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HomeMy WebLinkAboutBuilding Permit #407-11 - 180 LANCASTER ROAD 11/15/2010 BUILDING PERMIT of No or TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION '' -" Date Received Permit NO: � �R,TEo • ��^� � 9SSACHl1`''E'C Date Issued: IMPORTANT: Applicant must complete all items on this page F L<®,CPATION ` - - tTc iMAP>(NO I PARCEL: (�= 0 ZONING_DISTiRICT aHistonc Distpct ryes. `x ono ;MaehnecShoge no' TYPE OF IMPROVEMENT PROPOSED USE Res' ntial Non- Residential ❑ New Building a family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other o Septic t®tlNell ` .i ®Floodplain a®Wetlands - q i,Watershed Disfnct: DE CRIPTION OF W RK TO BE PREFORMED: Molle (f l(&e W-5 Iden fieation Please Type or Print Clearly) OWNER: Name: -Jo� h�`I'ec5c*-) Phone: 978487--2ND Address: tC®NT�RACTEOR Name JoQ0A f���►�'� lPh � t 7 x. _x . �.� _ one. 1 Z)�fY Supenlis0sConstrucfion Lieense b l�rl;� a ExpY ,Datesb7 l .s ARCHITECT/ENGINEER � Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 27UO FEE: $ Check No.: �7 ` X67 �r 9 " z7 Receipt No.: �3�v NOTE: Persons contracting w'h unregistered contractors do not have access to the guaranty fund Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ 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 COMMENTS HEALTH Reviewed on Signature r COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/S�nature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street iFiIREDEPARTMENT TempDumpster�onsite, eyes_ �_ _� - . „ . r_.._ r P z ,l . . . trio 4Located�at 1A24tManfStreet ` !FireDepartmentsignature/date Y - . . tiGOMMENT�S -- - Ii - 1 I Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. 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 MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine 1 NOTES and DATA— For department use i ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Biding, 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 ❑ Engineering Affidavits for Engineered products NOTE: 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 l Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign offrom Fire Departmentprior toissuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application I, ❑ 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 DOTE: All dumpster p q g 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 must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 ORT#q Town of A n- dover 0 No. `° X 4LAKE 0 dover, Mass., COCM,CMEWICK ADRATED PPa,�"`� `SS BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........�...� ..... ... ... .t. .................................................................. ... Foundation 7 has permission to erect..... g ! � � � Rough :....................... . buildings on ... .. to be occupied as............. ........ .... !i. .. ... �-- i ... ........ ...... .. Chimney provided that the person accepting this per it sryevery respect conArr�tothe 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 36 PERMIT EXPIRES IN 6 MONTHS• UNLESS CONS TR TARTS ELECTRICAL INSPECTOR Rough ........................... ................. Service BUILDING R 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. 1 CONTRACT# n EXTERIOR SOLUTLNS fNSTALLED;SALES CONTRACT' INST#,LED SALES SPECIALIST.. r NUMBER: CUSTOMER • e f STORE NO. STREET ADDR SSSSTREET ADDRESS r CITY STATE ZIP CITY t STATE ZIP a�J f It� A; r ic, TELEPHONE t' +tom TELEPHONE } ,1 f 1 t:) DATE ` LOWE'S CONTRAC TOR LICENSE NUMBER --I < CASH CBANKARS F REG CHAR E t t7 r{� Ilf This is only a quote for the merchandise and seances printed below.This beeomes.an agreement upon payment.Upon payment the entire agreement inctuding the specifically completed pages of this document,the Terms'and Condi tons included with this cimumentand any other addenda and attachments hereto,shall be referred to harem as this"Contract.";' PLEASE READ ALL TERMS AND CONDITIONS ON THE REVERSE SIDE OF THIS PAGE AND FOLLOWING PAGES BEFORE SIGNING,`j, � INSTALLATION STREET ADRESS CITY _ STATE ZIP n ih Fti +'�.. '� —r ���� �.f`�:r �}'�• � �rs � b..'a.