz,,&aa/ o ,�� nrry 7'-a� r ...... .......... 10 _.. B ..........._ ... M4 ... v STRUCTURAL �»<•. . 3�2 3Q .... ,� a�40 °�FSSlONAL� �c I March 16, 200 PARKVIEW CONSULTING, INC. Mr. Jerry Fitzpatrick St. Gregory's , rmenian Church PROFESSIONAL ENGINEERS 158 Main Streot AND CONSULTANTS North Andove4 MA Re: Final Comoletion Dear Mr. Fitzp0trick: I made an inspection of the work on the Church roof framing that was completed by ,john Lanzafame from All Under One Roof. The work was completed in a professional manner and in accordance with the project plans and specifications. This letter will olso serve as notice to the local Building Department that the work completed to my satisfaction and in accordance with the project plans and specifications. Please contact me at your convenience if you have an questions concerning the work that was completed. air Sincerely, i f'< 6 RAL .s Robert B. Tarquinio P President, Parkview onsulting, Inc. onrai >p' 060111 A P.O. Box 1080 Derry, NH 03038 Tel. 1-603-537-0300 Fax. 1-603-432-0196 Tel. 1-888-561-3366 (Toll Free) g� JUL Chimneys s Residential & Commercial Roofing Siding�} CHIMNEYS POINTED-REBUILT-CAPPED At Types Of Expert Masonry Work Mass Toil FreeRoof Leas Experts *I Licensed& insured 1-840-WAIT-4- S r ncat�y o,�.,��r caE,�rur�J sr�4F �h License#034200 (924-8487) ee Wazm oz,9ohov We Work Year Round 101, • ` • • DATE: 0. //3, f QUANTITY DESCRIPTION UNIT PRICE i AMOUNT ,,f�F�,.�a s i3-f -f- �' n tom`#�•-J . JUL f_ i f j ,fl� �c%�6S G� C�� r�fs'-��`�l t ��l QIZI•�t�i�r R/ �r If, �r7 , I Pfd , A SA G' 0 o-t if F ; a The Commonwealth of Massachusetts e� Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MAA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (t3usincss/(hganiralion/Individual): L CI'2 ��,� / Address City/State/Zip: �� `L�� U"t 1441l?T Phone #: Are you an employer?Check the appropriate box: Type of project(required): Ll trJ t atn a employer with �Z_ _ 4• ❑ 1 am a general contractor and 1 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. * ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for the in any capacity. workers' comp. insurance. q, ❑ Building addition [No workers' comp. insurance 5. [1 We are a corporation and its officers have exercised their 10.0 Electrical repairs or additions required.] 3.F-1i am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs insurance required.] + employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#I rout also till out the section below showing their workers'compensation policy information. +I lomeowners 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 anadditional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am cin employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:-- M J r�`� ___ Policy 4 or Self-ins. Lie. #:��e�� q G C./`' I ZJ U Expiration Date: Job Site Address: // g ) 7— 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 tine tip 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 p ' s riot pen does q/•perjury that the information provided above is true and correct. Si-mature: Date: Phone If: Olfrc•ial use only. Do not write in this area,to be completed ny vi(v or town glfic•ial 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 M ;+C Lir CEI -nFiCATE VF UAIRL Y INSURANCE afm9aMMy �TMsc 22Q%Oemftq PAAW Iwo Ardwvm W%O Yeo .fim VON= 1 _ DBA A" UNOM Oke MAW MMQ 30 TWAKE oft °_ M57HLMW M06 0 16" Tw m —MPJR ,is 11I Mlr�ORMP01r01t1� 111 0 Rfi�t�Rt!lE�� Apr t I ► IMit riAdt Obi eanv *A61II�Ir111161fsa1l�ld��e�t odualwaft 6Wa*.MW 0 - fiAON �/MlMAfi�i t,pae ; 1 � t rpsartwa �� c � t , tY WAY' i,AltS�is1�►t r _ � }311t COMA- 11 OUR �ip� +tAC �tr N�IaGoeio,• -�LIL'1f t GLEN tER 7 JUN% tl�+.�sier a.uw��sas9 �a�e sir t i�Ls az +►rfco. 90►All X11 R t2 fithlf i116 + vow*. 34 O�CY47777RF14! X MAKE OR 60%am r vo it N. �4A4 p4�A@a®aes7�ea2�kGR&OArdweilm. �4it4l� tz�an