Loading...
HomeMy WebLinkAboutBuilding Permit #173 - 18 PENNI LANE 9/5/2016 TOWN OF NORTH ANDOVER ! AORTH APPLICATION FOR PLAN EXAMINATION o* �20 , Ati oto Permit NO: Date Received �, e ' Date Issued: " �9SSAC HU`+���� IMPORTANT: Applicant must complete all items on this page LOCATION 4)/y Print I S PROPERTY OWNER �f e Jyo a /y e SS(2� Print MAP NO.: 6 7 D PARCEL: 7 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 ❑ Industrial O''Alteration No. of units: ❑ Repair, replacement ❑ Assessory Bldg ❑ Commercial 0 ❑ Demolition ❑ Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED •1 �' Identification Please Type or Print Clearly) OWNER: Name: S �ey 2 00 (,C IV e SS q Phone: Address: '1 e tVr?/ t Lit wf CONTRACTOR Name: ! w. (J u Lj/10 Phone: Address: Q 5 NGicl F f��1�L Supervisor's Construction License: D 6 0 ( / 2 Exp. Date: Q 7 Home Improvement License:___ 12 R C9 C 2 Exp. Date: O ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.•$12.Q0 PER$1000.00 OF THE TOTAL ESTIMATED OST BASED ON$125.00 PER S.F. Total Project Cost :$ 9�� FEE:$ Check No.: `7 ,? -3 2 Receipt No.:� Page 1 of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ F1 Tobacco Art E]Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to proj ect NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ 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/SiEnature& Date Driveway Permit Temp Dumpster on site yes no Fire Department signature/date 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) Page 3 of 4 Doe:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.1an2006 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 o 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 ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit o 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 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Pane 4 of 4 Location . 0 /\ \ Na Date 9 ' S` 0 m: �- TOWN OF NORTH ANDOVER . 0k. ` - Certificate of Occupancy $ # Build Permit Fe $ / � . $ / Funabn Permit Fe $ w ® Other Permit Fee $ © � ^ - \». TOTAL $ \\� Check * . . . 1954E > "'building inspect a . « REGULATIONS BOARD OF BUILDING License: UPERVISOR CONSTRUCTION S ,. 0601.12 sx{ Number`..:CS Birthdate�:.0810411956 28784 EXp►resc 0810412008 Tr.nos Restr►cted "'00° . ' THOMAS T DOYLE 8 WEST ST 03079 Commissionee SALEM. NH to ulsins gnd Standard tios,' , ^ Board ui Building g ONTRAC I OR ' HOME iMPROVEt{lMl:NT C itegisl?g1dn ^129612 - = 2007 _41281 , `F � Expl 1R THOMPSON'SROOFING "e THOMAS OOYLE �' 8 WEST ST Administrator SALEM,NH 03079 I NORTH own of ? Andover o 0 No. ) 73 -TW _ X z= dover, Mass.,a• 5 ' fe 0 LA COCMICMEWICK AERATED P'P�\ �� 7`s BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT............... r ��S ..................... ...... ... ........... ................................................................. Foundation has permission to erect........................................ buildings on ..........`. ....... ` a............................. Rough • to be occupied as...........$.rote .. .. .�'...... .....eit ..A?,:............�Z...�............................................. Chimney provided that the arson acceptingthis ermit shall in eve conform to the terms of the application on file in P P rY PP 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 PERMIT EXPIRES IN b MONTHS UNLESS 7 ^ D ELECTRICAL INSPECTOR V 1 V LESS CONSTR V� A O RTS _ 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. Burner Street No. SEE REVERSE SIDE Smoke Det. Page ®f Free Estimates 105 Haverhill Street Fully Insured Methuen, MA 01844 1111®Mi SON9S LOOPING (978) 691-1355 Shingles— Slate —Rubber hoof Single Ply — Copper Work PROPOSAL SUBMITTED TO Steven Vounessa PHONE vy /ItpfJ3._,_ Of 9 Q DATE STREET JOB NAME f 'p•L 18 Penni Lane CITY,STATE AND ZIP CODE J08 LOCATION North Andover MA 01845_ ARCHITECT DATE OF PLANS JOB PHONE J We hereby submit specifications and estimates for: Strip off a?_.1 roof shingles on cnt.Ere house Renail any loose boards and if any are rotten it will cost $50 .00 a sheet for plywood to replace Install aluminum drip edge around roof line Apply ice and water shield 6 ft. up all along edges and in valleys Apply 15 lb. felt paper on rest of roof area Reshingle with a 30 year ARchitect shingle Install flanges around soil pipes , Install ridge vents Remove all work related debris e e.4je_ 64 S`e. L✓X?'t orf 30 year warranty on material rleviGen 6evs 5 year guarantee on labor P/SAM Z°.0 a V7 AM construction lic. #060112 CAarycw eeq,,t_ 1jeue41—X4JI-Wlee improvement #128612 /4%4sf= S,44-r 4yew-g 4F7-e-,o_, >roflge hereby to furnish material and labor—complete in accordance with above specifications,for the sum of: Nine thousand eight hundred dollen,($ � , Rnn n0 Payment to be made as follows: $4 ,800 .00 start of iob balance U]2.Qn completion All material is guaranteed to be as specified.Afi work to be oomptoted in a worlarlsMiioe merrier according to standard practk*L Any sftretion or deviation from above apecifications Invo" Audio extra costs will be executed only upw wrdten orders,and will became an mft chsW over and slgna above the estimate.All agrearrmb cantmpent upon strikes,acckk to or ddgs beyond our control. owner to cant'fire,tornado turd other necessary Insurance.Our workem are fully Note:?tile proposal mpy be withdrawncovered by Workmen's compensation Msratce cr . idtdrawn by us If not accepted within -da Ltt�ltr1!'�tt1i•�j1t�;Efd�—The above prices.specifications and conditions are satisfactory and are hemby accepted.You are authorized to do the Signature .unrlr�c enunifi�ri Dflvm�n}will 1u na.ir a n..N:ne�..M..n ,� U//Zb/LUUb PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Pelham Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 960 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 122 Bridge Street Pelham NH 03076 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:NaUt1111S Thomas Doyle dba INSURER B:Associated Industries Thompson's Construction Roofing INSURER C: 8 West St INSURER D: Salem NH 03079 INSURER E: COVERAGES 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, INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/Yl LIMITS A GENERAL LIABILITY NC 532152 04/15/2006 04/15/2007 EACHOCCURRENCE $ 1,000,.000 x COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea occurrence $ r 50,000 CLAIMS MADE �OCCUR MED EXP(An one person) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) S ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) S HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) S PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $E AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ _ OCCUR M CLAIMS MADE AGGREGATE $ S _ DCOUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND AWC7012214012006 04/21/2006 04/21/2007 X DSR EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 100,000 OFFICER/MEMBER EXCLUDED1 if yes,describe under E.L.DISEASE-EA EMPLOYEE $ 100,000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT S 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTlSPECIAL PROVISIONS Various Construction CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT Steeple Chase Builders FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 57 Cross Street INSURER,ITS AGENTS OR REPRESENTATIVES. Andover, MA 01810 AUTHORIZEJ, D REPRE NTATIVE ACORD 26(2001/08) ©ACORD CORPORATION 1988 INS026(0108)07 AMS VMP Mortgage Solutions,Inc.(800)327-0545 Page 1 of 2