�' .� +"` �=,a^:— may.� E f`r�`•�: �� '� '}4 Fes„� �•> __ 1 �F r C e Contract Total ' *applicable taxes included r t NOTICE TO CUSTOMER: Federal law requires Lowe's to provide you with the pamphlet Renovate Right:Important Lead Hazard Information for Families,Child.Care Providers and Schools.By signing this Contract,Customer acknowledges having received a copy of this,pamphlet before work began informing Customer of the potential risk of the lead hazard exposure from renovation activity to be performed-in Customer's dwelling unit. Work'is to commence upon reasonable availability of Contractor and/or availability of any special order or custom made Goods which is anticipated to be -7-e ,{`9 [fill in date]. Estimated completion date is [Fill a [fill in.date]. Said estimated substantial completion date is not of the essence. Contingencies that may materially change said estimated substantial completion date follow: (If applicable,insert a statement of such contingencies). III t NOTICE TO CUSTOMER Al(items listed in.this Contract and specification sheet(s)are to be installed under conditions agreed upon at time of purchase and at the price appearing on this contract form. This assumes sound existing substructures,superstructure and points of attachments. Extra labor or material incident to installation necessitated i by defective substructures,superstructure,points of attachment,or the moving of fixtures or appliances to be billed at extra cost to Customer. This Contract provides that all claims by Customer or Lowe's will be resolved by BINDING ARBITRATION.Customer and Lowe's GIVE UP THE RIGHT TOGO TO COURT to enforce this Contract(EXCEPT for matters that,may be taken to SMALL CLAIMS COURT).Lowe's and Customer's rights will be determined by a NEUTRAL ARBITRATOR and NOT a judge or jury.Lowe's and Customer are entitled to a FAIR HEARING.But the arbitration procedures are SIMPLER AND MORE LIMITED THAN RULES APPLICABLE IN COURT.Arbitrator decisions are as enforceable as any court.order and are subject to VERY LIMITED REVIEW BY A COURT.FOR MORE DETAILS:Review the Arbitration Agreement and Waiver of Jury Trial section of the Terms and Conditions of this Contract and visit the American Arbitration Association's website at www.adr.org. { DO NOT SIGN THIS CONTRACT UNTIL COMPLETE AND YOU HAVE READ THE TERMS AND CONDITIONS CONTAINED ON ALL # PAGES OF THIS CONTRACT BY SIGNING BELOW,YOU ARE ACKNOWLEDGING THAT YOU.HAVE;READ,UNDERSTAND, AGREEyi�+OT�#�a��_}tTr�Ey�RMSya Ayt4Dga�CONDI�T)()NS SET,fOR ON ALI�PA�I S© f1S`0 3RA�3!+ i A 4J'YW17Fi DATE j J LOWE'S CONTRACTOR LICENSE NUMBESCC R CASH BANK REG � - CHARGE This is only a-quote for the merchandise and seroices'printed below.This becomes an,agreement upon payment, upon payment,the er;tire @greement,including the'spec ficalfy completed pages of this document,the Terms and Conditions included with this document.and`any other addenda and'attachments hereto,shall be referred to herein as this"Contrac;U PLEASE READ ALL TERMS AND CONDITIONS oN THE REVERSE SIDE OF THIS PAGIEAND FOLLOWINGPAGES BEFORE SIGNING: r INSTALLATION STREET ADRESS CITY_J STATE ZIP IG 3 �r,. , * + Contract Total *applicable taxes included NOTICE TO CUSTOMER: Federal law requires Lowe's to provide you with the pamphlet Renovate Right.Important Lead Hazard Information for Families, Child Care Providers and Schools.By signing this Contract,Customer acknowledges having received a copy of this pamphlet before work began informing Customer of the potential risk of the lead hazard exposure from renovation activity to be performed in.Customer's dwelling unit. Work is to commence upon reasonable availability of Contractor and/or availability of any special order or custom made Goods which is anticipated to be .1 [fill in date]. Estimated completion date iss t [fill in date]. Said estimated substantial completion date is not of the essence. Contingencies that may materially change said estimated substantial completion date follow: (If applicable,insert a statement of such contingencies). NOTICE TO CUSTOMER All items listed in this Contract and specification sheet(s)are to be installed under conditions agreed upon at time of purchase and at the price appearing on this contract form. This assumes sound existing substructures,superstructure and points of attachments. Extra labor or material incident to installation necessitated by defective substructures,superstructure,points of attachment,or the moving of fixtures or appliances.to be billed at extra cost to Customer. This Contract provides that all claims by Customer or Lowe's will be resolved by BINDING ARBITRATION.Customer and Lowe's GIVE UP THE RIGHT TO GO TO COURT to enforce this Contract(EXCEPT for matters that may be taken to SMALL CLAIMS COURT).Lowe's and Customer's rights will be determined by a NEUTRAL ARBITRATOR and NOT a judge or jury.Lowe's and Customer are entitled to a FAIR HEARING.But the arbitration procedures are SIMPLER AND MORE LIMITED THAN RULES APPLICABLE IN COURT.Arbitrator decisions are as enforceable as any court order and are subject to VERY LIMITED REVIEW.BY A COURT.FOR MORE DETAILS: Review the Arbitration Agreement and Waiver of Jury Trial section of the Terms and Conditions of this Contract and visit the American Arbitration Association's website at www.adr.org. DO NOT SIGN THIS CONTRACT UNTIL COMPLETE AND YOU HAVE READ THE TERMS AND CONDITIONS CONTAINED ON ALL PAGES OF THIS CONTRACT. BY SIGNING BELOW,YOU ARE ACKNOWLEDGING THAT YOU HAVE READ, UNDERSTAND AND,AGREE TO THE TERMS AND CONDITIONS SET FORTH ON ALL PAGES OF THIS,C.ONTRACM YOU ARE ENTITLED TO.A. . C6;iY'OF THIS'CONTRACT AT'-1 tRE T 1PAL OF SIGNA,T U E. { WITNESS OUR HAND(S)AND SEAL(S)BELOW THIS _DAY OF;� 2 Lowe's Dome Centers, Inc. f _ � rl Own'erg Specia'ifWdt Above Customer acknowledge.re ipt of a true copy of this contract which was completely filled in prior to Customer's execution hereof.You,the buyer,may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.See the attached notice of cancellation form for an explanation of this right. Tlfie Comilwnwecrlllt oflllassachusells - Deparfmont:of X,nduslrfal A er Mitis Office 6f1hV"N9110fs Tj 600 Wtisfiington Street Bo 'A 02111 vivim.,mangovIdirr. WorkeW Compensation Insuraitm Affidavit: Builders/C.6ntractorslElectriciabs/Plumbers A»ulicant Ilbforrnatian PleasAt Leabl� Milhe(Business/CJeganizatiortlindiyidua :_' Nlit G'fZQYtif. Address: LG S , City/State/Zip: 'C--+►�� /� o zlgq phone#: 617- 592-y3o Are ou an employer?Check the.-appropriato.�� Type of project.(required) 1.. I arra a Om l br with $ 4. ❑1 am a Vaerat contractor and Z P oY � 6. Q Neweortsfruction employees(full and/or part-tune):* have-hre+d the sulr-contractors 2'.❑ I atn.a sole proprietor of partner-- listed opt thottol d sheet. 7, Q.Remodeling These su rntrar ars have $, Daniolit oo ship and have no employees ❑ workingfor me in any capacity, employees and.'have Workars y esarrtp.3nsurartce:E 9. Q Building addition [No workers romp,insurance 51 C1 regttired.j Wir. 4.cbrporatitln and its 10.C] Electrical repairs,or.additions 3..❑ i am a,homeowner doing all work ofrmis lam e:t l sW thoh, 11.0 Plumbing repairs Or additions myself: [No workers'comp. right of_eftntption per MGL 12.[:]Roof repairs insuran ob required..)t c.152,:§1(4),W a have tto ❑ employef:[No worltiers' 13, Other coittp,inset ce i'eigtii .] *Any:appti t thaccheoks box W1 must atso fit&A the s it beiaw shoWrniq trice tvoticer5'opmpensatlaa poltgr tt foiniati+un. t lietnYeovimeis who s krait this aff de ift indicaft dW.wa doing ail 4nd'then hire othlb cobftcWft wwtsuCtmk anew affidavit indicating su& tC OMM910 s that check We box mnstantoelted an additional&OLAO g,tea none ortw.slubVwftc(emmd state Whawpr tot Dittoes have efiiptoyow. Mite 84-CoaInctarsi aft c;tt&Yec4 tbW W"PMVi41hqk Vis.".eo7ii ,pwky 040 I am an ew o er that is ovWng wo ktas'ce npenselCfott ittaut*art .ot► ter. At y f. Y by Below k the petky an4job stile in ormadon; Insurance,Ccntrpany Nanne;A'd WEnalaoA M 4t1�►P s J a•Pnc1J Policy#or Self ins.Lic.#: 'i 6 3 2 I Expiration Date: S lqjll job Site Address: 10� 1406a ` , ��,�1 Ctq t fZ-ip: Attach a copy of the workers'eompeits'tttion policy dodaration page'(shtrwaug the policy number and expiration date). Failure to secum coverage,as requited under Section 25A of MGL ca 152 eau lead tri the imposition of criminal ponalties of e fine up to$1,500.00 a 441or bb"ettr. iMpt sonriie%as well as c t+il penaltfes in the its of a STOP W(7pK f}RI L)Z and a tine of up to$250.00 a day against the violator: Be adAsed that A000 d This su mnetnt tnw be forwarded to the Office of Investigations 9f the DIA for.iinsoatice coyoage verification, I do hereby cert t urei c the pathsandpenaNes of pojoy that the irtf brmadbn pr ed above is true anti emect. 91 ate , 11 ho ,,;rt W4-4-e— 4 0 Z,��� Phone#• 417- 502—y30 f offlckd use..oilly, Vo not write.in:tbls Brea~,19.6c e mrpleled by dV or iown q pckl City or Town: Watertown. P-ertniq .aeon# Isswing Authority(eirrcle nne�; 1.1 oat tl tsfHeaYtlE, u I n� _.epar_den_. :City/Towa Clork #.Electrical hispedoar S.glumWng Inspector C Other. couftgt Person: MnThorn.pson, lttsp%tor.Of 01111MA90- Phan&#�617-972-6480 - IB CERTIFICATE IS ISSUED MASA MATTER OF INFORMATION ONLY AND WCONFEERS NO RIGtITS UPON THE ERTIFiCATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED Y THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN E 18BUING INSURERS AUTHORIZED REPRESENTATIVE OR PRODUCE AND THE CERTIFICATE HOLDER MPORTANT: If the Certif-ate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed, If SUBROGATION S WAIVED-sutiact 10 the terms and conditions of the potiey,cwtSin pakfes may require and endorsement. A statement ft certrftcate does not confer oghtp b the certificate holder in lieu of such endorsement PRODUCER New England Hwkeos Irrs Agemy 333 Midn St StotOttaM MA 02160 Cou,Aims AiFFOE INSURED COMPANY A GRANITE STATE INSURANCE COMPANY omfle iceatlss cc Inc 165 saw Stmot Evemtt.RSA 0294 THIS ISS TO CERTIFY THATTHE POLICES OF MURM"USTED SLON HAVE SEEN ISSUED TO THE INSURED NA-ED ABOVE FOR TME POLICY PERIMINDICATED.NOR WITHSTANDING ANY REDU T,TERM OR CONDIMN OF ANY CONTRACT OR OTHER DOCLWW VaM T TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERrAiN. POLICIES INSURANCE AFFORDEDRDW THE ID ICIES DESCROW HEREJN IS SSUBJECTMS TO ALL THE TER .E)CLIXWNS AND CONDITIONS OF SUCH POLICIES. SHOWNSHOWNMAY HAVE REDUCED BY PACLAIMS. cc iLTs Tw4woFMXNWJEM PQLwY�e oA�e P �Pf�IT10C!9p1! A OEM OVEg51.10ARCOMP � i PIBOPRETOW Ai3TllEA XECUTME i PM:ERe wAE NCL o EXCL o 4693293 3/04/20103J04/�19 TTUTORY L9811e Etd ��ODae9al+oonCd ACCKENT g g� POLICY 191111 s 900. ®F OP�T� Tnt' 9 A8E�ACM El1PWYFE wo +i 1 CEffnFICATiE HOLDER rAiCELLATION LO�lES HOME 1 R®�tM�N� ftw aMY OF TwEA90VEDESCR9#D POLICIIES W CAPoCELLEO EFkOflE TnE 15 COMMERCE WAY I WIPOATION DATE TMEREOF.NOTICE WILL K PKIKMD M ACCORDANCE I WIITE THE POLICY PIQOV181pN8 WOBURN,MA 01501 ( AUTHORIZED FEPRESEdTATIVE j i I 100/1.00A V68# 8591 OLOO181101 :aoij .._._..�I.i�NAAi ri s°Bi4 .. Ilik.p.jrYra cm of PuOlit ''akhto V }3rr.rt�€ sat l itetitt' Ftt' €almia ,avtk License nse Cc 61719 lis=-tr!•te 1 c ct its: G RONALD A GREENE 10 RITA DRIVE MEDFORD, MA 42155 ExpiraWn: 10/27/2011 ---......._..... t :,a:sraa@.ei<aae Tr#: 6717 .6A.. J pfficconsumcr utrs&Ru itiess e�ul�ation iHOME IMPROVEMENT CONTRACTOR "' Registration: 102957 Type: ` Expiration: 7/3/2012 Private Corporatior G42 NE INSTALLATION CO_ INC. Ronald Greene 165 Bow Street Everett,MA 02149 Undersecretary Location _/C� l/ No. Date NORTH TOWN OF NORTH ANDOVER f w A Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ ''"— s u"ust 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 0 �r- 2369 wilding Inspector